• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.11-28
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• 2005

Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had hemiplegia due to stroke. All subjects randomly assigned to 3 group: manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.1-6
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• 2009

Purpose : We investigated the effects of microcurrent(MC) electrical stimulation on each intensity($100{\mu}A,\;200{\mu}A,\;500{\mu}A$ - 30pps frequency was same) on delayed onset muscle soreness(DOMS). Methods : Subjects were assigned randomly divided into three groups of eight for three different treatment protocoals($100{\mu}A,\;200{\mu}A,\;500{\mu}A$-experimental groups). Twenty-four healthy males and females subjects were participated in this study. All subjects performed eccentric exercise of elbow flexor(biceps brachii) until exhausted. The measured items of elbow flexor muscle strength were Nicholas Manual Muscle Taster(NMMT). The measured items of elbow joint range of motion ROM) were Goniometer. The measured items of elbow flexor muscle pain were visual analogue scale(VAS). Treatment were applied at 30 minute exercise after and again at 24 hours and at 48 hours and at 72 hours after. Measurements were taken after treatment. Analysis of Results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: two-way ANOVA with repeated measurement for muscle strength, flexion ROM, extension ROM and VAS. Results : This results showed eccentric exercise casused DOMS, DOMS response to eccentric exercise were reduces by microcurrent therapy. DOMS was significant decreased at $100{\mu}A,\;200{\mu}A,\;500{\mu}A$. Muscle strength was significant difference at all intensity. Elbow flexion ROM was significant difference at all intensity but elbow extension ROM was insignificant difference at all intensity. VAS score was significant difference at $100{\mu}A$ and $500{\mu}A$ but insignificant difference at $200{\mu}A$. All experimental groups showed insignificant difference with all intensity MENS. Conclusion : These findings indicate that microcurrent therapy is had effect on recovery from exercise induced muscle damage. In our's suggestion, microcurrent therapy is particularly more appropriate therapeutic modality.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• The Journal of Korean Physical Therapy
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• 제12권1호
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• pp.163-172
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• 2000

The purpose of this study was to provide experimental evidence and theoretical background for the applicability of bilateral transfer paradigm to the rehabilitation programs for children with hemiplegic cerebral palsy. Children with hemiplegia, which means unilateral motor disabilities, display abnormal motor and postural patterns of the affected side due to hemiparesis, spasticity, and sensory disorders, resulting in a decreased motor abilities of the affected side compared to unaffected side. Accordingly, they tend to rely on the unaffected limb for everyday activities, which further deteriorates the functions of the affected side by causing associated reaction, abnormal postural patterns, and hypertonus. Rehabilitation programs developed for children with hemiplegic cerebral palsy include neurodevelopmental treatment, application of cast or splint to unaffected limb, neuromuscular electrical stimulation, and task oriented model. These programs, however, have several drawbacks, such as discontinuity in treatment effect and psychological hatred to the force use of the affected side. In order to solve these problems and enhance the efficiency of the rehabilitation programs, it is required to maximize the use of the affected side without hatred. Characteristics of the control system, such as temporal coupling and spatial assimilation between limbs and neural crosstalk at different levels of central motor pathway, suggest that the bilateral transfer paradigm may enhance the efficiency of the rehabilitation programs for children with hemiplegic cerebral palsy.

• Clinical Pain
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• 제18권2호
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• pp.121-125
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• 2019

Arthritis of hip joints deteriorates the quality of life in ankylosing spondylitis (AS) patients. Secondary to the articular inflammatory process, the shortened hip-girdle muscles contribute to the decreased joint mobility which may lead to the functional impairment. As the limitation of range of motion (ROM) usually progress slowly, clinicians regard it as a chronic condition and prescribe long-term therapy. However, by short-term intensive multimodal treatment, a 20-year-old man diagnosed as AS with severely limited hip joint ROM who relied on crutches doubled the joint angle and could walk independently only within 2 weeks. The combination included intra-articular steroid injection, electrical twitch obtaining intramuscular stimulation, extracorporeal shock wave therapy, heat, manual therapy, and stretching exercises. The management focused on the relaxation of hip-girdle muscles as well as the direct control of intra-articular inflammation. Hereby, we emphasize the effectiveness of intensive multimodal treatment in improving the function even within a short period.

• 대한수의학회지
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• 제43권3호
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• pp.405-414
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• 2003

