• 한국콘텐츠학회논문지
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• 제17권10호
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• pp.94-101
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• 2017

본 연구는 뇌졸중 편마비 환자 24명을 대상으로 마비측과 비마비측의 바이오 임피던스 값을 비교 분석하고자 하는 것이다. 본 연구에서는 2015년 10월부터 11월 까지 뇌졸중으로 진단 받은 편마비환자 24명을 대상으로 하였다. MultiScan 5000을 이용하여 바이오임피던스를 측정하였고 프래딕션마커(Prediction mark), 저항성분(resistance), 리액턴스(reactance), 위상각(phase angle)을 비교분석하였다. 뇌졸중 편마비 환자와 바이오임피던스 값의 비교분석을 위해 뇌졸중 편마비 가 아닌 일반인 6명의 오른쪽과 왼쪽을 비교분석하였다. 뇌졸중 편마비 환자의 마비측과 비마비측 부위에서 임피던스 값을 측정하여 정량화된 수치로 나타낸 결과 뇌졸중 편마비 환자의 마비측과 비마비측의 프래딕션마커(Prediction mark), 리액턴스(reactance), 위상각(phase angle)의 값의 유의한 차이를 보였다(p<0.05). 일반인을 대상으로 오른쪽과 왼쪽의 프래딕션마커(Prediction mark), 리액턴스(reactance), 위상각(phase angle)의 값의 유의한 차이를 보이지 않았다(p>0.05). 본 연구 결과를 통해 뇌졸중 편마비 환자의 마비측과 비마비측의 임피던스값의 유의한 차이가 있다는 것을 알 수 있었고 또한, 이를 통해 임상의 재활치료를 받는 뇌졸중 환자의 치료에 정량화된 수치로 측정할 수 있는 유용한 평가도구로서의 가능성을 제시하였다. 향후 연구에서는 임피던스 분석을 이용하여 뇌졸중환자의 마비측과 비마비측의 분석뿐만 아니라 다양한 대상군, 다양한 신체부위 그리고 재활치료 중재의 효과 등을 측정하는 연구가 필요할 것으로 보인다.

• 대한물리의학회지
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• 제16권3호
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• pp.37-44
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• 2021

PURPOSE: This study examined the effects of functional electrical stimulation (FES) on temporal-spatial gait and the activities of daily living in hemiplegic stroke patients. METHODS: The subjects were 29 hemiplegic stroke patients (57.7 ± 10.3). The patients walked at a self-controlled speed in four states: (1) walking without FES (non-FES), (2) walking with FES on the gluteus medius in the stance phase (GM), (3) walking with FES on the common peroneal nerve and tibialis anterior in the swing phase (PT), (4) walking with both GM and PT. A GAITRite system, Timed-Functional Movements battery, and Timed UP and Go test were used to measure the variables. RESULTS: Significant improvements were observed in all variables of the GM+PT, GM, and PT states compared to the non-FES state (p < .05). There were significant improvements in the GM+PT state compared to GM and PT states (p < .05). Moreover, significant improvements were noted in the single support time on the affected side, backward walking 10ft, and side stepping 10ft on the affected side of the GM state compared to the PT state (p < .05). There were significant improvements in the stride length on the affected side and side stepping 10ft on the unaffected side of the PT state compared to the GM state (p < .05). CONCLUSION: FES is effective in improving the temporal-spatial gait and activities of daily living in hemiplegic stroke patients.

• Journal of Oral Medicine and Pain
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• 제20권2호
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• pp.291-306
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• 1995

Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

• 한국전문물리치료학회지
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• 제5권2호
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• pp.23-38
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• 1998

The objective of this study was to identify the effects of pelvic tilting exercise on gait patterns of hemiplegic patients. The subjects of this study were 31 hemiplegic in- and out-patients of the Rehabilitation Hospital, Yonsei University Medical Center, from September 24, 1997 through November 5, 1997. Pre- and post-treatment change in gait patterns were measured using a ink foot-print. The data were analyzed by the paired t-test, one-way ANOVA, and independent t-test. The findings were as follows: The difference in gait patterns between pre- and post-treatment was statistically significant, with an increase in gait velocity to 7.98 cm/sec post-treatment; an increase in cadence to 7.29 steps/min; a narrowing of the base of support to 1.33 cm; an increase in step length of 3.92 cm on the less affected side and 3.73 cm on the more affected side; an increase in stride length of 5.82 cm on the less affected side and 5.92 cm on the more affected side(statistically not significant in foot angle). In relation to sex, age, cause of stroke, and laterality of paralysis, the difference in gait patterns between pre- and post-treatment was not statistically significant. Where there was no significant difference of the effects of pelvic exercise regarding the degree of spasticity, the presence of a decrease in proprioception, and the duration of treatment. In conclusion, hemiplegic pelvic tilting exercise was found to have transmitting positive effect in improving gait patterns.

