• 한국전문물리치료학회지
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• 제28권1호
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• pp.47-52
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• 2021

Background: Compared with normal people, stroke patients have decreased voluntary craniocervical motion, which affects their balance. Objects: This study was conducted in order to examine the effects of active craniocervical movement training using a cognitive game on stroke patient's cervical movement control ability, balance, and functional mobility. Methods: The subject of this study were 29chronic stroke patients who were randomly allocated to either an experimental, cognitive game group (n = 15), or control group (n = 14), to which only neuro-developmental treatment (NDT) was applied. The intervention was conducted 5 times per week, 30 minutes per each time, for a total of 4 weeks. Active angle reproduction test, static stability test, limits of stability test, and Time up and Go (TUG) test, respectively, were carried out in order to evaluate cervical movement control ability, static balance, dynamic balance, and functional mobility. Paired t-test was used in order to compare differences between prior to after the intervention, along with an independent-test in order to compare prior to and after-intervention differences between the two groups. Results: After the craniocervical training with a body-driven cognitive game, the experimental group showed significant differences in flexion, extension, and lateral flexion on the affected side, and rotation on the affected side in the active angle reproduction test. The experimental group indicated significant differences in sway length both with eyes-open and with eyesclosed in the static stability test and in limits of stability test and TUG test. The control group to which NDT was applied had significant differences in flexion in the active angle reproduction test and in limits of stability test and TUG test. Conclusion: The above results mean that craniocervical training using a body-driven cognitive game positively influences stroke patient's cervical movement control ability and as a result their balance and functional mobility.

• PNF and Movement
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• 제18권3호
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• pp.305-313
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• 2020

Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.

• 한국운동역학회지
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• 제32권3호
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• pp.87-93
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• 2022

Objective: The purpose of this research was to investigate the age-related changes in whole-body motor variability during sit-to-stand (STS) task. It has been reported that children perform motor tasks less accurately with greater variability as compared to adults. However, it is still unknown how they utilize the abundant degrees of freedom and accomplish voluntary actions. Uncontrolled manifold (UCM) analysis has been used to partition motor variabilities into two independent variability components, task-relevant variability (V_ORT) and task-irrelevant variability (V_UCM). We investigated what differences exist between children and adults with respect to these two motor variability components in relation to motor development stages. Method: Ten 6-year-old children (height: 116.2 ± 4.3 cm, weight: 23.1 ± 3.9 kg, motor development assessment percentile score: 77.5 ± 18.6%), ten 10-year-old children (height: 138.7 ± 7.2 cm, weight: 35.8 ± 10.3 kg, motor development assessment percentile score: 73.9 ± 12.7%), and ten young adults (age: 23 ± 1.6 year-old, height: 164.3 ± 11.4 cm, weight: 60.8 ± 12.0 kg) participated in this study. Each participant performed STS ten times, and a motion capture system was used to capture the whole-body kinematics. Each segment centers of mass and the whole-body center of mass were calculated, and UCM analysis was used to quantify motor variabilities, V_ORT and V_UCM. One-way ANOVA was used for statistical analysis. Results: We found that children produced more motor variabilities in V_ORT and V_UCM in all three dimensions, anterior-posterior, medial-lateral, and vertical. As age increased, both, V_ORT and V_UCM significantly decreased (p<.05). Conclusion: The greater V_ORT found in children compared to adults indicates that the repeatability over repetitions improves through development, while the greater V_UCM found in children suggests that children better utilize the abundant degrees of freedom during STS compared to adults.

