• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.2
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• The Journal of Korean Physical Therapy
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• v.27 no.1
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• pp.38-42
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• 2015

Purpose: Accuracy and variability of movement in daily life require synchronization of muscular activities through a specific chronological order of motor performance, which is controlled by higher neural substrates and/or lower motor centers. We attempted to investigate whether transcranial direct current stimulation (tDCS) over primary sensorimotor areas (SM1) could influence movement variability in healthy subjects, using a tapping task. Methods: Twenty six right-handed healthy subjects with no neurological or psychiatric disorders participated in this study. They were randomly and equally assigned to the real tDCS group or sham control group. Direct current with intensity of 1 mA was delivered over their right SM1 for 15 minutes. For estimation of movement variability before and after tDCS, tapping task was measured, and variability was calculated as standard deviation of the inter-tap interval (SD-ITI). Results: At the baseline test, there was no significant difference in SD-ITI between the two groups. In two-way ANOVA with repeated measurement no significant differences were found in a large main effect of group and interaction effect between two main factors (i.e., group factor and time factor (pre-post test)). However, significant findings were observed in a large main effect of the pre-post test. Conclusion: Our findings showed that the anodal tDCS over SM1 for 15 minutes with intensity of 1 mA could enhance consistency of motor execution in a repetitive-simple tapping task. We suggest that tDCS has potential as an adjuvant brain facilitator for improving rhythm and consistency of movement in healthy individuals.

• The Journal of the Korea Contents Association
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• v.11 no.4
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• pp.273-282
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• 2011

This study was to investigate the effect of improve forelimb sensorimotor function and neurotrophic factor(GAP-43) expression when differing an application time of tDCS in ischemic brain injury rat model(pre, $1^{st}$, $7^{th}$, $14^{th}$). Focal ischemic brain injury was induced in 80 Sprague-Dawley rats through middle cerebral artery occlusion(MCAO) by 'Longa' method. And then experimental groups were randomly divided into four groups; GroupI: MCAO induction, GroupII: application of tDCS(10 min) after MCAO induction, GroupIII: application of tDCS(20 min) after MCAO induction, GroupIV: application of tDCS(30 min) after MCAO induction. Modified limb placing test and single pellet reaching test were performed to test forelimb sensorimotor function. And the histological examination was also observed through the immunohistochemistric response of GAP-43(growth-associated protein-43) in the cerebral cortex. In modified limb placing test, groupIII(p<0.05) showed significantly improve than the other groups on $14^{th}$). day. In single pellet reaching test, groupIII(p<0.01) and groupIV(p<0.05) significantly improved on $14^{th}$) day. And in immunohistochemistric response of GAP-43, group III showed significantly positive response than the other groups on $14^{th}$ day. These results suggest that the intensity(0.1 mA)/time(20 min) condition of tDCS application has a significant impact on the sensorimotor functional recovery in focal ischemic brain injury rat models.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.75-75
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• 2003

Purpose: To investigate whether or not acupuncture of GB34 produces a significant response of the modulation of somatomotor areas by functional magnetic resonance imaging (fMRI) study. Methods: The acupoint, GB34, located in the back of the knee, is known to be effective in recovering motor function after stroke. Using 3T MRI scanner, functional MR imaging of the whole brain was performed in 12 normal healthy subjects during two stimulation paradigms; acupuncture manipulation on GB 34 and sham points. This study investigates the activation of the motor cortex elicited by a soft and an intensified stimulation of GB 34. Three different paradigms were carried out to detect any possible modulation of the Blood Oxygenation Level Dependent (BOLD) response in the somatomortor area to motor stimulation through acupuncture. Results: Group analysis from seven individuals showed that bilateral sensorimotor areas (BA 3,4,6 and 7) showed stimulation related BOLD signal contrast of approximately 6% whereas very few areas were activated when sham stimulation is given. Conclusions: The present study shows that acupuncture fMRI study can be safely conducted in 3T MRI environment, and acupuncture stimulation in GB34 modulates the cortical activities of the soma- to motor area in human. The present findings may shed light on the CNS mechanism of motor function by acupuncture and form a basis for future investigations of motor modulation circuits in the stroke patients. Acknowledgement: This study was supported by a grant of the Mid and Long Term Nuclear RID Plan Program, Ministry of Science and Technology, Republic of Korea.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.352-355
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• 2002

