• 한국전문물리치료학회지
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• 제23권3호
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• pp.40-47
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• 2016

Background: Assessments of Sit-to-Stand (STS) and gait functions are essential procedures in evaluating level of independence for the patients after stroke. In a previous study, we developed the software to analyze center of pressure (COP) in standing position on Wii Balance Board (WBB). Objects: This purpose of this study is to measure test-retest reliability of ground reaction forces, COP and time using WBB on STS and gait in healthy adults. Methods: Fifteen healthy participants performed three trials of STS and gait on WBB. The time (s), vertical peak (%) and COP path-length (cm) were measured on both tasks. Additionally, counter (%), different peak (%), symmetry ratio, COP x-range and COP y-range were analyzed on STS, 1st peak (%), 2nd peak (%) of weight were analyzed on gait. Intra-class correlation coefficient (ICC), standard error measurement (SEM) and smallest real difference (SRD) were analyzed for test-retest reliability. Results: ICC of all variables except COP path-length appeared to .676~.946 on STS, and to .723~.901 on gait. SEM and SRD of all variables excepting COP path-length appeared .227~8.886, .033~24.575 on STS. SEM and SRD excepting COP path-length appeared about .019~3.933, .054~11.879 on gait. Conclusion: WBB is not only cheaper than force plate, but also easier to use clinically. WBB is considered as an adequate equipment for measuring changes of weight bearing during balance, STS and gait test which are normally used for functional assessment in patients with neurological problems and elderly. The further study is needed concurrent validity on neurological patients, elderly patients using force plate and WBB.

• 한국운동역학회지
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• 제23권3호
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• pp.253-259
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• 2013

The purpose of this study is to evaluate the influence of posture elements on symmetrical weight bearing during STS (sit-to-stand) in patients with chronic stroke. The subjects were patients diagnosed with stroke: a total of 24 patients (16 males and 8 females) participated in this study. All the participants performed STS tasks(3 foot postures and 2 arm postures). Two force plates (AMTI) were used to measure the peak vertical ground reaction force(Peak Fz) and the symmetrical ratio to peak vertical ground reaction force. The data were analyzed using independent t-test and 2-way repeated analysis of variance. The results of this study were as follows: 1) The peak Fz placed more weight on the paretic leg during STS and 2) The symmetrical ratio to the peak Fz showed a significant difference according to the foot and arm posture (p<.05), and had the highest AYM_GA ($0.87{\pm}0.12$). These results indicate that arm and leg postures during STS in patients with chronic stroke had the highest AYM_GA. We believe that the outcome of this study will be a reference for the prognosis of STS in patients with stroke.

• 한국운동역학회지
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• 제23권1호
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• pp.37-43
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• 2013

The purpose of this study was to analyze the 12-week horse riding exercise effect on the locomotion of a body and bilateral balance and flexion/extension of trunk during the sit-to-stand(STS) in elementary and middle school students. One-hundred eleven participants were divided into three groups. Each group was subject to a different horse riding exercise: control group(n = 36), 1 time/week group(n=37), and 3 times/week group(n=38). Two-way repeated ANOVA was used to compare weight transfer time(WTT), trunk flexion velocity(TFV), trunk extension velocity(TEV), mean rising index(MRI), mean weight asymmetry( MWA) among the groups, and STS changes in before and after 12 weeks. There was a group interaction in WTT, TFV, TEV, MRI, and MWA with different responses to horse riding exercise participation. There was a significant increase in 1 time/week group and 3 times/week group of WTT, TFV, TEV, and MRI. Additionally, MWA(an index of a capacity for bilateral balance) in lower extremity was decreased in 3 times/week group. It seems that horse riding exercise positively affected musculoskeletal function of the trunk and lower extremity by accelerating locomotion and bilateral balance.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• PNF and Movement
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• 제17권2호
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• pp.275-282
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• 2019

Purpose: This study aimed to investigate the optimal positions of safety grab bars for effective sit-to-stand (STS) movement by comparing the results of the STS movement while using a safety grab bar installed under two different conditions: the height of the grab bar installation was determined by (1) the Building Act and (2) the principle of proprioceptive neuromuscular facilitation (PNF). Methods: A total of 50 undergraduate students participated in this study, and they were required to perform an STS movement twice under each condition. A baropodometric platform for sitting and a Biorescue (RM Ingenierie, France) were used to collect and analyze changes in the center of pressure (COP) on the left and right sides before and after performing the STS movement. The average completion time for the STS movement was also measured for analysis. Moreover, the participants were asked to express their individual subjective preferences regarding the two positions of the grab bars. Results: The COP changes were significantly smaller when performing the STS movement with the grab bar installed at the height determined by the PNF principle than the Building Act (p<0.01), and the difference in the completion time of the STS movement was not statistically significant between the two conditions. Conclusion: The findings of this study suggest that the principle of PNF can be useful for planning therapeutic exercise as well as for proposing the optimal grab bar position for older adults and those with health-related issues when performing the STS movement. In addition, this may serve as a basic rehabilitation technique for maintaining remaining functions and providing functional efficiency.

