• 한국전문물리치료학회지
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• 제11권4호
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• pp.51-60
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• 2004

Falls are common, costly, and a leading cause of death among older adults. The major predisposing factors of a fall may include age-related deterioration in the dynamic system composed of auditory, somatosensory, vestibular, visual, musculoskeletal, and neuromuscular subsystems. Older adults with a history of frequent falls demonstrated significant reductions in gait velocity, muscle force production, and balance performance. These altered neuromechanical characteristics may be further exaggerated when faced with conflicting multisensory conditions. Despite the important contribution of multisensory function on the sensorimotor system during postural and locomotor tasks, it remains unclear whether multisensory intervention will produce dynamic balance improvement during locomotion in older adults with a history of frequent falls. Therefore, the purpose of this paper is to address important factors associated with falls in elderly adults and provide theoretical rationale for a multisensory intervention program model.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.49-60
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• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

• 동의신경정신과학회지
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• 제29권2호
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• pp.79-97
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• 2018

Objectives: The purpose of this systematic review was to investigate the clinical effects of neurofeedback training on reducing anxiety. Methods: Eight databases were used to extract clinical reports on neurofeedback intervention for anxiety reduction published until 2016. We analyzed the characteristics of selected studies and evaluated biases using the Risk of Bias (RoB) assessment. Results: A total of 22 clinical trials were extracted for the analysis. The risk of bias in most studies was high or unclear. The Chinese Classification of Mental Disorders-3 (CCMD-3) was the most frequently used diagnostic criteria, the Hamilton Rating Scale for Anxiety (HAMA) was the most frequently used assessment tool, and the alpha wave activity increase, sensorimotor rhythm (SMR), and theta wave training were the most frequently used intervention methods. All papers showed a statistically significant decrease of anxiety symptoms; however, significant adverse events were not reported. Conclusions: Neurofeedback intervention might be beneficial for reducing anxiety. However, the quality of the studies used in the analysis was low, and the heterogeneity of the population and interventions was revealed. Therefore, more scientifically designed clinical studies regarding neurofeedback training are required.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.135-139
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• 2015

Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.119-130
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• 2005

Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

• 한국콘텐츠학회논문지
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• 제13권6호
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• pp.318-330
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• 2013

본 연구는 체계적 고찰을 통하여 뇌성마비 아동에게 적용한 작업치료의 세부적인 치료 방법과 치료 효과를 알아보고자 하였다. 연구대상논문은 2003년 1월부터 2012년 12월까지 출판된 논문이었고, 전자데이터 베이스인 PubMed를 이용하여 검색하였으며, 사용한 검색어는 'occupational therapy' OR 'exercise therapy' OR 'activities of daily living' OR 'splints' OR 'self-help devices' OR 'early intervention(education)' OR 'parents/education' OR 'parents/psychology' OR 'professional family relations' OR 'play and playthings' OR 'upper extremity' AND 'cerebral palsy'이었다. 분석대상논문은 총 18개이었다. 뇌성마비 아동에게 적용한 작업치료 방법은 보조기 26.2%, 부모교육 26.2%, 환경조정 9.6%, 감각운동기능 훈련 19.0%, 일상생활활동 19.0%로 나타났다. 뇌성마비 아동에게 적용한 작업치료의 효과는 보조기 40.0%, 부모교육 42.9%, 환경조정 40.0%에서 통계학적으로 유의하였다. 본 연구의 결과는 뇌성마비 아동의 작업치료에 있어서 근거를 마련하는데 중요한 자료가 될 것이다.

• 대한물리의학회지
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• 제11권4호
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• pp.147-156
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• 2016

PURPOSE: The purpose of this study was to investigate the effects of sensory motor training using ball exercise on shoulder range of motion, pain, dysfunction, and quality of life in Breast Cancer Women after Mastectomy. METHODS: A total of 26 patients from D University Hospital in Daejeon were included and randomly allocated to two groups (n=13 per group). The two groups performed the exercise five times a week for 4 weeks. A sensory motor training group (SMTG) received general physical treatment for 10 minutes and sensorimotor training for 20 minutes. A control group (CG) received general physical therapy for 30 minutes. Shoulder pain (the Visual Analog Scale), range of motion, disability (the shoulder pain and disability index) and quality of life (the Functional Assessment Cancer Therapy-Breast instrument) were measured in both groups before and after 4-weeks intervention. RESULTS: A significant difference was found in joint range of motion, shoulder pain, functional disability level, and quality of life within the two groups (p <.05). In addition, changes in joint range of motion, pain, functional disability level, and quality of life after then intervention were significantly different between the two groups (p <.05). CONCLUSION: These results suggest that a sensory motor training program is feasible, safe, and suitable exercise for shoulder functions and quality of life in Breast Cancer Women after Mastectomy.

• 대한물리의학회지
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• 제10권3호
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• pp.57-65
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• 2015

PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.

• The Journal of Korean Physical Therapy
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• 제23권3호
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• pp.7-12
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• 2011

Purpose: The cane is one of the most popular assistive devices for stroke patients. Clinical complaints of sensorimotor functions on the ipsilateral upper limb were appealed in stroke patients who had used a cane for a long period. Therefore, we investigated whether cane usage for a long-term period affected sensoriomotor dysfunctions on the non-affected upper limb, in terms of pain presence, shoulder joint sense, a nine-hole pegboard test, and a tracking task. Methods: We recruited 12 stroke patients, who were divided into the cane-using (CU) group or the non-cane using (NCU) group, according to cane usage experience. We evaluated joint position sense for the integrity of proprioceptive reposition sense in the shoulder joint, used a nine-hole pegboard test for upper limb dexterity evaluation, and a tracking task for visuomotor coordination. Results: Four patients in the CU group had complained of shoulder pain none did in the NCU group. In addition, the CU group showed more reposition errors on the shoulder joint than the NCU group did. In addition, the CU group had more difficulty in proprioceptive sense perception and in performance of the nine-hole pegboard teat and tracking task, compared with the NCU group. Conclusion: Our findings suggest that cane usage for a long period in stroke patients could give rise to trigger joint pain and decrease proprioceptive sense. In addition, complex motor performance in the ipsilateral upper limb could deteriorate. In stroke patients who had used acane for long period, careful observation and proper intervention will be necessary.