• Physical Therapy Rehabilitation Science
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• 제13권2호
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• pp.250-260
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• 2024

Objective: This study aimed to explore the effects of balance training using fully immersive VR devices on the balance and walking abilities of stroke patients. Design: Randomized controlled trial Methods: This study involved 54 stroke patients divided into three groups: VRT(VR and traditional physical therapy), VR(VR only), and TPT(traditional physical therapy only). Interventions were administered twice daily for 30 minutes over eight weeks. Outcome measures included the Berg Balance Scale, Timed Up and Go Test, 10-meter walk test, gait analysis, and Activities-specific Balance Confidence Scale. Results: The VRT and VR groups showed significant effects on spatiotemporal variables and confidence compared to the TPT group (p<0.05). Specifically, the VR group demonstrated superior effects in TUG, 10MWT, velocity, stride length, single-leg support, and ABC compared to the other two groups (p<0.05). Conclusions: Fully immersive VR balance training had a positive impact on balance, walking, and confidence in chronic stroke patients. Traditional physical therapy alone showed limited effectiveness, highlighting the potential of VR-based interventions in stroke rehabilitation. These findings underscore the importance of integrating VR technology into clinical practice to enhance outcomes for stroke survivors.

• 한국정보전자통신기술학회논문지
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• 제12권2호
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• pp.170-177
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• 2019

본 논문에서는 4족복 보행 로봇의 주행 안정성을 개선하기 위한 3가지 이론을 제시한다. 첫 번째는 Minimum-Jerk Trajectory를 이용하여 다리궤적을 최적화 시킨다. 두 번째는 본 논문에서 새롭게 제시한 사인파와 기존의 방식인 LSM을 Jerk값에 근거하여 비교한다. 셋째는 ADAMS-MATLAB co-simulation을 이용하여 반복적인 로봇 시뮬레이션을 통해 스웨이의 최적 보폭을 계산한다. 위의 과정을 통해 로봇의 보행 개선점을 기존의 이론과 비교하여 나타내었다. 첫 번째로 정 보행시 몸체와 타원형태의 다리 끝의 움직임에 Minimum-Jerk trajectory를 사용하여 다리궤적이 급격하게 변하는 지점의 평균 기울기를 최소 1.2에서 최대 2.9까지 감소시켜 지면에 다리 끝점이 도달할 때 충격을 최소화하여 안정성을 증가 하였다. 두 번째로 기존 LSM(Longitudinal Stability Margin)기법과 본 논문에서 제시한 사인파형 Sway를 사용하여 비교한 결과 평균 Jerk를 Z축에서 0.019, X축에서 0.457, Y축에서 0.02, 3D는 0.479 만큼 감소 시켰다. 특히 X축 Jerk는 크게 감소 하였다. 셋째로 로봇이 최소 Jerk 값으로 보행하기 위한 최적의 보폭의 길이를 상기 분석을 통해 도출하였으며 그 결과 20cm보폭 길이가 가장 안정적이었다.

• 한국운동역학회지
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• 제12권2호
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• pp.1-16
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• 2002

본 연구의 목적은 다운증후군 보행에 영향을 주는 근력 훈련이 성장기에 있는 다운증후군 아동의 지면반력의 변화에 미치는 효과를 살펴보는 것이다. 본 연구의 대상자는 삼염색체 다운증후군을 가진 남자 아동(11세~13세) 8명이며, 근력훈련 전에 지면반력 변인(수직력, 전후력, 좌우력, 총압력중심)을 측정하였으며 근력훈련 후에도 동일한 방법으로 지면반력 변인을 측정하였다. 지면반력 변인의 측정은 2대의 AMTI 지면반력기를 사용하였으며, 초당 100Hz로 데이터를 수집하여 분석하였다. 근력 훈련은 하지 근육 강화 훈련 4종목(스쿼트, 레그 컬, 레그 익스텐션, 토 레이즈)과 복근 및 척추기립근 강화 훈련 2종목(하이퍼 익스텐션, 윗몸 일으키기)으로 구성하여 8주간 주당 3회, 1회 운동 시 10~15RM${\times}$3세트로 점증부하 원리에 의거하여 실시하였다. 본 연구를 통한 결론은 다음과 같다. 근력 훈련 전후의 수직력, 전후력, 좌우력의 변화패턴은 다운증후군 아동별로 다양하게 나타났으며, 근력훈련으로 정상인과 비슷한 패턴으로 향상되었다. 또한, 훈련 전 후의 총압력중심의 이동궤적은 연구대상자별로 다양한 이동궤적이 나타나서 명확한 설명을 하기가 어려우며, 이에 대한 보다 종합적인 후속 연구가 필요할 것으로 사료된다. 본 연구를 통하여 다운증후군 아동들의 보행의 운동역학적 기전의 이해와 운동학적 결과의 해석을 돕고 향후 병적 보행의 평가에 대한 기초자료를 제시할 수 있을 것으로 사료된다.

