• 제목/요약/키워드: Upper limbs

검색결과 295건 처리시간 0.031초

뇌졸중 환자의 상지 강제유도운동치료에 관한 체계적 고찰 (A Systematic Review of Constraint Induced Movement Therapy about Upper Extremity in Stroke)

  • 박수향;백순형;신중일
    • 한국콘텐츠학회논문지
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    • 제16권3호
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    • pp.149-161
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    • 2016
  • 본 연구의 목적은 뇌졸중 환자를 대상으로 임상에서 보다 구체화된 강제유도운동치료 계획을 수립하는데 유용한 자료를 제공하고자 함이며, 추후 강제유도운동치료에 대한 연구 방안에 대해 제시하고자 함이다. 연구방법은 정해진 주제에 대해 과학적인 근거를 제공할 수 있는 체계적 고찰을 사용하였으며, 도출된 자료는 PICO(Patient, Intervention, Comparison, Outcome)원리에 따라 정리하였다. 분석대상 연구는 데이터베이스 Embase와 Medline에 'Constraint Induced Movement Therapy', 'Stroke'을 검색한 후 본 연구의 목적에 부합하는 총 42개 연구로 선정하였다. 연구결과 강제유도운동치료 연구의 질적 근거 수준은 체계적 고찰 메타분석 무작위 대조군 연구가 전체의 50%로 높은 질적 근거 수준이었다. 연구 진행시기는 2010년 이전에 진행된 연구가 2010년 이후에 진행된 연구 보다 42.8% 더 많았다. 강제유도운동치료 중재를 받는 뇌졸중 환자의 발병단계는 급성, 아급성, 만성 구분 없이 진행한 연구가 40.5%로 가장 많았다. 중재는 수정된 강제유도운동치료보다 기존의 강제유도운동치료로 진행한 연구가 40.2% 더 많았다. 강제유도운동치료 중재 방법에 따른 효과는 중재 방법에 상관없이 75% 이상의 연구에서 효과가 있다는 것을 확인하였다. 결론적으로 강제유도운동치료는 뇌졸중 환자의 손상된 상지에 효과가 있으며, 연구결과는 임상에서 강제유도 운동치료 계획을 수립할 때 유용한 자료로 사용할 수 있을 것이다. 추후 연구에서는 근거자료가 부족한 수정된 강제유도운동치료의 효과성 검증에 대한 연구가 이루어져야 할 것이며, 효과성 검증에 따른 고찰 연구가 필요할 것으로 사료된다.

토끼에서 경부 교감신경절의 무수 에틸 알코올에 의한 화학적 차단 (Chemical Neurolytic Block with Absolute Ethyl Alcohol on Cervical Sympathetic Ganglion in Rabbits)

  • 강유진;서재현
    • The Korean Journal of Pain
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    • 제7권2호
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    • pp.162-169
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    • 1994
  • Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

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동시과제가 운전 수행 능력에 미치는 영향 -차량 통제 및 동작신호 해석을 중심으로- (Effects of Secondary Task on Driving Performance -Control of Vehicle and Analysis of Motion signal-)

  • 문경률;최진승;강동원;방윤환;김한수;이수정;양재웅;김지혜;최미현;지두환;민병찬;정순철;탁계래
    • 감성과학
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    • 제13권4호
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    • pp.613-620
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    • 2010
  • 본 연구의 목적은 차량 통제 변인과 동작의 부드러움 변인을 이용하여 동시 과제 수행이 운전 수행 능력에 미치는 영향을 정량적으로 제시하는 것이다. 1~2년의 운전 경력을 가진 피험자 20명이 실험에 참여하였다. 피험자는 동작분석을 위해 상지(shoulder, elbow, wrist) 및 하지(knee, ankle, toe)에 9개의 마커를 부착한 후, 운전 시뮬레이터를 이용하여 80km/hr로 주행하는 선행 차량과 30m의 간격을 유지하며 직선 주행하도록 하였다. 동시과제는 문자 메시지 보내기와 네비게이션 검색으로 선정하였다. 실험 시간은 2분으로 운전 시작 후 1분은 운전만을, 다음 1분은 운전과 동시과제를 함께 실시하도록 하였고, 각각 운전구간과 동시과제구간으로 정의하였다. 차간거리(Anterior-Posterior Coefficient of Variation, APCV) 및 차선이격거리의 분산계수(Medial-Lateral Coefficient of variation, MLCV)와 저크비용함수(Jerk-cost function, JC)를 이용하여 운전 수행 능력을 평가하였다. APCV는 운전구간에 비해 운전 중 네비게이션 검색 시 222.1% 증가하였다. MLCV는 문자 메시지 전송 과제를 수행할 경우, 318.2%, 네비게이션 검색 과제를 수행할 경우 309.4%가 증가하였다. JC는 운전구간에 비해 동시과제 수행 시, 팔꿈치, 무릎, 발목, 발가락에서 유의하게 증가하였고, 하지마커 전체의 평균값은 문자과제 수행 시 218.2%, 네비게이션 과제 수행 시 294.7%가 증가하였다. 운전 중 동시과제의 수행은 JC를 증가시켜 운전자의 동작의 부드러움을 감소시키고, APCV와 MLCV를 증가시켜 차량의 횡적 종적 통제를 어렵게 한다고 결론 내릴 수 있다.

