• 제목/요약/키워드: individual rehabilitation

검색결과 324건 처리시간 0.035초

체간 조절을 통한 앉기 자세 교정이 경직형 뇌성마비 아동들의 호흡근과 음향학적 측정치들의 변화에 미치는 효과 (The Effects of Changing the Respiratory Muscles and Acoustic Parameters on the Children With Spastic Cerebral Palsy)

  • 김선희;안종복;서혜정;권도하
    • 한국전문물리치료학회지
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    • 제16권2호
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    • pp.16-23
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    • 2009
  • The purpose of this study was to investigate the effects postural changes on respiratory muscles and acoustic parameters of the children with spastic cerebral palsy. Nine children with spastic cerebral palsy who required assistance when walking were selected. The ages of the children ranged from 6 to 9 years old. The phonation of the sustained vowel /a/ and the voice qualities of each child such as fundamental frequency($F_0$; Hz), pitch variation (Jitter; %), amplitude variation (Shimmer; %) and noise to harmonic ratio (NHR) were analyzed by Multi-Dimensional Voice Program (MDVP). The muscle activity of three major respiratory muscles: pectoralis major muscle, upper trapezius muscle and rectus abdorminalis muscle, were measured by examining the root mean square (RMS) of the surface EMG to investigate the impact of changes in the adjusted sitting posture of each subject. However, the RMS of pectoralis major muscle showed a significant differences (p<.05). Secondly, there were no significant differences in $F_0$, Jitter and Shimmer between pre and post posture change, but there was a significant difference in NHR (p<.05). The data were collected in each individual; once prior and once after the sitting posture change. The data were analyzed by Wilcoxon signed ranks-test using SPSS version 14.0 for Windows. The findings of this study were as follows; Firstly, the RMS of upper trapezius and rectus abdorminalis muscle were not significant different between pre and post sitting posture changes. From the result, it is concluded that changes in the adjusted sitting posture decreases the abnormal respiratory patterns in the children with spastic cerebral palsy which is characterized by the hyperactivity of the respiratory muscles in breathing. Also, there is increased on the voice qualities in children with spastic cerebral palsy.

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복부 동시수축 형태에 따른 하지 근활성도 비교 (Comparison of Lower-Limbs Muscle Activity according to the Abdominal Co-contractive Activation)

  • 이현주;이남기;태기식
    • 재활복지공학회논문지
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    • 제10권1호
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    • pp.81-86
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    • 2016
  • 본 연구는 복부 동시수축 형태에 따라 하지의 근활성도에 어떤 영향을 미치는지에 대해 알아보고자 하였다. 연구대상자는 허리와 하지에 통증이 없고, 근골격계에 이상이 없는 건강한 20대 여성 30명을 대상으로 진행하였다. 복부 이완(Rest), 복부 당기기 기법(ADIM), 복부 브레이싱 기법(ABM)을 유지하는 각 자세에서 무릎의 굽힘없이 발을 능동적으로 바닥으로부터 20cm 올린 상태(ASLR)로 약 10초간 유지하도록 하여 하지의 5개 근육(중간볼기근, 엉덩긴모음근, 넙다리곧은근, 넙다리두갈래근, 앞정강근)의 근활성도를 측정하였다. 연구결과, Rest에서 ASLR을 유지하였을 때보다 ADIM 수축형태로 ASLR 유지할 때 하지의 모든 근육에서 근활성도가 높게 나타났다. 또한 Rest에서 ASLR을 유지하였을 때보다 ABM 수축형태로 ASLR을 유지하였을 때 중간볼기근을 제외한 나머지 근육에서 모두 근활성도가 높게 나타났다. ADIM과 ABM을 비교한 결과 중간볼기근과 앞정강근은 ADIM 수축형태에서, 엉덩긴모음근, 넙다리곧은근, 넙다리두갈래근은 ABM 수축형태에서 통계적으로 유의하게 높은 근활성도가 나타났다. 본 연구의 결과로 체간중심 안정화 운동이 필요한 요통 환자의 선제적 복부 수축형태로서 뿐만 아니라 하지의 선택적 근력강화가 필요한 환자들에게 개별화된 방법으로써 근거를 제시할 수 있을 것이다.