• Clinical Pain
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• 제19권1호
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• pp.1-7
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• 2020

Objective: A prospective, assessor-blinded, randomized controlled trial was conducted in patients with chronic low back pain to evaluate the efficacy of portable low power laser therapy (LPLT) and the effect when combined with exercise therapy on pain and functions. Method: 60 patients were recruited and 56 patients, excluding 4 dropouts, were randomly allocated to the LPLT group (Group 1: 19 patients), placebo laser therapy with exercise group (Group 2: 18 patients), and LPLT with exercise group (Group 3: 19 patients). Laser therapy and exercise was performed five times a week for 4 weeks. Visual analogue scale (VAS), Schober test, lumbar range of motion (ROM) measures (flexion, extension and lateral flexion), Oswestry Disability index (ODI) were measured at baseline, at 4 weeks after intervention, and at 6 weeks after 2 weeks of no intervention. Results: Statistically significant improvements were noted in all group by time interaction with respect to all outcome parameters (p<0.05). All parameters in each group improved not only in the period of treatment (4 weeks), but also in the final evaluation (6 weeks) 2 weeks after the end of treatment. Post-hoc analysis showed statistically significant difference between the LPLT with exercise group and the other groups in all outcome parameters except for the ODI at 4 weeks and at 6 weeks. Conclusion: Portable LPLT is effective treatment in reducing pain and improving lumbar ROM and with exercise is more effective than laser or exercise monotherapy for the chronic low back pain patients.

• 대한정형도수물리치료학회지
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• 제29권2호
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• pp.77-91
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• 2023

Background: Congenital muscular torticollis results in reduced head mobility, such as cervical rotation, due to the abnormal size and contraction of the sternocleidomastoid muscle. Korea Pediatric integrative manual therapy and stretching are recommended to improve head rotation upper cervical spine mobility. Therefore, in this study, the effect of the new PIMT was investigated. Methods: The patient is a 3.5 month-old diagnosed with congenital muscular torticollis (CMT). Due to the limitation of head rotation and cervical spine rotation and flexion mobility, the child visited a rehabilitation center and after diagnosis, Pediatric integrative manual therapy (PIMT) treatment was performed five times a week for a total of 15 weeks. The child's head rotation and flexion limitation and plagiocephaly were evaluated. Results: In conclusion, this study shows that compared to other treatments, PIMT approach is a more effective treatment for improving head rotation and cervical limitation for range of motion in CMT infants. Conclusion: PIMT approach was effective in improving cervical rotation and Head lateral flexion mobility and plagiocephaly in CMT patients.

• 한국전문물리치료학회지
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• 제30권2호
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• pp.110-119
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• 2023

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

• PNF and Movement
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• 제22권1호
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• pp.129-137
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• 2024

Purpose: The aim of this study was to investigate and compare the risk factors focusing on the neck and lower back between general workers (GW) and mild intellectual disability workers (MIDW) in the automobile manufacturing industry. Methods: A total of 32 participants were required for this study design to achieve 80% power, 0.9 effect size, and an alpha level of 0.05. Each group consisted of 16 subjects, including GW and MIDW. Pain levels in the neck and lower back were measured for all participants using the visual analog scale (VAS). A dual digital inclinometer was used to measure the range of motion (ROM) in the neck and lower back three times, and the average was used for analysis. The independent t-test was used to compare between the wo groups. Cohen's d effect analysis was employed to determine the effect size. The significant level was set at 0.05. Results: In the MIDW, neck pain was significantly higher, and left cervical flexion was significantly decreased compared with the GW. There was no significant difference in lower back pain between the MIDW and GW. However, both lumbar flexion and extension, as well as lateral flexion, were significantly reduced in the MIDW compared with the GW. Conclusion: This study reveals that MIDW working in the automobile manufacturing industry have a greater risk of neck pain, limitation in left cervical flexion, and overall restriction in the ROM of the lower back compared with GW.

• 한국운동역학회지
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• 제34권1호
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• pp.34-44
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• 2024

