• 대한기계학회논문집B
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• 제41권2호
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• pp.125-133
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• 2017

본 연구에서는 환자의 손가락 경직을 모사하는 손가락 시뮬레이터를 통해 손가락 경직도 검진에서의 검진자간 신뢰도에 대해 연구하였다. 시뮬레이터를 제어하기 위해 경직에서 나타나는 토크를 간단하게 모델링 하고 손가락 경직 환자로부터 간단한 측정 모듈을 이용해 각각의 Modified Ashworth Scale(MAS) 등급에 맞는 파라미터를 얻어냈다. 또한 중수지 관절에 모터가 위치한 손가락 형태의 로봇을 설계하여 경직 토크 모델을 따르는 시뮬레이터를 개발하였다. 이 시뮬레이터를 통해 일곱 명의 재활의학과 전문의들의 검진 결과를 평가해본 결과 중수지 관절에서 0.619, 근위지간 관절에서 0.514의 Cohen's Kappa 값을 보였다. 검진자간의 Fleiss' Kappa 값은 중수지 관절에서 0.513, 근위지간 관절에서 0.486으로 나타났다. 또한 검진자들은 각각의 주관적인 MAS 검진 기준을 가진다는 것을 확인하였다. 결과적으로 같은 환자에 대한 MAS 검진 신뢰도가 높지 않기 때문에 개발된 로봇 시뮬레이터는 검진자의 신뢰도를 높일 수 있는 교육용 도구로서 활용 가능함을 확인하였다.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.341-348
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• 2017

본 연구에서는 척추측만증 환자의 척추 만곡 위치와 방향이 자세 균형에 미치는 영향을 평가하였다. 총 15명의 실험대상자를 흉추 만곡 그룹, 요추 만곡 그룹, 이중 만곡 그룹으로 분류하여 연구를 진행하였다. 초음파 기반 동작 분석 시스템과 압력 분포 시스템을 사용하여 환자의 동적 체간 움직임(요추, 흉요추, 하흉추, 상흉추에서의 각도 변화)과 족저 압력 분포(최대힘, 최대압력)을 측정하였다. 측정 결과를 통해, 특발성 척추측만증 환자의 동적 체간 움직임과 족저 압력 분포 모두 척추 만곡의 발생 부위와 방향에 따라 비대칭적으로 각도와 압력이 증가하면서 자세 불균형이 발생하는 것을 알 수 있었다. 또한, 단일 만곡과 이중 만곡을 가진 그룹 간의 자세 균형 패턴에서의 차이를 확인할 수 있었다. 추후 연구에서는 본 연구에서의 결과를 기반으로 척추측만증 환자의 자세 조절 능력과 체간 균형을 향상시키고 척추측만을 치료하는데 도움을 줄 수 있는 재활 훈련 장치를 개발하고자 한다.

• PNF and Movement
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• 제13권1호
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• pp.25-30
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• 2015

Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.

• PNF and Movement
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• 제19권3호
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• pp.401-412
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• 2021

Purpose: The study aimed to determine the effect of the proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, shoulder range of motion, and shoulder pain and disability index (SPADI) in patients with frozen shoulder. Methods: Following baseline measurements, 30 subjects (n=30) with frozen shoulder were randomized into two groups: the PNF group (n=15), which received PNF strength training of the lower trapezius muscles, and the control group (n=15), which received gentle palpation of the skin. Each group participated in the intervention for 30 minutes, three times per week, for six weeks. The visual analogue scales for pain, range of motion, and SPADI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention period compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and SPADI (p < 0.05) and significantly increased shoulder flexion, abduction, internal rotation, and external rotation range of motion (p < 0.05). The PNF group that received the PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and range of motion than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces shoulder pain and disability levels and enhances shoulder range of motion in patients with frozen shoulder.

• 대한통합의학회지
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• 제9권2호
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• Neurospine
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• 제15권4호
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• pp.348-352
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• 2018

Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods: DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients' pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results: In the postanesthesia care unit, the mean VAS back pain score was $5.87{\pm}0.9$ in the DC group and $6.95{\pm}1.0$ (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were $3.8{\pm}1.1$ vs. $5.4{\pm}0.7$ (p < 0.001) at 6 hours postoperatively, and $2.7{\pm}0.7$ vs. $6.25{\pm}0.9$ (p<0.001) at discharge, respectively. The cumulative mean analgesic consumption of paracetamol, tenoxicam, and tramadol in the DC group vs. control group was $3,733.3{\pm}562.7mg$ vs. $4,633.3{\pm}693.5mg$ (p<0.005), $53.3{\pm}19.5mg$ vs. $85.3{\pm}33.4mg$ (p<0.005), and $63.3{\pm}83.4mg$ vs. $393.3{\pm}79.9mg$ (p<0.0001), respectively. Conclusion: The results of this study demonstrated a positive association between the use of DC therapy and accelerated improvement in patients during early rehabilitation after adult spine surgery compared to patients who were treated with painkillers only.

