• 대한물리의학회지
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• 제15권4호
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• pp.101-109
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• 2020

PURPOSE: This study investigates the therapeutic effect of a prototype of a hand rehabilitation device based on magnetic forces. METHODS: Using an electromagnet and permanent magnets, we developed an end effector type device that induces various movements of the finger in accordance with the magnetic field direction. A total of 26 subacute stroke patients were enrolled and assigned to two groups in this randomized controlled trial. The intervention group received 30 minutes hand rehabilitation therapy per day for 4 weeks, using the device developed by us. Conventional physical therapies were conducted equally twice a day, 30 minutes per session, during the same period in both groups. RESULTS: After 4 weeks, rate of the Wolf Motor Function Test as a primary outcome measure showed significant improvement in the intervention group as compared to control group(p = .036). Scores of the Manual Function Test and Fugl-Meyer Assessment of upper limb were also significantly increased in the intervention group as compared to control group(p = .038 and p = .042, respectively). Moreover, the Korean version of Modified Barthel Index tended to improve after subjecting to physical therapy in both groups. CONCLUSION: Our results indicate that the novel hand rehabilitation device developed using a magnetic force, improves the hand motor functions and activities of daily life in subacute stroke patients.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.23-31
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• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

• 대한물리의학회지
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• 제8권2호
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• pp.271-280
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• 2013

PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.

• 대한물리의학회지
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• 제15권3호
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• pp.69-77
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• 2020

PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.

• The Journal of Korean Physical Therapy
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• 제26권6호
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• pp.449-452
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• 2014

Purpose: The purpose of this study was to analyze the coordination between trunk flexion and lower limb extension contributing to vertical propulsion during sit-to-stand (STS) at different chair heights in the elderly. Methods: Ten elderly subjects were asked to stand up at their natural speed from different chair heights : (1) $90^{\circ}$ knee flexion; (2) $100^{\circ}$ knee flexion; (3) $110^{\circ}$ knee flexion; and (4) $120^{\circ}$ knee flexion. A standard chair without a backrest or armrests was used in this study. To remove inertial effects of upper limb movements, subjects were asked to stand up from a chair with their arms crossed at the chest. Mean of results of three trials were used in the analysis at different knee flexion angles. Distances moved by the shoulder for compensatory trunk movement was recorded by motion analysis and vertical force was recorded under foot using force plates. Distances moved by the shoulder and vertical ground reaction force measurements were analyzed using repeated ANOVA. Results: Distances moved by the shoulder significantly decreased with higher chair (p<0.05). Vertical forces were not significant difference on chair heights (p>0.05), but results of pairwise comparisons for vertical force revealed significant difference between $90^{\circ}$ knee flexion and $120^{\circ}$ knee flexion (p<0.05). Conclusion: Trunk movement is probably used as a compensatory mechanism at low chair heights to increase lift-off from sitting by the elderly.

• Safety and Health at Work
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• 제12권2호
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• pp.225-229
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• 2021

Background: The socioeconomic burden of musculoskeletal disorders (MSDs) is significant, and kitchen work is a high-risk occupation for MSDs due to the intensive manual workload and repetitive movements that are involved. However, there are very few studies on MSDs and rest breaks as a workplace intervention among kitchen workers. This study examined the relationship between insufficient rest breaks and increased MSD risk among Korean kitchen workers. Methods: Sociodemographic and occupational factors of 1,909 kitchen workers were collected from the 3rd-4th Korean Working Conditions Survey data. Five items on rest breaks at work were categorized into two groups, "sufficient" and "insufficient." The number of MSDs and work-related MSDs (WMSDs), an outcome variable, was obtained from the sum of MSDs/WMSDs in three anatomical sites (back, neck, and upper limb, lower limb). The association between rest breaks and MSDs was estimated using zeroinflated negative binomial analyses, with adjustments for age, education level, and weekly working hours, and the analyses were stratified by sex. Results: After adjustment, significant associations were found between insufficient rest breaks and an increased risk of MSDs (odds ratio [OR] 1.68 95% confidence interval [CI] 1.11-2.54) and WMSDs (OR 1.40 95% CI 1.01-1.96) among female kitchen workers. Insufficient rest breaks were significantly associated with MSDs in female kitchen workers in all three anatomical sites. Conclusion: This study emphasizes the need for rest breaks as a workplace intervention for preventing MSDs in kitchen workers. Further studies to reveal the causality of this relationship are required.

