• 한국전문물리치료학회지
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• 제24권4호
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• pp.54-59
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• 2017

Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was $52.73{\pm}2.13%$ without a cane, $42.75{\pm}3.26%$ with a strong grip, and $43.00{\pm}2.55%$ with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects' centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

• 재활복지공학회논문지
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• 제9권4호
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• pp.301-308
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• 2015

본 연구는 정상 성인 20명을 대상으로 복부 안정화에 영향을 미치는 노르딕 워킹과 파워 워킹을 2주간 집중 시행한 후, 복부중심 근육(배속빗근, 배바깥빗근, 배가로근)의 활성도 및 두께, 그리고 복부 피하지방의 두께 변화를 비교하였다. 연구 결과, 근전도를 이용한 배속빗근과 배바깥빗근의 근활성값은 노르딕 워킹과 파워 워킹군 모두에서 훈련 후 높게 나타났으며, 특히 노르딕 워킹 훈련군의 경우 파워 워킹 훈련군에 비해 통계학적으로 유의하게 높은 근활성도의 변화를 보였다. 초음파를 이용한 배가로근과 배속빗근, 배바깥빗근의 두께는 노르딕 워킹 훈련군과 파워 워킹 훈련군 모두에서 통계학적으로 유의한 증가를 나타내었으나 군간 변화 차이는 없었다. 노르딕 워킹은 스틱을 이용하여 균형 안정감을 제공하며 상지와 하지의 큰 움직임을 통해 복부 안정화를 유도하는 효과적인 훈련방법으로써 다양한 재활운동의 형태로 적용하기에 유용할 것으로 여겨진다.

• 대한임상전기생리학회지
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• 제10권1호
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• pp.15-22
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• 2012

Purpose : We investigated the effects of the combined use of FES and over ground walking with partial body-weight support (PBWS) on walking function and balance control in people with chronic strokes. Methods : Twenty-seven people who were ambulatory after chronic strokes were evaluated. The exercise's intervention consisted of the combined use of FES and over ground walking with PBWS and general exercise groups. The FES + PBWS group and general exercise group consisted on a-20-minute session per day, 3 times a week during a 4 week period. The evaluation was carried out before, after, and two weeks after the exercise intervention. Outcome measures were a 6 Minute Walk Test, 6-Meter walk Test, Timed Up and Go Test, and a Balance Test, measured before and after the exercise interventions at a-2 week follow up. Results : The endurance was significantly increased in both the FES+PBWS group and general exercise group (p<0.05). Significant increase on the gait velocity was observed in both the FES+PBWS group and general exercise group (p<0.05). The TUG was significantly different in both the FES + PBWS group and general exercise group (p<0.05). However there were no differences in both the between-group & interaction. The stability index was significantly different in both the FES + PBWS group and general exercise group (p<0.05). Conclusion : In conclusion, the combined use of FES and over ground walking with PBWS led to an improvement in walking function and balance control. Thus, it is possible to combine the use of FES and over ground walking with PBWS for physical therapy intervention to improve walking function and balance control. It is suggested to apply this intervention in the clinical field.

• 한국운동역학회지
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• 제28권1호
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• pp.45-54
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• 2018

Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at ${\alpha}=.05$. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.

• Korean Journal of Acupuncture
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• 제26권4호
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• pp.77-88
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• 2009

Background : Qigong is an exercise therapy based on the principles of Traditional East Asian Medicine. The exercises combine the practice of motion and breathing, both guided by mental imagery. Beneficial effects of qigong have been reported on a variety of complaints in chronically ill patients and on gait imbalance in the elderly. Parkinson's disease is a progressive neurodegenerative disorder that affects neurophysiological function, movement abilities, and quality of life. Objectives : We developed a qigong program based on the Traditional East Asian medical theory regarding the improvement of clinical symptoms of Parkinson's disease. Methods and Results : Our qigong program consists of three parts. The first one includes movements which stimulate the meridians that run from the toes to the top of the head. The second one is composed of breathing and qigong movements that create harmony and balance with the circulation of Qi and blood on the Meridians. The third is a stage of finger pressure therapy and massage from Daoyin medical qigong to maintain meridian stability. Conclusions : These qigong program would help relieve the clinical symptoms of Parkinson's disease patients.

• 대한통합의학회지
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• 제9권4호
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• pp.191-200
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• 2021

Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.