비만 유전자 단일 염기 다형성 문헌 고찰 (A literature Review of Single Nucleotide Polymorphisms in Obesity Genes)

  • 김성수;송희옥
    • 한방비만학회지
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    • 제4권1호
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    • pp.139-160
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    • 2004
  • The obesity is detrimental to the health of people living in affluent societies. Individual differences in energy metabolism are caused primarily by single nucleotide polymorphisms(SNPs), some of which promote the development of obesity-related type 2 diabetes mellitus. Type 2 diabetes mellitus is a common multifactorial genetic syndrome, which is determined by several different genes and environmental factors. In this review, five major conclusions are reached: (1)To be clinically significant, SNPs must be relevant, prevalent, modifiable, and measurable. (2)Differences in SNPs may have been caused by famine, ultraviolet light, alcohol, climate, agricultural revolution. livestock, lactase persistence, and westernized lifestyle. (3)Candidate obesity genes of calorie intake restriction are SIM 1, MC3R, MC4R, AGRP, CART, CCK, CNTFR, DRD2, Ghrelin, 5-HT receptor, NPY, PON and those of energy metabolism are LEP, LEPR, UCP1, UCP2, UCP3, B2AR, B3AR, PGC-1, Androgen receptor and those of fat mobilization are AGT, ACE, ADA, APM1, Apolipoproteins, PPAR, FABP, FOXC2, GCGR, $11-{\beta}HSDI$, LDLR, Hormonal sensitive lipase, Perilipin, $TNF-{\alpha}$, $TNF-{\beta}$ (4)Candidate obesity genes in the eastern are NPY, LEP, LEPR, UCP1, UCP2, UCP3, B2AR, B3AR, ACE, APM1, PPAR, and FABP. (5)Candidate obesity genes in type 2 diabetes mellitus are MC3R, MC4R, B2AR, B3AR, ADA, APM1, PPAR, FABP, FOXC2, PC1, PC2, ABCC8, CAPN10, CYP19, CYP7, ENPP1, GCK, GYS1, IGF, IL-6, Insulin receptor, IRS, and LPL. The discovery of SNPs will lead to a greater understanding of the pathogenesis of obesity and to better diagnostics, treatment, and eventually prevention.

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빈곤문화실태에 대한 탐색적 연구 - 긴급구호시설 종사자들을 대상으로 - (An Explorative Study on the Culture of Poverty)

  • 이진숙
    • 한국사회복지학
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    • 제56권4호
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    • pp.149-172
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    • 2004
  • 본 연구는 우리 사회 내의 빈곤문화 실태에 대한 기초자료를 생산하는데 그 일차적 목적을 두고 있다. 이러한 목적에 따라 긴급구호시설의 종사자들을 대상으로 하여 빈곤의 한계상황에 처해 있는 대표적 집단으로서 정부에서 일시 긴급구호사업의 대상으로 규정하고 있는 노숙자들과 쪽방생활자 그리고 부랑인들에게 있어서 빈곤문화실태는 어떠한 지를 파악하고, 이들이 빈곤상황에서 탈피하여 심리적 자립과 자활의욕을 고취하기 위해서는 어떠한 사회복지서비스가 필요한지에 대해 조사해 보았다. 본 연구의 결과는 다음과 같다. 긴급구호시설 종사자의 긴급구호서비스 대상자에 대한 인식은 가족적 특성을 제외하고는 평균적으로 보통정도나 보통이하로, 비교적 부정적이었다. 그리고 서비스대상자와의 관계에 대한 인식은 보통이상의 긍정적 경향이 크게 나타났다. 이 결과를 통해 긴급구호서비스 대상자들에게서 빈곤문화의 존재가능성을 유추해 볼 수 있으며, 이에 대한 심리적 재활 프로그램들을 강화해야 할 필요성이 제시되었다.

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뇌성마비 아동의 한방의료 이용행태 - 근거이론에 의한 질적연구 (Utilization of Korean Medicine among Children with Cerebral Palsy - Qualitative Study by Grounded Theory)

  • 이현주;김부영;윤영주
    • 대한예방한의학회지
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    • 제23권2호
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    • pp.25-42
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    • 2019
  • Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.