• 한국운동역학회지
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• 제31권4호
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• pp.259-269
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• 2021

Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I² = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I² = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I² = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I² = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I² = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.139-147
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• 2007

The aim of this study was to evaluate effects of short-tenn repetitive-bilateral excercise on the activation of motor network using functional magnetic resonance imaging (fMRI). The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer Assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1); and (2) passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral sensorimotor cortex but increased in contralateral sensorimotor cortex and ipsilateral cerebellum. Task 2 showed cortical reorganizations in bilateral sensorimotor cortex, premotor area, supplemetary motor area and cerebellum. Therefore, this study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral excercise using the symmetrical upper-limb ann motion trainer.

• 국제물리치료학회지
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• 제11권1호
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• pp.2012-2020
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• 2020

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl-Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant between-group difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

• Tuberculosis and Respiratory Diseases
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• 제45권5호
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• pp.1039-1046
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• 1998

연구배경: 주기성 사지운동장애(PLMD)는 여러 수면장애와 함께 공존하는 경우가 많으며, 특히 수면관련 호흡장애(SRBD)와의 관계는 밀접하다고 알려져 있다. PLMD는 반복적이고 상동증적인 사지의 움직임에 의하여 전기생리적인 각성을 일으키기 때문에 불면증과 주간 졸립증을 초래하므로 이에 대한 관심이 필요하다. 본 연구는 SRBD 환자에서 PLMD의 빈도를 조사하고, PLMD로 진단된 환자군의 특성을 조사함으로써, SRBD 환자에서 PLMD의 동반 이환에 대한 이해를 높이는데 있다. 대상 및 방법: 진단적인 수면다원 검사로 수면관련 호흡장애의 진단이 내려진 106명을 대상으로 이들의 수면기록을 후향적으로 조사하였다. 수면다원 검사의 기록과 판독은 표준적인 방법을 사용하였다. OSA 의 진단은 RDI가 10 이상인 경우 내렸고, UARS는 낮 동안에 심한 졸림증을 호소하고 수면다원 검사상 RDI가 5 이하이나 호흡노력의 증가에 이어서 짧은 각성이 반복되는 경우 내렸다. 수면중 주기성 사지운동장애의 진단은 주기성 사지운동지수가 5 이상일 때 내렸다. 자료처리는 SPSS/$PC^+$를 이용하였다. 곁 과: 평균연령은 49.5세였고, 성별은 남자 76명, 여자 30명이었다. 진단은 폐쇄성 무호흡증 78명, 상기도저항증후군 28명이었다. 전체 연구대상의 평균 수면효율은 76.3%, 평균 호흡장애 지수는 22.3/hr, 평균 혈중 산소포화도는 84.9%로 중등도의 수면중 호흡장애가 있음을 알 수 있다. 평균 주지성 사지운동 장애지수는 13.1/hr였으며 70% 이상의 환자들이 32/hr 이하에 분포하였고 개인차이가 많았다. 주기성 사지운동 장애지수가 5 이상으로 수면중 주기성 사지운동장애를 동반한다고 판단된 군이 47명으로 전체의 44.3%를 차지하였다. 수면중 주기성 사지운동장애를 동반하는 군과 동반하지 않는 군의 비교에서, 두 군간에 나이, 무호흡 지수, 성별, 1 단계 수면의 백분율에서 유의한 차이가 있었다. 결 론: 본 연구의 결과는 이전의 타 연구들보다 수면관련 호흡장애에서의 주기성 사지운동장애의 동반이환율이 더 높다. PLMD를 동반하는 군의 나이가 유의하게 더 많고, 여성에서의 동반율이 더 높고, 무호흡 지수(apnea index)가 유의하게 더 낮다. 수면중 주기성 사지운동장애는 수면관련 호흡장애와 함께 불면증과 주간 졸림증을 초래하고, 본 연구에서 뒷받침 하듯이 수면중 호흡장애 환자에서 흔히 함께 동반되기 때문에, 수면관련 호흡장애 환자의 진단 및 가료시 이에 대한 배려가 필요하다.