• 대한물리의학회지
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• 제5권3호
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• pp.477-485
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• 2010

Purpose : The clinical scale to assess spasticity of muscle was wildly used the modified Ashworth scale (MAS). But reliability of the MAS has been controverted for ambiguity among the grades. The purpose of this study was to establish the inter-rater reliability of the modified MAS (MMAS) translated into Korean in stroke patients. Methods : Twenty-five patients (sixteen men and nine women) with hemiplegia (ten right and fifteen left) were measured by two raters who were physical therapist in the rehabilitation hospital. The raters assessed spasticity of shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor in the same patients according to ratings criteria of the MAS and the MMAS. Results : For the inter-rater reliability of the MAS, two raters agreed on 57.3% and the Kappa values were moderate ($\kappa$=0.41) between two rater. The inter-rater reliability of the MAS was fair for the wrist flexor and the hip adductor and moderate for the other muscles. The intra-rater reliability was good for the shoulder adductor and the knee extensor and moderate for the other muscles. For the inter-rater reliability of the MMAS, two raters agreed on 84.7% and the Kappa values were good ($\kappa$=0.78) between two rater. The inter-rater reliability of the MMAS was moderate for the hip adductor, and good for the shoulder adductor and the wrist flexor, and very good for the other muscles. The intra-rater reliability was good for the wrist flexor and the hip adductor and very good for the other muscles. Conclusion : This study suggests that the MMAS translated into Korean is reliable test scale for the spasticity with stroke patients in the clinical field.

• 대한물리의학회지
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• 제12권4호
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• pp.133-138
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• 2017

PURPOSE: The purpose of this study was to investigate the effect of modified motor developmental intervention on the SCM muscle thickness and the range of motion (ROM) of neck in subjects with congenital muscular torticollis. METHODS: Thirteen subjects who had congenital muscular torticollis were participated in this study and they were offered the modified motor developmental interventions for 8 weeks by pediatric physical therapist. SCM thickness of affected and non-affected side and ROM of neck rotation were collected between before and after intervention. SCM thickness was measured by using Ultrasound Unit (IU 22, Ultrasound system, Philips, Netherlands) and ROM of neck was measured by using the goniometer (Arthrodial protractor, North coast, USA). Data were represented as means ${\pm}SD$. Paired t-test was used to determine the effect of interventions on the SCM muscle thickness and neck ROM. RESULTS: SCM thickness of affected side was significantly decreased after the modified motor developmental interventions and that of non-affected side was generally increased but it was not significantly difference between pre and post interventions. ROM of neck rotation and lateral flexion was significantly increased after interventions. CONCLUSION: These results suggested that the modified motor developmental interventions could improve the recovery of SCM muscle thickness and neck ROM.

• 한국산학기술학회논문지
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• 제13권3호
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• pp.1129-1137
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• 2012

본 연구의 목적은 뇌졸중 환자의 족관절 저측굴근 경직에 대하여 Myotonometer와 surface Electromyography(sEMG)를 이용하여 경직의 정량적 평가에 유용한 지표를 알아보고, 이 지표들과 임상적으로 평가되는 modified Ashworth scale(MAS)과의 관계를 알아보고자 하였다. 족관절 저측굴근의 경직평가는 물리치료사 5명(임상경력 5년이상)이 MAS를 이용하여 MAS 2, 3, 4 해당 군에 각 5명씩을 무작위로 15명씩 배정하였다. 각 군의 조직탄성과 근활성 측정은 Myotonometer와 sEMG로 이완(relaxed)상태와 최대 수의적 수축(contracted)상태에서 측정하였다. 연구 결과, MAS 등급이 높아짐에 따라 이완과 수축상태 간의 조직저항도 전위차와 근활성도의 차이는 작아졌고, 상관관계 분석에서도 MAS 등급이 높아질수록 이완 시보다 수의적 수축 시 실린더가 받는 낮은 강도에서의 상관성이 더 높아짐을 확인할 수 있었다. 따라서 Myotonometer는 경직을 평가하는 방법으로 다양한 인체의 관절에 비교적 쉽게 적용할 수 있으며 경직의 변화를 민감하게 반영할 수 있어 보다 객관적이고 정량적인 경직의 평가 도구로 사용될 수 있을 것이다.