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중쇠뼈 찢김골절로 인한 고리중쇠 관절 불안정의 교정 (Correction of Atlanto-axial Instability by Avulsion Fracture of the Axis in a Dog)

  • 황용현;김민경;박정현;진소영;박기태;이희천;이재훈
    • 한국임상수의학회지
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    • 제30권6호
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    • pp.499-502
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    • 2013
  • 목 부위에 교상을 입은 8살의 중성화된 수컷 푸들이 내원하였다. 신체 검사에서, 보행이 불가능하였고 심부통증이 있는 사지의 불완전 마비로 UML 증상을 보였다. 방사선과 CT 검사에서 경추 1번의 횡돌기의 골절, 경추 2번의 가시돌기의 골절이 관찰 되었다. 보존적 처지를 1주일 실시 하였으나 증상이 완화 되지 않아 수술적 교정이 선택되었다. 수술적 안정은, 배쪽으로 접근하여 나사, K-wires 와 bone cement를 이용하여 내원 7일차에 실시 되었다. 수술 후 4주 이후 혼자 설 수 있었으며, 6주 이후 보행이 가능하였다. 본 증례에서는 등쪽과 배쪽 부위 중쇠뼈 골절을 교정하기 위하여 배쪽 복합 고정을 실시하였으며, 좋은 예후를 보였다.

양적 결과지식의 종류가 요추의 고유수용성감각 훈련에 미치는 영향 (The Influence of Different Quantitative Knowledge of Results on Performance Error During Lumbar Proprioceptive Sensation Training)

  • 신원석;최흥식;김택훈;노정석;이진복
    • 한국전문물리치료학회지
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    • 제11권3호
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    • pp.11-18
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    • 2004
  • This study is aimed at investigating the influence of different quantitative knowledge of results on the measurement error during lumbar proprioceptive sensation training. Twenty-eight healthy adult men participated and subjects were randomly assigned into four different feedback groups(100% relative frequency with an angle feedback, 50% relative frequency with an angle feedback, 100% relative frequency with a length feedback, 50% relative frequency with a length feedback). An electrogoniometer was used to determine performance error in an angle, and the Schober test with measurement tape was used to determine performance error in a length. Each subject was asked to maintain an upright position with both eyes closed and both upper limbs stabilized on their pelvis. Lumbar vertebrae flexion was maintained at $30^{\circ}$ for three seconds. Different verbal knowledge of results was provided in four groups. After lumbar flexion was performed, knowledge of results was offered immediately. The resting period between the sessions per block was five seconds. Training consisted of 6 blocks, 10 sessions per one block, with a resting period of one minute. A resting period of five minutes was provided between 3 blocks and 4 blocks. A retention test was performed between 10 minutes and 24 hours later following the training block without providing knowledge of results. To determine the training effects, a two-way analysis of variance and a one-way analysis of variance were used with SPSS Ver. 10.0. A level of significance was set at .05. A significant block effect was shown for the acquisition phase (p<.05), and a significant feedback effect was shown in the immediate retention phase (p>.05). There was a significant feedback effect in the delayed retention phase (p<.05), and a significant block effect in the first acquisition phase and the last retention phase (p<.05). In conclusion, it is determined that a 50% relative frequency with a length feedback is the most efficient feedback among different feedback types.

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화상 반흔구축 재건 시 유리피판술의 적응증 및 적절한 피판의 선택 (Correction of Burn Scar Contracture: Indication and Choice of Free Flap)

