• 대한정형도수물리치료학회지
• /
• 제27권3호
• /
• pp.25-36
• /
• 2021

Background: This study aimed to investigate the effect of modified constraint-induced movement therapy (mCIMT) and resistive exercise using elastic band with pressure belt on improving upper extremity function in stroke patients. Methods: Sixteen patients with stroke were randomly assigned to a control group that received mCIMT and resistive exercise using elastic band (n=8) and an experimental group that received mCIMT and resistive exercise using elastic band with pressure belt (n=8). Over the course of four weeks, mCIMT were conducted 60 minute three times per week and resistive exercise using elastic band (with pressure belt) were conducted twice daily, three times per week. The function of the upper extremities were evaluated before, after 2 weeks and 4 weeks using the grip strength test (GST), the box and block test (BBT), and motor activity log (MAL). Results: The values for the GST, the BBT, and MAL increased in both groups as the treatment period progressed. The values for the GST (p<.01), the BBT (p<.001), and MAL (p<.001) were significantly higher in the experimental group than in the control group at 4 weeks after initiating the treatment. Conclusion: We found that mCIMT and wearing a pressure belt during resistive exercise was very useful in improving the function of the upper extremities in patients with stroke.

• Nuclear Medicine and Molecular Imaging
• /
• 제40권6호
• /
• pp.316-321
• /
• 2006

목적: 동정맥 혈관기형은 혈역학적 변화를 일으켜 생명에 위험을 줄 수 있으므로, 사지의 선천성 혈관기형 환자에서 동정맥 혈관기형과 비동정맥 혈관기형을 정확히 감별진단 하는 것이 중요하다. 이 연구에서는 혈관조영술과 비교하여 경동맥 폐관류 신티그라피(transarterial lung perfusion scintigraphy, TLPS)가 선천성 혈관기형 중 상하지에 위치하는 동정맥 혈관기형의 진단과 치료 효과 평가에 유용한 지를 알아보았다. 대상 및 방법: 색전술/경화요법 전에 처음 TLPS를 시행 받은 57명(나이: $21{\pm}13$세, 남:여 = 26:31)이 연구대상이 되었다. 병변의 위치는 상지가 9명이었고 하지가 48명이었다. TLPS에서 폐의 시간 방사능 곡선을 이용하여 혈액 단락량을 구하였다. 모든 환자들에서 혈관조영술을 시행하여 혈관기형의 해부학적 및 혈역학적 평가를 하였다. 혈관조영술로 동전맥 혈관기형이 진단된 환자들은 치료 후 TLPS를 추적 시행하였다. 결과: 혈관조영술상 16명은 동정맥 혈관기형(상지 8명, 하지 8명), 나머지 41명은 비동정맥 혈관기형(상지 1명, 하지 40명)으로 진단되었다. 동정맥 혈관기형 환자들의 치료 전 평균 혈액 단락량은 비동정맥혈관기형 환자들에 비하여 유의하게 높았다($66.4{\pm}25.8%\;vs.\;2.8{\pm}4.3%$, p<0.0001). TLPS의 치료 전 상하지 동정맥 혈관기형을 진단하는 예민도와 특이도, 정확도는 각각 93.8% (15/16), 100% (41/41), 98.2% (56/57)이었다(혈액 단락량 기준 역치 = 20%). 동정맥 혈관기형 환자 16명은 추적 TLPS를 시행하였고 이 중 13명은 치료 평가에서 혈관조영술과 일치하는 결과를 보여주었다(81.3%). 색전술/경화요법 시행 후 TLPS 혈액 단락량은 유의하게 감소하였다($69.5{\pm}24.0%\;vs.\;41.0{\pm}34.7%$, p = 0.01). 결론: TLPS는 상하지동정맥 혈관기형에서 혈액 단락량의 반정량적인 정보를 제공해주며 혈관 조영술과 높은 검사결과 일치도를 보여주었다. 그러므로, TLPS는 상하지 동정맥 혈관기형의 진단과 치료 평가에 유용하다.

• 한국전문물리치료학회지
• /
• 제13권2호
• /
• pp.52-60
• /
• 2006

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

• The Journal of Korean Physical Therapy
• /
• 제25권2호
• /
• pp.88-95
• /
• 2013

Purpose: The purpose of this study was to conduct an analysis of kinematics of lower extremities and trunk in stance phase of walking according to turning direction. Methods: Ten university students (five male, five female) who were in their 20s (mean age was 20.6 years old) participated in this study. Participants did not have participants did not have any problem with skeletal muscular system. We used the "Qualisys motion capture system" for analysis of trunk and lower extremity movement in stance phase of walking according to turning direction. We collected data while subjects walked a distance of 10 m, and at the 6 m line, subjects were required to turn to the left side and the right leg was positioned in stance phase and the left leg was positioned in swing. For data analysis, the SPSS for Windows ver. 20.0 statistics program was used in performance of one way analysis of variance according to turning direction. Results: Significant difference of trunk and lower extremities was observed for turning direction according to walking cycle (p<0.05). Upper trunk movement showed a greater increase at three dimensions than lower trunk, and in heel off phase, pelvic movement showed a greater increase than lower trunk (p<0.05). In 45 degree and 90 degrees of turning direction, all movements of trunk and lower extremities were significantly different among three events of stance phase (p<0.05). Conclusion: We suggest that three-dimensional movement analysis of trunk and lower extremities during turning movement was very important in order to indicate increasing balance or walking ability for people with impaired movement or walking.

