• 대한정형도수물리치료학회지
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• 제7권2호
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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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• 제27권1호
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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.

• 한국콘텐츠학회논문지
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• 제11권4호
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• pp.273-282
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• 2011

본 연구는 국소 허혈성 뇌손상 흰쥐 모델에서 tDCS의 자극 적용시간을 달리하였을 때, 앞다리 운동감각 기능변화와 신경영양인자(GAP-43)발현에 미치는 영향을 알아보고자 하였다. 뇌손상 모델은 Sprague -Dawley계 흰쥐 80마리를 'Longa'방법을 이용하여 중대뇌동맥(middle cerebral artery)을 폐색하여 유발하였고, 실험군을 4개로 나누었다; 실험군I은 허혈성 뇌손상 유발군(n=20), 실험군II는 허혈성 뇌손상 유발 후 tDCS(10분) 적용군(n=20), 실험군III은 허혈성 뇌손상 유발 후 tDCS(20분) 적용군(n=20), 실험군IV는 허혈성 뇌손상 유발 후 tDCS(30분) 적용군(n=20)으로 나누었다. 앞다리운동감각 기능검사를 위해 수정된 앞다리배치 검사와 단일 팰릿 닿기 검사를 실시하였으며, 신경가소성에 대한 면역조직화학적 검사로 운동감각 영역에서의 GAP-43 단백질 발현을 관찰하였다. 앞다리운동감각 검사는 14일에서 실험군III (p<0.05)이 다른 군들에 비해 유의한 차이를 보였으며, 단일 팰릿 닿기 검사는 14일에서 실험군III(p<0.01)과 실험군IV(p<0.05)에서 유의한 차이를 보였다. 또한, 면역조직학적 검사는 14일에 실험군III이 다른 군들에 비해 현저한 면역양성반응의 증가를 보였다. 따라서, 0.1 mA의 강도로 20분간 적용했을 때가 앞다리운동감각 기능과 신경가역성 인자 GAP-43 발현에 가장 좋은 조건임을 알 수 있었다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2003년도 제27회 추계학술대회
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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.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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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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• 제5권2호
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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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• 제32권6호
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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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• 제1권6호
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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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• 제14권2호
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• pp.115-120
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• 2010

목적 : 활성자극 파라다임을 사용한 기능적 자기공명영상 데이터에서 자발적 요동에 해당하는 저주파 BOLD 신호의 존재여부를 규명해 보고자 하였다. 대상 및 방법 : 20명의 여자 양궁선수들과 양궁 경험이 없는 23명의 여자들을 대상으로 finger-tapping 파라다임은 30초간의 운동기와 휴지기를 3회 반복하였다. 혈액산소수준의존(BOLD) fMRI 영상은 3.0 T MR 기기에서 경사자장 반향 EPI 영상을 해부학적 영상은 3차원 T1 강조영상을 사용하였다. 뇌활성화 차이는 SPM-5를 사용하여 분석하였고 저주파 요동성분을 찾기 위해 GIFT 프로그램을 사용하였다. 결과 : 두군 모두에서 finger-tapping에 따라 대뇌좌측의 주운동영역과 보조운동영역 그리고 우측 소뇌에서의 활성화가 관찰되었다. GIFT를 사용한 ICA 분석에서 피검자들의 반측 감각운동망, 동측 감각운동망 그리고 인지기능과 연관된 신경망에 해당하는 독립적인 성분들이 구별되었다. 결론 : Finger-tapping fMRI 데이터에서 BOLD 신호의 자발적 요동에 해당하는 저주파 신호 성분들을 ICA 기법을 사용하여 분리해 낼수 있었고 이러한 독립성분들이 일차운동감각 신경망 그리고 운동 인지기능을 담당하는 신경망의 휴지기 신경활동을 나타낸다는 사실을 규명할 수 있었다.

• 대한간호학회지
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• 제18권2호
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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.