• 제목/요약/키워드: Knee rehabilitation

검색결과 613건 처리시간 0.025초

뇌졸중 편마비 환자에서 하지 근력강화운동이 상지 연합반응에 미치는 영향 (The Effects of Strengthening Exercise for the Lower Extremities on Associated Reaction of the Upper Extremities in Patients With Hemiparesis)

  • 박형기;김종만;김원호
    • 한국전문물리치료학회지
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    • 제13권2호
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    • pp.52-60
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    • 2006
  • Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

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야생 검은댕기해오라기에서 대퇴관절 탈골의 수술적 교정 (Surgical Repair of Coxofemoral Joint Luxation in a Wild Black-Crowned Night Heron (Nycticorax nycticorax))

  • 김은주;이종현;김민수;이기창;김남수;신기욱;이해범
    • 한국임상수의학회지
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    • 제30권1호
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    • pp.49-52
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    • 2013
  • 왼쪽 뒷다리의 파행을 보이는 야생 검은댕기해오라기가 내원하였다. 신체검사에서 왼쪽 뒷다리가 외측으로 $90^{\circ}$ 돌아가 있었으며 대퇴관절부위의 부종이 관찰되었다. 혈액검사와 더불어 영상학적 검사가 진행되었다. 골반 방사선 사진상 왼쪽 대퇴관절의 앞쪽 등쪽 방향 탈골이 확인되었다. 비흡수성 봉합사를 이용하여 탈골을 고정한 후 관절낭 성형술을 이용한 수술적 방법으로 교정하였다. 수술 10일 후 거의 정상에 가까운 보행을 보였으며, 수술 20일 후 자연으로 복귀되었다. 본 보고는 야생조류에서 대퇴골 탈골의 영상 진단 과정과 수술적 교정방법에 대해 소개하였다.

전신진동운동이 드랍랜딩점프 동작에 미치는 영향 (Effect of Whole Body Vibration Training in Drop Landing Jump)

  • 홍수연;장영관;김진현
    • 한국산학기술학회논문지
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    • 제19권3호
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    • pp.423-429
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    • 2018
  • 연구목적 본 연구의 목적은 전신진동운동(whole body vibration exercise)이 드랍랜딩점프(drop landing jump) 동작에 미치는 영향을 규명하는 것으로 진동운동그룹(n=5, VEG, Vibration Exercise Group)과 단순운동그룹(n=5, OEG, Only Exercise Group)을 4주 동안 트레이닝 시킨 후 운동 전과 운동 4주 후 변화를 비교 분석하였다. 실험방법 3차원 영상 데이터는 10개의 적외선카메라(Vicon, UK)를 샘플링 율, 100 Hz.를 사용하여 획득하였으며, 하지 관절의 파워는 2대의 지면반력기(AMTI, USA)를 샘플링 율 1000Hz.로 데이터를 획득 하였다. 연구결과 첫째, 무게중심의 변동성은 하강국면에서 가장 크게 나타나 점프 후 착지 시 상해위험성이 큰 것으로 나타났다. 둘째, 진동운동그룹은 훈련기간에 관계없이 단순운동그룹보다 점프높이가 증가하였다. 셋째, 운동그룹간의 관절파워가 4주 훈련 후 엉덩관절 P1(굴곡)과 무릎관절 P2(신전)에서 통계적으로 유의한 차이를 보였으나, 훈련기간에 따른 하지의 관절파워는 모든 국면과 운동그룹에 관계없이 통계적으로 유의한 차이를 보이지 않았다. 결론 훈련기간에 관계없이 진동과 운동을 병행한 진동운동그룹이 운동만을 수행한 단순운동그룹보다 점프높이에 증가를 가져왔으나 점프높이와 하지의 관절 파워와의 일관성 규명할 수 없었다.

