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

• 한국전문물리치료학회지
• /
• 제24권2호
• /
• pp.66-75
• /
• 2017

Background: After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke. Objects: The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time. Methods: Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter. Results: The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention. Conclusion: VBF training may be distribute a patient's buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

• Physical Therapy Rehabilitation Science
• /
• 제3권1호
• /
• pp.7-12
• /
• 2014

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

• 대한피부과학회지
• /
• 제56권10호
• /
• pp.631-635
• /
• 2018

Microvenular hemangioma (MVH) is a rare acquired benign vascular neoplasm, which presents commonly as a solitary purple-to-red nodule or plaque measuring approximately 10 mm in diameter. MVH occurs primarily on the extremities or the trunk. Most lesions are solitary, and multiple lesions are rare. Histopathological features of MVH include numerous, scattered, thin and irregularly branching small vessels in the dermis and endothelial cells without atypia. Owing to similarities in clinical morphology and histopathological features, MVH may often be indistinguishable from the early patch stage of Kaposi sarcoma. Immunohistochemical (IHC) analysis helps differentiate between the 2 diseases. The results of IHC tests in patients with MVH show positive staining for CD31 and smooth muscle actin and typically, negative staining for the human herpes virus 8 antigen. We report a rare case of multiple MVH clinically mimicking the early patch stage of Kaposi sarcoma in a 63-year-old woman who presented with a 3-year history of slowly growing, compressible, soft, bluish-purple macules and plaques on the trunk and right arm.

• Clinical and Experimental Pediatrics
• /
• 제65권3호
• /
• pp.142-149
• /
• 2022

Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

• 대한정형도수물리치료학회지
• /
• 제28권2호
• /
• pp.7-14
• /
• 2022

Purposed: This study was conducted to find out by ultrasonic waves the thickness change of the deep abdominal muscles, such as transverse abdominal, internal oblique and external oblique when performing general bridge exercise on the stable surface (GBE), single-legged bridge exercise on the stable surface (BES), bridge exercise with a sling (SBE) and single-legged bridge exercise with a sling (SBS). Methods: The subject, 33 healthy adults(18 men and 15 women) in their 20s of V university in J city were subjected to take four postures of GBE, BES, SBE, and SBS. When performing each posture, the thickness of transverse abdominal, internal oblique and external oblique were measured by ultrasonic waves and analyzed by repeated measures of ANOVA. This significance level was set to be p<.05. Results: Muscle thickness was increased in the order of BES, SBE, and GBE in the external oblique, resulting in statistically significant differences(p<.001). The internal oblique was significantly thicker in SBE and SBS rather than in GBE, and was thicker in SBE and SBS rather than in BES (p<.01). The thickness of the transverse abdominal was significantly increased in SBS than in GBE (p<.01). Conclusion: As the result, it may be more effective for the trunk stabilization exercises to activate the internal oblique and transverse abdominal by applying both-legged or single-legged bridge exercise in slings.

• 한국산학기술학회논문지
• /
• 제15권3호
• /
• pp.1548-1556
• /
• 2014

본 이 연구는 S시 지적장애인센터의 지적장애인 19명(남12명, 여7명)에게 10주 동안 주 1회(120분), 놀이운동프로그램 처치가 기간별(사전·사후검사) 신체구성(체중, 체지방량, 체지방률, 근육량, 세포량)과 건강관련체력[심폐지구력, 근력(악력, 배근력), 유연성(좌전굴)〕요소에 어떠한 영향을 미치는지를 알아보는데 그 목적이 있다. 자료 분석은 SPSS 18.0 프로그램을 이용하여 기술통계치를 산출하였고, 놀이운동프로그램 참여에 따른 기간별 신체구성 및 건강관련체력의 변화에 대해 paired t-test를 실시하였다. 가설검증을 위한 유의수준은 ${\alpha}=.05$로 설정하였다. 연구결과 신체구성 변화 중 유일하게 근육량에서 유의한 차이가 나타났고, 건강관련체력은 배근력, 좌악력, 우악력, 좌전굴, 심폐지구력 모두에서 유의한 차이가 나타났다. 따라서 지적장애인들의 놀이운동프로그램이 신체구성 및 건강관련체력에 긍정적인 영향을 미친 것으로 나타났으며, 이러한 결과는 성인병 예방에도 기여 할 수 있는 에너지 소비적 활동으로 활용가능하다고 본다.