The purpose of this study was to investigate whether or not acupuncture of GB34 produces a significant response of the modulation of somatomotor areas by functional magnetic resonance imaging (fMRI) study. The acupoint, GB34, located in the back of the knee, is known to be effective in recovering motor function after stroke. Using 3T MRI scanner, functional MR imaging of the whole brain was performed in 12 normal healthy subjects during two stimulation paradigms; acupuncture manipulation on GB 34 and sham points. This study investigates the activation of the mortor cortex elicited by a soft and an intensified stimulation of GB 34. Three different paradigms were carried out to detect any possible modulation of the Blood Oxygenation Level Dependent (BOLD) response in the somatomortor area to motor stimulation through acupuncture. Group analysis from seven individuals showed that bilateral sensorimotor areas (BA 3,4,6 and 7) showed stimulation related BOLD signal contrast of approximately 6% whereas very few areas were activated when sham stimulation is given. The present study shows that acupuncture fMRI study can be safely conducted in 3T MRI environment, and acupuncture stimulation in GB34 modulates the cortical activities of the somatomotor area in human. The present findings may shed light on the CNS mechanism of motor function by acupuncture and form a basis for future investigations of motor modulation circuits in the stroke patients.

• Annals of Clinical Neurophysiology
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• v.5 no.2
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• pp.181-186
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• 2003

Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.365-371
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• 2020

Objective: To investigate the action observation effects of functional electrical stimulation (FES) on the communication between motor cortex and muscle through corticomuscular coherence (CMC) analysis. Methods: Electroencephalogram (EEG) and electromyogram (EMG) of 27 healthy, nonathlete subjects were measured during action observation, FES, and action observation with FES, which lasted for 7sper session for 10 times. All trials were repeated for 30 times. Simultaneously measured EEG raw data and rectified EMG signals were used to calculate CMC. Only confidence limit values above 0.0306 were used for analysis. CMC was divided into three frequency domains, andthe grand average coherence and peak coherence were computed. Repeated ANOVA was performed to analyze the coherence value difference for each condition's frequency band. Results: CMC showed significant differences in peak coherence and average coherence between the conditions (p<0.05). Action observation application with FES in all frequency band showed the highest peak and average coherence value. Conclusions: The results of this study are assumed to be the combination of increased eccentric information transfer from the sensorymotor cortex by action observation and an increased in concentric sensory input from the peripheral by the FES, suggesting that these are reflecting the sensorimotor integration process.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.6
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• pp.603-611
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• 1997

The motor evoked potentials (MEPs) have been advocated as a method of monitoring the integrity of spinal efferent pathways in various injury models of the central nervous system. However, there were many disputes about origin sites of MEPs generated by transcranial electrical stimulation. The purpose of present study was to investigate the effect of major extrapyramidal motor nuclei such as lateral vestibular nucleus (VN) and medullary reticular nucleus (mRTN) on any components of the MEPs in adult Sprague-Dalwey rats. MEPs were evoked by electrical stimulation of the right sensorimotor cortex through a stainless steel screw with 0.5mm in diameter, and recorded epidurally at T9 - T10 spinal cord levels by using a pair of teflon-coated stainless steel wire electrodes with 1mm exposed tip. In order to inject lidocaine and make a lesion, insulated long dental needle with noninsulated tips were placed stareotoxically in VN and mRTN. Lidocaine of $2{\sim}3\;{\mu}l$ was injected into either VN or mRTN. The normal MEPs were composed of typical four reproducible waves; P1, P2, P3, P4. The first wave (P1) was shown at a mean latency of 1.2 ms, corresponding to a conduction velocity of 67.5 m/sec. The latencies of MEPs were shortened and the amplitudes were increased as stimulus intensity was increased. The amplitudes of P1 and P2 were more decreased among 4 waves of MEPs after lidocaine microinjection into mRTN. Especially, the amplitude of P1 was decreased by 50% after lidocaine microinjection into bilateral mRTN. On the other hand, lidocaine microinjection into VN reduced the amplitudes of P3 and P4 than other MEP waves. However, the latencies of MEPs were not changed by lidocaine microinjection into either VN or mRTN. These results suggest that the vestibular and reticular nuclei contribute to partially different role in generation of MEPs elicited by transcranial electrical stimulation.