Reliability of joint angle during sit-to-stand movements in persons with stroke using portable gait analysis system based wearable sensors

  • An, Jung-Ae;Lee, Byoung-Hee
    • Physical Therapy Rehabilitation Science
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    • 제8권3호
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    • pp.146-151
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    • 2019
  • Objective: The purpose of this study was to investigate the test-retest reliability and concurrent validity of the joint angle of the lower extremities during sit-to-stand movements with wearable sensors based on a portable gait analysis system (PGAS), and the results were compared with a analysis system (MAS) to predict the clinical potential of it. Design: Cross-sectional study. Methods: Sixteen persons with stroke (9 males, 7 females) participated in this study. All subjects had the MAS and designed PGS applied simultaneously and eight sensor units of designed PGAS were placed in a position to avoid overlap with the reflexive markers from MAS. The initial position of the subjects was 90º of hip, knee, and ankle joint flexion while sitting on a chair that was armless and backless. The height of the chair was adjusted to each individual. After each trial, the test administrator checked the quality of data from both systems that measured sit-to-stand for test-retest reliability and concurrent validity. Results: As a result, wearable sensor based designed PGAS and MAS demonstrated reasonable test-retest reliability for the assessment of joint angle in the lower extremities during sit-to-stand performance. The intra-class correlation coefficients (ICCs) for wearable sensor based designed PGAS showed an acceptable test-retest reliability, with ICCs ranging from 0.759 to 0.959. In contrast, the MAS showed good to excellent test-retest reliability, with ICCS ranging from 0.811 to 0.950. In concurrent validity, a significant positive relationship was observed between PGAS and MAS for variation of joint angle during sit-to-stand movements (p<0.01). A moderate to high relationship was found in the affected hip (r=0.665), unaffected hip (r=0.767), affected knee (r=0.876), unaffected knee (r=0.886), affected ankle (r=0.943) and unaffected ankle (r=0.823) respectively. Conclusions: The results of this study indicated that wearable sensor based designed PGAS showed acceptable test-retest reliability and concurrent validity in persons with stroke for sit-to-stand movements and wearable sensors based on developed PGAS may be a useful tool for clinical assessment of functional movement.

심한 하악 치조제 흡수를 가진 환자에서 임플란트를 이용한 가철성 국소의치로 수복한 증례 (Implant-assisted removable partial denture for severely atrophied mandible)

  • 최바다;김연주;이재훈
    • 대한치과보철학회지
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    • 제57권2호
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    • pp.171-175
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    • 2019
  • 치조제가 심하게 흡수된 하악의 정확한 해부학적 구조를 채득하는 것은 매우 어렵다. 이 경우 보다 정확한 인상을 채득하기 위하여 수정모형 제작법을 통한 기능 인상 채득이 추천된다. 이를 위해서는 양측에 2개의 임플란트 크라운을 이용하여 적절한 고정원을 얻을 필요가 있다. 이를 통해 임플란트 피개의치에서는 불가능하였던 수정모형 제작법을 시행할 수 있다. 본 증례에서는 하악의 치조제가 심하게 흡수된 80세 여환을 하악 양측 견치 부위의 임플란트 크라운을 지대치로 한 가철성 국소의치를 이용하여 수복하였다. 가철성 국소의치의 금속구조물을 이용하여 개인 트레이를 제작하고 수정모형 제작을 위한 이차 인상을 채득하였다. 환자는 앞선 2회의 피개의치 실패 후 제작된 최종 보철물에 만족하였다. 치료 초기에 행해진 피개의치 치료에서는 부정확한 인상법에 따른 부적절한 보철물로 인해 술자와 환자 모두 만족하지 못했지만, 2개의 임플란트를 적절한 고정원으로 이용함으로써 성공적인 수복이 가능하였다.

The Immediate Effects of Single Leg Bridge Exercise on Abdominal Muscle Activity in Subacute Stroke Patients : a Preliminary Study