• 대한정형도수물리치료학회지
• /
• 제14권1호
• /
• pp.48-60
• /
• 2008

Purpose : The purpose of this study was to compare the effects of Joing Mobilization and Group back Pain Exercise Program on the disability level and the pain of flexibility and the back muscle strength in the hearing impairment patients with Low back pain. Methods : The subjects of this study were 12 patients, 8 males and females. They visited clinic for physical treatment within 6 months after onset of low back pain. One group was applied with Joing Mobilization and other group was with Group back Pain Exercise Program. The patient were treated special program 3 times session weekly. And treatment 2 times session was 15min with physiotherapy weekly. The muscle strength was measured by Cybex 660, the level of disability by Oswestry low back pain disability scale, the intensity of pain by visual analogue scale (VAS). The data was analysed by paired T-test and independent T-test. Results : The results of this study were summarized as follow : 1. The Oswestry disability score of experimental and control group were significantly decreased and there was no difference in the Oswestry disability score change between joint mobilization group and back pain exercise group. 2. The pains in anterior, postrior, lift lateral and right lateral bending and in rotation of back pain exercise group were significantly increased compared with those of joint mobilization group. 3. The flexors and extensors peak torque of back pain exercise group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of the joint mobilization group. There was no significant difference in extensors and flexors peak torque at $30^{\circ}$/sec, $60^{\circ}$/sec between two group. The results showed that the back pain exercise group were effective in decreasing disability score and pain of trunk activity, increasing trunk extension and flexion peak torque. Conclusion : It is suggested theat the back pain exercise program could be an essential factor for the effective intervension to the hearing impairment patients suffere from low back pain.

• 대한인간공학회:학술대회논문집
• /
• 대한인간공학회 1993년도 추계학술대회논문집
• /
• pp.223-235
• /
• 1993

요통(Lowback Pain)을 유발하는 주요원인으로 알려져있는 MMH(Manual Materials Handling) 작업에 있어서 작업조건의 변화가 근육의 활동과 피로도에 미치는 영향을 평가하기 위해 4가지 서로 다른 작업조건하에서 몸통부위(Trunk)의 주요근육에 대한 EMG 파형분석을 실시 하였다. 본 연구에서의 분석대항작업은 실제 작업조건과 유사하레 설계된 120분간의 단속적인 인양(Lifting)/하역(Lowering) 작업으로서 작업중량은 작업자의 MVIS(Maximum Voluntary Isometric Strength)를 기준으로 설정되었으며, 매 10분 간격으로 EMG 측정이 이루어졌다. 작업물이 작업자의 정면에 위치한 대칭형(Symmetric) 작업의 경우 배면부(Dorsal) 근육인 천극근(Erector Spinae)과 활배근(Latissimus Dorsi)이 활동근(Active Muscle)인 것으로 나타났으며, 정중면(Medial Plane)을 중심으로 좌우측 근육이 동일한 근력을 발휘하였다. 작업물이 작업자의 한쪽 측면에 위치한 90도 비대칭형(Asymmetric) 작업의 경우 천극근과 활배근외에 작업물과 반대쪽 외사근(External Oblique)이 활동근으로 추가되었으며, 작업물과 반대쪽의 근육들이 더욱 큰 근력을 발휘하였다. 작업의 반복에 따른 근육의 피로도를 평가하기 위해 실시한 EMG 파형의 Spectral Analysis 결과, 비대칭형 작업시 작업물과 반대쪽의 천극근에서 작업시간의 경과에 따라 중위주파수(Median Power Frequency)가 저주 파수대로 천이(Lower Shift)하는 현상이 나타났으며, 일정한 작업량이라도 작업중량을 줄이고 작업 빈도를 높여서 작업할 경우에 이러한 현상이 더욱 두드러졌다. 작업시간의 경과에 따른 MVIS의 감소 현상은 작업빈도가 높고 비대칭형 작업일 때 가장 크게 나타났다. 총손실을 줄이고, 상대적 비용절감효과를 갖게할 수 있다고 하였다. 따라서 본 연구에서는 성인 여성기성복의 치수적합성을 높이기위하여 출산 후 중년에 접어 들면서 체형이 변화되는 것을 고려하여 연령을 분류하고(18세-34세, 30세-51세), 각 연령 집단에 따른 체형을 각각 3가지로 분류하였다. 이에 따라 의복 생산시의 총손실을 줄이기위한 상의, 하의생산시 필요한 부위별 최적규격치 간격을 제시하였다.적인 기능으로 보여지는 것에 좁혀서 작업능력의 연령증가 변화에 대하여다원적 평가를 하는 것이 실제적이라고 할 수 있다. 따라서 본 연구에서는 인간이 가지고 있는 다수의 기능중에서 수지교 치성과 연령증가와의 관계를 조사한다. 만약 연령증가 만으로 수지교치성을 평가 할 수 없는 경우에는 어떠한 요인이 수지기민성의 변화에 영향을 미치는가를 검토한다.t list)에서 자동적으로 사건들의 순서가 결정되도록 확장하였으며, 설비 제어방식에 있어서도 FIFO, LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를

• Journal of Oral Medicine and Pain
• /
• 제35권2호
• /
• pp.155-163
• /
• 2010

피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.