  • 허지연;이종욱;고장휴;서동국;최재구;장영철;오석준
    • Archives of Plastic Surgery
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    • 제35권5호
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    • pp.521-526
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    • 2008
  • Purpose: Most burn scar contractures are curable with skin grafts, but free flaps may be needed in some cases. Due to the adjacent tissue scarring, local flap is rarely used, and thus we may consider free flap which gives us more options than local flap. However, inappropriate performance of free flap may lead to unsatisfactory results despite technical complexity and enormous amount of effort. The author will discuss the points we should consider when using free flaps in treating burn scar contractures Methods: We surveyed patients who underwent free flaps to correct burn scar contractures from 2000 to 2007. We divided patients into two groups. The first group was those in which free flaps were inevitable due to exposure of deep structures such as bones and tendons. The second group was those in which free flap was used to minimize scar contracture and to achieve aesthetic result. Results: We performed 44 free flap on 42 patients. All of the flaps were taken well except one case of partial necrosis and wound dehiscence. Forearm free flap was the most common with 21 cases. Most of the cases(28 cases) in which free flaps were inevitable were on the wrist and lower limbs. These were cases of soft tissue defect due to wide and extensive burns. Free flaps were done in 16 cases to minimize scar contracture and to obtain aesthetic outcome, recipient sites were mostly face and upper extremities. Conclusion: When using free flaps for correction of burn scar contractures, proper release and full resurfacing of the contracture should be carried out in advance. If inadequate free flap is performed, secondary correction is more challenging than in skin grafts. In order to optimize the result of reconstruction, flap thickness, size and scar of the recipient site should be considered, then we can achieve natural shape, and minimize additional correction.

황제내경(黃帝內經) 소문(素問) 자열론(刺熱論)에 대한 연구(硏究) (A study on the Theory of 'Ja-Yeol(刺熱)' in 32nd Chapter of 'So Moon(素問) Yellow Emperior's Nei-Ching(黃帝內經)')

  • 권건혁;홍원식
    • 대한한의학원전학회지
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    • 제3권
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    • pp.151-217
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    • 1989
  • In this thesis, I intend to study the translational and clinical interpretation through the theory of Ja-Yeol, and reached the following conclusions. 1. Liver-Heat-Disease due to absess of the function of expelling and lifting off, that Liver-Yang cannot lift up to upper-warmer, and stagnate liver. I think the symptoms of yellowish urine, abdominal pain, somnolence, fever belong to the syndrome of 'Gi-Bun(氣分)', and the symptoms of ravings with surprising, distending pain of hypochondrium, restless involuntary movement of the limbs, unable to lie flat belong to the syndrome of 'Hyeol-Bun(血分)'. 2. Heart-Heat-Disease due that 'Eum-Gi(陰氣)' in heart cannot lay down and reach to stagnate at heart, inner part. I think the symptoms of unjoy, acute cardiac pain, fidgetiness, well-nausea, headeche, reddish face, anhidrosis, etc. reveal with Heart-Heat-Disease. 3. Spleen-Beat-Disease due that 'Eum-Gi' in spleen cannot lay down and Yin of spleen changs heat. I think the symptoms of heaviness of head, cheek pain, fidgetiness, cyanosis, well-nausea, fever, not to let flex and reflex with back pain, diarrhea with abdominal pain, left and right cheek pain reveal with Spleen-Heat-Disease. I think symptoms of fever, diarrhea with abdominal pain belong to the syndrome of Yin-exhausion. 4. Lung-Heat-Disease due to that 'Eum-Gi' in lung cannot lay down. When 'Wi-Gi(衛氣)' stagnates at external part, I think, the symptoms of intolerance to wind and cold, yellowish fur, fever reveal. When Wi-Gi stagnates at lung, inner part, I think, the symptoms of dispnea with cough, pain on chest and back, unable to breath deeply, hydrosis and chilling reveal. 5. Kidney-Heat-Disease, in that the symptoms of back pain, leg aching, extreme thirst and frequently drink, fever, pain and stiffness of nape, cooling and aching leg, heat on plantar pedis, not trying to speak reveal is regarded external heat disease of 'Tai-Yang-Gyeong's(太陽經)' disease that asthenic fever open 'Tai-Yang-Gyeong' and lift by not enough of 'Yang-Gi(陽氣)' lifeing up from Kidney space, the water space of five elements.

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자이로 센서와 인공신경망을 이용한 장애인용 컴퓨터 (Computer Interface for the Disabled Using Gyro-sensors and Artificial Neural Network)

