• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.136-142
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• 2013

Purpose: The application of transcutaneous electrical nerve stimulation (TENS) is beneficial for joint movements, inhibition of spasticity, and the improvement of walking ability in patients with chronic hemiplegia. This study aimed to identify the effect of the application of TENS to the knee extensor on the affected side with respect to postural-sway distance and velocity during the sit-to stand movement. Methods: We included 19 patients with post-stroke hemiplegia in this study. They underwent measurements during the sit-to stand movement on a force plate with 5 different stimulation dosages applied over 7 s:No TENS, high-frequency and high intensity TENS, high-frequency and low intensity TENS, low-frequency and high intensity TENS, and low-frequency and low intensity TENS The 5 different condition were administered in random order. Results: The group that received TENS application exhibited a significant decrease in path length and average velocity of center of pressure (COP) displacement compared with the group that did not receive TENS application. TENS dosage at low frequency (3Hz) and high intensity yielded a significant decrease in path length, average velocity, mediolateral distance and anteroposterior distance of COP displacement (p<0.05). Conclusion: Our results demonstrated the effectiveness of the application of low-frequency TENS on STS performance. These findings provide useful information on the application of TENS for the reduction of postural sway during the sit-to-stand movement after stroke.

• 감성과학
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• 제5권4호
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• pp.45-49
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• 2002

가상환경시스템은 매우 현실감 있는 정보를 제공할 수 있다는 점에서 산업, 의료, 교육훈련 등에 널리 사용되고 있다. 그러나 아직 많은 가상환경 시스템에서 부정적 요인으로 멀미, 시각피로, 방향감각 상실로 대표되는 cybersickness중세를 수반하고 있어 그 사용과 확산에 제약이 되고 있다. 이러한 cybersickness문제에 대응하기 위해서는 우선 이것을 객관적으로 측정, 평가할 수 있는 방법의 개발이 필요하다. 이러한 방법들 중의 하나로 신체동요의 정도를 평가 지표로 사용할 수 있다. 이번 연구에서는 45 명의 피실험자들을 대상으로 가상현실 운전시뮬레이터를 운전하기 전과 후의 신체동요 정도를 힘판(force platform)을 이용해 측정하였다. 특히 본 실험에 사용된 가상현실 운전시뮬레이터는 피실험자에게 운동판(motion platform)을 이용해 운동감을 제공할 수 있었고, 피실험자의 멀미 현상이 검지되면, 시야각을 1/3로 줄여주는 멀미 완화 피드백(feedback) 시스템이 연결되어 있었다. 그래서 motion의 제공여부와 feedback의 제공 여부도 실험의 독립변수로 추가하였다. 실험 결과, 가상현실 체험 후 유의한 차이는 아니나 피실험자들의 신체동요가 약간 증가하는 것이 관측되었다. motion과 feedback에 대한 분석에서는, 유일하게 motion을 제공하는 것이 제공 안할 때에 비해 좌우 방향의 신체동요가 더 적어지는 것으로 나타났다. 신체동요를cybersickness의 지표로 사용하기 위해서는 추후연구가 더 요청된다.

• 제어로봇시스템학회논문지
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• 제13권9호
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• pp.843-850
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• 2007

This paper proposes a somatosensory stimulation system for the improvement of postural stability using vibration as somatosensory stimulation. This system consists of vibratory stimulation and postural response measurement. To evaluate this system, the center of pressure(COP) was closely observed in turn with simultaneous or separate mechanical vibratory stimulations to flexor ankle muscles (tibialis anterior, triceps surae) and two plantar zones on both feet while standing on a stable and an unstable support. The simultaneous vibratory stimulations cleared influenced postural stability and the effects of vibrations were higher with the unstable support. In separate vibratory stimulations, the extent of the COP sway reduced when the direction of the vibratory stimulations and that of the inclination of body coincided for flexor ankle muscle stimulations. In the contrary, the extent of the COP sway increased when the direction of the stimulations and that of body inclination coincided for plantar zone stimulations. These results can be useful for the development of rehabilitation systems that utilizes somatosensory inputs for postural balance.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.35-54
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• 2000