• 대한지역사회작업치료학회지
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• 제5권2호
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• pp.31-42
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• 2015

목적 : 상상연습(mental practice)이 노인의 균형 능력에 미치는 효과를 규명하고 노인 낙상 예방을 위한 효과적인 중재 방법으로써 적용 가능성에 대해 알아보는 것이었다. 연구방법 : 본 연구는 2013년 7월부터 10월 까지 인지에 문제가 없고 낙상에 경험이 있지만 보조 도구 없이 자립보행이 가능한 65세 이상 노인 3명에게 상상연습을 제공하였다. 개별 사례 실험 연구 중 ABA' 설계를 사용하여 기초선 과정 4회기, 중재 과정 5회기, 재 기초선 과정 4회, 총 13회기로 진행되었다. 독립변수는 노인의 균형 능력 및 낙상 효능감 증진을 위해 상상연습을 사용하였고, 종속변수로는 전반적 균형능력의 변화를 알아보기 위해 버그 균형 척도(Berg Blance Scale; BBS), 낙상효능감에 변화를 알아보기 위해 낙상효능감척도(Fall Efficacy Scale: FES), 정적, 동적 균형에 변화를 측정하기 위해 각각 외다리기립검사(One-Leg Standing test; OLS), 일어나 걸어가기 검사(Timed Up & Go test : TUG)를 실시하였다. 결과 분석은 평균값과 시각적 그래프를 통해 제시하였다. 결과 : 상상연습 기법 적용 후 모든 대상자의 낙상효능감이 기초선 과정에서 측정된 수치 보다 증가된 결과를 보였으며 또한 전반적 균형 능력과 정적 동적 균형 능력 또한 증진 또는 유지 되었다. 결론 : 본 연구는 상상연습이 노인의 낙상효능감과 균형능력의 향상과 유지에 효과가 있는 것으로 나타났음으로 노인의 낙상 예방 활동으로 상상연습의 적용을 추천한다.

• 대한물리의학회지
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• 제12권3호
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• pp.99-104
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• 2017

PURPOSE: Gait disturbances in patients with hemiplegic stroke involve asymmetry of stance time. Step box training is used to supplement the limitations of stair walking training and increasing the torque value of the paralyzed lower leg's strength. This study aimed to investigate whether step-up training on unstable support could change walking ability in patients with chronic stroke. METHODS: Thirty stroke patients were randomly assigned to the step-up training group (experimental group), that performed training on an unstable surface, and the control group, that performed training on a stable surface. Walking speed, step length, and cadence were measured before and after training. Paired t-tests were used to compare pre- and post-intervention data, while the independent samples t-test was used to determine intergroup differences. Values of p < .05 were considered statistically significant. RESULTS: There was a significant difference in walking ability before versus after the intervention in both groups, although the experimental group showed greater differences than the control group (walking velocity by 8.1%; step length of the non-paralyzed side by 6.9%, respectively; p<.05). CONCLUSION: Step-up training might be more effective on an unstable surface than on a stable surface for increasing walking speed and step length of the non-paralyzed side.

• Journal of Korean Neurosurgical Society
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• 제56권6호
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• pp.504-508
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• 2014

A 59-year-old male patient had 5-month history of gait disturbance and memory impairment. His initial brain computed tomography scan showed $3.5{\times}2.8cm$ sized mass with high density in the pineal region. The tumor was hypointense on T2 weighted magnetic resonance images and hyperintense on T1 weighted magnetic resonance images with heterogenous enhancement of central portion. The tumor was totally removed via the occipital transtentorial approach. Black mass was observed in the operation field, and after surgery, histopathological examination confirmed the diagnosis of malignant melanoma. Whole spine magnetic resonance images and whole body 18-fluoro-deoxyglucose positron emission tomography could not demonstrate the primary site of this melanoma. Scrupulous physical examination of his skin and mucosa was done and dark pigmented lesion on his left leg was found, but additional studies including magnetic resonance images and skin biopsy showed negative finding. As a result, final diagnosis of primary pineal malignant melanoma was made. He underwent treatment with the whole brain radiotherapy and extended local boost irradiation without chemotherapy. His preoperative symptoms were disappeared, and no other specific neurological deficits were founded. His follow-up image studies showed no recurrence or distant metastasis until 26 weeks after surgery. Primary pineal malignant melanomas are extremely rare intracranial tumors, and only 17 cases have been reported since 1899. The most recent case report showed favorable outcome by subtotal tumor resection followed by whole brain and extended local irradiation without chemotherapy. Our case is another result to prove that total tumor resection with radiotherapy can be the current optimal treatment for primary malignant melanoma in the pineal region.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.536-540
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• 2006

