• 대한물리의학회지
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• 제13권2호
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• pp.75-87
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• 2018

PURPOSE: The purpose of this study was to describe and analyze the components of physical therapy interventions to enhance postural control and mobility in children with spastic diplegia. METHODS: Thirsty-eight physical therapists working in rehabilitation settings volunteered to record the components of physical therapy interventions used during 894 treatment sessions for 179 children with spastic diplegia presenting with difficulties in postural control and mobility. Descriptive statistics were used to analyze the general characteristics of the therapists, the patients, and the frequency of the interventions. A one-way analysis of variance (ANOVA) and chi-square test were used to describe the components of the interventions and the goals of treatment. RESULTS: In clinical practice, physical therapists primarily used methods including "Hands-on: facilitation" (n=1990, 36.47%) and "Hands-off: practice" (n=1355, 24.83 %). Only 13.96% (n=762) of the interventions allowed patients to be independent or active outside of the treatment sessions. Interventions reflecting the therapeutic aims were performed for sitting (17.53%), standing (18.25%), and walking (27.39%). CONCLUSION: Physical therapists mostly used "therapistled" interventions to treat impaired postural control and mobility in children with spastic diplegia. Interventions to facilitate independent activity or practice outside the treatment sessions are infrequently used. These types of interventions were used regardless of the aims of treatment.

• 대한물리치료과학회지
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• 제19권1호
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• pp.63-69
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• 2012

Background : The purpose of this study was to investigate the frequency domain characteristics of ground reaction forces during quiet standing on inclined surfaces twenty healthy individuals(10 elderly women $68.78{\pm}3.29$ years and 10 young women $20.90{\pm}0.74$ years) participated. Methods : Subjects stood in quiet stance over a force platform positioned in one of three different fixed positions: flat, down and up. Healthy participants completed with eyes open for 120 s trials. Evaluation of postural control were generally based on the interpretation of center of pressure(COP) time series. The COP have been determined using an experimental setup with 3D kinematic and the ground reaction force system. All the data were expressed means and standard deviation by using SAS package program. Results : SEF 50% were not significant in AP and ML direction according to surface slope of both groups. SEF 95% were showed highest frequency in AP direction on down slope of both groups. MEF were not significant all direction according to surface slopes of elderly women. There was no difference between young and elderly women. Conclusion : Elderly women used to ankle strategy during a quiet stance according to COP perturbation of AP direction showed more expanded than ML direction. SEF 95% were showed highest frequency on down slope in elderly women who showed more used ankle strategy for postural control on down slope.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.1-7
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• 2010

The aim of this study was to investigate the effects of lumbar stabilization on both trunk and lower limb muscle activity and center of pressure (COP) in single leg standing. Surface electromyography (EMG) was used to collect muscle activity data, the mean velocity of COP was measured using a force plate, and a pressure biofeedback unit was used for lumbar stabilization training. The findings of this study are summarized as follows: 1) The EMG activity of the erector spinae decreased significantly and the activity of the rectus abdominis, internal oblique, external oblique, gluteus maximus, and gluteus medius increased significantly with lumbar stabilization single leg standing. 2) No differences in activity in the tibialis anterior, medial gastrocnemius, rectus femoris, and medial hamstrings were found with single leg standing. 3) The mean velocity of COP in the antero-posterior and medio-lateral directions in the lumbar stabilization single leg standing decreased significantly compared with the preferred single leg standing. The findings of this study therefore indicate that lumbar stabilization can facilitate the co-activation of deep stabilization and global muscles that improve postural control capability during single leg standing.

• 대한정형도수물리치료학회지
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• 제7권2호
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• pp.5-22
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• 2001

The purpose of this study was to investigate the balancing training effect on weight bearing ratio and postural sway on the unstable surface for the CVA patients with balance disability. The inclusion criteria were walking independently 20m distances. Eighteen subjects, 4 with right and 14 with left hemiplegic patients were participated in this study. The range of age was from 35 to 75 and the duration from onset time was from 1 to 38 months. The intervention program including balancing training that they were introduced for 10 minutes every other day during 12 weeks to experimental group, and general therapeutic exercise to control group. The result of this study were as following; 1. The balancing training on the unstable surface showed that the postural sway of left/right distribution would appear more effective on sitting with eyes opened. 2. The balancing training on the unstable surface showed that the postural sway of forward/rear distribution, left/right distribution and distance would appear more effective on standing with eyes opened. 3. The balancing training on unstable surface would increase more effective on the weight-bearing ratio of left/right difference and frequency. 4. The balancing training on unstable surface was statistical significant on the postural sway of left/right distribution and area in experimental group. and it was statistical significant on the postural sway of forward/rear distribution, left/right distribution and distance in control group, too.

