• 한국콘텐츠학회논문지
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• 제9권7호
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• pp.202-210
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• 2009

본 연구는 뇌졸중 후 상지기능의 관련 요인과 각 요인의 상대적 영향력을 알아보기 위해 시행되었다. MMSE-K(Mini Mental State Examination Korean version) 24점 이상인 100명의 뇌졸중 환자를 대상으로 하였다. 상지기능은 성별, 우세손, 뇌손상 원인, 뇌반구 손상부위, 신체마비 부위, 언어장애 유무와는 유의한 차이가 없었으나(p>0.05), 아탈구 유무는 상지기능에 유의한 차이를 보였다(p<0.05). 상지기능은 상지근력(Manual Muscle Testing), 고유수용성감각(Proprioception), 근 긴장도 (Modified Ashworth Scale), 장악력(Grip strength), 통증(Visual Analog Scale)과 상관관계를 보였다(p<0.05). 위의 변수를 모두 포함하여 분석하면 77.6%의 상지기능 설명력을 보였고 이 중 상지근력이 가장 높은 설명력을 보였다. 뇌졸중 환자의 상지기능 재활을 위해서는 특히 상지근력 강화와 더불어 고유수용성감각, 근 긴장도, 장악력, 통증 그리고 아탈구 유무의 관련 요인들을 포괄적으로 중재에 포함시켜야 할 것으로 사료된다.

• 대한간호학회지
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• 제29권3호
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• pp.665-678
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• 1999

Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.

• 한국전문물리치료학회지
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• 제25권3호
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• pp.1-11
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• 2018

Background: Lumbopelvic stability is highly important for exercise therapy for patients with low back pain and shoulder dysfunction. It can be attained using a pelvic compression belt. Previous studies showed that external pelvic compression (EPC) enhances form closure by reducing sacroiliac joint laxity and selectively strengthens force closure and motor control by reducing the compensatory activity of the stabilizer. In addition, when the pelvic compression belt was placed directly on the anterior superior iliac spine, the laxity of the sacroiliac cephalic joint could be significantly reduced. Objects: This study aimed to compare the effects of EPC on lumbopelvic and shoulder muscle surface electromyography (EMG) activities during push-up plus (PUP) and deadlift (DL) exercise, trunk extensor strength during DL exercise. Methods: Thirty-eight subjects (21 men and 17 women) volunteered to participate in this study. The subjects were instructed to perform PUP and DL with and without the EPC. EMG data were collect from serratus anterior (SA), pectoralis major (PM), erector spinae (ES), and multifidus (MF). Trunk extensor strength were tested in DL exercise. The data were collected during 3 repetitions of all exercise and the mean of root mean square was used for analysis. Results: The EMG activities of the SA and PM were significantly increased in PUP with pelvic compression as compared with PUP without pelvic compression (p<.05). In DL exercise, a significant improvement in trunk extensor strength was observed during DL exercise with pelvic compression (p<.05). Conclusion: The results of this study indicate that lumbopelvic stabilization reinforced with external pelvic compression may be propitious to strengthen PUP in more-active SA and PM muscles. Applying EPC can improve the trunk extensor strength during DL exercise. Our study shows that EPC was beneficial to improve the PUP and DL exercise efficiency.

• 대한물리치료과학회지
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• 제24권1호
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• pp.14-21
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• 2017

Background; This study was to investigate effects of distance of muscle activity of 4 sections of rectus abdominis(RS-RA, LS-RA, RI-RA, LI-RA) by the shoulder width(x0.5, x1.0, x1.5) and the angle of the elbow joint($0^{\circ}$, $45^{\circ}$, $90^{\circ}$) Method : This study was conducted on 20 healthy male and 20 female adult. respectively, elbow joints were maintained at $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ flex postures on The shoulder width is 0.5, 1.0, and 1.5 times. at the same time 4 sections of rectus abdominis were measured using EMG with maintaining isometric contraction of the rectus abdominis for 5 seconds. Results; The results were as follows: First, muscle activity of 4 sections of rectus abdominis(RS-RA, LS-RA, RI-RA, LI-RA) by angle of the elbow joint($0^{\circ}$, $45^{\circ}$, $90^{\circ}$) was a statistically significant(p<0.05), Second, muscle activity of 4 sections of rectus abdominis(RS-RA, LS-RA, RI-RA, LI-RA) by the shoulder width(x0.5, x1.0, x1.5) was a statistically non-significant Conclusion; It was found to be most effective to perform arm posture with rectus abdominis muscle strength exercise.

• 성인간호학회지
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• 제24권3호
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• pp.317-326
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• 2012

Purpose: The purpose of this study was to identify the effects of an exercise program on muscle strength, Activities of Daily Living (ADL), health perception, and depression among post-stroke elders. Methods: Nonequivalent control group design with pretest and posttest was used. A total of 23 post-stroke elders who met inclusion criteria were recruited. Muscle strength in upper and lower extremities, ADL, health perception, and self-rated symptoms of depression were measured. The exercise program consisted of deep breathing, range of motion, and muscle strengthening exercises using Thera-band, 30~40 min/day, three days a week, for 12 weeks. Results: Muscle strength of right shoulder (U=11.50, p=.001), right leg (U=13.50, p=.002), and health perception (U=24.00, p=.010) in the experimental group was significantly higher compared to the control group at 12 weeks of post-intervention. Depression scores were significantly lower in the experimental group compared to the control group at 6 weeks (U=28.00, p=.021), at 12 weeks (U=22.00, p=.006) of an exercise program. Conclusion: By applying this program, post-stroke elders showed increases in muscle strength and a decrease in depression as well as improvement of health perception. Further study is needed to verify the effects of the exercise program on cardiovascular physiologic variables through long-term follow-up.

• 한국보건간호학회지
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• 제13권2호
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• pp.101-114
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• 1999

This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.9-14
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• 2014

Violinists tend to position the neck asymmetrically to hold the violin between the chin and the left shoulder. Asymmetrical neck posture may induce unilateral neck pain. Previous studies have suggested that individuals with unilateral neck pain exhibit reduced muscle strength of the lower trapezius, but no study has investigated violinists with unilateral neck pain. To this end, we recruited 18 violinists with unilateral neck pain for the present study in which the side on which neck pain was experienced, pain duration, and intensity were recorded. Lower trapezius strength was measured bilaterally in each subject using a handheld dynamometer. Significant differences in lower trapezius strength were evident between the ipsilateral and contralateral sides of neck pain (p<.05). No significant association between neck pain intensity or duration, and the extent of a deficit in lower trapezius strength, was evident (both p>.05). The association between the sides of weakened lower trapezius strength and neck pain was significant (p<.05). In conclusion, violinists with unilateral neck pain exhibited significantly less lower trapezius strength on the ipsilateral compared to the contralateral side of the pain. Unilateral neck pain more frequently involved the left side of the neck, which is used to stabilize the violin during playing. Thus, our study suggests that a possible relationship exists between muscle weakness in the lower trapezius and neck pain.

• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.67-75
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• 2022

Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

• 대한간호학회지
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• 제42권6호
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• pp.783-790
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• 2012

Purpose: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. Methods: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. Results: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. Conclusion: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.245-252
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• 2023

Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting-side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.