• 대한물리의학회지
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• 제1권1호
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• pp.1-12
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• 2006

Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.

• PNF and Movement
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• 제3권1호
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• pp.17-26
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• 2005

Objectives : The purpose of this study is to identify influence that PNF method have an effect in function restoration of the impaired patients of central nervous system. Methods : The data were collected by 15 adult stroke patients. The treatment was based on proprioceptive neuromuscular facilitation techniques. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was significantly increased in the PNF method. The gait velocity, cadence and single support time asymmetry ratio was significantly increased in the PNF method. The Motor Assessment Scale was significantly increased in the PNF method. Conclusions : Based on these results, it is concluded that the forced PNF method for 6 weeks can be improve the temporal-spatial gait parameters including FAP in hemiplegic patients. Therefore, the forced PNF method is useful to improve the function restoration in hemiplegic patients. Further study should be done to analyze the effects of intervention duration of treatment, optimal time to apply the treatment in more long peried.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2003년도 춘계학술대회 논문집
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• pp.723-728
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• 2003

The physical restoration technology for lower limb amputees is being advanced as the biomechatronics is being applied to the area of rehabilitation. As the advanced prosthetics for lower limb amputees are introduced, a suitable prescription of biomechanical rehabilitation training becomes important to utilize the advanced full features of the devices. Since lower limb amputation significantly affects biomechanical balance of mosculoskeletal system for gait, an appropriate and optimal biomechanical training and exercise should be provided to rebalance the system before wearing the prostheses. Particularly, biomechanical muscular training for hip movements in the both affected and sound lower limbs is important to achieve a normal-like ambulation. However, there is no study to understand the effect of hip muscle strength on the gait performance of lower limb amputees. To understand the hip muscle strength characteristics for normal and amputated subjects, the isokinetic exercises for various ratios of concentric contraction to eccentric contraction were performed for hip flexion-extension and adduction-abduction. As a results. biomechanical isokinetic training protocols and performance measurement methodologies for lower limb amputees were developed in this study. Using the protocols and measurement methods, it has been understood that the appropriate and optimal biomechanical prescription for the rehabilitation process for lower limb amputees is important for restoring their gait ability

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.206-214
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• 1991

We treated three cases of bone tumors-giant cell tumor, chondroblastoma and malignant fibrous histiocy toma-with a custom-made prosthetic replacement. The patients were followed from 10 months to 18 months, postoperatively. The results of these study are as follows : 1. satisfactory anatomic restoration 2. early ambulation 3. good function 4. biomechanically sound reconstruction.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.119-124
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• 2003

Introduction : The purpose is a retrospective evaluation of the clinical results of the radial forearm flap transfer for foot reconstruction. Materials and methods : We evaluated 21 cases with medical records including etiology, wound dimension, presence of infection, associated fracture, ischemic time of free flap, complication of donor and recipient site. The final results were evaluated with our clinical score (walking, shoe-in, cosmetic). Results : Defects were located on the heel (12 cases), dorsum of foot (4 cases) and sole (5 cases). Mean wound dimension was $7.56{\times}6.0cm$, and mean ischemic time of free flap was 94.5minute. There were superficial skin necrosis (1 case), recurrent ulceration (2 cases) in recipient site, and no complication in donor site but complaint about cosmetic problem (3 cases). The clinical score showed excellent in 14 cases, good in 4 cases, fair in 1 case and poor in 2 cases. Conclusion : We consider the radial forearm flap could provid the stable and durable restoration of normal foot contour without debulking in the foot reconstruction and achieved normal ambulation and cosmetic satisfaction.

• 대한한방내과학회지
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• 제45권2호
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• pp.199-207
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• 2024

Introduction: Gullain-Barre syndrome (GBS) is a rapid, symmetric muscle weakness that often follows respiratory or gastrointestinal infections. Standard treatments include plasmapheresis and intravenous immunoglobulin, but outcomes can vary among patients. The integration of Korean medicine, notably unexplored in quantitative assessments of balance and walking, provides a novel approach to treatment. Case presentation: A 53-year-old male diagnosed with GBS presented to the hospital 8 days post-onset. He received treatments consisting of acupuncture, electroacupuncture, and rehabilitation over a period of approximately 4 weeks. Upon admission, the patient exhibited symptoms of both limb weakness and paresthesia, requiring the use of a wheelchair. Post-treatment, muscle strength and balance were significantly improved, leading to the restoration of independent ambulation, including running. Conclusions: This case illustrates the potential of integrated Korean and conventional medical treatments to accelerate recovery in GBS patients, overcoming typical prognosis timelines. The improvements in gait and balance were substantiated by quantitative assessments, suggesting a promising area for further research into the effects of combined therapeutic approaches to GBS recovery.

• Journal of Korean Neurosurgical Society
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• 제46권1호
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• pp.1-4
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• 2009

Objective: To report an unsuspected adaptive plasticity of single upper motor neurons and of primary motor cortex found after microsurgical connection of the spinal cord with peripheral nerve via grafts in paraplegics and focussed discussion of the reviewed literature. Methods: The research aimed at making paraplegics walk again, after 20 years of experimental surgery in animals. Amongst other things, animal experiments demonstrated the alteration of the motor endplates receptors from cholinergic to glutamatergic induced by connection with upper motor neurons. The same paradigm was successfully performed in paraplegic humans. The nerve grafts were put into the ventral-lateral spinal tract randomly, with out possibility of choosing the axons coming from different areas of the motor cortex. Results: The patient became able to selectively activate the re-innervated muscles she wanted without concurrent activities of other muscles connected with the same cortical areas. Conclusion: Authors believe that unlike in nerve or tendon transfers, where the whole cortical area corresponding to the transfer changes its function a phenomenon that we call "brain plasticity by areas". in our paradigm due to the direct connection of upper motor neurons with different peripheral nerves and muscles via nerve grafts motor learning occurs based on adaptive neuronal plasticity so that simultaneous contractions of other muscles are prevented. We propose to call it adaptive functional "plasticity by single neurons". We speculate that this phenomenon is due to the simultaneous activation of neurons spread in different cortical areas for a given specific movement, whilst the other neurons of the same areas connected with peripheral nerves of different muscles are not activated at the same time. Why different neurons of the same area fire at different times according to different voluntary demands remains to be discovered. We are committed to solve this enigma hereafter.