Purpose: The soft tissue injuries of the patellar area are difficult problems because of insufficient arterial blood supply and lack of muscle layer. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, local flap and free tissue transfer. However, each method has some limitations in their application. After the first introduction, the fasciocutaneous flaps are widely used to reconstruct the soft tissue injuries. The saphenous nerve, one of the superficial sensory nerves in the lower leg, is supplied by the saphenous artery and its vascular network. We used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. Methods: From March 2002 to May 2005, we used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. The flap was elevated with saphenous nerve, saphenous vein and saphenous artery and its vascular network. The flap donor site was reconstructed with primary closure or split-thickness skin graft. Results: Five cases survived completely but 1 case developed partial necrosis of the skin on the upper margin of the flap. However, the necrosis was localized on skin layer, and we reconstructed with debridement and split-thickness skin graft only. After the operation, there was no contracture or gait disturbance in any patient. Conclusion: In conclusion, the saphenous fasciocutaneous island flap is safe, comfortable and effective method to reconstruct the soft tissue injuries of the patellar area.

• 대한의용생체공학회:의공학회지
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• 제34권4호
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• pp.163-169
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• 2013

The purpose of this study was to verify exercise effect of horse riding exercise according to estimate basal physical fitness and activities of daily living(ADL) function in the aged. Participants were nineteen peoples who have no impediment of activity. They performed horse riding exercise using SRider(Neipplus, Co., Korea) at sixty minutes a day. Exercise has progressed three days a week for eight weeks. We measured trunk flexion, sit up, whole body reaction, leg strength and maximal oxygen uptake as basal physical fitness. Also three meter gait, single stance with eyes opened and single stance with eyes closed as ADL function were estimated once a month. The result of legs strength and whole body reaction showed the higher significantly than before the exercise. Moreover, the result of three meter walking ability only increased significantly among the ADL function. This means that horse riding exercise might be activated continuous muscular contraction with maintained tonus of muscle. We thought that continuous movement of horse riding could be lead to isometric muscle contraction in lower limbs. Our study found that horse riding exercise could improve lower strengths and muscle reaction for exercise effect. Also we suggested that horse riding exercise could be adapted to exercise methods that could provide rehabilitation and treatment enough for the aged or disabled person.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.115-120
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• 2015

Objective: To examine the effects of different shoe weights on lower leg muscle fatigue when walking by electromyographic (EMG) analysis due to the most effective weight for loading not being established. Design: Cross-sectional study. Methods: Thirty healthy university students (15 male, 15 female) were enrolled and randomly assigned into three conditions, which included wearing athletic shoes with an addition of 300 g, 500 g, and 1,000 g weights respectively. Prior to walking, all subjects were instructed to sit in a chair for 10 minutes. All subjects walked at a speed of 3.6 m/s on a treadmill for 20 minutes without rest. EMG measurements were taken using the median power frequency to assess for the effect of the different weight of shoes on muscle fatigue of the soleus, gastrocnemius, and tibialis anterior while walking on a treadmill in an upright posture. EMG measurements were taken during the first and last 30 seconds of walking. Results: In terms of muscle fatigue, for the soleus, the median power frequency was significantly lower with 1,000 g compared with 300 g and 500 g (p<0.05). For the tibialis anterior, the median power frequency was significantly lower with 1,000 g than 300 g and 500 g (p<0.05). For the gastrocnemius, the median power frequency was significantly lower with 1,000 g compared with 300 g (p<0.05). Conclusions: Increased shoe weight increases soleus, gastrocnemius, and tibialis anterior muscle fatigue during ambulation.

• 전기학회논문지
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• 제58권1호
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• pp.203-209
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• 2009

The purpose of this study is to develop a minimally constraint joint angle measurement system for the feedback control of FES (functional electrical stimulation) locomotion. Feedback control is desirable for the efficient FES locomotion, however, the simple on-off control schemes are mainly used in clinic because the currently available angle measurement systems are heavily constraint or cosmetically poor. We designed a new angle measurement system consisting of a magnet and magnetic sensors located below and above the ankle joint, respectively, in the rear side of ipsilateral leg. Two magnetic sensors are arranged so that the sensing axes are perpendicular each other. Multiple positions of sensors attachment on the shank part of the ankle joint model and also human ankle joint were selected and the accuracy of the measured angle at each position was investigated. The reference ankle joint angle was measured by potentiometer and motion capture system. The ankle joint angle was determined from the fitting curve of the reference angle and magnetic flux density relationship. The errors of the measured angle were calculated at each sensor position for the ankle range of motion (ROM) $-20{\sim}15$ degrees (dorsiflexion as positive) which covers the ankle ROM of both stroke patients and normal subjects during locomotion. The error was the smallest with the sensor at the position 1 which was the nearest position to the ankle joint. In case of human experiment, the RMS (root mean square) errors were $0.51{\pm}1.78(0.31{\sim}0.64)$ degrees and the maximum errors were $1.19{\pm}0.46(0.68{\sim}1.58)$ degrees. The proposed system is less constraint and cosmetically better than the existing angle measurement system because the wires are not needed.