• 대한통합의학회지
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• 제6권1호
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• pp.7-14
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• 2018

Purpose : The purpose of this study was to confirm changes in the muscle activity of the quadriceps femoris with changes in the ankle and hip joint angles during the transition from sitting to standing. Method : Twenty-five healthy 20-30-year-old women participated in the study. The subjects performed standing-up movements in four positions: standard posture (hip = $90^{\circ}$/ankle = $0^{\circ}$); posture on a decline board (hip > $90^{\circ}$/ankle < $0^{\circ}$), posture on a footboard (hip > $90^{\circ}$/ankle = $0^{\circ}$); and posture on a decline board with a higher chair (hip = $90^{\circ}$/ankle < $0^{\circ}$). Then, the muscle activities of the rectus femoris, vastus medialis and vastus lateralis were measured using surface electromyography. Result : The muscle activities of the rectus femoris, vastus medialis and vastus lateralis in the footboard application were statistically significantly higher than in the application of the decline board with a higher chair. Conclusion : This study confirms that the flexion of the hip joint has a greater effect than the plantar flexion of the ankle joint on the muscle activity of the quadriceps during a sit-to-stand movement.

• 생명과학회지
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• 제14권3호
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• pp.484-489
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• 2004

인공관절은 21세기 정형외과 발전의 주요변화들 중의 하나이다. 1997년이래 전 세계적으로 무릎인공관절(Total Knee Arthroplasty: TKA)을 사용하는 사람들이 해마다 약 600,000명씩 증가하고 있는 추세이고 미국에서만 인공관절을 사용하고 있는 사람들이 210,000명에 달하고 있으며 그 시장은 대략 $5 billion을 넘고 있다(7). 무릎인공관절은 일상생활에서 의자에 앉았다 일어날 때 계단을 올라 갈 때 등, 무릎의 근 모멘트가 적당한 활동을 해서 무릎관절 근육에 지레와 같은 작용을 하게 하고, 완전한 무릎으로 정상인의 무릎과 같은 기능을 오랫동안 유지하게 한다. 이러한 목적을 달성하기 위해서는 무릎인공관절 디자인 시 정상적인 무릎 회전축(normal knee's axes of rotation)들의 정확한 위치를 파악하는 것은 중요하다. 인공관절 수술 후 무릎관절의 신전과 굴곡 운동을 하는 동안 하나의 회전축(single-axes)을 가진 하나의 회전 반경(single-radius)을 알아보는 것은 여러 축(multi-axes)으로 움직이게 된다는 다축 회전반경(multi-radius)을 분석하기에 앞서 중요한 연구이다. 따라서 본 연구에 서는 무릎이 신전운동과 굴곡 운동 시 신전과 굴곡 모멘트를 만들어내는 대퇴 사두근(quadriceps muscle)과 무릎 오금근 (hamstring)의 역할을 알아보았고, 또한 모멘트와 대퇴 사두근의 iEMG 형태를 파악하였다. 본 연구를 수행하기 위해 무릎인공관절 수술을 받고 1년과 3년이 지난 정상적인 생활을 하는 피검자(1년2명, 3년2명)를 대상으로 Isometric 테스트를 위한 KIN-COM III을 사용하여 60$^\circ$, 30$^\circ$의 무릎굴곡 측정을 하였고, Isokinetic concentric 테스트를 위해서 무릎굴곡각도의 $10^\circ$-80$^\circ$까지 움직임을 측정하였다 또한 15$^\circ$-75$^\circ$까지의 신전운동(sit-to-stand movement)과 굴곡운동(stand-to-sit movement)을 실시하여 시간의 차이, 내전과 외전의 차이 그리고 iEMG의 차이를 알아보았다. 본 연구의 데이터는 여러 번의 실험을 통하여 가장 일반적인 수치를 사용하였다. 이 때 16-channel BTS TELEMG를 사용하여 대퇴사두근과 무릎오금근의 근육활동모양을 알아보았다. 본 연구결과는 시술 후 3년이 지나면서 TKR (Total Knee Replacement)의 대퇴 사두근 토큐가 약해지는 것으로 나타났고, iEMG 실험에서는 N-TKR (Non-Total Knee Replacement)의 대퇴 사두근이 TKR의 대퇴 사두근 보다 근 수축력이 더 크게 발휘되는 것으로 밝혀졌다. 단축회전반경의 굴곡과 신전의 $10^\circ$-80$^\circ$까지의 각 속도는 굴곡동작이 1.19s, 신전 동작이 1.68s로 나타났다. 굴곡과 신전동작에서 다리의 외전(abduction)의 각도변화는 굴곡 시 5.5$^\circ$, 신전 시 5.2$^\circ$로 나타났고, 내전(adduction)의 각도변화는 굴곡 시 7.2$^\circ$, 신전 시 6.1$^\circ$로 나타났다. 대퇴 사두근의 iEMG변화에서는 15$^\circ$-60$^\circ$까지 vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) 모두 굴곡동작에서 큰 값으로 나타났고, 61$^\circ$-75$^\circ$사이에서는 신전동작에서 iEMG가 큰 값으로 나타났다. 이와 같은 결과들은 인공관절 수술자들의 다축회전 반경을 분석하기에 앞서 중요한 선행연구가 될 것으로 생각된다.