• The Journal of Korean Physical Therapy
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• 제28권1호
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• pp.33-38
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• 2016

Purpose: The aim of this study was to determine the effectiveness of pelvic tilt training using an inclinometer on joint position sense and postural alignment in individuals with stroke. Methods: Thirty-one subjects with chronic stroke were divided into two groups: the experimental group (16 subjects) and the control group (15 subjects). Subjects in both groups received neuro-developmental therapy five times per week. In addition, the patients in the experimental group also received pelvic tilt training using an inclinometer for 30 minutes, 3 times a week for 4 weeks. Maximal range of anterior, posterior pelvic tilt and joint position sense were used to evaluate pelvic tilt motion. Image analysis was performed for evaluation of postural alignment on in standing position. Results: Significant difference in Iimprovement of pre- and post-intervention of joint position sense was observed showed significant difference (p<0.05) in all groups. Experimental groups showed sSignificant differences in maximal range of posterior pelvic tilt in on the paretic side were observed in the experimental groups compared to with the control group (p<0.05). Conclusion: These findings suggest that pelvic tilt training using an inclinometer may help to improve range of pelvic tilt and joint position sense of stroke patients.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.155-161
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• 2020

Background: The consequences of falls are often debilitating, and prevention is important. In theory, the lower the center of mass (COM), the greater postural stability during standing, and a weight belt at the waist level may help to lower the COM and improve the standing balance. Objects: We examined how the limit of stability (LOS) was affected by the lowered center of mass with the weight belt. Methods: Twenty healthy individuals participated in the LOS test. After calculating each participant's COM, a weight belt was fastened ten centimeters below the COM. Trials were acquired with five weight belt conditions: 0%, 2%, 4%, 6%, and 8% of body weight. Outcome measures included reaction time, movement velocity, endpoint excursion, maximum excursion, and directional control in 4 cardinal moving directions. Results: None of our outcome variables were associated with a weight belt (p > 0.075), but all of them were associated with moving direction (p < 0.01). On average, movement velocity of the COM and maximum excursion were 31% and 18% greater, respectively, in mediolateral than anteroposterior direction (5.4°/s vs. 4.1°/s; 97.5% vs. 82.6%). Conclusion: Our results suggest that postural stability was not affected by the weight-induced lowered COM, informing the development and improvement of balance training strategies.

• 한국체육학회지인문사회과학편
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• 제58권6호
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• pp.449-459
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• 2019

이 연구의 목적은 외발서기 동작 시 취득한 운동역학데이터로부터 주파수분석의 기법을 통하여 인체 운동명령신호가 어떻게 자세조절 과정에 영향을 미치는지를 규명하는 자세역학의 토대연구이다. 이를 위하여 체조경력 10년 이상의 운동신경이 우수한 국가대표상비군(n=6)과 일반인(n=6)을 대상으로 발바닥 압력중심점(CoP)의 궤적데이터를 FFT신호처리기법에 의한 저주파대역Rambling (RM)과 고주파대역 Trembling (TR)의 주파수분석을 탐색하였다. 본 연구결과에 따르면 눈뜨고 외발서기와 눈감고 외발서기 동작을 중심으로 두 집단 간 자세조절능력의 안정화지수 평가에서 독립표본 t검증에서 유의한 차이가 나타났으며(p<.05), 이러한 차이는 저주파대역 RM의 주요주파수 f1과 고주파대역 TR의 주요 주파수 f2의 최대진폭의 출력 차이로 밝혀졌다(p<.05). 특히 자세송환피드백에 관여하는 고유주파수인 저주파수대역에서는 주요주파수가 8-9 Hz 대역에서 뇌지시 하 안정적 자세조절의 운동기전을 행하는 운동명령으로 확인하였으며, 120-135 Hz의 고주파수대역에서는 자세 흔들림을 최소화하기 위한 반사적 근반응의 적응성을 보이는 것으로 연구되었다. 자세조절의 중추신경계 운동조절에 관여하는 고유주파수와 최대진폭에서 유의한 차이가 발견됨으로서 외발서기 시 발바닥 압력조절에 의한 신호파형의 운동명령이 자세조절에 영향을 미치는 것으로 해석되었다.