오공약침의 안전성에 대한 임상적 연구 (Clinical study on safety of Scolopendrid aquacupuncture)

  • 소기숙;최회강;박소영;고강훈;김성남;이옥자;윤민영;문형철;김성철;이정훈;나원경
    • Journal of Acupuncture Research
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    • 제21권1호
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    • pp.136-148
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    • 2004
  • Objective: Recently scolopendrid aquacupuncture has been a good effect on pain control but it has not been known about clinical safety. So, In order to prove the clinical safety of scolopendrid aquacupuncture, We have observed the physical reac-tion and clinical pathology test after scolopendrid aquacupuncture treatment. Methods: We analyzed physical reaction and clinical pathology test before and after Scolopendrid aquacupuncture treatment of 30 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results & Conclusions: The results were summarized as follows. 1) The distribution of sex was 14 males and 16 females, and the average of patients age was 46.2 years. 2) The distribution of symptom was lumbago, lumbago with radiating pain, nuchal pain and knee joint pain. 3) In the 30 patients treated with Scolopendrid aquacupuncture, hematologic test did not show remarkable change. 4) In the 30 patients treated with Scolopendrid aquacupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 1.0%(from 3.3% to 2.3%) compared with previous study. 5) In the 30 patients treated with Scolopendrid aquacupuncture, Renal function test(BUN, Cr) and abnormal rate(from 2.5% to 2.0%) showed a slight decrease on the contrary. 6) In the 30 patients treated with Scolopendrid aquacupuncture. Electrolyte were normal range before & after treatment. 7) In the results of the Urine analysis of 30 patients, Leukocyte, Protein. Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aquacupuncture treatment, and the rest almost made no difference. 8) In the Physical reactions, all of the patients complained of pain of body partially, only one patient showed reddish and itch, but symptoms like those were entirely disappeared within 24 hours and whole body pain, swelling, headache, dizziness, fatigue and nausea was not observed.

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류마티스 관절염에서 우슬과 전침자극의 항관절염 효과 (Effects of Achyranthes Radix and Electroacupuncture on Type II Collagen-Induced Arthritis)

  • 김계엽;성락선;김용억;장미경;유영대;최기복;정현우
    • 동의생리병리학회지
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    • 제21권2호
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    • pp.425-431
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    • 2007
  • The purpose of this study was to observe the effects of Achyranthes Radix(AR) and electroacupuncture(EA) in rats with rheumatoid arthritis induced by type II collagen for 28 days. Control group was daily administered 0.9% NaCl 0.5 $m{\ell}$, Group I was daily administered 0.9% NaCl 0.5 $m{\ell}$ to arthritic rats, Group II was orally administered with Achyranthes Radix 500 mg/kg 0.5 $m{\ell}$ to arthritic rats. Group III was given 2 Hz EA of chok samni acupoint(ST36) in the test group for 30 min/days to arthritic rats. Group IV was daily orally administered with Achyranthes Radix 500 mg/kg 0.5 $m{\ell}$ and 2 Hz EA of chok samni acupoint(ST36) in the test group for 30 min/days to arthritic rats. This studies have been designed to evaluate the hind paw edema, assessment of arthritis indices, analgetic effects by analysis of blood chemistry(WBC, CRP, ALP, AST). In each group, histologic observations, Safranin O-fast green stain were observed and analyzed. The following results were obtained. Group II, III, IV were significantly decreased arthritis indices and the rate of paw edema compared with Group I . Especially group IV was the most significantly decreased. The WBC, CRP, AST, ALT was that Group II, III, IV were significantly decreased compared with Group I . In conclusion, Achyranthes Radix and Ea contribute to the improvement of blood chemistry and change in safranin O-fast green by knee joint of arthritic rats.

