• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2004년도 추계학술대회 논문집
• /
• pp.1303-1306
• /
• 2004

We developed a symmetrical upper limb motion trainer for chronic hemiparetic subjects. This trainer enabled the practice of a forearm pronatio $n^ination and wrist flexion/extension. In this study, we have used functional magnetic resonance imaging(fMRI) with the developed symmetrical upper limb motion device, to compare brain activation patterns elicited by flexion/extension wrist movements of control and hemiparetic subject group. In control group, contralateral somatosensory cortex(SMC) and bilateral cerebellum were activated by dominant hand movement(Task 1), while bilateral movements by dominant hand(Task 2) activated the SMC in both cerebral hemispheres and ipsilateral cerebellum. However, in hemiparetic subject group, contralateral supplymentary motor area(SMA) was activated by unaffected hand movement(Task 1), while the activation of bilateral movements by unaffected hand(Task 2) showed only SMA in the undamaged hemisphere. This study, demonstrating the ability to accurately measure activation in both sensory and motor cortex, is currently being extended to patients in clinical applications such as the recovery of motor function after stroke.ke.

• PNF and Movement
• /
• 제6권1호
• /
• pp.41-51
• /
• 2008

Purpose : This paper reviews evidence supporting adaptive plasticity in skeletal muscle fibers induced by various exercise training and neuromuscular activity. Result : Skeletal muscle fiber demonstrates a remarkable adaptability and can adjust its physiologic and contractile makeup in response to alterations in functional demands. This adaptive plasticity results from the ability of muscle fibers to adjust their molecular, functional, and contractile properties in response to altered physiological demands, such as changes in exercise patterns and mechanical loading. The process of activity-dependent plasticity in skeletal muscle involves a multitude of signalling mechanisms initiating replication of specific genetic sequences, enabling subsequent translation of the genetic message and ultimately generating a series of myosin heavy chain isoform. Conclusions : Knowledge of the mechanisms and interaction of activity-dependent adaptive pathways in skeletal muscle is important for our understanding of the synthesis of muscle myosin protein, maintenance of metabolic and functional capacity with physical activity, and therapeutic intervention for functional improvement.

• 신경치료
• /
• 제22권3호
• /
• pp.19-23
• /
• 2018

Purpose The purpose of this study was to investigate the change of balance ability by performing closed chain exercise on stable support surface and unstable support surface in twenties. Methods This study randomly selected 15 students in the closed chain exercise group on the stable support side and 15 on the closed chain exercise group on the unstable support side. Balance ability was measured before and after the start of exercise and static balance was measured by OLT(One Leg Standing Test) and FRT (Functional Reach Test). Result The changes of the function reach test of the closed chain movement according to the ground type were significant in the unstable and stable support surfaces and the change of function reach test after the intervention in the two groups was significantly improved compared with the closed chain movement respectively. The one leg standing test changes of the closed chain movement according to the ground type showed significant results on the unstable and stable support surfaces, but there was no significant difference in the one leg standing test changes after intervention between the two groups. Conclusion The effect of closed chain training on ground type is unstable. The change of function reach test and one leg standing test of the closed chain exercise group on the stable support surface resulted in significant changes after exercise, but there was a significant difference in the balance ability of function reach test change after intervention between the groups.

• PNF and Movement
• /
• 제19권3호
• /
• pp.331-340
• /
• 2021

Purpose: The purpose of this study was to investigate the differences in body composition, upper and lower limb muscle strength, and functional physical ability in urban-dwelling elderly women with or without obesity. Methods: All study participants were assigned to the normal weight group (n=8, BMI<25) and the obesity group (n=7, BMI>25) based on their obesity rate. Anthropometric measurement was conducted and body composition was measured. For the upper and lower limb strength, grip strength and maximal isometric knee extension and flexion were evaluated by a dynamometer. The senior fitness test was performed to measure functional ability. Data analysis was conducted by the independent t-test and the alpha level was set at 0.05. Results: The waist, hips, and thighs of obese elderly women were thicker than those of normal-weight elderly women. This physical difference resulted from body fat mass, not muscle mass. Despite a similar level of limb muscle mass between the two groups, the upper limb grip strength was higher (24.00% for left, 19.95% for right) in the normal-weight women than the obese women (p<0.05), but otherwise there was no difference in maximal knee flexion or extension isometric strength. Functional physical ability showed no difference in a 30-second chair sit and stand test and a six-minute walk test, but a 30-second arm-curl (11.00% for left, 14.81% for right), back stretch (8.54cm for left, 8.99cm for right), chair sit and reach (9.22cm for left, 6.24cm for right), and 2.44 meter round trip walk (0.62 sec, 9.39%) were faster in performance for normal-weight elderly women than obese elderly women (p<0.05). Conclusion: Taken together, despite similar levels of upper and lower extremity muscle mass, normal-weight elderly women showed higher performance in upper limb strength, flexibility, and agility than obese elderly women, but there was no difference in lower extremity functional muscle strength and cardiopulmonary endurance.

