• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 춘계학술대회 논문집
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• pp.771-772
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• 2012

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.114-118
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• 2018

Objective: The left and right sides of the brain has different roles. This study investigated the differences in cognitive driving ability between stroke survivors with damage to the left brain and right brain. Therefore, the purpose of this study was to compare the driving cognitive ability of left and right hemispheric drivers following stroke. Design: Cross-sectional study. Methods: The Stroke Drivers' Screening Assessment (SDSA) from the UK was translated to the Korean Stroke Drivers' Screening Assessment (K-SDSA) to meet the specific traffic environments of Korea. The SDSA is composed of 4 tasks :1) a dot cancellation task that measures concentration and visuospatial abilities necessary for driving, 2) a directional matrix task to measure spatio-temporal executive function required for driving, 3) a compass matrix task to measure accurate direction determination ability required for driving, and 4) recognition of traffic signs and reasoning ability to understanding traffic situation. The SDSA assessment time is about 30 minutes. The K-SDSA was used to compare the cognitive driving abilities between 15 stroke survivors with left and 15 stroke survivors with right brain damage. Results: There were significant differences between the persons with stroke patients with left brain lesions (right hemiplegia) compared to the persons with stroke with right brain lesions (left hemiplegia) (p<0.05). It was found that the cognitive driving ability of those with right brain damage was lower than that of the group of left brain damage. Conclusions: This research investigated the driving cognitive ability of persons with stroke. The therapists can use this information as basis for the driving test and training purposes. It could also be used as a basis to understanding if the cognitive ability of not only stroke survivors but also those with brain damage is adequate to actually drive.

• 대한의용생체공학회:의공학회지
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• 제45권2호
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• pp.66-74
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• 2024

This study analyzed the occurrence of abnormal muscle coactivations based on the assistance of upper limb weight during reaching task in stroke patients. Nine chronic stroke survivors with hemiplegia performed reaching tasks using a programmable haptic robot. Electromyography (EMG) coactivation levels in the upper limb muscles were analyzed using a linear model describing the activation levels of two muscles when the patient's upper limb weight was assisted at 0%, 25%, and 50%. As the upper limb weight assistance of the haptic robot decreased, the magnitude of the EMG signal in both the deltoid and biceps muscles increased simultaneously on both the paretic and non-paretic sides. However, no difference was found between the paretic and non-paretic sides when comparing the slope of the linear model describing the activation relationship between the deltoid and biceps. The aforementioned results suggest that in some stroke survivors, the deltoids, triceps, and biceps on the paretic side may not be abnormally coupled when supporting the upper limbs against gravity. Furthermore, these results suggest that the combination of haptic robots and EMG analysis might be utilized for evaluating abnormal coactivations in stroke patients.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.50-57
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• 2007

The purpose of this study was to investigate the relationship between delays in initiation and termination of tibialis anterior contraction through surface electromyographic (sEMG) analysis in adults with hemiplegia and healthy subjects and clinical assessment of lower-limb mobility. EMG activity of 6 long-term survivors of stroke and 5 healthy subjects was recorded during maximal isometric ankle dorsiflexion in 3 seconds beeper signals. It must be done as fast and forcefully as possible. Lower limb mobility was assessed with Modified Emory Functional Ambulation Profile (mEFAP). Delay in initiation and termination of muscle contraction was significantly prolonged in the affected lower limb relative to the unaffected limb. Termination of muscle contraction in the hemiplegic lower limb was significantly delayed than the initiation on the affected sides. Delay in initiation and termination of muscle contraction correlated significantly with a few range of mEFAP. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in hemiparetic patients. Consequently, this study showed that abnormal delay of initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in adults with hemiplegia. Further studies are needed to demonstrate a treatment effect.

• 대한물리치료과학회지
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• 제28권2호
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• pp.30-39
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• 2021

Background: The purpose of this study was to compare the differences in gait and mobility according to the types of assistive device for ankle joint including ankle foot orthosis (AFO), non-elastic tape, elastic tape, and high ankle shoes in chronic hemiplegic stroke survivors. Design: A cross-over design. Methods: Twelve hemiplegic stroke survivors participated in this study, and they walked under 5 different conditions including bare feet, wearing a AFO, wearing a non-elastic tape, wearing a elastic tape, and wearing a high ankle shoes. During the participants walked, the spatio-temporal gait analysis and mobility examinations were performed. For the spatio-temporal gait analysis (gait velocity and cadence, step length, stride length, and single and double leg support time) and mobility examinations, the gait mat, TUG and TUDS were used. Results: As s results, on the AFO, non-elastic tape, elastic tape, and high ankle shoes, there were significantly differences in the all spatio-temporal gait parameters, TUG, and TUDS compared to barefoot (p<0.05). In particular, all spatio-temporal gait parameters, TUG, TUDS were significantly improved with AFO compared to barefoot. TUG was significantly improved with AFO compared to non-elastic tape, TUG and TUDS were significantly improved with AFO compared to elastic tape, gait velocity was significantly improved with non-elastic tape compared to high ankle shoes, gait velocity and TUG were significantly improved with elastic tape compared to high ankle shoes, and TUDS was significantly improved with non-elastic tape compared to elastic tape. Conclusion: The AFO, non-elastic tape, elastic tape, and high ankle shoes showed a positive effect on gait and mobility compared to barefoot, and among them, wearing AFO was most effective for improving gait and mobility of chronic hemiplegic stroke survivors.

