• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.168-171
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• 2001

It has been said that variable anatomical structures and neural circuits are related to the generation of tremor. There are cerebral cortex, thalamus, basal ganglia, inferior olivary nucleus, midbrain tegmentum, stretch reflex, and musculoskeletal structures. The stretch reflex is related with the physiologic tremor and various peripherally originated tremors. We experienced a case with the post-stroke resting tremor which was induced and aggravated by mechanical stretching stimulation. In the present case, stretch reflex has a major role in the generation and exacerbation of tremor. It is presumed that the development of tremor is attributed to the increased rhythmicity of ventral intermedius nucleus of thalamus. The enhancement of thalamic rhythmicity may be due to the increasement of long latency reflex by post-stroke rigidity. This case suggests that stretch reflex may have a major role in the pathophysiologic mechanisms of a certain centrally originated tremor.

• PNF and Movement
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• 제5권1호
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• pp.57-66
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• 2007

This review discusses the development of muscle receptors, in particular, that of muscle sensory neurons and monosynaptic stretch reflex circuit. The development of muscle sensory neurons and monosynaptic stretch reflex requires a series of steps including expression of neurotrophic transcriptional factors and their receptor. The monosynaptic stretch reflex circuit is unique neuronal circuit system, and highly precise synaptic connection systems. Thus, coordination of sensory-motor function in muscle receptors depend on the expression of distinct classes of molecular cues, and on the formation of selective synaptic connections between sensory-motor neurons and their target muscle. Recent neurotrophic and transcription factor expression studies have expanded our knowledge on how muscle sensory neuron is formed, and how sensory-motor system is developed.

• PNF and Movement
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• 제1권1호
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• pp.19-25
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• 2003

Objectives: The purpose of this article is to summarize the effect of stretch stimulus on muscle contraction facilitation. Methods : Some studies of the stretch reflex. ${\gamma}-motor$ system, and the effect of stretch stimulus on muscle activation were reviewed. Results : To facilitate muscle contraction, before the movement is started, the prime mover is in stretched position. The patient must be instructed to occur voluntary muscle contraction after quick stretching. It elicits the functional stretch reflex to produce a more powerful and functional contraction. The intensity of muscle contraction depends on two ways. One is firing rate of ${\alpha}-motor$ neuron by sensory information from the periphery induced in stretched position and stretch reflex. The other is excitation level of the cortical motor area and the corresponding motor neurons. Conclusions: To activate central nervous system and to increase firing rate of ${\alpha}-motor$ neuron. the therapist should apply quick stretch for the patient with stretched position and the patient should make voluntary muscle contraction.

• 대한임상전기생리학회지
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• 제1권2호
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• pp.39-48
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• 2003

The purpose of this study was to describe the alteration of stretch reflex and electrical activity of lower leg muscle in cerebral palsy by the water temperature. We used ten cerebral palsy. Participants classified according to each group in $29^{\circ}C$, $32^{\circ}C$, $35^{\circ}C$ by the water temperature. All subjects participated 3 session, which at least 1 week between session. The test was measured continuously pre test, post-test by thermometer and surface electromyography(sEMG). The following results were obtained; 1. Superficial temperature were significantly decreased in $29^{\circ}C$(p<0.001) group but were significantly increased $32^{\circ}C$, $35^{\circ}C$ group(p<0.001). 2. Muscle stretch reflex were significantly decreased in $32^{\circ}C$(p<0.05) and $35^{\circ}C$(p<0.001) group. 3. Stretch-evoked EMG were significantly increased in $29^{\circ}C$ group(p<0.01). These results lead us to the conclusion that changes of stretch reflex and electrical activity of lower leg muscle in cerebral palsy were influenced by the water temperature. Therefore, a further direction of this study will be to provide more evidence that a moderate water temperature have an effect on muscle tonus in a patient with cerebral palsy.

• The Korean Journal of Physiology
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• 제4권2호
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• pp.19-24
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• 1970

Since the discovery of the muscle spindle by Hassall (1831), an intensive studies of its anatomical and physiological characteristics had been undertaken. Recent morphological studies of Boyd (1962) demonstrated that the muscle spindles have two different intrafusal muscle fibers, nuclear bag and nuclear chain fiber, and these intrafusal fibers are under independent motor innervation by ${\gamma}_1$ and ${\gamma}_2$ motor neurone. Neurophysiological studies of Hunt and Kuffler (1951) showed regulatory effect of ${\gamma}$ motor neurone upon the excitability of the spindle afferents. Harvey and Mathews (1961) observed the dynamic and static characteristics of the two different spindle afferents, the primary and secondary ending. Furthermore, Mathews (1962) postulated the functional existance of two kind of ${\gamma}$ motor neurones, namely, the dynamic and static fusimotor fiber. Recent report of Kim and Partridge(1969) pointed out that the descending vestibular signals had increased the slope of the length-tension relationship in stretch reflex; Kim (1967) demonstrated that the descending vestibular impulses act upon the stretch reflex loop through the ${\gamma}$ motor pathway. These experimental evidences from the morphological and neurophysiological studies on the muscle spindles support the concept that the stretch reflex action of the skeletal muscle operates as a negative feedback control system. The author had discussed the way by which the f system participates in the control of stretch relfex feed back system. that was taken for a prototype of posture and movement.

