• 한국전문물리치료학회지
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• 제27권3호
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• 대한물리의학회지
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• 제15권1호
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• pp.25-32
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• 2020

PURPOSE: This study examined the efficacy of an interferential current (IFC) treatment on the improvement of pain, disability, and quality of life in stroke patients with lumbago. METHODS: A double-blind, randomized clinical trial was conducted on 40 stroke patients with lumbago. The patients were allocated randomly into two groups: the IFC treatment group (n= 20) and the placebo treatment group (n= 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment but without real electrical stimulation. The intervention was administered five days a week for four weeks. The primary outcomes of pain intensity were measured using a visual analogue scale. The secondary measurements included the Barthel Index, Oswestry Disability Index (ODI), and health-related quality of life (HRQoL). RESULTS: The measurements were conducted before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in the pain intensity (p<.05), ODI (p<.05), and SF-36 (p<.05) at the end of the intervention. No significant differences in the Barthel Index were found between the two groups. CONCLUSION: These findings show that an IFC treatment can improve pain, functional ability, and quality of life, highlighting the benefits of somatosensory stimulation from IFC in stroke patients with lumbago.

• 대한물리의학회지
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• 제15권3호
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• pp.21-27
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• 2020

PURPOSE: This study investigated the efficacy of interferential current (IFC) treatment on the improvement of pain, disability, and balance in patients with chronic nonspecific low back pain. METHODS: A double-blind randomized clinical trial was conducted with 40 patients with chronic nonspecific low back pain. The patients were randomly allocated into two groups: the IFC treatment group (n = 20) and the placebo treatment group (n = 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment without real electrical stimulation. The intervention was administered five days a week for two weeks. RESULTS: The primary outcomes of resting pain and pain during functional movement were measured by a visual analogue scale. The secondary measurements included the Oswestry disability index (ODI) for low back pain and postural sway. The measurements were performed before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in pain during anterior trunk flexion in the standing position (p = .029), ODI (p = .039), and postural sway when subjects stood with their eyes closed (p = .010) at the end of the intervention. CONCLUSION: Our findings show that IFC treatment can improve pain, disability, and postural sway, thus, highlighting the benefits of somatosensory stimulation from IFC.

• 한국전문물리치료학회지
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• 제12권2호
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• pp.73-80
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• 2005

We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.

• 재활치료과학
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• 제5권2호
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• pp.11-22
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• 2016

목적: 본 연구는 국외 뇌졸중 환자에게 적용한 한 말초감각신경자극의 효과에 대하여 고찰하기 위한 것으로 국외 학술지를 대상으로 체계적 문헌고찰 연구방법을 시행하였다. 연구방법: 2015년 10월 이전까지 국외 학술지에 게재된 논문을 Pubmed를 통하여 검색하였다. 주요 검색 용어로는 'peripheral nerve stimulation', 'electrical stimulation', 'sensory stimulation', 'somatosensory stimulation', 'stroke', 'hemiplegia', 'hemiparesis' 와 'hand', 'arm', 'upper limb'를 사용하였다. 최초 검색된 논문은 501편이었으나 선정 및 배제기준을 거쳐 10편의 연구가 선정되었다. 결과: 임상적으로 널리 사용되고 있는 말초감각신경자극은 뇌졸중 환자들에게 적용이 될 때에 보다 다양한 중재방법으로 연구에 적용이 되고 있었다. 말초감각신경자극치료는 뇌졸중 환자의 상지 기능에 효과를 나타냈으며, 대뇌피질의 활성화에도 긍정적인 영향을 나타냈다. 결론: 본 연구는 말초감각신경자극치료의 적용에 대한 근거를 제시하며, 향후 국내연구에서는 다양한 중재방법을 적용하여 말초감각신경자극의 효과를 더 정확하게 측정을 할 수 있는 방법에 대한 연구가 필요하다.

• 대한물리치료과학회지
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• 제15권1호
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• pp.11-20
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• 2008

This study was designed to test the effects of comprehensive rehabilitation management on functional recovery after attack of cerebrovascular disease. 16 cerebrovascular disease patients applied comprehensive rehabilitation management of physical therapy at department of physical Therapy, C medical center in Gwang－ju. The collection of the data had been executed for 4months(April 15, 2007${\sim}$July 15, 2007). For evaluating, Functional Independence measure(FIM) and Somatosensory Evoked Potential(SSEP) were used to assess functional recovery. The results of this study were as follows: 1. In the comparison of latency of median nerve SSEP before and after treatment, the lat. N20 and P25 increased, the ampl. P25/N20 was decreased. In the comparison difference data of median nerve SSEP, however there was no significant difference in the group(p>0.05). 2. In the comparison of latency of Post Tibial nerve SSEP before and after treatment, the lat. P40, P50, P60 increased, the ampl. P40 was decreased. In the comparison difference data of post tibial nerve SSEP, however there was no significant difference in the group(p>0.05). 3. In the comparison of FIM scores of Self－care, Sphincter Control, Mobility: Transfer, Locomotion before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was significant difference(p<0.05). 4. In the comparison of FIM scores of Communication, Social Cognition before and after treatment, the scores of FIM was significantly increased. In the comparison of difference of the motor part of FIM, however there was no significant difference in the group(p>0.05). Based on these results, it is concluded that the comprehensive rehabilitation management for cerebrovascular disease case was not significant difference in the SSEP, was significant difference in the motor part of FIM. Further study should be done to analyze the effect of intervention duration of treatment, optimal time to apply the treatment in more long period.

