• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• 척추신경추나의학회지
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• 제2권1호
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• pp.99-114
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• 2007

Objectives : The purpose of this study was to introduce the Chuna Manual Therapy (CMT) using Bong (a type of stick which is called 'bong') as a part of Oriental Medicine. Methods : We searched several traditional methods of CMT using Bong, either individual contact to specialist of CMT using Bong or referred to publications, and summarized briefly for introduction. Authors also made a comparative study between existing CMT and CMT using the bong. Results & Conclusions : The indications of Bong CMT are regarded as acute or chronic pain syndrome, whiplash associated disorders, facet syndrome, vertebral misalignment, chronic fatigue syndrome, obesity and also lower extremity length difference caused by malalignment of vertebrae and pelvic bone. The Meridian Muscle Therapy by pressing down using the Bong can be carried out on the imbalances of the muscle by shortening and lengthening contraction. CMT with Bong is considered more effective than other existing CMT in terms of effectiveness. In the case of pelvic correction which needs a tremendous amount of force, it can reduce the force required effectively. This fact can be inferred by the theory of composition and decomposition of force during the transmission of power. We can perform Bong CMT feeling less fatigued subsequently than general CMT. Pressing down with flexed fingers to grip bong acts on the contraction of flexor digiti and extensor digiti muscle, this protects the $doctor^{\circ}{\emptyset}s$ wrist joints from injury. The bong which acts as a tool between the doctor and the patient, while being given treatment, absorbs and spreads out the direct impact from the patient to the doctor. CMT with Bong is able to apply to both existing massage therapies with the hand. The bong appliance can be used in all applications, particularly, but not limited to; Orthopedic and Manual Correction Therapy, Meridian Muscle Pressing, Exercise Therapy, and Meridian Point Manual Pressing Therapy. CMT with Bong belongs to the category of oriental rehabilitation and Chuna manual medicine.

• The Journal of Korean Physical Therapy
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• 제23권1호
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• pp.77-82
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• 2011

Purpose: Recently, many studies have demonstrated that application of external stimulation can modulate cortical excitability of the human brain. We attempted to observe cortical excitability using functional magnetic resonance imaging (fMRI) during the application of transcranial direct current stimulation (tDCS) or functional electrical stimulation (FES). Methods: We recruited two healthy subjects without a history of neurological or psychiatric problems. fMRI scanning was done during? each constant anodal tDCS and FES session, and each session was repeated three times. The tDCS session consisted of three successive phases (resting phase: 60sec dummy cycle: 10sec tDCS phase: 60sec). The FES session involved stimulation of wrist extensor muscles over two successive phase (resting phase: 15sec FES phase: 15sec). Results: The average map of the tDCS and FES analyses showed that the primary sensory-motor cortex area was activated in all subjects. Conclusion: Our findings show that cortical activation can be induced by constant anodal tDCS and FES. They suggest that the above stimuli have the potential for facilitating brain plasticity and modulating neural excitability if applied as specific therapeutic interventions for brain injured patients.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.120-126
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• 2000

저자들은 1992년 7월부터 수부에서 연부 조직이 손상되어 결손된 부위를 신경감각 유리 피부판을 이용하여 재건하여 평균 5년 11개월 추시하였다. 수부에서 적절한 신경감각 유리 피부판은, 절개와 문합시 미세 수술이 가능하도록 충분한 직경과 길이를 가진 혈관이 존재하여야 하며, 피부판에 존재하는 신경은 임계 감수성이 가장 중요하며, 때로는 방어 감수성을 향상시키기 위하여 선택되어져야 한다. 포장 주위 유리 피부판은, 족부의 제 1 협부-공간 피부판과 족지-수질 피부판과 함께 임계 감수성을 향상시키기 위한 중요한 피부판이지만, 수부에서 결손 부위, 그리고 결손 부위의 특수한 상황과 결손 부위가 넓은 경우에는, 2차적으로 방어 감수성의 향상을 위하여 족 배유리 피부판이나 외 상완 피부판 등이 선택되어 질수 있다. 저자들이 치험한 수부 무지의 재건에 이용한 포장 주위 피부판 4례는 임계 감수성이 우수하고, 2점 감별 검사에서 양호한 결과를 보였다.

• Korean Journal of Acupuncture
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• 제23권4호
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• pp.27-47
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• 2006