• 한국운동역학회지
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• 제18권1호
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• pp.63-72
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• 2008

본 연구는 운동유형별 운동 전후 뇌졸중 환자의 보행시 하지근육 활성도의 차이를 비교 분석하여 임상에서 기능적 수행능력의 개선을 위한 효과적인 근력강화 방법을 제시하는데 그 목적이 있다. 이를 위하여 운동치료군, 탄성밴드군 및 신장반사군으로 구분하여 각각 7명씩 총 21명을 대상으로 하였고, 운동프로그램은 8주 동안 주 5회 실시하였다. 1차 단하지 지지기에서 장요근 및 대퇴이두근의 %MVIC는 신장반사군이 운동치료군과 탄성밴드군보다 높은 수준을 보였고, 반면 전경골근의 %MVIC는 탄성밴드군이 운동치료군보다 낮은 수준을 보였다. 2차 양하지 지지기에서 장요근의 %MVIC는 신장반사군이 운동치료군과 탄성밴드군보다 높은 수준을 보였고, 반면 내측 비복근의 %MVIC는 신장반사군이 운동치료군보다 낮은 수준을 보였다. 결론적으로 신장반사 운동은 운동치료와 탄성밴드를 이용한 근력강화 운동 보다 고관절의 안정성 및 하지 분절의 운동성을 제공하는 주요 근육의 활성도에 효과적인 영향을 미침으로써 임상에서 근 약화로 인한 운동 기능이 제한된 편마비 환자에게 실용적으로 접근할 수 있는 운동방법이라고 판단된다.

• 한국정밀공학회지
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• 제23권7호
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• pp.152-158
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• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.

• 대한기계학회논문집B
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• 제39권3호
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• pp.215-221
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• 2015

삼두박근 반사는 인체 상지에서 발생하는 대표적인 신장반사이며 경추의 이상 등을 판단하는데 중요한 역할을 수행한다. 본 연구에서는 이를 생체역학적으로 해석하기 위하여 새롭게 정의된 신장반사 해석 모델을 이용하여 해석적으로 상완 이두박근과 삼두박근의 근활성도 및 상완의 운동 정보를 예측하였다. 해석을 통해 예측된 운동 정보와 실험 결과가 같도록 하는 근활성도를 구하고, 이를 근전도 실험 결과와 비교하여 해석 모델과 방법의 타당성을 검증하였다. 제안된 모델과 실험을 통해 얻은 관절의 각도들의 최소자승오차는 0.056 으로 기존의 모델을 사용하여 얻은 오차의 절반 수준이다. 이것은 제안된 모델이 실제 현상과 잘 부합한다는 것을 나타낸다.

• 전기학회논문지
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• 제59권1호
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• pp.217-219
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• 2010

Spasticity is a motor disorder characterized by a velocity dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex. The aim of this study is to develop a portable system for quantifying the grade of spasticity which could calculate the biomechanical as well as neurophysiologic parameters, and for determining the relationship between the Tonic Stretch Reflex Threshold (TSRT) and Modified Ashworth Scale (MAS). Eleven patients with stroke participated in the study (6 males and 5 females, the average age of $64.5\pm16.0$ years). As a results, the mean and standard deviation values of the TSRT were $129.8\pm4.2$, $123.4\pm5.2$ and $119.1\pm2.6$ in the MAS 1, MAS 1+ and MAS 2 groups, respectively. Also, there was a negative correlation between the TSRT and MAS (rho=-0.72, p<0.05). This demonstrated that the TSRT could be made clinically available for the more objective and reliable evaluation of the spasticity, instead of using the conventional clinical scales and an isokinetic dynamometer.

• The Journal of Korean Physical Therapy
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• 제5권1호
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• pp.109-114
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• 1993

The originator of the proprioceptive neuromuscular facilitation method was Dr. Herman Kabat, a man who received the bachelor of science degree from New York University in 1932. In 1936 he moved to the University of Minnesota where he served as instructor in physiology and also studies medicine. He received his medical doctorate in 1942. When Dr. Karbat meet Sister Kenny suggested that certain change. She does not receptive his ideas. So that he decided to pursure the treatment of patients. Upon the establishment of the Karbat- kaiser Institute to be opened in 1946. Margaret Knott, the first physical therapist to be employed by him and to become his head physical therapist. In 1948 Vallejo center was opened. Dr. Kabat developed the PNF method combined motions to ascertain the effectiveness of maximal resistance and stretch in facilitating the response of a weak distal muscle. He identified mass movement patterns that were spiral and diagonal in character in 1965. Margaret Knott presented lecture at tile APTA Annual Conference in Las Vegas. The title was In the groove. On December 18, 1978 she passed away at her home in Vallejo. Marie-Louise Mangold is director of the Kaiser Foundation Rehabilitation Center now. She is the Vice President of International Proprioceptive Neuromuscular facilitation Association. About 20 physical therapist working teaching and study at KFRC in Vallejo. PNF neuromuscular mechanism becomes integrated and efficient without awareness of individual muscle action, reflex and a multitude of other neurophysiological reactions. The principles of PNF are visual consideration, verbal consideration, and proprioceptive input consideration with tactile stimulation, joint receptors, appropriate facilitation, stretch reflex normal timing, irradiation, pattern of movement.