  • 안용식;엄광문;김철승;허지운;나유진
    • 대한의용생체공학회:의공학회지
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    • 제24권5호
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    • pp.411-419
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    • 2003
  • 본 연구에서는 교통사고나 뇌졸중 등에 의해 상지의 장애를 가지는 장애인을 대상으로 하여, 인터넷의 브라우저와 같은 소프트웨어를 사용 할 수 있도록 하는 컴퓨터 인터페이스를 구현하는 것을 목적으로 한다. 이 인터페이스는 커서를 제어하기 위해 머리 움직임의 정보를 이용한다. 실제 시스템은 머리의 수평, 수직 각속도를 검출하여 컴퓨터로 전송하는 하드웨어부분과, 전송 받은 신호를 처리하여 마우스의 움직임과 클릭신호로 변환하는 소프트웨어 부분으로 구성하였다. 클릭신호는 순간적인 끄덕임으로 정의하였으며 특히, 인공신경망이 각 사용자별 클릭 패턴을 학습하여 사용자 친화적인 인터페이스를 제공하도록 하였다. 구현된 시스템의 성능을 클릭의 인식률, 커서의 이동제어오차, 이동출현하는 목표박스의 단위시간당 클릭율의 세가지 항목으로 평가하였다. 또한. 일반적으로 사용되는 광마우스와 본 연구에서 개발한 자이로마우스를 각각 이 실험에 사용하여, 양자간의 차이를 비교하였다. 개발된 자이로마우스에서 클릭의 인식률은 평균 93%였고, 커서의 수평수직 이동 제어오차는 광마우스의 1.4∼1.5배였다. 랜덤위치에 출현하는 50픽셀의 목표박스의 클릭률은 광마우스의 40% (30 클릭/분)의 성능을 보였으며, 시행횟수에 따라 증가하여 l회차의 35%에서 3회차에는 44%로 단조증가하는 경향을 보였다. 제안된 시스템은, 장애인에게 사회와 의사소통 할 수 있는 새로운 가능성을 제시할 것이 기대된다.

약쑥엑스제 쑥뜸방식에 의한 체간 온도 변화와 당뇨병 임상에 관한 연구 (A Study on the Variations of the Trunk Temperature and the Clinical Test for the Diabetics by the Artemisia Extract Moxibustion Method)

  • 윤동업;조봉관;배종일;구자성;김종원;이현민;조훈석;신우진;서상호;박동일;홍상훈
    • 대한한의학회지
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    • 제27권1호
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    • pp.165-183
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    • 2006
  • Objectives : We implemented the Artemisia Extract Moxibustion Method and had the clinical tests for the diabetes with it. Methods : We implemented Artemisia extract made by extracting the vasodilator and antioxidant compounds from Artemisia-CH2C12 fraction and the moxibustion method constructed with DC Power supply, controller, Artemisia pad. single and multiple heating terminal with PTC(Positive Temperature Coefficient) thermistor. And we performed to estimate the efficiency on the questionnaire and the clinical tests with 23 cases of the diabetics. Results : We have estimated the improvement over 60% the symptoms that were the upper and lower limbs pain, frequent urination, spontaneous perspiration, thirst, decrease of body weight, and malaise after the moxibustion treatment on 5 cases among 23 cases. And the 19 cases took the biochemical check-up after the moxibustion treatment. From the results of biochemical check-up, the average HbAlc of before treatment was 8.400%, and after treatment 7.632%. The average HbAlc was decreased significantly after treatment (P<0.001). And the average urinary blood of before treatment was 0.73 and after treatment 0.27. The average urinary blood was decreased significantly after treatment (P<0.001). In addition the average FBS before treatment was 182.64 mg/dl, after treatment 161.77 mg/dl. Conclusions : We could estimate that our proposed moxibustion method was a significant treatment method for the diabetes.

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운동용 속옷의 착용효과 -소재별 발한량과 체중감량을 중심으로- (The Wearing Effect of Sport Underwear -Focusing on the Loss of Weight and Amount of Sweat according to the Materials-)

  • 나미향;김미선;정복희
    • 한국생활과학회지
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    • 제11권3호
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    • pp.273-285
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    • 2002
  • Three materials for sport underwear were manufactured by order for study, and among them, suitable material in order to perform an experiment on the effect of wearing was adopted. The results are as follows: The result of wearing an experimental clothes for sports manufactured as a foundation-type underwear for sports showed that if the same compositional materials were applied, laminating material had higher rate than that of others in the amount of sweat. Concerning relative humidity in clothes and the amount of sweat absorbed in clothes among the two kinds of materials which were produced by laminate, material 2(nylon+modal) was statistically exerts higher influence on the amount of sweat. The humidity in clothes keeps the optimal condition of 59.8%, and breast part showed the highest relative humidity. The material 2(nylon+modal) showed the highest comfortableness, the sense of warmth, humidity and voluminousness, and the sense of pressure. Follow-up survey revealed that in case of material 2, higher amount of sweat than that of the group objects in its early phase, and the amount of sweat varies from individuals. The temperature in clothes of folded parts of experimental clothes and maximum surface temperature was equivalent to that of average skin. With the lapse of time, the weight decreased of 11.03% in maximum, and 3.12% in minimum. The amount of change in the girth was greater in part of body frame than that of limbs, and especially, navel and waist part showed high decrease, and upper breast, breast and the largest part of abdomen showed relatively low decrease. The above experiment revealed that materials for suitable to the underwear for sports for loss of weight by an exercise should be made of doubled-nylon and modal, along with the laminate processing, which heightens the amount of sweat. Thus, wearing an experimental wear gave satisfaction in the view of the beauty of appearance as it did not discharge flowing secretion to the outside at the time of exercise.

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