연결형(반구속형) 주관절 인공 관절 치환술 (Linked (Semi-constrained) Total Elbow Arthroplasty)

  • 정홍준;전인호;전재명;이태균
    • Clinics in Shoulder and Elbow
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    • 제16권2호
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    • pp.170-177
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    • 2013
  • 주관절 인공 관절 치환술은 고관절이나 슬관절 인공 관절 치환술에 비해 아직은 발전 단계에 있는 수술이다. 많은 임상 경험을 통해 여러 형태의 치환물이 개발되어 사용되고 있지만, 이에 대한 장기 추시 결과는 여전히 부족한 실정이다. 현대의 주관절 치환물은 크게 두 가지 디자인 범주로 나누어지는데, 연결형 치환물과 비연결형 치환물이 그것이며, 이들은 다른 말로 반구속형과 비구속형으로 불리기도 하며, 이에 추가적으로 비구속형/구속형 전환 가능한 치환물도 사용되고 있다. 연결형 치환물과 비연결형 치환물의 선택은 우선적으로 주관절의 안정성 및 골성 구조물의 적절성에 의해 결정된다. 연결형 치환물의 경우 전통적으로 마모, 조기 이완, 해리 등과 같은 합병증으로 인해 장기 추시 결과가 좋지 않았던 것이 사실이다. 하지만, 최근 들어 적절한 환자의 선택, 새로운 디자인의 개발, 수술 술기의 발달, 그리고 수술 후 적절한 재활 치료 등으로 인해 이러한 문제점이 많이 해결되었다. 하지만, 여전히 신체적인 활동에 대한 요구가 높은 환자에 있어서는 마모나 이완 등과 같은 문제점으로 인해 연결형 치환물이 적절한 선택이 되지 못하는 경우가 있다. 본 종설에서는 연결형 (반구속형) 주관절 인공 관절 치환물에 대해서 자세히 살펴보고자 한다.

요부 안정화 운동에 따른 몸통 근육들의 근활성도 비교 (The Comparison of Trunk Muscle Activities During Sling and Mat Exercise)

  • 최희수;권오윤;이충휘;전혜선;오재섭
    • 한국전문물리치료학회지
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    • 제12권1호
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    • pp.1-10
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    • 2005
  • The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

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외상성 뇌손상 청소년 대상 리듬청각자극(RAS) 보행 훈련 시 선율 적용 사례 (Exploring the Use of Melody During RAS Gait Training for Adolescents with Traumatic Brain Injury: A Case Study)

  • 박혜지
    • 인간행동과 음악연구
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    • 제12권2호
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    • pp.19-36
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    • 2015
  • 본 연구는 외상성 뇌손상 청소년을 대상으로 리듬청각자극(RAS) 적용 시 선율의 유무에 따른 보행 훈련 효과를 비교하고, 보행인자의 변화를 알아보고자 시행하였다. 이를 위해 3명의 외상성 뇌손상 청소년을 대상으로 사전 사후 평가를 제외한 총 8회의 보행훈련을 진행하였다. 회기별 중재 시 선율 유무에 따른 보행 속도 차이를 비교하였고, 훈련 효과에 따른 시공간적 지표 및 운동 형상학적 지표 변화 비교를 위해 VICON 370 Motion Analysis System을 사용하여 보행 지표를 측정하였다. 연구 결과 RAS 보행 훈련 시 제공한 음악 자극 형태에 따라 보행 속도에 미치는 유의미한 영향이 없으므로, 선율의 사용 유무는 보행 훈련 효과와 직접적인 관련이 없음을 알 수 있었다. 또한 사전사후 검사 결과, RAS 보행 훈련 후 분속수, 보행 속도, 활보장, 활보장 시간, 보행 대칭성이 공통적으로 개선되었으며, 대상자 모두 공통적으로 고관절 및 슬관절의 움직임에서 필요 이상의 과도한 굴곡이나 신전이 감소함에 따라 양측의 비대칭성 감소 및 움직임의 안정성이 증가한 모습을 보였다. 리듬 적용과 리듬 자극에 선율을 반영한 음악 자극 적용에 따른 보행 속도 간 차이를 비교한 본 연구 결과는 운동기능을 위한 RAS 적용 시, 일정한 간격의 리듬자극에 의한 리듬-운동 동조화가 핵심 기제로 작용함을 시사한다. 또한, 본 연구는 외상성 뇌손상 청소년을 대상으로 RAS 보행 훈련을 통한 보행 기능뿐만 아니라 보행 패턴의 개선을 살펴본 것에 의의가 있다.