• 대한의생명과학회지
• /
• 제17권4호
• /
• pp.313-319
• /
• 2011

Diabetes mellitus (DM) leads to a variety of complications and thus we have retrospectively studied to investigate problems of nerve conduction velocity (NCV) study and the heart in the patients with type-II DM. Blood glucose and blood pressure levels were higher in DM group than in Non-DM group. We found that several latencies were delayed in motor conduction study of upper (median and ulnar nerve) and lower extremities (peroneal and tibial nerve), whereas amplitudes and NCVs were decreased in DM group compared with Non-DM group. Latencies of sensory conduction study in upper and lower extremities (sural nerve) were delayed, while amplitudes and NCVs were lower in DM group than in Non-DM group. Abnormal percent of the electrocardiogram was higher in DM group than in Non-DM group. This retrospective study suggests that type-II DM can cause a damage effect on the peripheral nerve and the heart function.

• 한방재활의학과학회지
• /
• 제25권3호
• /
• pp.91-102
• /
• 2015

Two patients, diagnosed as cervical spinal cord injury, were hospitalized and treated by Korean medical interventions with Functional Electrical Stimulation (FES). The range of motion of the shoulder joint, manual muscle test were adopted to measure the resulting motor recovery after treatment. And the Korean version of Barthel index (K-MBI) was adopted as a method of measuring the improvement of quality of life after treatment. The range of motions and muscle strengths of the shoulder joints were improved. The activities of daily living were slightly improved in case 2, but showed no improvement in case 1. FES was effective for upper extremities rehabilitation of spinal cord injured patients. Further studies are needed to set up an Korean medical protocol for spinal cord injury rehabilitation.

• Journal of Chest Surgery
• /
• 제37권2호
• /
• pp.176-179
• /
• 2004

30세 여자 환자가 어지러움증과 심계항진을 주소로 입원하였다. 양측 상지 및 양측 총경동맥에서 맥박이 촉지되지 않았으며, 대동맥 조영술상 무명동맥과 양측 총경동맥이 심하게 좁아져 있었고 양측 쇄골하동맥은 완전 폐쇄되어 있었다. 제Ⅰ형의 Takayasu 동맥염으로 진단하고 뇌 혈류 개선과 양측 상지의 혈류 개선을 위해 수술을 시행하였다. 4개의 서로 다른 절개를 통해 상행 대동맥, 양측 경동맥, 양측 쇄골하동맥, 양측 액와동맥을 노출시키고 인조 혈관을 이용하여 상행 대동맥-양측 총경동맥-양측 액와동맥 간의 우회술을 시행하였으며, 수술 후 어지러움증과 심계항진은 사라졌다.

• The Journal of Korean Physical Therapy
• /
• 제22권2호
• /
• pp.39-46
• /
• 2010

Purpose: This study was designed to determine whether General Coordinative Manipulation (GCM) Intervention Models have effects on the balanced restoration of asymmetrical muscles in the extremities. Methods: Fifty-nine healthy subjects (1st hypothesis: n=40, 2nd hypothesis: n=19) participated in studies using the two GCM intervention models. Subjects were studied 2 times a week for 3 weeks. Electromyography (EMG) was used to measure muscle activity, and measurements were performed before and after the application of the each intervention model. Results: Hypothesis 1: GCM Intervention, which coordinates flexion types of muscle contractions of the upper extremity and extension types of muscle contractions of the lower extremity (excluding self-care) is effective for treating shows the treatment in efficiency on more than two 2 of 3 muscles (vastus medialis, gastrocnemius medial, and deltoid middle) and the effects affects on more than 3 types of 4 body types (Vastus medialis, Gastrocnemius medial of Body type III, p<0.05). GCM body type was classified by the relative tilting of right and left scapulars and iliums into four groups. Hypothesis 2: GCM Intervention, which coordinates flexion types of muscle contractions of the lower extremity and extension types of muscle contractions of the upper extremity (excluding self-care) is effective for treating more than two 2 of 3 muscles (vastus medialis, gastrocnemius medial, and deltoid middle) and the effects affects on more than 2 types of 3 body types (p>0.05).

• Clinical Pain
• /
• 제20권1호
• /
• pp.39-42
• /
• 2021

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

• Transactions on Electrical and Electronic Materials
• /
• 제18권5호
• /
• pp.298-302
• /
• 2017

With an increasing aging population and improved standards of living, more attention has been paid to health. Although walking exercise is known as an aerobic exercise, it imposes repeated and continuous impacts on the joints of the lower extremities. Therefore, when overweight gives a burden to the lower extremity or there is a joint disease, exercise limit occurs. The articular cartilage, weakened with age, also makes it difficult for the elderly to perform walking exercises. Accordingly, this study conducted a comparative analysis between regular walking using only the lower extremity and Nordic walking, which has been known as stable. For analysis, electromyography (EMG) was performed and the ground reaction force of the upper and lower extremities were measured in the same exercise. Integrated EMG (iEMG) revealed that the upper extremity muscles were more active in Nordic walking than in regular walking, where lower extremity muscles were relatively more inactive. In addition, when EMG measurements were performed at each measurement point during walking exercise, the pattern was different. Nevertheless, the result was the same as in iEMG. The load that occurs in each exercise was measured using the ground reaction force system. As a result, Nordic walking had a lower load than regular walking. Therefore, it was found that Nordic walking minimized the load on the lower extremities owing to the effect of whole-body exercise and was a safer and more efficient exercise method.