• PNF and Movement
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• 제9권2호
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• pp.1-7
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• 2011

Purpose : The purpose of this research was to determine the effects of Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined on gait ability in hemiplegic gait. Methods : The subjects of this study were 13 hemiplegic patients. Each subjects was taken PNF pattern and FES of combined with 5 times per week for 4weeks. Pre- and Post-intervention change in gait ability were measured using an Timed up and Go test, stride length of the affected side, step length of the affected side. The data were analyzed using the paired t-test. Results : The results of this study were showed significantly improvement in TUG, stride length of the affected side, step length of the affected side after intervention. Conclusion : These results suggest that the Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined exercise is an effective way of improving gait ability for hemiplegic patients.

• 한국전문물리치료학회지
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• 제27권3호
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• pp.178-184
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• 2020

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

• Journal of Power Electronics
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• 제19권6호
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• pp.1380-1392
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• 2019

Input filters are very important to matrix converters (MCs). They are used to improve grid side current waveform quality and to reduce the input voltage distortion supplied to the grid side. Due to the effects of the input filter and the output power, the grid side power factor (PF) is not at unity when the input power factor angle is zero. In this paper, the displacement angle between the grid side phase current and the phase voltage affected by the input filter parameters and output power is analyzed. Based on this, a new grid side PF unity compensation method implemented in the indirect space vector pulse width modulation (ISVPWM) method is presented, which has a larger compensation angle than the traditional compensation method, showing a higher grid side PF at unity in a wide output power range. Simulation and experimental results verify that the analysis of the displacement angle between the grid side phase current and the phase voltage affected by the input filter and output power is right and that the proposed compensation method has a better grid side PF at unity.

• 대한물리의학회지
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• 제8권3호
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• pp.425-431
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• 2013

PURPOSE: The purpose of this study was to examine the effect of visual control on gait speed and balance in patients with stroke. Static balance and gait speed were investigated with comparison and fixed direction of visual. METHODS: We included twenty-six patients with stroke. Participants were measured static balance while standing on a forceplate with one of 4 different visual direction in front, floor, non-affected side and affected side for 30 seconds. To compare of the gait speed, participants had to walk with one of fixed visual direction. And to compare of gait speed with visual dispersion, gait speed were measured with visual change in left and right, up and down direction every 5m, 2m and 1m intervals. RESULTS: The result of the static balance with fixed visual showed that the affected side and the non-affected side were shown significantly increased sway of total sway length, mediolateral distance, anteroposterior distance, average velocity(p<.05). The gait speed with fixed visual showed that affected side was significantly slower(p<.05). And the gait speed significantly increased as interval of visual dispersion decrease in the sagittal and horizontal plane(p<.05). CONCLUSION: The results from this study showed that the visual direction effected on static balance and the faster visual movement made to increase the gait speed. Therefore the rehabilitation training with visual control may be implemented for stroke patients.

• PNF and Movement
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• 제18권2호
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• pp.215-222
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• 2020

Purpose: The study investigated the effect on chronic stroke patients' balance of a weight shift to the affected side using an insole on the less affected side during treadmill walking training. Methods: The subjects were 7 patients who had been diagnosed with stroke 6-24 months prior to the study. In each case, an insole was applied on the patient's less affected side during treadmill walking training. Each training session lasted 30 minutes and was undertaken 5 times per week for 4 weeks. Biorescue equipment that measures shifts in center of pressure was used to assess balance ability as measured by the Korea-Berg balance scale (K-BBS) before and after each training intervention. The Wilcoxon signed-rank test was used to evaluate within-group effects. Results: The results revealed statistically significant before and after differences in area, pressure, length, and mean velocity of the balance test and on K-BBS (p < 0.05). Conclusion: In chronic stroke patients, using an insole to adjust the height of the shoe on the less affected side is an effective means of increasing weight-shifting on the paralyzed side during treadmill gait training.

• 대한물리의학회지
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• 제7권3호
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• pp.319-327
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• 2012

Purpose : This study aimed to identify the asymmetry observed in the rehabilitative ultrasound imaging of lateral abdominal muscle thickness and performance between the affected and unaffected side during the abdominal drawing-in maneuver (ADIM), an exercise used to facilitate activation of selectively TrA to stabilize the trunk prior to limb movement. Methods : The Participants were twenty one patients with post-stroke hemiplegia in this study. Ultrasound imaging was used to measure amount of changes in thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrA). A Paired t-test was used to compare relaxed muscle thickness to contracted muscle thickness of all 3 muscles between the affected and unaffected sides. Results : The outcome measures included side to side differences of absolute thickness, contraction ratio among the lateral abdominal muscles. There was no significantly difference in between the affected and unaffected side at rest. But, there was a significantly difference in absolute muscle thickness between the affected and unaffected side of only TrA muscle. Also contraction ratio was a significantly difference between the affected and unaffected TrA muscle. Conclusion : These findings support the asymmetrical activation of TrA muscle during abdominal muscle contraction in patients with post-stroke hemiplegia. Further studies are warranted for confirming this outcome.