• The Journal of Korean Physical Therapy
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• 제30권2호
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• pp.63-66
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• 2018

Purpose: The purpose of the current study was to examine the effects of exercise-induced fatigue of the plantar flexor muscle in the dominant ankle on the plantar flexor strength and postural control function of the contra-lateral side. Methods: Twenty-one young adults (male: 10, female: 11) volunteered to participate in this study. An exercise-induced fatigue protocol to induce fatigue was performed in the plantar flexor of the dominant ankle. For the fatigue protocol, the participants were instructed to raise their heels as high as possible in the position with one leg stance of the dominant lower limb, and the heel was then downed after holding for 1 second. The muscle strength of the contra-lateral plantar flexor was measured using a digital muscle strength test device, and the static and dynamic postural control were tested by acquiring the center of gravity velocity while performing one leg standing. A paired t-test was used to identify the differences between the pre- and post, and the data were analyzed using SPSS 12.0 software. Results: Comparison of the pre- and post-test data revealed a significant difference in the plantar flexor strength and dynamic postural control after exercise-induced muscle fatigue in the dominant side. On the other hand, there was no significant difference in the static postural control. Conclusion: These findings have practical implications, suggesting that unilateral muscle fatigue affects the ankle muscle strength and postural ability of the contralateral side.

• 재활복지
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• 제14권3호
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• pp.225-256
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• 2010

본 연구는 초등학교 지적장애아동의 자세조절 특성을 파악하기 위해 시각, 안뜰감각 그리고 몸감각을 조합하여, 실험 조건에 따라 자세유지를 위하여 어떤 감각을 활용하고 있는지, 부적절한 감각자극에 대해서 통합시스템에서 어떻게 반응하는지, 외부 동요에 대해 신경근육의 자세조절 전략 시 동원되는 근육의 수축 개시시간과 개시순서를 각각 측정하여, 지적장애 아동의 자세조절 특성을 살펴보고, 나아가 초등학교 지적장애아동과 일반아동 간에 어떠한 차이가 있는지를 비교분석하여 자세조절능력 향상 프로그램에 적용 시 방향을 제시해주는데 있다. 이를 위하여 성별과 연령을 고려하여 초등학교 지적장애아동 26명과 일반아동 26명의 아동으로부터 자세조절능력을 비교하였다. 그 결과 자세조절과 감각계와의 관계를 파악한 평형점수와 감각활용 분석, 엉덩관절 전략에 의지하는 자세조절 전략, 근수축 개시지연과 근수축 개시순서의 변화 등을 종합해 볼 때 초등학교 지적장애아동의 자세조절의 문제는 운동시스템, 감각시스템, 통합시스템의 자세조절 시스템 전반에 걸친 총체적인 문제로 나타났다. 따라서 초등학교 지적장애아동의 자세조절 문제 해결을 위해서는 운동시스템, 감각시스템, 통합시스템을 포함하는 포괄적 자세조절 훈련 프로그램의 접근이 필요하다는 것을 알 수 있다. 자세조절 프로그램을 구성할 때, 다양한 감각을 제공하여 주고, 제공된 감각을 효율적으로 활용할 수 있는 감각훈련과 함께 고위중추에서 입력된 감각들을 정상적인 자세조절 발달에 활용할 수 있도록 훈련 시켜주어야 한다. 적응 반응을 계획하고 조직화하여 의미 있는 활동을 통해 중추신경계의 처리능력을 향상시키는 치료프로그램이 제공되어야 한다. 또한 자세조절을 안정적으로 할 수 있는 안정성 한계를 넓힐 수 있는 신경발달학적 치료와 함께, 근골격계에서 빠른 근수축 반응과 효율적인 근수축 개시순서를 유발 할 수 있도록 고유수용성 운동조절 프로그램, 자세반응 촉진 프로그램과 같은 훈련이 필요하다고 할 수 있다.

• 대한기계학회논문집A
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• 제33권1호
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• pp.27-33
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• 2009

Human postural responses appeared to have stereotyped modality, such as ankle mode, knee mode and hip mode in response to various perturbations. We examined whether human postural control gain of full-state feedback could be decoupled along with the eigenvector. To verify the model, postural responses subjected to fast backward perturbation were used. Upright posture was modeled as 3-segment inverted pendulum incorporated with feedback control, and joint torques were calculated using inverse dynamics. Postural modalities such as ankle, knee and hip mode were obtained from eigenvectors of biomechanical model. As oppose to the full-state feedback control, independent eigenvector control assumes that modal control input is determined by the linear combination of corresponding modality. We used optimization method to obtain and compare the feedback gains for both independent eigenvector control and full-state feedback control. As a result, we found that simulation result of eigenvector feedback was not competitive in comparison with that of full-state feedback control. This implies that the CNS would make use of full-state body information to generate compensative joint torques.

• 대한의용생체공학회:의공학회지
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• 제30권6호
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• pp.495-502
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• 2009

This paper investigated the effects of dynamic postural control for maintaining upright standing on a support surface during continuous sinusoidal horizontal translation in anterior-posterior direction. 15 healthy young subjects participated in this experiment. The analysis of body movement was analyzed using Ariel Performance Analysis System. Motion pattern was analyzed by seven markers on subject's body. Position of markers were head, chest, hip, right knee, left knee, right ankle and left ankle. Seven different frequencies of support surface were employed ; 0.1, 0.25, 0.5, 0.75, 1, 1.5 and 2Hz at 2cm of moving path of motionbase. The experiments were performed dynamic postural reponses at the condition of eye open. The results showed that median frequency of the knee, ankle were increased in all frequency bands. Following the frequency of perturbation increased, postural control strategy was changed from ankle strategy to combined strategy. The experiment results could be applied to the dynamic postural training for the elderly and the rehabilitation training for the patients to improving the ability of postural control.