The purposes of this study were to assess variation of body sway prior to and after submaximal treadmill exercise; to determine the time course of the effects of a fatiguing performed on a treadmill on body sway; and to compare position sense prior to and after exercise in order to assess any variance in proprioception caused by submaximal treadmill exercise. The subjects were twenty-four healthy men in their twenties. They stood barefoot on the Kinesthetic Ability Training Balance Platform to measure body sway. Control trials were performed with eyes alternately open and closed. In the eyes open condition, they were asked to look at a target placed at eye level 1 m in front them. A total of 10 trials, each lasting 20 seconds, were performed. After this series of trials, position sense was measured. Subjects then exercised on the treadmill until 85% of each person's maximal heart rate was reached. The first series of postural sway measurements began immediately after this exercise. The second identical series of postural sway trials was performed at approximately 10 minutes after exercise. The third series was performed approximately 20 minutes after exercise. This allowed approximately 5 minutes of rest between each experimental series. Position sense was measured at approximately 15 and 25 minutes after exercise. The results were as follows: 1) There was a significant increase in body sway after submaximal treadmill exercise compared to pre-exercise values under both visual conditions (p<.05). 2) After submaximal treadmill exercise, under the eyes open condition, the mean value of body sway was significantly increased after both the first and second series (p<.05). Under the eyes closed condition, the mean value of body sway increased significantly after the first series but decreased significantly after the third series (p<.05). 3) Position sense, measured repeatedly after submaximal treadmill exercise, did not change significantly with respect to pre-exercise values (p>.05). These results suggest that fatigue induced by submaximal treadmill exercise produced an increase in body sway in young healthy subjects with or without visual input, but the increase appeared to be lasting less than 15 minutes. No significant change in position sense suggested that proprioception was unaffected by submaximal treadmill exercise-induced fatigue.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.63-70
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• 2010

Purpose: In this study, children with cerebral palsy were treated for 8 weeks using horse riding trunk proprioception, stability and posture to investigate the effect of hippotherapy in the field of physical therapy. Methods: A total of 18 subjects were divided into an experimental group treated by horseback riding and a control group. Both groups were evaluated pre- and post-treatment. Trunk proprioception was measured three times in the sitting position with their eyes and ears closed to reach the target position the angle error of the mean was calculated. Trunk stability was measured using a forceplate and the data were used to calculate the postural sway path & postural sway velocity. Posture was evaluated using the Posture Assessment Scale (PAS). Results: After hippotherapy, the experimental group showed a significant improvement in trunk proprioception, stability and posture (p<0.05), but the control group improved in posture only (p<0.05). Trunk proprioception, stability and posture was significantly different between the two groups (p<0.05). Conclusion: Eight weeks of hippotherapy is effective in improving trunk proprioception, stability, and posture. Research using this therapy should be studied further as a possible new therapeutic approach in the field of physical therapy.

• 대한의용생체공학회:의공학회지
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• 제30권6호
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• pp.521-528
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• 2009

This study is about to evaluation of postural stability according to characteristics of electrical stimulation on the ankle muscles. We measured body sway(center of pressure, COP) when various parameters of electrical stimulation was applied to ankle muscles in stable and unstable posture. Subjects consisted of 10 young adults, and electrical stimulation was delivered on right and left of tibialis anterior and Achilles tendon. The body sway was measured during electrical stimulation of three duty cycle and frequencies in stable posture and three amplitudes of sensory threshold in unstable posture. Consequently, the COP Shift is higher during electrical stimulation of 1/30(duty ratio) and 100Hz(frequency) in stable posture. In unstable posture, 100% amplitude of sensory threshold induced postural stability. These findings are important for the rehabilitation system of postural stability and the use of electrical stimulation as somatosensory information.

• 대한물리의학회지
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• 제3권3호
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• pp.169-176
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• 2008

Purpose : Tandem stance is a clinical measure of standing balance considered to assess postural steadiness in a heel-to-toe position by a temporal measurement. The aim of this study is to investigate postural steadiness and to explore the weight distribution between legs during 25s of quiet stance and tandem stance(right foot was leading) in healthy young adults. Methods : 107 healthy young adults(mean age 21.1 years) are participated. Weight distribution beneath both feet and sway distance were recorded while the subjects performed 25s of quiet stance and tandem stance. Results : Subjects placed more weight on the rear leg in tandem stance and on the left foot in quiet stance. So, quiet stance and tandem stance is not a task for equal weight bearing. Subjects show larger sway distance in anteroposterior direction of tandem stance than quiet stance. Conclusion : The results of this study will be useful to researchers and clinicians using tandem stance measures to evaluate postural steadiness and to predict fall. The results suggest that tandem stance is useful to treat of weight distribution and to improve of balace in elderly adults and stroke patients.

• 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.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 1992년도 정기총회 및 추계학술대회
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• pp.32-32
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• 1992