• 디지털융복합연구
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• 제17권7호
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• pp.417-422
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• 2019

정보통신기술분야(ICT)의 발전은 우리의 삶을 더욱더 편리하게 하고 있으며 우리 삶의 다양한 영역에 많은 변화를 일으키고 있다. 특히 장애인의 정보 및 물리적 접근성을 가능케하며 장애인들이 노동시장 진입에서 겪게 되는 불편함을 해소하는 역할을 하며 ICT기반의 원격근무는 전통적인 근무환경과 직무배치에서 벗어나 물리적 접근성을 용이하게 함으로써 장애인을 위한 고용가능성을 향상시킬 수 있다. 이에 본 논문은 ICT의 발전이 장애인의 노동시장과 고용환경에 어떠한 변화를 일으키는지 알아보고 장애인을 위한 국내외 원격근무 사례를 소개하였다. 또한 ICT기반의 근무환경과 직무배치 활성화를 위하여 이 분야의 직무개발과 관련 교육 훈련의 체계화, 실무서 및 지원인프라 등을 포함한 원격근무 지원의 다양화 노력 등 몇 가지 필요한 전략을 제시하였다.

• 문화기술의 융합
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• 제4권4호
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• pp.227-232
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• 2018

본고에서는 구한말 학교체육의 중심이 되었던 병식체조의 도입과 발전과정 다루었다. 특히, 일제의 강제하에 관립학교의 병식체조교육이 제한된 이후의 사립학교의 병식체조교육의 민족주의적 특성을 조명하고자 하였다. 사실 1905년 을사조약이후 관립학교의 병식체조교육이 제한되었지만 사립학교의 병식체조는 더 강화되었다고 볼 수 있다. 이는 당시 조선인의 민족위기의식이 더 고조되었고, 또 1907년 조선의 군대해산이후 무관학교 출신 교사들이 사립학교의 체육교사로 자원했기 때문이다. 이들 체육교사들은 병식체조교육을 독립운동의 연장선으로 여기며 사립학교의 체육교사로 부임해 와서 학생들에게 병식체조 교육과 함께 민족주의 정신을 심어 주었다. 이처럼 매우 강한 부국강병과 조국수호의 목적을 가지고 시작한 병식체조 수업은 학교체육 교육안에 속해 있는 활동이었다. 하지만 당시 시대적 부국강병과 국가 침탈의 위기의식으로 인하여 조화로운 신체발달을 추구하기보다 군사훈련의 목적이 더 강했다고 볼 수 있다.

• The Journal of Korean Physical Therapy
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• 제31권2호
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• pp.129-133
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• 2019

Purpose: This study aimed to investigate effect of ankle instability on peripheral muscle activation among female ballet dancers to provide information on the development of prevention programs for ankle injury rehabilitation. Methods: 32 female ballet dancers were randomly divided into two groups: experience ankle sprain group (n=16, age, $20.7{\pm}0.8years$, BMI $18.6{\pm}1.2kg/m2$) and non-experience ankle sprain group (n=16, $age=21.0{\pm}0.8years$, BMI $19.6{\pm}2.0kg/m2$). Activation of the peroneus longus, tibialis anterior muscle, and gastrocnemius during vertical landing, half pointe, and gait between the two groups were measured. Body composition analyzer was used to examine skeletal muscle mass and body fat mass. Results: A total of 32 patients were included. In the experience ankle sprain group (n=16: left sprain 14, right sprain 2), average ankle sprain injury occurred 7.5 months before the study. The average age of the dancers in the experience ankle sprain group and non-experience ankle sprain group was $20.7{\pm}0.8$ and $21.0{\pm}0.8years$, major period was $64.5{\pm}23.8$ and $71.6{\pm}25.8months$, BMI was $18.6{\pm}1.2$ and $19.5{\pm}2.0kg/m2$, respectively. No significant differences were found on body composition between the two groups (p>0.05). The experience ankle sprain group showed significantly lower tibialis anterior and peroneus longus muscle activation (p<0.5), while gastrocnemius muscle activation appeared to be significantly higher (p<0.05) during landing, half pointe, and normal gait. Conclusion: Ankle sprain can cause a decline in peripheral muscle activation and coordination, which increased the risk for repetitive ankle sprain in the future. Moreover, ankle peripheral muscle selective strength training, coordination program development, and application need to be considered to prevent ankle sprain.

• 한국운동역학회지
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• 제31권3호
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• pp.214-219
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• 2021

Objective: The aim of this study was to evaluate the differences in muscle activity of hamstring muscle depending on the position of the feet during Swiss ball hamstring curl exercise. Method: Total of 15 male participants with no history of hamstring muscle injuries and musculoskeletal disorders in the past 6 months were participated in this study (Age: 29.27 ± 4.96 yrs, Height: 173.47 ± 5.18 cm, Body mass: 75.47 ± 12.50 kg). The muscle activation of semitendinosus and biceps femoris with four different feet positions including neutral stance, internal rotation, external rotation, and wide stance were measured during a Swiss ball hamstring curl exercise. For the analysis, the Swiss ball exercise movement comprised of 3 events (90°→ 0°→ 90°) based on the knee angle and 2 phases relative to the mechanism of muscle contraction (eccentric/concentric contraction). To pursue the study goal, an one-way ANOVA with repeated measures was performed with statistical significance as α = 0.05. Results: There was no statistically significant feet position effect found during the Swiss ball hamstring curl with eccentric contraction phase (p>.05). It is, however, semitendinosus showed an enhanced muscle activation in concentric contraction phase, displaying the highest muscle activity in wide stance and the lowest in external rotation (p<.05). Conclusion: Our findings suggest that this exercise can be beneficial in selectively training the semitendinosus. In other words, Swiss ball hamstring curls performed in wide stance strengthens semitendinosus, which improves the stability of knee and are effective in preventing knee injuries and reinforces rehabilitation.