• PNF and Movement
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• 제16권3호
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• pp.317-332
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• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• PNF and Movement
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• 제17권1호
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• PNF and Movement
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• 제19권2호
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• pp.153-162
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• 2021

Purpose: The purpose of this study was to investigate the difference in the dynamic balance and leg muscle activity of adults in their 20s with or without shoes. Methods: In this study, seven male and 11 female university students in their 20s were randomized to determine the order of being with or without shoes, and the dominant foot was supported on the central platform of dynamic balance according to the order procedure. Using the opposite foot, the distance of leg stretching in the anterior, posterior medial, and posterior lateral directions and the muscle activity of the supporting leg were measured. Muscle activity measurement sites were attached to the dominant vastus medialis oblique muscle, vastus lateral oblique muscle, tibialis anterior muscle, peroneus longus muscle, and lateral gastrocnemius muscle. Results: As a result of this study, the distance of leg stretching was significantly increased in the anterior, posterior medial, and posterior lateral directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the vastus medial and lateral oblique muscles was significantly increased in all three directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the tibialis anterior was significantly increased in the anterior direction when barefoot (p < 0.05), the peroneus longus muscle was significantly increased when it was barefoot in the posterior medial direction (p < 0.05), and the lateral gastrocnemius muscle activity significantly increased when barefoot in the posterior direction (p < 0.05). Conclusion: The movement of the legs is freed when barefoot as compared to when wearing shoes, and being barefoot can effectively activate muscle activity and improve balance ability.

• 대한물리치료과학회지
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• 제29권2호
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• pp.57-65
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• 2022

Background: This study was to determine whether the diaphragmatic breathing exercise using a DiP Belt(Diaphragmatic Pressure Belt) is effective in increasing the diaphragmatic motion and forced vital capacity. Design: Pretest-Posttest design. Methods: A total of 44 subjects(15 male, 29 female) participated in this study. All subjects were measured the diaphragmatic motion with a sonography and the Forced Vital Capacity(FVC) was measured with a digital spirometer. After 4 weeks, the subjects were intervened the diaphragmatic breathing exercise using a DiP belt and were remeasured for diaphragm motion and FVC. Results: After exercise intervention, quiet breathing significantly increased with the change in diaphragmatic motion and showed a moderate effect size (p<.01, Cohen's d = -0.53). In addition, it was significantly increased in deep breathing and showed a high effect size (p<.001, Cohen's d = -1.32). The mean diaphragmatic contraction pressure increased, but there was no significant difference and the peak diaphragmatic contraction pressure increased significantly (p<.05). Both diaphragmatic contraction pressure showed small effect sizes (respectively Cohen's d = -0.28, -0.33). In spirometry, FVC, Forced Expiratory Volume in 1 second (FEV₁), and FEV₁/FVC% all increased, but there was no significant difference. Only peak expiratory flow increased significantly and showed a small effect size (p<.05, Cohen's d = -0.41). Conclusion: The DiP belt diaphragmatic breathing exercise that the principle of visual feedback can correct diaphragm breathing in a short time, so it is a useful breathing exercise device that can help the diaphragm breathing exercise in the right way in clinical practice.

• 대한물리의학회지
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• 제17권3호
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• pp.51-58
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• 2022

PURPOSE: This study aimed to evaluate the correlation between executive function and gait evaluations for the elderly, and validate the obstacle gait evaluation as a cognitive impairment test tool. METHODS: This study was a cross-sectional design. 79 people aged 65 years or older were selected as subjects. The Korean version of the Mini-Mental State Examination (MMSE-KC) to evaluate overall cognitive function and the Trail Making Test (TMT) A, B to measure executive function were performed. The 4-meter walking speed test and the walking speed test while crossing over an obstacle were carried out to evaluate gait. The Spearman's correlation was used to measure the correlation between cognition and gait speed. RESULTS: There was no significant correlation between the 4 m gait speed and executive function( TMT-A (p = .056), TMT-B (p = .115)). However, there was a significant correlation between the 4 m gait speed and MMSE-KC (r = .277, p < .05). There was also a significant correlation between walking speed while crossing over an obstacle and all tests (MMSE-KC (r = .382, p < .01). TMT-A (r = -.327, p < .01), TMT-B (r = -.283, p < .05)). CONCLUSION: It was found that the gait speed while crossing over an obstacle was correlated with all cognitive function tests. Therefore, we suggest the use of the gait speed test while crossing over an obstacle rather than the simple gait test to diagnose cognitive decline.

