• 한국융합학회논문지
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• 제11권9호
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• pp.31-37
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• 2020

본 연구는 뇌졸중 환자에게 과제 지향적 훈련과 진동 자극을 결합한 중재에 경두개 직류 전류 자극을 융합했을 때 상지 기능의 회복에 미치는 영향을 알아보고자 하였다. 총 20명을 대상으로 총 4주간, 주 5회, 30분씩 실시했으며, 경 두개 직류 전류 자극을 융합한 과제 지향적 훈련과 진동자극의 결합 중재의 실험군과 과제 지향적 훈련과 진동자극의 결합 중재의 대조군으로 나누었다. 측정은 손의 기민성과 상지기능의 회복을 측정하였다. 실험군과 대조군은 손의 기민성과 잡기, 쥐기, 큰 동작 움직임에서 유의한 개선을 보였으며(p<.05), 실험군은 손의 기민성과 잡기, 쥐기 동작에서 대조군 보다 유의한 개선을 보였다(p<.05). 중재 전후 효과 크기는 모든 평가 항목에서 작은 효과이상을 보였다. 본 연구 결과를 근거로 하여 임상 환경에서 보다 효과적이고 효율적인 재활 치료를 할 수 있을 것으로 사료된다.

• 대한청각학회지
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• 제24권3호
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• pp.113-118
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• 2020

Tinnitus is a prevalent disorder that has no cure currently. Within the last two decades, neuroscientific research has facilitated a better understanding of the pathophysiological mechanisms that underlie the generation and maintenance of tinnitus, and the brain and nerves have been identified as potential targets for its treatment using non-invasive brain stimulation methods. This article reviews studies on tinnitus patients using transcranial magnetic stimulation, transcranial electrical stimulation, such as transcranial direct current stimulation, alternating current stimulation, transcranial random noise stimulation as well as transcutaneous vagus nerve stimulation and bimodal combined auditory and somatosensory stimulation. Although none of these approaches has demonstrated effects that would justify its use in routine treatment, the studies have provided important insights into tinnitus pathophysiology. Moreover bimodal stimulation, which has only been developed recently, has shown promising results in pilot trials and is a candidate for further development into a valuable treatment procedure.

• Journal of Audiology & Otology
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• 제24권3호
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• pp.113-118
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• 2020

Tinnitus is a prevalent disorder that has no cure currently. Within the last two decades, neuroscientific research has facilitated a better understanding of the pathophysiological mechanisms that underlie the generation and maintenance of tinnitus, and the brain and nerves have been identified as potential targets for its treatment using non-invasive brain stimulation methods. This article reviews studies on tinnitus patients using transcranial magnetic stimulation, transcranial electrical stimulation, such as transcranial direct current stimulation, alternating current stimulation, transcranial random noise stimulation as well as transcutaneous vagus nerve stimulation and bimodal combined auditory and somatosensory stimulation. Although none of these approaches has demonstrated effects that would justify its use in routine treatment, the studies have provided important insights into tinnitus pathophysiology. Moreover bimodal stimulation, which has only been developed recently, has shown promising results in pilot trials and is a candidate for further development into a valuable treatment procedure.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.91-98
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• 2010

Neurostimulation approaches have been developed and explored to modulate neuroplastic changes of cortical function in human brain. As one of the most primary noninvasive tools, transcranial direct current stimulation (tDCS) was extensively studied in the field of neuroscience. The alternation of cortical neurons depending on the polarity of the tDCS has been used for improving cognitive processing including working memory, learning, and language in normal individuals, as well as in patients with neurological or psychiatric diseases. In addition, tDCS has great advantages: it is a non-invasive, painless, safe, and cost-effective approach to enhance brain function in normal subjects and patients with neurological disorders. Numerous previous studies have confirmed the efficacy of tDCS. However, tDCS has not been considered for clinical applications and research in the field of physical therapy. Therefore, this review will focus on the general principles of tDCS and its related application parameters, and provide consideration of motor behavioral research and clinical applications in physical therapy.

• 대한통합의학회지
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• 제9권3호
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.