• 대한골관절종양학회지
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• 제13권1호
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• pp.48-54
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• 2007

목적: 대퇴골 근위부의 광범위 골 파괴를 보이는, 전이성 골 종양에 의한 병적 골절 환자들을 대상으로 종양 대치물 삽입술 시행 후 임상 결과를 알아보고자 하였다. 대상 및 방법: 2005년 10월부터 2006년 10월까지 전이성 골 종양에 의한 병적 골절로 진단 받은 환자 중 대퇴골 근위부에 광범위 전이를 보여 근위부 절제술 및 종양 대치물 삽입술을 시행한 6예를 대상으로 하였다. 평균 연령은 61세(범위, 48~77)였으며 평균 추시 기간은 10.5개월(범위, 6~16)이었다. 원발 종양으로는 다발성 골수종이 2예, 폐암이 1예, 유방암이 1예, 신장암이 1예, 원발 종양을 확인할 수 없었던 경우가 1예였다. 6예 모두에서 $MUTARS^{(R)}$ proximal femur system (Implantcast, Munster, Germany)를 이용하여 재건을 시행하였다. 하지 기능평가에는 Musculoskeletal Tumor Society 1993 score를 사용하였으며, 수술 전 후 동통의 정도를 Visual Analogue Scales (VAS)로 평가하였다. 결과: 최종 추시 시에 모든 환자들이 생존하였으며 하지 기능 점수는 평균 17.8(59.3%)점(범위, 12~25)이었다. VAS는 수술 전 평균 8.5에서 수술 후 최종 추시 시 평균 2.5로 호전되었다. 수술 후 가능한 한 조기 보행을 독려하여 수술 후 평균 7.3일(범위, 3~16)에 보행이 가능하였다. 수술 후 삽입물 주위 골절, 치환물의 해리 또는 감염은 없었으며, 1예에서 수술 후 재발성 탈구가 발생하였다. 결론: 전이성 골 종양의 대퇴골 근위부 광범위 침범 소견이 있는 병적 골절 환자에서 종양 대치물 삽입술은 조기에 동통의 경감 및 하지 기능 회복을 기대할 수 있으면서도 수술 후 합병증 발생이 적어 상대적으로 안전한 술식으로 전이성 골 종양의 치료 취지에 부합되는 적절한 치료로 생각된다.

• 대한골관절종양학회지
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• 제20권1호
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• pp.7-13
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• 2014

목적: 대퇴골 근위부에 발생한 악성 골 종양의 치료로 사지 구제술을 시행하는 경우 환자의 생존과 더불어 술 후 보행 등의 기능회복이 중요하다. 대퇴골 근위부의 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 환자에 대하여 종양 대치물을 이용한 사지 구제술 시행 후 임상 결과에 대해서 분석하였다. 대상 및 방법: 2005년 2월부터 2014년 1월까지 대퇴골 근위부 악성 골 종양을 진단 받고 통증 또는 병적 골절이 발생하여 대퇴골 근위부 절제술 및 종양 대치물을 이용한 사지 구제술을 시행한 20예(19명)를 대상으로 하였다. 평균 연령은 63.1세(범위 35-86세)였으며 남자가 14예, 여자가 6예였다. 평균 추시 기간은 20개월(1-94개월)이었고, 전이성 골 종양 15예, 골육종 4예, 다발성 골수종 1예였으며, 전이성 병변의 원발 암은 폐암 4예, 간암 3예, 신장암 3예였고, 유방암, 갑상선암, 대장암, 전립선암, 악성 방추 세포암이 각각 1예씩 이었다. 사용된 종양 대치물은 모두 조립형 종양 대치물로 Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey)가 3예에서 사용되었고, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany)이 17예에서 사용되었다. 수술 전 후의 동통 정도를 Visual Analogue Scales(VAS)로 평가하였으며, 술 후 하지의 기능적 평가를 위해 Musculoskeletal Tumor Society score(MSTS) grading system 을 이용하였다. 결과: 최종 추시 시 20예(19명) 중 11예(10명)가 생존하고 9예(9명)가 사망하였으며 사망한 환자의 술 후 평균 생존기간은 10.1개월(1-38개월) 이었다. VAS 점수는 술 전 평균 8.40점(5-10점)에서 술 후 평균 1.35점(0-3점)으로 호전 되었고, 수술 후 MSTS 기능적 평가는 평균 19.65점(65.50%) (7-28점)이었다. 수술과 관련된 합병증으로는 국소 재발 2예, 혈종 3예, 감염 3예, 음낭 종창 2예, 탈구 1예였고 치환물 주위 골절이나 해리는 없었다. 결론: 대퇴골 근위부에 발생한 악성 골 종양에 의한 통증 또는 병적 골절이 발생한 경우 종양 대치물을 이용한 사지 구제술은 조기의 통증 감소 및 기능 회복을 위한 적절한 치료로 생각된다.