Objectives : The aim of this study was to analyze how to treat various symptoms through the combination of Yoelgyoel $(LU_7)$ and Johae $(KI_6)$, according to reviewing the contents and data since Ling Shu (靈樞經) to recent literatures including thirty-five medical books. Methods : It was arranged and considered that the location, needling, and symptoms of each acupoint were described in various literatures before the publication of Chim Kyung Ji Nam (鍼經指南). Through various literature since the Publication of Chim Kyung Ji Nam, it was examined how to be recognized and be referred about Yoelgyoel $(LU_7)$ and Johae $(KI_6)$. Results and Conclusions : The location of Yoelgyoel is the superior 1.5cun at wrist joint striation, medial of extensor carpi radialis longus; the location of Johae is the depression part under foot medial condyle. Yoelgyoel is often used for respiratory organ disease, urinary organ disease, neuopsychiatory disease, musculoskeletal system disease; Johae is often used for urinary organ disease, circulatory organ disease. At Chim Kyung Ji Nam, Yoelgyoel is often used for thoraco-abdominal Pain, gynecological disease, digestive organ disease; Johae is often used for abdominal pain, gynecological disease, digestive organ disease. Therefore, these points are used together for general internal disease. As well, these are not directly continuous with Previous literatures from Chim Kyung Ji Nam. The combination of Yoelgyoel and Johae have been developed to the three categories as follows; it is quoted from as it is; it is reconstructed in the form of song; it has new symptoms enlarged. Consequently, the combination of Yoelgyoel and Johae was not bind to the rule of Up-Bottom harmony (上下配合), but asserted for the rule of Ju-Eng harmony (主應配合), which add specific acupoints to e combination of Yolgyol and Chohae as the complication of the symptoms.

• 재활치료과학
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• 제9권4호
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• pp.7-20
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• 2020

목적 : 본 연구는 뇌졸중 환자들의 상지기능 개선을 위해 말초신경감각자극과 과제지향적 훈련의 동시적용하여 효과를 알아보는 것이다. 연구방법 : 본 연구는 29명의 편마비 환자를 대상으로 수행하였다. 말초신경감각자극과 과제지향적 훈련을 동시에 적용한 실험군은 14명, 과제지향적 훈련만 실시한 대조군은 15명으로 주5회, 회기당 30분씩, 총 4주간 진행하였다. 결과측정은 손목과 어깨근육의 자발적 근수축 비율과 상자와 나무토막 검사, 잡기와 쥐기의 근력, Action Research Arm Test를 사용하여 중재 전·후로 측정하였다. 결과 : 4주간의 중재 후 짧은노쪽손목폄근, 노쪽손목굽힘근의 근 활성도와 잡기 근력, Action Research Arm Test에서 실험군은 대조군 보다 유의한 개선을 나타냈다. 결론 : 말초신경감각자극과 과제지향적 훈련의 동시적용은 과제지향적훈련만 하는 것보다 뇌졸중 환자의 상지기능 개선에 보다 효과적이었다.

• 생명과학회지
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• 제32권4호
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• pp.325-330
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• 2022

수영은 육상과 더불어 대표적인 기초 종목으로 손, 발을 사용하여 물속에서 헤엄치는 종목이기 때문에 기술적 훈련과 더불어 물의 압력에 따른 신체적 적응이 매우 중요하게 고려된다. 수영은 지상의 운동과는 다르게 물속에서 손과 발을 이용해 나아가고, 물의 저항으로 인해 근육을 움직이는 전신운동으로 높게 평가되고 있으며, 비만의 예방과 혈관질환의 치료에 많이 사용되는 운동 중 하나이다. 비교적 안전한 종목에 속하지만 다른 스포츠 종목들과 비슷하게 크고 적은 스포츠 상해가 발생 한다. 하지만 현재까지 수영 종목에서 유발되는 상해와 재활에 관한 연구 자료는 부족한 상황이다. 수영 선수의 상해는 일반적으로 고강도의 훈련, 많은 훈련 량 등으로 인해 발생하며, 수영 선수들에게 가장 많이 발생하는 상해와 질환으로는 극상근건염(supraspinatus tendinitis), 이두근건염(biceps tendinitis), 슬관절의 내측 활액막염(synovitis), 발등의 신근 건염(extensor tendinitis), 요통(low back pain)을 동반하는 척추분리증(spondylolysis), 척주전방전위증(spondylolisthesis) 등이 있다고 보고되고 있다. 또한 수영 경영 선수의 스포츠상해 부위 및 빈도조사 연구분석에 의하면 상해부위는 어깨관절(50%), 허리(23%), 하지(22%) 등의 순으로 높게 나타났으며, 상해종류로는 근육 손상과 인대손상이 대부분을 차지한다. 본 연구결과 수영 종목의 상해 부위는 상지(목, 어깨, 팔, 손목), 하지상해(무릎, 발목), 및 허리상해 순으로 나타났다. 그리고 영법별 상해분석으로 자유형, 배영, 접영 영법에서는 어깨 부위 상해가 많이 발생하였고 회전근개손상, 충돌증후군, SLAP (superior labral tear from anterior to posterior) 병변 순으로 나타났다. 평영 영법은 하지손상인 무릎손상, 평영과 접영은 척수상해, 접영은 허리상해 순서로 나타났다. 따라서 지도자는 선수들이 부상을 당하지 않도록 충분한 준비운동과 정리운동을 실시하도록 하고, 응급처치를 숙지하여 부상 발생 시 빠른 응급처치로 2차 손상을 예방할 수 있도록 해야 한다. 아울러 코치 및 지도자는 선수들에게 알맞는 재활 방법들을 처치하고, 선수들의 상해 예방과 처치에 대한 이해와 교육이 수반되어야 할 것이다. 추후 수영 영법 별 상해 예방과 상해 처치 그리고 재활방법에 관한 구체적인 기전적 연구들이 수행 되어져야 할 것으로 사료된다.