• 대한물리치료과학회지
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• 제8권2호
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• pp.1059-1064
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• 2001

This study is aimed at diagnosing transmutation aspect with the respective of hemiplegia patient's static adaptation of posture which is influenced by anti-gravity excercise, center of gravity shifting movement and segmental movement adaption of the legs and arms by key-point control in the process of Bobatli's treatment approach. The patients for the investigation of this study were selected as a total 17 patients who were doing the physical-therapy in Tae-gu Rehabilitation Center, and diagnosed as hemiplegia patients by Rehabilitation Medicine department in Kyung-buk University hospital. And also, there investigated into temporal transition that keep the attitude with one-leg standing on the ground concerning static attitude adaption on the basis of the before of anti-gravity movement and the after of 4-weeks movement. The findings of this study were as follows: With the respective the time to keep standing pose by one-leg at static attitude transmutation, affected side showed meaningful differences as a l.86/sec, 2.62/sec at 4 weeks later considering the before and after of this experiment.(p<0.01), non-affected side at the aspect of attitude keeping time, but there didn't showed meaningful differences statistically.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.74-78
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• 2019

Objective: Myofascial release (MFR) is used to restore tissue extensibility of the fascia tissue and is considered to be useful in a number of clinical settings, such as low back pain (LBP). Dynamic myofascial release (DMFR) is the manual therapy, which combined the conventional MFR with the joint mobilization. The purpose of this study was to investigate the effects of the DMFR on trunk mobility, and furthermore, whether the increase of trunk mobility can carry over the improvement of dynamic standing balance in persons with chronic nonspecific LBP. Design: Randomized controlled trial. Methods: Thirty persons with chronic non-specific LBP participated in the study and were randomly assigned to the DMFR group (n=15) or the control group (n=15). DMFR was performed for two sessions (15 minutes/session) per week for four weeks for the treatment group. Both the DMFR and control groups were allowed to perform low-intensity physical activities during the treatment period. The Modified-modified $Sch{\ddot{o}}ber$ test (MMST) for trunk mobility and the Functional Reach Test (FRT) for dynamic standing balance were measured before and after the treatment period in both the DMFR group and the control group. Results: The MMST value of DMFR group increased significantly in all trunk range of motion (flexion, extension, lateral flexion, and rotation) after treatment, compared with the control group (p<0.05). Additionally, the FRT value of the DMFR group improved significantly after treatment, compared with the control group (p<0.05). Conclusions: We suggest that DMFR have a positive effect on trunk mobility and standing balance in persons with chronic LBP.

• 대한의용생체공학회:의공학회지
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• 제33권2호
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• pp.98-103
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• 2012

The purpose of this study was to compare premotor time(PMT) and electro-mechanical delay(EMD) between sitting and standing posture. Twenty four healthy young subjects(12 women and 12 men) participated in this study. Subjects were instructed to perform maximal, voluntary, isometric contraction of ankle muscle(tibialis anterior and gastrocnemius muscles) in reaction to auditory stimulus. PMT and EMD, calculated from stimulus, EMG and torque profile were compared between sitting and standing postures. As statistical analysis, paired t-test was performed to assess difference between sitting and standing posture. In both tibialis anterior and gastrocnemius muscles, EMD was found to be significantly longer for standing than sitting. However, PMT in standing posture was longer than that in sitting posture only in gastrocnemius muscles. These result indicate that increased reaction time, particularly, increased EMD of ankle muscles in standing posture may be caused by co-contraction of ankle muscles for postural control in standing posture.