만성관절염 환자의 삶의 만족도에 관한 연구 (A Study of Life Satisfaction by Chronic Arthritis Patient)

  • 김원숙
    • 근관절건강학회지
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    • 제4권1호
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    • pp.87-97
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    • 1997
  • This study is descriptive research clarifying the relations between physical inconvenience, social aptitude and sense of satisfaction In life of the chronic arthritis patients. This research has been conducted from 115 patients by structured self-reporting questionnaires and direct interview of the adult patients over the age of 16 years old who had been under treatment in 3 University hospitals in Seoul from Oct. 4, 1996 through Oct. 24, 1996 for 20 days. The collected materials have been under t-test and F-test(ANOVA) per variables after computerizing using SPSS package and the correlation between various causes was conducted by pearson's correlation coefficient method. The results are as the follows : 1) Generally the age of starling the disease was 40-60 with 91 in female(79.0%) and male 88(76.5%), the persons who had the religion showed the high rate of being taken ill and the persons with over high school education have fallen ill by 46.1%. The monthly income has shown that 77.5% was over 1,000,000won or over, the periods of the disease in average was 4 years 3 months showing it was the chronic disease, the degree of recognizing the disease was 19.0%, spouse and children were most concerned about their disease and the part of Joint attacked was knee(73.0%), wrist(43.5%) and others which showed that they have been very inconvenient in daily life. 2) The variables affecting to physical inconvenience were by age (F=9.06, p=.000), education level(F=7.14, p=000), economic standards (F=2.18, p=.05), the period of disease(F=3.09, p=.03), hospitalized or not(F=3.23, p=.002), showing such correlations. 3) The variables affecting to the social adaptation were by age (F=3.47, p=.018), education level(F=4.98, p=.001), periods of taken ill (F=419, p:.007), hospitalized or not (F=3.23, p=.004) and the operation or not (F=1.30, p=.028) showing such correlations. 4) The variables affecting to life satisfaction were by sex(t=2.08, p=.045), economic status(F=3.15, p=.01) being able to explain statistically. Through the above correlations, they are required to receive self-management education positively to elevate the effect of rehabilitation treatment and effective nursing arbitration and also they required to be reduced physical inconvenience at the early stage and be helped to be able to lead the quality life in satisfaction by elevating the diverse adaptation to the society by correcting the transformed joint.

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만성 편마비 환자에 대한 교감신경 활동 강화가 근 긴장도와 중추신경흥분성 변화에 미치는 영향 (Effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in chronic stroke patients)

  • 강병길;남기원
    • 한국산학기술학회논문지
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    • 제12권11호
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    • pp.5019-5026
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    • 2011
  • 본 연구는 만성 편마비 환자의 교감신경 활동 강화가 근 긴장도 및 중추신경 흥분성 변화에 미치는 영향을 알아보기 위해 시행하였다. 연구기간은 2009년 10월 12일부터 12월 4일까지 실시하였으며, 연구대상자는 발병 후 6개월 이상 된 만성 편마비 환자 30명을 대상으로 하였다. 실험은 교감신경 활동을 강화하는 세 가지 과제(암산, 정적인 상태에서 쥐기운동, 쥐기운동 후 허혈)를 실시하였으며 측정은 과제를 수행하기 전과 중의 global synkinesis 수준과 중추신경원 활동전위을 각각 측정하였다. 중추신경원 활동전위는 H/Mmax비, V/Mmax비를 측정하였고, global synkinesis 수준은 근전도 활동전위의 실효치 값을 측정하여 분석하였다. 본 연구에서, global synkinesis 수준은 정적인 상태에서 쥐기 과제를 제외한 나머지 과제(암산, 쥐기 후 허혈)에서 슬관절 굴곡, 신전 시 감소했다(p<.05). 또한 V/Mmax비에서는 세 가지 과제 모두에서 감소하였다(p<.05). 결론적으로, 교감신경 활동 강화는 만성 편마비 환자의 중추신경 흥분성과 근 긴장도를 감소시킴을 알 수 있었다.