The purpose of this study was to assess the role of tachykinins (TK) in mediating nonadrenergic noncholinergic (NANC) contractions produced by electrical field stimulation (EFS) in the longitudinal muscle of the rat ileum. In the presence of atropine ($1{\mu}M$), guanethidine ($5{\mu}M$), and L-nitroarginine (L-NNA, $200{\mu}M$), EFS (0.5ms pulse duration, 120 V, 1-20 Hz for 2 min) produced a frequency-dependent slowly-developing tonic contraction with superimposed phasic contractions ('on'-contraction) followed by off slowly-decreasing tonic and superimposed phasic contractions ('off'-contraction) of mucosa-free longitudinal oriented muscle strip. These EFS induced responses were blocked by tetrotoxin. $NK_1$ receptor selective antagonist L-732,138 strongly inhibited the EFS-induced excitatory responses. However $NK_2$ receptor selective antagonist, GR 159897 and $NK_3$ receptor selective antagonist SB 222200 did not significantly inhibited the responses. $NK_1$ receptor selective agonist [$Sar^9$,$Met(O_2)^{11}$] Substance P and $NK_2$ receptor selective agonist [${\beta}-Ala^8$]-neurokinin A (4-10) induced tonic contraction with superimposed phasic contractions of longitudinal oriented muscle strip and almost blocked by selective antagonist L-732,138 and GR 159897, respectively. But $NK_3$ receptor selective agonist senktide did not showed any effect. Nifedipine ($1{\mu}M$) abolished the contraction produced either by EFS or by the TK receptor agonists [$Sar^9$,$Met(O_2)^{11}$] Substance P or [${\beta}-Ala^8$]-neurokinin A (4-10). It is concluded that, in the longitudinal muscle of rat ileum, both $NK_1$ and $NK_2$ receptors modulated the responses to exogenous tachykinins, whereas $NK_1$ is mainly involved in NANC neuromuscular contraction.

• 대한정형외과학회지
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• 제55권2호
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• pp.117-126
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• 2020

슬관절의 퇴행성 관절염에서 슬관절 전치환술은 널리 시행되고 있고 그 빈도도 점점 증가되고 있다. 수술 후 일상생활로의 복귀, 근력 및 운동범위의 회복 등 기능 회복을 위한 노력이 이루어져야 하고 이는 환자 요인, 수술 술기 및 재활 등 다양한 관점에서 접근해야 한다. 환자의 연령이나 비만의 정도, 성별, 대퇴사두근의 근력 등이 수술 후 기능 회복에 영향을 줄 수 있고 환자의 기대치나 만족도 같은 정신적인 상태도 영향을 준다. 기능 회복을 위하여 수술 전부터 환자교육 및 통증 조절, 대퇴사두근 근력의 강화 같은 치료를 시행할 수 있다. 수술 후 냉찜질 및 압박, 경피적 전기 신경 자극 치료, 신경근육 전기 자극 치료, 저주파 저강도 자기장 치료, 대퇴사두근의 근력운동, 관절범위 운동과 같은 물리치료도 적용할 수 있다. 최근에는 수중에서 근력과 균형감각을 회복시키는 수 치료도 점점 시행되는 추세이다. 이런 기능 회복을 위한 치료들은 수술 후 단기적으로만 시행될게 아니라 장기적으로 꾸준히 시행되는 것이 중요하며 술자는 환자의 상태나, 순응도, 사회적, 심리적 상황 등을 고려하여 적절히 적용하여야 한다.

• 대한임상전기생리학회지
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• 제1권1호
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• pp.31-43
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• 2003

The present studies are designed to determine whether the NMES can affect the muscle atrophy in rats following administration of steroid. Rats were divided into four groups: 1) Control group treated with administration of distilled water. 2) The group treated with administration of steroid. 3) The group treated with NMES once a day after adminstration of steroid. 4) The group treated with NMES twice a day after administration of steroid. The muscle atrophy was induced by one week administration of dexamethasone once a day by 3 mg/kg. The change in the structure of muscle fiber and the amount. of myofibril protein and gastrocnemius were determined after every week dissection of the tissues. The results were as follows; 1. The administration of steroid significantly affected the decrease in the weight, but NMES did not affect the inhibition of decrease in the weight. 2. The weight of gastrocnemius in the group once treated with NMES was changed two weeks later; similarly in the group twice treated with NMES significantly did two or three weeks later. These indicated that NMES affected the muscular activation of gastrocnemius(p<.05). 3. The changes in the amount of gastrocnemius protein by NMES might, indicate that NMES activated the capacity of synthesis of muscle fiber protein(p<.05).

• 한국임상수의학회지
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• 제34권4호
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• pp.287-290
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• 2017

A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

• 수면정신생리
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• 제2권1호
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• pp.23-30
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• 1995

유뇨증은 발병기전이 단일한 원인으로 설명되기 어려운 임상적으로 복합적인 질병이다. 유전적 요인, 신경근육계 및 비뇨기계의 미성숙, 심리사회적 요인이나 대소변 가리기 훈련의 이상, 그리고 생물학적 요인 등 여러 가지 원인론들이 있으나 아직 확실한 것은 없다. 그러나 최근 신경생리학적 연구와 신경 내분비학적 연구들의 결과, 야뇨증과 수면주기와의 관련성이나 야간의 항이뇨호르몬 (antidiuretic hormone) 분비 저하와의 관련성 등 보고되어 야뇨증의 치료에 있어 새로운 접근을 가능하게 하고 있다. Vasopressin 이 우수한 치료율, 안전성, 적은 부작용 등으로 새로운 치료약물로서 시도되고 있으나 재발율이 높아, imipramine또는 vasopressin의 투여와 Bell-alarm행동요법을 병행하여 치료하는 것이 바람직하다.