• Investigative Magnetic Resonance Imaging
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• v.14 no.2
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• pp.115-120
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• 2010

Purpose : To separate and evaluate the low frequency spontaneous fluctuation BOLD signals from the functional magnetic resonance imaging data using sensorimotor active task. Materials and Methods : Twenty female archery players and twenty three control subjects were included in this study. Finger-tapping task consisted of three cycles of right finger tapping, with a subsequent 30 second rest. Blood oxygenation level-dependent (BOLD) data were collected using $T2^*$-weighted echo planar imaging at a 3.0 T scanner. A 3-D FSPGR T1-weighted images were used for structural reference. Image processing and statistical analyses were performed using SPM5 for active finger-tapping task and GIFT program was used for statistical analyses of low frequency spontaneous fluctuation BOLD signal. Results : Both groups showed the activation in the left primary motor cortex and supplemental motor area and in the right cerebellum for right finger-tapping task. ICA analysis using GIFT revealed independent components corresponding to contralateral and ipsilateral sensorimotor network and cognitive-related neural network. Conclusion : The current study demonstrated that the low frequency spontaneous fluctuation BOLD signals can be separated from the fMRI data using finger tapping paradigm. Also, it was found that these independent components correspond to spontaneous and coherent neural activity in the primary sensorimotor network and in the motor-cognitive network.

• Journal of Korean Academy of Nursing
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• v.18 no.2
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• pp.211-219
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• 1988

운동학습이론인 감각운동 통합이론을 본 연구의 개념적 틀로하여 한방병원에 입원한 뇌졸중 환자 중 구강인두 기능이 저하된 환자를 대상으로 감각운동자극이 구강인두 기능에 미치는 효과를 조사하기 위하여 1988년 3월초부터 5월 중순까지 예비실험 연구하였다. 감각운동자극을 주기 전에 구강인두기능을 시정하고 대상자 전원에게 저하된 구강인두기능에 따라 감각운동자극을 선택하여 하루 3번 매식후 30분전에 주었으며, 이를 일주일 동안 계속하였다. 일주일 후 다시 구강인두기능을 측정하여 자극을 주기전, 후의 기능정도를 paired t-test로 비교 분석하였으며 다음과 같은 성적을 얻었다. 1. “자극을 주기 전보다 준 후에 머리와 목운동 조절점수가 높을 것이다”라는 제1가설은 지지되었다(t＝-2.71, df＝5, p＝.042). 2. “자극을 주기 전보다 준 후에 씹는 능력이 증가되었으나, 통계적으로는 유의하지 않았다(t＝-2.00, df＝5, p＝.102). 3. “자극을 주기 전보다 준 후에 입술운동의 조절점수는 높을 것이다”라는 제3가설은 지지되었다(t＝-4.77, df＝5, p＝.005). 4. “자극을 주기 전보다 준 후에 혀 운동 조절점수가 높을 것이다”라는 제4가설은 지지되었다(t＝-3.61, df＝5, p＝.015). 5. 자극을 주기 전보다 준 후에 연하능력이 증가되었으나 통계적으로는 유의하지 않았다(t＝-2.24, df＝5, p＝.076). 이상의 결과로 감각운동자극은 연하장애환자의 구강인두기능을 증진시키는데 효과적인 방법이라고 할 수 있다.