• 대한통합의학회지
• /
• 제11권2호
• /
• pp.159-168
• /
• 2023

Purpose : This study aimed to investigate how neuromuscular electrical stimulation (NMES) affects the balance ability of patients who have undergone total knee arthroplasty owing to osteoarthritis. Methods : Thirty patients who had undergone total knee arthroplasty were randomized to an experimental group (n=15) and a control group (n=15). The experimental group received conventional physical therapy for 50 minutes and NMES treatment for 30 minutes, whereas the control group received conventional physical therapy for 50 minutes and active range of motion (AROM) exercises for 30 minutes. Within-group and between-group changes in static and dynamic balance ability before and after the 4-week intervention were analyzed. Results : In the within-group comparison, sway velocity in the center of gravity and total distance were significantly improved in both the experimental and control groups (p<.05), with no significant differences between the groups (p>.05). In the within-group comparison, both the experimental and control groups showed significant improvement in the functional reach test and movement velosity (p<.05). In the between-group comparison, the experimental group showed a significantly better improvement than the control group in the functional reach test (p<.05), but there was no significant difference in the movement velosity test (p>.05). Conclusion : In this study, NMES improved the static and dynamic balance in patients who had undergone total knee arthroplasty. Compared with AROM exercises, there was a greater effect on dynamic balance partially; however, the overall effect was similar. Therefore, NMES may be one option among various interventions to improve the balance ability in patients who have undergone total knee arthroplasty. In particular, this method may be effective when it is difficult to apply balance training for patients with total knee arthroplasty in a clinical setting.

• PNF and Movement
• /
• 제19권2호
• /
• pp.287-301
• /
• 2021

Purpose: Gait training for stroke patients focuses on adjusting to new environments to facilitate outdoor walking. Therefore, the purpose of this study was to identify the effects of various ground obstacle walking combined with treadmill walking on the gait parameters and functional gait ability of chronic stroke patients. Methods: Twenty-four chronic stroke patients were divided into two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group received a combined gait training using various ground obstacle walking and treadmill walking (VGOW) five times/week for four weeks. The control group received traditional treadmill training (TW) five times/week for four weeks. Patients were evaluated using the figure-8 walk test (F8WT) and the Functional Gait Assessment (FGA) before and after each intervention. Results: The ANCOVA results showed that both treatments significantly influenced F8WT steps, F8WT time, and FGA score. The paired t-test results showed a significant improvement in F8WT steps, F8WT time, and FGA score in the experimental group compared to those in the control group. Conclusion: Combined gait training using various ground obstacle walking and treadmill walking can improve gait ability in chronic stroke patients.

• PNF and Movement
• /
• 제20권1호
• /
• pp.41-49
• /
• 2022

Purpose: The aim of this study was to examine the effects of vibration exercise on balance control ability, gait ability, and depression in the elderly. Methods: A total of 24 elderly subjects were recruited and randomized into an experimental (n = 12) or a control (n = 12) group. The experimental group performed both a vibration and a stabilization exercise, and the control group performed a stabilization exercise alone. Balance ability was measured using the functional reach test (FRT), gait ability was measured using the timed up and go test (TUGT), and depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Results: The experimental and control groups showed significant differences for all pre- and post-experiment FRT, TUGT, and CES-D measurements (p <0.05). In a comparison between the two groups, the experimental group in which vibration exercise was applied showed more significant difference in FRT, TUGT, and CES-D than the control group (p <0.05). Conclusion: This study showed vibration exercise to be effective in balance control ability, gait ability, and depression in the elderly.

• PNF and Movement
• /
• 제15권1호
• /
• pp.105-113
• /
• 2017

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

• The Journal of Korean Physical Therapy
• /
• 제27권2호
• /
• pp.112-117
• /
• 2015

Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

• PNF and Movement
• /
• 제12권3호
• /
• pp.143-150
• /
• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.