• 한국교육논총
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• 제40권3호
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• pp.67-84
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• 2019

본 연구는 건강한 20대 남자 대학생 30명을 대상으로 플랭크운동과 탄력밴드에 의한 엉덩관절모음운동이 보행에 어떤 영향을 미치는지를 알아보고자 하는 것이다. 연구방법은 플랭크운동집단 10명, 양쪽 엉덩관절모음-플랭크운동군 10명, 한쪽 엉덩관절모음-플랭크운동군 10명을 30분씩, 주 3회, 총 6주로 진행하였다. 그 결과 분속수의 변화와 왼쪽다리의 한걸음길이, 오른쪽다리의 한걸음길이, 오른쪽 다리의 한걸음시간이 시기와 집단 간 상호작용에서 유의한 차이가 있었다(p<0.05). 본 연구의 결론은 양쪽 엉덩관절의 모음에 대한 저항 운동이 일반적 플랭크운동과 한쪽 엉덩관절 모음보다 몸통의 자세불안정성을 더욱 증가시켜 보행 능력을 향상시키는 것으로 차후의 자세불안정성을 증대하는 다양한 운동프로그램 개발이 보행능력의 향상에 도움이 될 것으로 기대해본다.

• 대한족부족관절학회지
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• 제18권3호
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

• 재활복지공학회논문지
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• 제10권4호
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• pp.305-313
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• 2016

두 발을 번갈아 옮기며 몸을 앞으로 움직이는 단순한 동작의 반복으로 보이는 보행이란 과정은 실제 인체 내의 대부분의 근육 및 인대, 뼈가 연관되어 이루어지는 복잡한 행동이다. 신체 일부가 소실된 하퇴 절단자의 경우 생체조직이 온전히 보전되어 있는 일반인과는 달리 남은 생체 부위와 의지의 공학적인 성능에만 의존해 보행을 해야 한다는 어려운 상황에 직면하게 된다. 따라서 하퇴절단자를 위한 하퇴의지는 우선 환자가 기본적인 보행이 가능케 함과 동시에 최대한 복잡한 지면 상태에 적응할 수 있도록 설계가 되어야 한다. 원활한 보행을 위해서는 배/저굴 방향의 발목의 회전이 매우 중요하고 고르지 못한 지면 상태를 극복하기 위해서는 내/외전 방향의 족부의 회전 기능이 요구된다. 최근 생체역학적인 연구를 접목한 다양한 하퇴의지가 개발되고 있으나, 이러한 고가의 고성능 하퇴의지의 경우 주로 활동성이 높은 하지절단 환자들에 초점이 맞춰져 있다. 본 연구에서는 하퇴의지 착용자의 대다수인 활동성이 낮은 K2 레벨의 환자들을 위한 하퇴의지를 개발했다. 기본적인 보행 능력 향상을 위해서 배/저굴 방향으로의 회전이 가능한 유압식 발목을 개발했고, 이를 통해서 배/저굴 방향으로 각각 $2.5^{\circ}$와 $4^{\circ}$의 회전이 가능함을 확인했다. 또한 수동 조절이 가능한 유압 노즐을 탑재해 환자 개개인에 적합한 발목 회전 저항력을 설정할 수 있도록 설계했다. 내/외전 방향으로의 족부의 회전이 가능하도록 이중고무 방식의 중간재를 삽입해 각각 $3.6^{\circ}$와 $4.1^{\circ}$의 회전이 가능하도록 설계되어 측경사나 작은 장애물들을 극복할 수 있도록 제작했다. 본 연구를 통해 개발된 하퇴의지는 K2 레벨의 하퇴절단자들이 일상생활 중에 겪게 되는 다양한 지면 환경을 극복하는데 도움을 줄 것이다.

• 재활복지공학회논문지
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• 제5권1호
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• pp.47-52
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• 2011

기능성 발보조기는 신발 착용 시 발바닥과 직접 접촉되어 비정상적인 신체 분절의 교정 및 발의 기능을 향상시킬 뿐만 아니라 체중 및 균형을 유지시키고 약화된 부위를 지지함으로써 사람의 직립자세 유지를 위한 균형 유지에 많은 도움이 된다. 이에 본 사례 연구에서는 보행 안정성을 비롯한 충격 흡수 기능을 수용할 수 있는 기능성 발보조기가 족부 형태 및 재질에 따라 신체의 균형유지에 미치는 영향에 대하여 연구하였다. 사람의 평균 무게 중심점의 흔들림 속도(sway velocity)를 이용한 균형감각 자세유지도의 고찰을 통해 족부형태별, 기능성 보조기의 재질에 따른 신체의 균형능력에 미치는 영향을 비교 평가한 결과, 안정한 상태에서 눈을 뜬 자세에서만 유의(p<0.006)한 결과를 나타냈으며, 이 자세에서 발의 형태별로 구분하여 통계 처리한 결과, 정상족(p<0.010), 편평족(p<0.000), 요족(p<0.003)의 순으로 나타났다. 그리고 기능성 발보조기의 재질에 따른 발의 형태별 균형에 미치는 영향을 분석한 결과, 연성재질은 정상의 발에서 그리고 경성재질은 편평족과 요족에 있어서 균형유지에 효과가 있는 것으로 나타났다.