• PNF and Movement
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• 제21권1호
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• pp.139-146
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• 2023

Purpose: The aim of this study is to provide basic information to create an efficient training program to improve shoulder stability and function in patients with injuries and in patients having undergone surgery of the supraspinatus and infraspinatus muscles, which have a relatively high incidence of injury in shoulder joint disease. Further, independent activities of the supraspinatus and infraspinatus muscles were investigated according to forearm rotation and the neutral and lateral rotation postures. Methods: The activities of the supraspinatus and infraspinatus muscles were measured using surface electromyography in 22 healthy adults in Busan, and isokinetic muscle strength measurement equipment was used to measure muscle strength during shoulder lateral rotation. The subjects performed lateral rotation of the shoulder in three different forearm postures (neutral, supine, prone) to measure shoulder muscle activity and lateral rotation strength. Results: The independent activity ratio (% Isolation) of the supraspinatus and infraspinatus muscles during lateral rotation of the shoulder joint demonstrated a significant difference (p<0.05) according to the change in forearm posture. Conclusion: The supraspinatus muscle showed independent activity ranging from highest to lowest in the order of pronation, neutral, and supination of the forearm, while the independent activity of the infraspinatus muscle ranged from highest to lowest in the order of neutral, supination, and pronation of the forearm. Therefore, the most active forearm positions for the supraspinatus and infraspinatus muscles are pronation and neutral, respectively.

• 대한통합의학회지
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• 제12권3호
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• pp.25-36
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• 2024

Purpose : After coronavirus disease 2019 pandemic, many people around the world became aware of respiratory diseases and developed increased interest in health and exercise. As the elderly population grows larger, the prevalence of brain diseases and respiratory conditions increases. This study aimed to investigate the impact of dynamic neuromuscular stabilization (DNS) exercises on pulmonary function and electroencephalogram (EEG) findings in the elderly population. Methods : In this study, we measured the pulmonary function and performed EEG of 30 elderly individuals. The participants were randomly divided into an experimental group (n=15) and a control group (n=15). The experimental group completed a DNS exercise training protocol, while the control group performed simple exercise training. After the exercise, the pulmonary function and EEG testing were repeated, and the amounts of change within and between groups were determined. Results : In terms of pulmonary function, the experimental group's forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) increased significantly after the exercise (p<.05), while the FVC differed significantly between groups (p<.05). In terms of EEG findings, the relative alpha waves significantly decreased in the F3 region (p<.05), while the relative beta waves significantly increased in the F4 region (p<.05). The relative gamma waves increased significantly in the Fp2 and P3 regions (p<.05), while the values in the F3 region differed significantly between groups (p<.05). Conclusion : DNS exercises performed by this elderly population demonstrated significant clinical value by providing fundamental data about both pulmonary function and EEG activity.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.11-22
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• 2019

Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking. Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury. Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 Hz vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups. Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed. Conclusion: The sling exercise with local vibration of 50 Hz affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.

• PNF and Movement
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• 제19권1호
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• pp.97-104
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• 2021

Purpose: The human body can experience a variety of injuries. As a result, it may be difficult to directly treat the damaged area. In such a case, indirect treatment is required. Indirect treatment is typically PNF treatment. Morphological changes in muscle have been confirmed through several previous studies; however, few studies have analyzed neurological changes. Therefore, the purpose of this study was to determine how irradiation during resistance exercise using a diagonal pattern effects neurological excitability. Methods: Electromyography was performed on 13 healthy adults. A compound muscle action potential (CMAP) was obtained through a median motor nerve conduction velocity test, which was conducted before and after performing the irradiation exercise and general exercise. Results: Compared to baseline measurements, there was no significant difference in the latency of the irradiation exercise and general exercise. The amplitude of the CMAP measured after the irradiation exercise was significantly higher than after general exercise. Conclusion: Neurological excitability was high in irradiation during resistance exercise using a diagonal pattern. When clinically direct treatment is difficult, it is thought that irradiation can be used indirectly as a technique to induce nerve excitability.

• 한국의학물리학회지:의학물리
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• 제15권4호
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• pp.247-254
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• 2004

신체 심부의 악성종양치료를 위한 6～15 MV의 강력한 에너지의 방사선과 종양만을 조사하기 위한 입체조형치료, 세기 조절방사선치료, 입체적 치료방법 등이 개발됨으로써 방사선의 사출구가 전체 공간으로 확대되고 출력선량도 환자당 5～10 Gy의 과다 선량을 방출하기 때문에 고밀도의 차폐벽이 요구된다. 저자들은 세기조절방사선치료(IMRT)용 고 에너지 선형가속기를 기존건물에 설치하기 위하여 일반 콘크리트와 철, 티타늄등 중금속을 혼합한 고 밀도 차폐벽돌을 제작하여 방어벽을 설계하고 건축된 차폐벽으로부터 투과 산란된 선량을 측정하여 상호 비교하였다. 고 밀도 차폐벽돌을 사용함으로서 기존의 콘크리트(3.5 g/cc)에 비하여 고 에너지의 차폐율 즉 반가층 두께를 약 1/2로 줄일 수 있었다.