• 한국전문물리치료학회지
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• 제26권1호
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• pp.37-50
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• 2019

Background: Stroke is one of the most common diseases responsible for physical disabilities. In addition to their physical and occupational therapy, the self-exercise programs were developed for patients with hemiplegia to increase the intensity of their therapeutic exercise. Objects: The purpose of this study was to assess the effect of a customized self-exercise program (CSP) to walking function on improving stroke survivors' muscle strength and ambulation function. Method: To test the effect of the self-exercise program, the following tests were conducted: The functional ambulation category (FAC), Tinetti performance-oriented mobility assessment gait part (POMA-G), timed up and go (TUG), 10-meter walk, and 2-minute walk. The study included 161 consenting stroke patients (FAC score>1) from a randomized, screened sample of 217. The CSP group participated in a 30-minute CSP each day for 10 weeks in addition to completing a routine rehabilitation program. The control group received only a routine rehabilitation program. All the subjects were monitored by a therapist once a week and had to submit an exercise checklist at the end of each session. Result: The strength of the participants' upper and lower extremity muscles showed no significant differences between the CSP group and the control group. The FAC score and POMA-G also showed no significant differences. However, there were significant differences in the TUG, 10-meter walk test, and 2-minute walk test (p<.05). Conclusion: The findings of this study suggest that a CSP may improve gait-related function in stroke survivors.

• Journal of Chest Surgery
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• 제31권10호
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• pp.939-944
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• 1998

연구배경 : 심장의 구조적 이상을 동반하지 않는 만성 심방세동에 대한 Cox-Maze 술식의 성적은 매우 좋은 것으로 보고되고 있으나 승모판막 질환과 같은 기질적 심장질환에 동반된 심방세동에서의 성적은 다소 떨어지는 것으로 보고되고 있다. 대상 및 방법 : 본 서울대학교병원 흉부외과학 교실에서는 승모판막 질환에 대한 수술과 함깨 시행한 Cox-Maze 술식의 효과와 안전성을 평가하기위해 1994년 4월부터 1997년 10월까지 경험한 70례(남;23, 여;47)를 대상으로 임상 연구를 하였다. 결과 : 70례중 67례가 류마티스성 승모판막 질환이었으며 3례가 퇴행성 질환이었다. 술전 심방세동의 평균 유병기간은 66$\pm$70개월이었다. 15명의 환자에서 과거력상 혈전색전증의 병력이 있었으며 24명의 환자에서 수술중 좌심방내의 혈전이 존재하였다. 과거에 조직판막을 이용한 판막치환술의 병력이 있었던 재수술례가 12례였다. 수술시 대동맥차단시간은 평균 151$\pm$44분이었으며 심폐우회시간은 평균 246$\pm$65분이었다. Cox-Maze 술식과 함께 시행한 수술로는 승모판막 치환술이 19례,승모판막과 대동맥판막 치환술이 14례, 승모판막 치환술과 삼첨판막륜 성형술이 8례, 승모판막 치환술 및 대동맥판막 성형술이 3례있었으며 11례에서는 승모판막 성형술이 가능하였다. 판막치환술과 관상동맥우회술을 같이 시행한 례가 3례있었으며 승모판막 재치환술이 10례, 승모판막 및 대동맥 판막 재치환술이 2례 있었다. 수술사망률은 1.4%(1/70)였다. 수술후 합병증으로는 술후 일시적 심방세동의 재발을 보인 례가 44례였으며 상심실성 빈맥이 10례, 저심박출증후군이 4례, 출혈에 의한 재수술이 4례있었다. 그 밖의 합병증으로는 급성 신부전이 1례, 수술전의 일측 편마비가 악화된 경우가 1례, 그리고 일시적 섬망이 1례 있었다. 생존한 모든 환자를 평균 16.4개월간 외래를 통한 추적관찰하였는데 동기능부전 증후군과 빈맥-서맥 증후군을 보인 2명의 환자에서 영구형 심박동기의 삽입이 필요하였고, 2례만이 현재 심방세동을 보이고 있어서 동율동으로의 전환율은 94.2%였다. 수술만으로 심방세동이 조절되었던 경우가 73.9% 이었고, 수술후 항부정맥제의 병행 투약이 필요했던 경우가 20.3% 이었다. 술후 심방수축력과 기타 심기능의 평가를 위하여 시행한 경흉부 심초음파 검사 소견상 우심방 수축력은 92%에서, 좌심방 수축력의 회복은 53%에서 관찰되었다. 판막재치환술을 시행한 환자들을 첫 수술인 환자들과 비교하였을 때, 심방세동의 유병기간은 재수술한 례에서 통계적으로 유의하게 길었으나 대동맥차단시간, 심폐우회시간, 수술당일의 출혈량, 동율동으로의 전환율등에서는 차이가 없었다. 결론 : 결론적으로 승모판막 질환에 대한 수술과 함께 시행한 Cox-Maze 술식은 비교적 낮은 수술위험도 하에서 높은 동율동 전환률을 보였으며 특히 재수술시에도 비교적 안전하며 매우 효과적이었다.