• The Korean Journal of Pain
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• 제9권1호
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• 대한물리의학회지
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• 제6권3호
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• pp.277-286
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• 2011

Purpose : This study was to investigate the prevention of spasticity with modified Ashworth scale(MAS) and range of motion(ROM) increase with goniometer in ankle joint by functional electrical stimulation(FES) and exercise for 4 weeks in chronic stroke patients. Methods : 60 chronic stroke patients participated in this study. The subjects were divided into 3 groups, FES group(n=20), FES+exercise group(n=20) and control croup(n=20). After FES application on tibialis anterior muscle by 35Hz for 4 weeks, the change of ankle joint movement was measured by goniometer. Results : The spasticity in ankle joint was decreased greatly in FES and FES+excercise groups(p<.05), and the ROM of ankle joint was increased greatly in FES and FES +exercise groups(p<.05) than control group(p>.05). Conclusion : It shows that FES made the angle of dorsiflexion in spastic ankle joint increase with functional improvement of tibialis anterior muscle in chronic stroke patients. This show that the FES is avaliable for facilitation of ROM and decrease of spasticity as a therapeutic tool.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• PNF and Movement
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• 제20권1호
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• pp.31-39
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• 2022

Purpose: The purpose of this study was to identify the effects of general exercise after blood flow restriction on trunk muscles thickness in children with spastic cerebral palsy. Methods: Twenty children with cerebral palsy were assigned randomly to an experimental (n = 10) or a control (n = 10) group. The experimental group performed general exercise after blood flow restriction, while the control group performed general exercise alone. The study used an ultrasonic instrument to measure trunk muscles thickness. The Wilcoxon signed-rank test was used to determine differences before and after treatment, and the Mann-Whitney U test was used to determine differences between treatment groups. Results: From a comparison within the groups, the experimental and control groups showed significant difference in trunk muscle thickness after the experiment (p < 0.05). In a comparison between the two groups, the experimental group showed more significant difference in trunk muscle thickness than the control group (p < 0.05). Conclusion: Based on these results, general exercise after blood flow restriction effectively improves trunk muscle thickness in children with cerebral palsy.

• 대한물리의학회지
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• 제9권3호
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• pp.293-299
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• 2014

PURPOSE: The purpose of this study was to investigate the effect of functional training using a sliding rehabilitation machine (SRM) on the mobility of the ankle joint and balance in children with cerebral palsy (CP). METHODS: The subjects consisted of 11 children who were diagnosed with spastic CP. They carried out the functional training using the SRM for 30 minutes, three times a week, for 8 weeks. Before and after all of the training sessions, the subjects were tested using the Pediatric Balance Scale (PBS) and Gross Motor Function Measurement (GMFM), range of motion (ROM) in the ankle joint, the pennation angle of the gastrocnemius muscle and the fascicle length of gastrocnemius muscle were measured to determine the mobility of the ankle joint and balance ability. RESULTS: There were significant differences between the pre-test and post-test in the PBS and GMFM. The ROM of the ankle joint was significantly increased after the functional training using the SRM. Moreover, the fascicle length was increased and the pennation angle was decreased after the functional training using the SRM, but the difference was not significant. CONCLUSION: These results suggest that functional training using the SRM may have some effect on the mobility of ankle joint and balance in children with CP. According to the results, this study could present an approach to the rehabilitation or treatment of children with CP.

• 한국전문물리치료학회지
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• 제8권4호
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• pp.81-89
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• 2001

전시냅스 억제(presynaptic inhibition)와 동시냅스 억제(homosynaptic depression)는 보행 시에 분절반사(segmental reflex)를 조절하는 두 가지 독립적인 기전이다. 근방추 피드백(feedback)은 전시냅스 억제(inhibition)를 통해 보행 시 원심성 근육 수축기에서 적절이 조절될 수 있다. 이러한 전시냅스 억제 작용은 H-reflex의 강도로 나타내질 수 있는데, 원심성 근육 수축기 동안 H-reflex의 강도가 약해지는 것으로 보아 전시냅스 억제 작용은 증가되는 것으로 보여진다. 근방추 구심성 피드백(feedback) 역시 동시냅스 억제를 통해서 조절될 수 있다. 따라서 전시냅스와 동시냅스 억제는 보행 시작 중에 반사의 기전을 조절하는 중요한 역할을 한다. 반사의 조절 기전은 알파(alpha) 운동 신경원의 흥분도와 더불어 상위 척수의 기전들을 통해서 영향받고 조절된다. 경직성 마비 환자들은 초기의 입각기, 혹은 유각기 중에 손상된 비정상 비복근 H-reflex 조절기전을 보여준다. 이러한 비정상적인 조절기전은 발바닥의 말초신경을 자극함으로써 부분적으로 회복될 수 있다.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.95-98
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• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• 대한통합의학회지
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• 제8권4호
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• pp.183-190
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• 2020

Purpose : The purpose of this study was to investigate the effect of increased gait function enhancement exercise in three adolescent convulsive cerebral palsy sinuses on children's large movement function, balance and gait function, self-efficacy, and guardian attitude. Methods : The purpose of this study was to conduct a program to strengthen trunk muscles and strengthen walking ability 5 times a week for 8 weeks in 3 children with convulsive cerebral palsy in adolescence. The main reinforcement of the program was 20 minutes of muscle strength and 20 minutes of walking on a treadmill five times a week. Exercises were focused on the reinforcement of the flexor muscles of the proprioceptive neuromuscular promotion (PNF) and the extension of the legs in the bridge posture exercise and squat movements. Results : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences. Conclusion : The results of GMFM-88 to determine the effects of this functional enhancement program on the body of children with convulsive cerebral palsy, and PBS & TUG to determine the effects of balance and gait ability were improved. In addition, parenting attitudes of guardians, self-efficacy of children, and self-efficacy of parents increased positively due to mental consequences.

• 대한치과의사협회지
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• 제48권12호
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• pp.889-892
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• 2010

Botulinum toxin type A (BTX-A), a potent neurotoxin that reversibly blocks presynaptic acetylcholine release, has been applied successfully to treat facial spastic conditions such as blepharospasm, strabismus and cervical dystonia. Since the first reported application in dentistry in 1994, BTX-A has been used with great success to used in the orofacial region to help treat masticatory and facial muscle spasm, severe bruxism, facial tics, and hypertrophy of the masticatory muscles. The clinician may be aware of the many courses becoming available and aimed at dentists to start using it in the cosmetic context. This article intends to provide a basic understanding of the many functional uses of the drug in the orofacial region that may be relevant to everyday practice, especially in orthodontic field.

• 대한물리치료과학회지
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• 제5권3호
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• pp.617-624
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• 1998

A variety of neuromuscular diseases in children cause muscle imbalance. impaired function, and resultant deformity of the lower extremities. Equinovarus, equinos, adductor contracture are common deformity of lower extremities in the children. Generally, the transfer was successful in improving or maintaining range of motion, stability of the joint and gait. Postoperative physical therapy is important. Physical therapy was instituted after cast removal. All children received stretching exercise, range of motion exercise for the joint, proprioceptive neuromuscular fascilitation and gait training was administered. This article describes our experience with the physical therapy for tendon transfered spastic cerebral palsy and discusses the therapeutic protocol.