  • Kim, Hoyoung;Park, Chanbum;Bang, Sooyong;Jang, Hoyoung;Kim, Yongju;Lee, Sukmin
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.167-174
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    • 2021
  • Objective: Single leg bridge exercise (SLBE) improves trunk muscle activation and provides muscle stability by aligning joints related to posture. This preliminary study aimed to investigate the effects of SLBE on abdominal muscle activation in subacute stroke patients. Design: Cross-sectional study. Methods: Fifteen subacute stroke patients (9 males, 6 females) voluntarily participated in this study. SLBE was performed on the affected side. Each individual patient performed an SLBE ten times in three sets and was asked to hold their position for 5 s. Muscles activity was recorded using a surface electromyography (EMG) system before and after the SLBE. A surface EMG system was used to analyze the muscle activity during general bridge exercise, including the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) abdominal muscles. Results: Muscle activity of both EO and IO on the affected side significantly increased (p<0.05), whereas the muscle activity of the RA and the three muscles on the unaffected side did not show a significant difference. In addition, improvement in muscle asymmetry of the EO and IO showed a significant change after SLBE (p<0.05). Conclusions: SLBE is effective in activating the abdominal muscles of stroke patients on the affected side and is a helpful exercise intervention that activates the muscles to transform asymmetric abdominal muscles into symmetric patterns.

견관절 관절경 수술 후 기능 회복 치료법 (Various Regimens for the Functional Recovery after Arthroscopic Shoulder Surgery)

  • 오주한;윤지영
    • 대한정형외과학회지
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    • 제55권2호
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    • pp.103-116
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    • 2020
  • 회전근 개 파열은 인구의 고령화 및 영상 진단의 발전 등으로 인해 그 빈도가 빠르게 증가하고 있다. 최근에는 관절경적 봉합술이 일반화되어 있으며 수술 결과 역시 관혈적 봉합술과 대등한 유합률을 보이고 있다. 관절경적 수술 자체가 최소 침습적 방법이므로 수술 후 통증 감소와 조기 기능 향상이라는 부가적인 이점을 가질 수 있지만 최근에는 견관절의 관절경 수술 후 환자의 기능 회복을 더욱 향상시키기 위한 다양한 방법에 대한 관심이 높아지고 있다. 견관절 관절경 수술 후 기능 회복 치료 방법들은 수술 후 시기별로 나누어져 있으며 각 단계별로 활발히 연구되고 개선되고 있다. 그러나 각 시기별, 재활 단계별, 환자 개개인의 특성, 회전근개 파열의 정도 및 기저 질환에 따라 다양한 방법들이 많아 관절경적 회전근 개 봉합술 후 정상 견관절 상태로의 기능 회복을 위해 각 시기에 맞는 적합한 견관절의 기능 회복 방법에 대한 확립이 필요하다고 할 수 있다.

Integrated Effect of Non-Invasive Neuromodulation on Bladder Capacity in Traumatic Spinal Cord Injury Patient: Single Case Report

  • Priyanka Dangi;Narkeesh Arumugam;Dinesh Suman
    • Physical Therapy Rehabilitation Science
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    • 제13권1호
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    • pp.86-94
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    • 2024
  • Objective: To evaluate the changes in bladder capacity and storage through non-invasive neuromodulation by application of repetitive Trans magnetic stimulation (rTMS) and genital nerve stimulation (GNS) in traumatic spinal cord survivors. Design: A Single Case Study. Method: The Patient was registered in trail with the clinical trial registry of India (CTRI/2022/05/042431). The Patient was interposed with rTMS on lumbar area, from T11-L4 vertebrae with 1 Hz and the intensity was 20% below that elicited local paraspinal muscular contraction for 13 minutes. GNS was placed over dorsum of the penis with the cathode at the base and anode 2 cm distally at 20 Hz, 200 microseconds, Continuous and biphasic current was delivered and amplitude of stimulation necessary to elicit the genito-anal reflex. For assessment, Neurological examination was done for peri-anal sensation (PAS), voluntary anal contraction (VAC) and bulbocavernous reflex (BCR), deep anal pressure (DAP), and American Spinal Injury Association Impairment Scale (ASIA scale). Outcome assessment was done using Urodynamics, Spinal Cord Independence Measure Scale Version-III (SCIM-III), American Spinal Injury Association Impairment Score (ASIA Score), Beck's Depression Inventory Scale (BDI). The baseline evaluation was taken on Day 0 and on Day 30. Results: The pre-and post-data were collected through ASIA score, SCIM-III, BDI and Urodynamics test which showed significant improvement in bladder capacity and storage outcomes in the urodynamics study across the span of 4 weeks. Conclusion: rTMS along with GNS showed improvement in bladder capacity & storage, on sensory-motor score, in functional independence of individual after SCI.