Objective: This study aimed to investigate how the movements occurring during the follow-through phase after releasing an arrow among elite compound archers, are associated with the arrow impact points on the target. Method: Nine elite archers performed consecutive compound archery shooting under conditions identical to actual competitions using their own bows and equipment. Motion capture system and force platform were utilized to record the changes in joint positions and center of pressure, respectively. Principal component analysis was employed to identify the patterns in which multidimensional joint positions and COP changes were organized with horizontal and vertical coordinates of arrow impact points. Subsequently, correlation analysis quantified the relationship between individual variables and the coordinates of arrow impacts on the target. Results: We found a common organizational pattern in which the two axes of the impact point coordinates were grouped into the first two principal components. The movements of the upper and lower limbs following release exhibited opposite patterns in the anterior-posterior axis, with significant correlations observed between the arrow impact points of the horizontal axis and the left shoulder, right elbow, left hip, and both knees. Additionally, the lateral movements induced by the reaction force upon arrow release showed significant associations with the vertical coordinates of the impact points. Particularly, the correlations between the movements of the left shoulder and elbow, as well as the bilateral hip and right knee, were consistently observed among all participants. Conclusion: These findings implied that the post-release movements could significantly influence the trajectory and impact points of the arrows in compound archery. We suggest that a consistent and controlled movement during the follow-through phase may be more beneficial for optimizing shooting accuracy and precision rather than minimizing movements.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.287-295
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• 2023

Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

• Clinical and Experimental Pediatrics
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• 제48권8호
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• pp.846-856
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• 2005

목 적 : 최근 심장 기능 평가에 많이 사용되는 TDI 지표들에 대해서 우리나라의 정상 소아에 대한 연구가 아직 미흡한 실정이다. 이에 정상 소아 72례(남아 : 42례, 여아 : 30례)를 대상으로 한 TDI 및 31례를 대상으로 한 M-형 심초음파 검사를 이용한 지표들에 대한 계측치를 확인하고, 이러한 계측치에 여러 변수들(몸무게, 심박동수, 측정한 위치 등)이 미치는 영향에 대해서 관찰하였다. 방 법 : 선천성 심질환이나 심장에 영향을 미칠 수 있는 질환이 없는 건강한 소아를 대상으로 하여, 심첨 4방도, 심첨 2방도의 여러 부위에서 PW-TDI를 이용하여 최대 심근 속도를 측정하고, 측정 부위에 따른 계측치의 차이, 나이, 몸무게 및 심박동수 등이 이러한 측정치들에 미치는 영향에 대해서 연구하였다. 또한 심첨 4방도에서 각각의 판막륜 방향으로 M-형 심초음파 검사를 시행하여 나이, 몸무게 및 심박동수와 연관 관계가 있는지 알아보았다. 또한 M-형 심초음파 검사에서 측정한 값들과 TDI 계측치들과의 관계에 대해서도 연구하였다. 결 과 : TDI로 측정한 여러 변수들은 남녀, 심초음파 기기간 및 검사를 시행한 의사간에는 의미있는 차이를 보이지 않았다. 판막륜과 판막륜 및 심첨의 중간 부위에서 측정한 값간에는 판막륜에서 측정한 값들이 의미있게 높게 측정되었으며, 우심실 측벽의 측정치가 심실 중격 및 좌심실 부위에서 측정한 값보다 높았다. 심근 단축률과 TDI 측정치간에는 상관 관계를 보이지 않았다. 심박동수와의 상관 관계를 보면 S-및 E-파형의 경우 심박동수와 상관 관계가 없었으나, A-파형 및 A/E 비는 심박동수와 양의 상관 관계를 보였다. 몸무게와의 상관 관계도 측정한 부위 및 계측치 들마다 일정한 상관 관계를 보여 주지는 못하였다. M-형 심초음파 검사로 측정한 판막륜의 움직임은 성별간에 유의한 차이를 보이지 않았으며, ALD는 몸무게와 양의 상관 관계를, 이동률은 음의 상관 관계를 보이는 경향이 있었다. 그러나 이동률과 TDI 계측치들 간에는 유의한 상관 관계를 발견할 수 없었다. 결 론 : 정상 소아들에서 TDI를 이용하여 최대 심근 속도를 측정하고, 또한 M-형 심초음파 검사를 이용한 판막륜의 움직임을 관찰해 보았다. 이러한 계측치들을 토대로 좀더 많은 례를 통한 한국 소아들의 TDI 및 M-형 심초음파 검사를 이용한 판막륜의 움직임에 대한 정상치를 확립하여야 하겠으며, 선천성 및 후천성 심질환을 가진 환아들에서의 임상 적용을 기대해 본다.