• 재활치료과학
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• 제7권3호
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• pp.23-33
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• 2018

목적 : 본 연구는 국외 학술지를 대상으로 한 체계적 문헌고찰 연구를 통해 경직을 가지고 있는 뇌졸중 환자를 대상으로 진동자극의 효과를 제시하는 데에 목적이 있다. 연구방법 : 전자 데이터베이스인 NDSL과 RISS를 사용하여 2009년 4월부터 2017년 10월까지의 논문을 검색하였다. 주요 검색 용어로 'Vibration therapy', 'Focal vibration ', 'Somatosensory', 'Upper limb'와 'Spasticity after stroke를 사용하였다. 선정기준과 배제기준을 통해 최종적으로 6개의 논문이 선정하였다. 결과 : 국소 진동자극의 효과를 알아보기 위한 중재방법으로는 진동자극만을 적용한 중재부터 과제기반 진동자극 중재부터 다양하였다. 중재효과를 알아보기 위해 경직, 상지기능, 일상생활동작 평가도구가 사용되었다. 국소 진동자극은 뇌졸중 환자의 경직 감소와 상지기능에 긍정적인 영향이 있는 것으로 나타났으며, 대뇌피질의 활성화에도 유의미한 효과가 있는 것으로 나타났다. 결론 : 본 연구를 통해 치료사들은 국소 진동자극 적용에 필요한 정보 및 근거를 찾을 수 있을 것이다. 하지만 다양한 국소 진동자극의 적용 방법으로 인해 효율적인 진동수, 진폭의 크기 및 진동을 적용할 위치를 확인하는 데에는 어려움이 있었다. 향후 국내연구에서는 국소 진동자극의 효과를 극대화 할 수 있는 체계적인 중재 프로토콜에 대한 연구가 필요하다.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.235-244
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• 2021

Background: The body schema, which is constantly updated using somatosensory information, enables accurate movement. Since pain is reported as a possible source to alter the body schema, the left right judgement test (LRJT) has been widely used in the pain rehabilitation. However, there was a lack of consistency in the effect of the pain on the LRJT results, and for the effect of the LRJT as a part of intervention programs for pain patients. The deeper understand of the LRJT is necessary for better reproducibility, and to expand the therapeutic applications of the LRJT in the pain and musculoskeletal rehabilitation. Objects: This literature review aimed to understand the LRJT and to study the potential of the LRJT for therapeutic applications. Methods: The PubMed database was searched for studies relevant to LRJT. To establish the query set, the term was regarded from various perspectives. Results: The selected studies were classified into three categories: LRJT development, factors influencing LRJT, and therapeutic applications. Conclusion: Left right judgement test is the evaluation tool for the integrity of body schema as well as a tool for implicit motor imagery. Pain, proprioception, and other factors influence the performance of the LRJT.

• 한국노년학
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• 제30권3호
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• pp.993-1003
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• 2010

본 연구는 여성노인을 대상으로 8주간의 경피신경자극(TENS)과 균형운동을 적용하여 균형 능력의 개선 여부를 알아보고자 하였다. 노인대학에 참여한 65세 이상의 여성노인 42명을 연구대상자로 선정하였다. 대상자는 무작위로 두 그룹으로 나누어 TENS군(21명, 84.53세)과 균형운동군(21명, 79.93세)으로 진행하였다. TENS의 적용과 균형운동은 8주 동안 주 3회에 걸쳐 연구자에 의해 실시하였다. 실험 전과 후에는 동적균형검사로 일어나 걸어가기 검사 (TUG)와 정적균형검사로 힘판을 이용하여 맨 바닥과 foam 위에서의 자세 동요 속도와 기능적 팔 뻗기 검사 (FRT)와 측방 기능적 팔 뻗기 검사 (LFRT)를 시행하여 다음과 같은 결과를 얻었다. TUG는 두 군 모두 유의하게 감소되었고(p<.05), 힘판을 이용한 자세동요 속도에서도 두 군 모두 모든 조건에서 유의하게 감소되었다(p<.05). FRT와 LFRT는 두 군 모두 유의하게 증가하였다(p<.05). TUG와 눈 감은 상태의 자세동요 속도는 두 군 간의 유의한 차이를 나타냈다(p<.05). 체성감각이 떨어져 있는 여성노인에게 적용한 TENS는 균형능력 증진에 효과적인 것으로 나타났다.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.57-66
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• 2019

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.