• 대한물리의학회지
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• 제6권1호
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• pp.31-38
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• 2011

Purpose : The purpose of this study was to examine the effect of upper extremity exercise and Bandage on the edema and range of motion. Complex decongestive physiotherapy was one of the latest methods to deal with the limitation of range of motion and the edema that were the prime problems of patients with lymphedema. Methods : Twenty patients undergone mastectomy were participated in this study voluntarily. They had lymphedema on upper extremity and partial limitation of range of motion. The subjects had been treated with upper extremity home exercise and complex decongestive physiotherapy with Bandage for 4 weeks. The measure of these patients with upper extremity edema was included: the volume, arm circumfenence and range of motion. These were measured two times: before the treatment, after 4 weeks of the treatment. Results : The upper extremity edema of patients treated home exercise group and complex decongestive physiotherapy group with Bandage was definitely decreased (p<0.05). Moreover, the upper volume of those who were the same condition also significantly shrank and patients' arm circumferences of upper arm breathtakingly diminished as well (p<0.05). But home exercise group patients' arm circumferences of forearm was not remarkable(p>0.05). However, patients' range of motion who were treated with upper extremity exercise were evidently increased when compared to that of the before treatment (p<0.05). Conclusion : Complex decongestive physiotherapy and bandage performed by physical therapist increased the ROM of upper arm and reduced the edema in patients with lymphedema.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.21-27
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• 2016

Purpose: The system of clinical education program of Korean academic of orthopedic manual physical therapy (KAOMPT) was changed in 2014. The purpose of this study was to compare the level of satisfaction of clinical education program in KAOMPT before and after the new program. Methods: The subjects of this study were consisted of the physical therapist who participated the education program of KAOMPT from 2013 to 2015. 7687 structured questionnaires were divided in the courses and analysed. Results: There were significant differences of level of satisfaction of introduction course (p<.05), cervico-thoracic course (p<.001), lumbo-sacral course (p<.001), upper extremity course (p<.001), lower extremity course (p<.001), and advance course (p<.001) for three years. The satisfaction of introduction course was decreased in 2014 than 2013, but it was restored in 2015. The satisfaction of cervico-thoracic course was decreased in 2014 than 2013, but it was increased in 2015 than in 2013. The satisfaction of lumbo-sacral course in 2014 was decreased than in 2013, but it was restored in 2015. The satisfaction of upper extremity course in 2014 was increased than in 2013, but it became same level with 2013 in 2015. The satisfaction of lower extremity course in 2014 was increased than in 2013, and it was maintained same level in 2015. The satisfaction of advance course in 2014 was decreased than in 2013, and it is maintained same level in 2015. Conclusions: The level of satisfaction of clinical education program was decreased in 2014, but it became same or higher level with 2013 in 2015. It is assumed that the new clinical education program of KAOMPT was established completely in 2015.

• 한국콘텐츠학회논문지
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• 제8권11호
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• pp.189-202
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• 2008

본 연구의 목적은 병원 물리치료사들의 병원감염에 대한 인식도와 실천도를 조사하고 인식도와 실천도에 영향을 미치는 요인을 분석하여 물리치료실 내 병원감염 관리 프로그램 및 정책 수립을 위한 자료를 제공하고자 하는데 있다. 본 연구의 자료는 405명의 물리치료사로부터 수집하여 분석하였다. 본 연구에서는 일반적 특성, 병원감염에 대한 교육 상태 및 교육의 필요성 그리고 병원감염을 예방하기 위한 인식도와 실천도 등을 묻는 리커트 5점 척도의 자기 기입식 설문지를 사용하였다. 연구의 결과 물리치료사들의 병원감염 교육은 거의 이루어지지 않고 있었으며 이러한 교육 결여로 인해 물리치료사들의 병원감염 예방에 대한 인식도 및 실천도는 매우 낮은 실정이었으나 물리치료사들의 병원감염 프로그램의 필요성 인식과 병원감염 교육에 대한 요구는 매우 높은 수준이었다. 따라서 현행 물리치료학과 교육 중, 병원감염에 대한 교육 프로그램이 도입되어야 할 것으로 사료되며 이와 더불어 물리치료실을 운영하는 병원에서도 물리치료실의 병원감염 관리에 대한 교육 프로그램의 수립이 필요한 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제10권2호
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• pp.183-193
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• 1998

여성의 요실금 치료방법을 선택하는데 있어서는 무엇보다도 정밀한 진단이 필요하며, 이 정확한 진단을 통하여 치료방법을 선택하여야 한다. 여러 논문을 검토해본 결과 요실금 치료의 밥법은 다양하며 극히 일부분의 수술을 요하는 환자를 제외하고는 대부분의 환자가 약물이나 전기치료, 운동처방만으로도 치료가 가능하다고 한다. 따라서 본 논문은 여러 문헌을 종합하여 물리치료의 한 영역으로써 요실금 치료에 기여할 수 있는 여러 분야 중 운동치료 분야에 관해 간략히 언급하였다. 운동을 위해서는 먼저 정확한 진단과 평가가 요구되며, 초기에 각 운동을 실시할 때는 복압이 증가하지 않게 누워서 치료를 시작할 것과 쉬운 운동부터 시작하여 전차 어려운 운동으로 발전시키며, 환자의 진전에 따라 자세의 변화와 치료시간도 점점 늘여가도록 한다. 또한 요실금 환자는 커피와 같은 자극성이 있는 음료는 삼가도록 한다. 요실금에 관한 물리치료는 더욱 많은 연구와 치료개발이 필요하다고 생각되며, 임상치료에 많은 도움이 되길 바란다