• 한국전문물리치료학회지
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• 제16권4호
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• pp.23-30
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• 2009

Core stability exercises for patients with hemiplegia have become increasingly important and a variety of exercises have been developed over the years to give the hemiplegic patients more stable postural control. This study examined the therapeutic effects of the core stability exercises on the ability of static and dynamic postural control. Fifteen hemiplegic patients (7 males, 8 females, age ranging from 46 to 76 years) hospitalized in a Daejoen rehabilitation hospital were enrolled in this study. Nine and 6 patients had a cerebral infarction and cerebral hemorrhage, respectively. The subjects participated in a core stability exercise program consisting of a total of 12 sessions 3 times each week over a 4-week period with each exercise lasting approximately 15 minutes. The ability of static and dynamic postural control by Berg Balance Scale (BBS) and Timed Up and Go (TUG), respectively, were measured before and after the core stability exercise. A Wilcoxon signed ranks test was used to compare the effects of the ability of static and dynamic postural control before and after core stability exercise in patients with hemiplegia. The ${\alpha}$=.05 level of significance was used for the statistical tests. Core stability exercises were effective in improving the ability of static postural control; BBS (p<.05). Core stability exercises were also effective in improving the ability of dynamic postural control; TUG (p<.05). Overall, core stability exercise is believed to be an important therapeutic method in rehabilitation programs for hemiplegic patients.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.40-50
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• 2012

The purpose of this study was to investigate the effect of visual feedback on the postural control of stroke patients, by systematically varying conditions of visual feedback [eye-open condition (EO) vs. eye-closed condition (EC)], and base-support (both-side support, affected-side support, and unaffected-side support). In this study, we allocated 41 stroke patients with no damage in the cerebellum and visual cortex who can walk at least 10 meters independently, and 35 normal adults who have no experience of stroke to the control group. Both groups were asked to perform a "sit-to-stand" task three to five times, and their postural control ability was measured and compared in terms of asymmetric dependence (AD) instead of the traditional symmetric index (SI) in the literature. The results showed that although both subject groups maintained better postural control in the EO condition than in the EC condition, the patient group appeared to be more stable in EC than in EO when they were required to perform the task of the support condition given on the affected side. These results implied that visual feedback can impair stroke patients' postural control when it is combined with a specific support condition.

• 대한물리의학회지
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• 제4권3호
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• pp.193-200
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• 2009

Purpose：In this study is to verify the effects postural control training based on Bobath approach for body schema and visual perception on Middle Cerebral Artery(MCA) Infarcts. Methods：The subject was a 46 years old man with MCA infaction, lives in B city. An AB design for a single-subject research was used for this study. The procedures consisted of 1 time of baseline phase(A), 20 times of treatment phase(B). We applied the Bobath approach at the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. Results：With this treatment, the majority of body schema and visual perception and postural control was improved in treatment phase compared with in baseline phase. Therefore, this study supported the effectiveness of postural control training based on Bobath approach for body sechma and visual perception of hemiplegia. Conculusion：This study is integrated postural control training with Bobath approach that are widespread for hemiplegia and measured outcomes based on individualized therapy goals. Consequently the study is suggested the meaning of quality effectiveness of Bobath approach.

• 대한물리치료과학회지
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• 제9권3호
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• pp.97-106
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• 2002

Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

• 대한치과교정학회지
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• 제21권3호
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• pp.521-541
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• 1991

The purpose of this study was to investigate the growth changes of the mandible and associated structure in response to postural hyperpropulsion and changes after removal of postural hyperpropulsor. The experimental animals were four-week-old Sprague-Dawley males rats. The animals were worn the postural hyperpropulsor diurnally for 10 hours per day. The animals were sacrified after 1-week, 2-week, 4-week postural hyperpropulsion and 4-week postural hyperpropulsion 4-week removal period. The growth changes of rat mandible and associated structures following postural hyperpropulsion on the growing rat mandible were observed biometrically, radiographically and histologically. The finding were as follows. 1. The angle between the chief axis of the bone trabeculae in the condyle and the mandibular plane of rats observed for 4 weeks after worn the hyperpropulsor for 4 weeks was directed posteriorly as compared with that of control rats. 2. The ratio of mandibular length to maxillary length of experimental rats was higher than that of control rats. 3. The tooth axis of mandibular first molar of rats worn the postural hyperpropulsor for 4 weeks was mesially inclined as compared with control rats. 4. Histologically, the cartilage layer at the superior region of the condyle of rats worn the postural hyperpropulsor for 2 weeks appeared thicker than that of same aged normal rats, and generalized increase of the cartilage layer was shown on the condyle of rats worn the postural hyperpropulsor for 4 weeks. 5. There was no significant histologic difference between rats observed for 4 weeks after worn the postural hyperpropulsor for 4 weeks (8 week experimental rats) and same aged normal rats. 6. The newly formed bone at anterior region of articular fossa of rats worn the postural hyperpropulsor for 2 weeks and 4 weeks was thicker than that of same aged normal rats.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.57-66
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• 2019

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.