• Journal of Magnetics
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• 제17권1호
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• pp.36-41
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• 2012

The transcranial magnetic stimulation recharges the energy storing condenser, and sends the stored energy in the condenser to the pulse shaping circuit, which then delivers it to the stimulating coil. The previous types of transcranial magnetic stimulation required a booster transformer, secondary rectifier for high voltages and a condenser for smooth type. The energy storing condenser is recharged by switching the high-voltage direct current power. Loss occurs due to the resistance in the recharging circuit, and the single-pulse output energy in the transcranial magnetic stimulation can be changed because the recharging voltage cannot be adjusted. In this study a booster transformer, which decreases the volume and weight, was not used. Instead, a current resonance inverter was applied to cut down the switching loss. A transcranial magnetic stimulation, which can simultaneously alter the recharging voltage and pulse repeats, was used to examine the output characteristics.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.73-79
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• 2009

Purpose: Recently, neurostimulation studies involving manipulation of cortical excitability of the human brain have been increasingly attempted. We investigated whether transcranial direct current stimulation (tDCS) applied to the underlying cerebral cortex, directly induces cortical activation during fMRI scanning. Methods: We recently recruited five healthy subjects without a neurological or psychiatric history and who were right-handed, as verified by the modified Edinburg Handedness Inventory. fMRI was done while constant anodal tDCS was delivered to the underlying SM1 area?? immediately after the pre-stimulation for eighteen minutes. Results: Group analysis yielded an averaged map that showed that the SM1 area and the superior parietal cortex in the ipsilateral hemisphere were activated. The voxel size and peak intensity were, respectively, 82 and 5.22 in the SM1, and 85 and 5.77 in the superior parietal cortex. Conclusion: Cortical activation can be induced by constant anodal tDCS of the underlying motor cortex. This suggests that tDCS may be an effective therapeutic device for enhancing? physical motor function by modulating neural excitability of the motor cortex.

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.49-53
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• 2011

Purpose: The purpose of this study is to investigate whether dual-hemisphere transcranial direct current stimulation (tDCS) could induce more cortical activity, compared to single-hemisphere, using functional MRI (fMRI). Methods: One right-handed healthy subject was recruited. Three phases of dual-hemisphere tDCS (i.e. anodal tDCS over the left-dominant primary sensoriomotor cortex (SM1) and cathodal tDCS over the right-non dominant SM(1) were consecutively delivered on to a subject, during fMRI scanning. The voxel count and the intensity index in the averaged cortical map were analyzed among the three tDCS phases. Results: Our result showed that cortical activation was observed on all the three phases of the dual-hemisphere tDCS. Voxel count and intensity index were as following; 912 and 4.07 in the first phase, 1102 and 3.90 in the second phase, 1031 and 3.80 in the third phase. Conclusion: This study demonstrated that application of the dual-hemisphere tDCS could induce cortical activity and maintain to recruit cortical neurons. Our findings suggested that application of dual-hemisphere tDCS could produce efficiency of the ongoing tDCS effect to facilitate cortical excitability.

• 대한통합의학회지
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• 제7권1호
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• pp.9-17
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• 2019

Purpose : This study assessed the effects of transcranial direct current stimulation (tDCS) on balance, fall efficacy, and fall-related fitness in stroke patients, using a cohort of 30 stroke patients divided into two groups. Methods : The experimental group (was given transcranial direct current stimulation in a virtual reality program) and the control group was given false tDCS in virtual reality. there were 15 patients in each group, receiving appropriate treatment over 30 sessions (30 minutes per session per week over a six-week period). In order to assess the change in balance before and after the intervention, the Berg Balance scale was utilized. Fall efficacy was evaluated using the Korean Falls Efficacy Scale for the Elderly (FES-K), The following exercises were performed by patients to assess fall-related fitness : sitting down in a chair and standing up : walking a 244 cm round= trip, and standing on one foot. Results : After the intervention, the experimental group exhibited significantly increased fall efficacy and fall-related fitness, while the control group exhibited no change. These findings suggest that tDCS has positive effects on balance, fall efficacy, and fall-related fitness in stroke patients. Conclusion : Using tDCS as an intervention would bring positive effects on balance, fall efficacy, and fall-related fitness in stroke patients undergoing rehabilitation.

• PNF and Movement
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• 제11권2호
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• pp.9-19
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• 2013

Purpose : Study on the effects of attention(working memory) for normal adults by applying transcranial Direct Current Stimulation(tDCS). Methods : There are two groups of 10 random people aged between 20 to 30, one is an experimental group(stimulation) and the other is a comparison group(simulate stimulation). For the 1st da y, pre-stimulation test is executed, and for the 2nd day to the 4th day, tDCS is applied stimulated both on the right prefrontal lobe and the left occipital lobe through the electrode. The stimulation lasts for 15 minutes with voltage power of 1mA for each day. The post-stimulation test is executed on the day of 5th. In this paper, a FAIR attention test is used for measuring the attention. Results : As the result of the experiment, there are significant gaps both on the value of P, the ability of selective attention, and the value of C, the consistent ability after the stimulation on right prefrontal and left occipital lobe. And there is no significant gap on the value Q, the quality(Control). However, all the P, Q, and C values are increased according to the average value between the pre-stimulation test and the post-stimulation. Conclusion : Finally, ability of selective attention and self-control, and consistent attention is progressed by applying the tDCS to the normal people.