• 한국운동역학회지
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• 제18권2호
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• pp.59-64
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• 2008

본 연구는 3축 가속도 센서를 허리에 부착하여 실시간으로 스포츠 동작분류를 할 수 있는 모니터 링에 관한 연구를 실시하였다. 이 모니터링 시스템은 스포츠 동작의 기본이라고 할 수 있는 걷기, 달리기, 자세변화 동지 정지상태의 동작들과 추가적으로 사이클링 동작을 분류할 수 있도록 하였다. 또한 운동 시에 발생할 수 있는 낙상을 감지하여 위급상황에 대한 정보도 나타나게 하였다. 가속도센서모듈은 인체에 부착된 형태로 스포츠 활동을 모니터링하기 위하여 소형으로 설계되었으며 활동에 방해가 되지 않게 허리에 부착되었다. 측정된 데이터는 RF통신을 통해 PC로 전송되며 알고리즘을 통해 실시간으로 동작분류를 시행하게 된다. 개발된 알고리즘을 검증하기 위한 실험으로 5명의 피험자를 대상으로 서로 다른 속도의 걷기, 달리기, 사이클링 동작을 각각 100초간 실시하였으며 낙상과 자세변화 동작(앉았다 일어서기, 누웠다 일어서기, 서있다 앉기, 누웠다 앉기, 서있다 눕기, 앉았다 눕기)은 각각 20회씩 실행하였다. 그 결과 동작분류 정확도는 95.4%를 나타내었다. 이번 연구에서 스포츠 모니터링을 통하여 정확한 자신의 운동 정보를 알려주고 운동 시에 발생하는 낙상에 대한 위급상황을 알려줌으로써 스포츠 활동에 도움을 주고자 하였으며, 추가적인 연구로 각각의 스포츠 활동에 대한 정확한 에너지 소비 추정 알고리즘을 개발 중에 있다.

• 한국전문물리치료학회지
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• 제19권2호
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• pp.29-38
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• 2012

This study aimed to identify the asymmetry observed in the electromyography (EMG) activity patterns of selected trunk and thigh muscles between the affected and unaffected sides during the sit-to-stand movement in ambulatory patients with post-stroke hemiparesis. This study included 20 patients with post-stroke hemiparesis. The differences between stroke fast walkers (${\geq}8m/s$, 11 subjects) and stroke slow walkers (<8 m/s, 9 subjects) were compared. The activation magnitude and onset time of the multifidus, lumbar erector spinae, hamstrings, and quadriceps during the sit-to-stand movement were recorded through surface EMG. Moreover, the EMG activation magnitude and onset time ratios of each bilateral corresponding muscle from the trunk and leg were measured by dividing the relevant values of the unaffected side by those of the affected side. In all the subjects, the activation magnitudes of the multifidus, hamstring, and quadriceps on the affected side significantly decreased compared to those on the unaffected side (p<.05). The onset time of muscle activity in the affected side was markedly delayed for the multifidus and quadriceps during the task (p<.05). The activation magnitude ratios of the quadriceps were markedly decreased in the stroke slow walkers as compared to those in the stroke fast walkers. These findings indicate that the asymmetry in the multifidus, hamstring, and quadriceps muscle activation patterns in patients with post-stroke hemiparesis may be due to the excessive muscle activation in the unaffected side to compensate for the weakened muscle activity in the affected side. Our findings may provide researchers and clinicians with information that can be useful in rehabilitation therapy.

• 재활복지공학회논문지
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• 제10권1호
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• pp.47-57
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• 2016

본 연구에서는 다자유도 동적 하네스 시스템을 개발하고 동적 하네스 체중지지에 따른 인체 영향평가를 하고자 한다. 건강한 성인 남성 20명을 대상으로 실험을 진행하였으며 평지보행, 앉기, 서기, 계단 오르기, 계단 내려오기 5가지 일상생활 동작을 수행하였다. 일상생활 동작 수행 시 각 피험자 체중의 0%, 30%, 50%에서의 근육 활성도와 족압 분포를 측정하였다. 근육 측정부위는 대퇴직근, 대퇴이두근, 전경골근, 외측 비복근이다. 하네스 체중지지율 증가에 따라 족압의 평균값은 전체적으로 감소하는 경향을 보였다. 평지보행에서는 체중지지율 증가에 따른 전족부의 압력의 감소폭이 크게 나타났으며 비복근과 대퇴이두근의 활성 감소를 보였다. 앉기 동작에서는 후족부의 족저 압력 감소폭이 크게 나타났으며 체중지지율에 따라 전경골근의 근육 활성이 감소하였다. 계단 내려오기 동작에서는 체중지지율 증가에 따라 전족부의 압력이 크게 감소하였고 대퇴직근의 활성감소가 크게 나타났다. 의자에서 일어나기동작과 계단 오르기 동작에서는 동적 하네스 체중지지효과가 미비하였으며 이는 속도가 건강한 성인 남성의 동작 수행 속도보다 느리기 때문이다. 후속 연구에서는 본 시스템을 개선하기 위한 연구가 지속되어져야 할 것이다.