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.183-189
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• 2015

Purpose: The aim of this study was to examine the test-retest and inter-rater reliability of the pediatric functional muscle testing (PFMT) when applied to children with developmental delay. Methods: Sixteen children with developmental delay (seven females, nine males) participated in this study. For the inter-rater reliability, each was scored on the PMFT by two pediatric physical therapists with more than 8 years of clinical experience on the same day. For assessment of the test-retest reliability, one therapist tested the children again within 10 days. The second measurement was performed by taking a first measurement in video. Intraclass correlation coefficient (ICC) was calculated to determine the test-retest and inter-rater reliability of the PFMT, and Chronbach's alpha was used to measure internal consistency. Results: The results of this study were as follows: 1) The test-retest ICC of the score of the infant action month and the right side of the PFMT was from 0.53 to 1.00 and from 0.63 to 0.99, respectively. 2) The inter-rater ICC of the score of the infant action month and the right side of the PFMT was from 0.66 to 1.00 and from 0.64 to 1.00, respectively. 3) Chronbach's alpha was 0.93. The internal consistency indicated excellent. Conclusion: In conclusion, this study showed that the test-retest and inter-rater reliability of the PFMT was relatively high, except for a few items. Therefore, it can be suggested that the PFMT will be a useful tool for measurement of muscle strength for children with developmental delay if it be some modifications.

• 한국운동역학회지
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• 제19권3호
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• pp.529-538
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• 2009

본 연구의 목적은 여성고령자의 균형과 관련된 평가항목 BBS(Berg balance scale), SPPB(short physical performance battery), TUG(timed up and go)를 측정하여 COP와의 상관관계를 알아보고자 하였다. 이를 위해 여성고령자 10명을 대상으로 신체기능검사와 정적직립자세 동안 지면경사(평지, 내리막, 오르막경사)에 따른 COP 이동범위와 평균속도를 산출하였다. 여성고령자들의 COP 좌우와 전후 값 비교에서 평지와 내리막, 오르막 모두 전후 값이 유의하게 크게 나타났으며, 좌우와 전후 각 방향에서 지면경사에 따른 유의한 차이는 나타나지 않았다. 신체 기능 점수와 COP 상관관계에서 BBS와 SPPB 점수가 높을수록 COP 이동범위와 평균속도 값은 감소하였으며 TUG 값이 클수록 COP 값이 크게 나타나는 유의한 상관관계를 나타냈다. 고령자들에게 균형과 관련된 신체기능검사와 COP는 지면경사에 따라 유의한 상관관계를 가지므로 임상에서 치료사들은 고령자들의 균형평가 시 COP 변수뿐만 아니라 BBS, SPPB, TUG를 통한 균형평가 활용이 가능하다고 본다.

• 한국전문물리치료학회지
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• 제19권2호
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• pp.48-58
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• 2012

The objective of this study was to evaluate the effects of mirror therapy on motor function recovery following a stroke through a systemic review and meta-analysis. In total, nine of the 48 studies were identified from search engines between 1997 and 2011, as well as from a review of the reference lists of each identified study. The quality of each study was assessed using Jadad scale, and the effect size was calculated as a Cohen's effect size using MetaAnalyst (Beta 3.13). The overall effect size of the mirror therapy was 2.005 (95% confidence interval=1.041~2.970) in a random-effects model. This finding suggests that mirror therapy is beneficial for improving motor function following a stroke. The results from the subgroup analysis according to categorical variables were as follows: First, the effect size was larger for an onset time of less than 1 year (1.166) than for a duration of 1 year or more (.668). Second, the effect size of unpublished dissertations (1.610) was larger than published articles (1.221). Third, motor recovery of upper extremities (1.609) had a greater effect than motor recovery of lower extremities (.903). The major limitation of this study is the relatively small study population. Therefore, further individual studies of mirror therapy should be conducted in order to generalize the effects. In addition, mirror therapy supervised by a physical therapist should be recognized as a potential approach to manage motor function following a stroke and recommended to patients to improve their motor function.