• 제목/요약/키워드: upper-limb

검색결과 646건 처리시간 0.033초

뇌졸중 환자의 로봇 재활 치료를 위한 실시간, 동시 및 비례형 근전도 제어 (Real-Time, Simultaneous and Proportional Myoelectric Control for Robotic Rehabilitation Therapy of Stroke Survivors)

  • 정영진;박혜연
    • 재활치료과학
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    • 제7권1호
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    • pp.79-88
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    • 2018
  • 목적 : 본 연구에서는 뇌졸중 환자의 치료 효과를 증진시키기 위한 방법으로, 로봇 기반에 연속적이며, 실시간으로 환자의 의지에 따른 표면 근전도 신호에 비례한 제어가 가능한 최적 알고리즘을 구현 및 재활로봇과 PC소프트웨어에 적용기술을 개발하였다. 연구방법 : 뇌졸중 환자의 치료를 위한 재활로봇 제어 알고리즘 개발을 위해서 본 연구에서는 선형 재귀모델을 이용하였다. 또한, 이를 PC 소프트웨어에 적용하여 실제 근전도 신호에 비례하여 게임을 진행할 수 있도록 환경을 구축하였으며, 이를 활용하여 모의 훈련을 진행하였다. 결과 : 모의실험 결과 실제 움직인 위치와 선형 재귀모델로부터 추정된 위치의 결과가 상당히 유사하게 나타나는 것을 확인할 수 있었다. 또한 3명의 피험자를 대상으로 실험 한 결과, 3번의 각기 다른 시도에 따라 훈련이 진행되면서 그 결과가 좋아짐을 확인할 수 있었다. 결론 : 본 연구에서는 재활로봇에 적용 가능한 실시간으로 동작하는 근전도에 비례한 움직임을 유도해 낼 수 있는 선형 재귀 모델을 개발하였다. 또한, 이를 활용한 소프트웨어도 함께 구축하여 그 활용 가능성이 높음을 확인하였다. 향후 실제 재활로봇에 적용하여 자가-재활 및 원격재활 로봇에 기본 알고리즘으로 널리 활용될 수 있을 것이라 기대된다.

4가지 종류의 좌측 핸드 컨트롤 장치에 대한 사용자의 EMG 분석 및 운전 성능 평가 (Analysis of EMG Activities and Driving Performance for Operating Four Types of Left Hand Control Devices)

  • 송정헌;김용철
    • 대한의용생체공학회:의공학회지
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    • 제38권4호
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    • pp.143-152
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    • 2017
  • The main purpose of this research was to examine the EMG characteristics of driver's upper limb and driving performance for operating accelerator and brake pedal by using four types of left hand control devices(Push/Pull, Push/Right angle, Push/Rock, Push/Twist) during simulated driving. The persons with disabilities in the lower extremity have problems in operation of the vehicle because of functional impairments for controlling accelerator and brake pedal. Therefore, if hand control device is used for adaptive driving controls in persons with lower extremity loss, the disabled people could improve their quality of mobility life by driving a car. Twenty subjects were involved in this research to assess driving performance and EMG activities for operating accelerator and brake pedal by using four types of left hand controls in driving simulator. We measured EMG responses of six muscles(posterior deltoid, middle deltoid, biceps, triceps, extensor carpi radialis, and flexor carpi radialis) during pulling and pushing movement with four types of left hand controls for acceleration and braking. STISim Drive 3 program was used for evaluation test of four types of left hand control devices in straight lane course for time to reach target speed and brake reaction time. While operating the four types of left hand controls for acceleration, EMG activities of posterior deltoid in normal subjects were significantly increased(p < 0.05) compared to the disabled subjects. It was also found that EMG responses of triceps and posterior deltoid were significantly increased(p < 0.05) when using the Push/Right angle type than Push/Pull type. While operating the four types of left hand controls for braking, EMG activities of flexor carpi radialis and triceps in subjects with disability were significantly increased(p < 0.05) compared to the normal subjects. It was shown that muscle responses of posterior deltoid, middle deltoid and triceps were significantly increased when using the Push/Right angle type than Push/Rock type. Time to reach target speed and brake reaction time in subjects with disability was increased by 2.5% and 4.6% on average compared to normal subjects. The person with disabilities showed a tendency to relatively slow performance in acceleration at the straight lane course.

한방병원에 내원한 파킨슨병 환자의 통증의 임상적 특성에 관한 후향적 의무기록 분석 연구 (Clinical Characteristics of Pain in Patients with Parkinson's Disease Who Have Visited a Korean Medical Hospital : A Retrospective Chart Review)

  • 정혜선;김하리;김서영;임태빈;진철;권승원;조승연;정우상;문상관;박정미;고창남;박성욱
    • 대한한의학회지
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    • 제41권2호
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    • pp.23-33
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    • 2020
  • Objectives: To investigate the prevalence of pain, clinical characteristics of pain, association between clinical features and pain of patients with Parkinson's Disease(PD). Methods: We undertook a retrospective review of the medical records of patients diagnosed with PD between 2012 and 2019 at Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea. Results: A total of 172 PD patients met entry criteria and 147 out of 172 patients(85.5%) reported pain. In comparison with general population, PD patients has high prevalence of pain. Female PD patients more frequently reported pain than male (P=0.03). 102 out of 147patients(69.3) complained of musculoskeletal pain, and musculoskeletal pain show significant difference depending on the PD motor subtypes (P=0.039). Pain was mainly locatedin the leg (57.8%) in all PD motor subtypes. Tremor-dominant PD more frequently felt pain in upper limb than postural instability-gait difficulty dominant(PIGD) PD, but it was not statistically significant. Conclusions: These findings showed high prevalence of pain in PD patients, the correlation between female and pain, and the relationship between PD motor subtype and pain type. Our study can contribute to the clinical approach based on a more in-depth understanding of PD patients with pain.

태풍 수치모의에서 GPS-RO 인공위성을 사용한 관측 자료동화 효과 (Impact of GPS-RO Data Assimilation in 3DVAR System on the Typhoon Event)

  • 박순영;유정우;강남영;이순환
    • 한국환경과학회지
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    • 제26권5호
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    • pp.573-584
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    • 2017
  • In order to simulate a typhoon precisely, the satellite observation data has been assimilated using WRF (Weather Research and Forecasting model) three-Dimensional Variational (3DVAR) data assimilation system. The observation data used in 3DVAR was GPS Radio Occultation (GPS-RO) data which is loaded on Low-Earth Orbit (LEO) satellite. The refractivity of Earth is deduced by temperature, pressure, and water vapor. GPS-RO data can be obtained with this refractivity when the satellite passes the limb position with respect to its original orbit. In this paper, two typhoon cases were simulated to examine the characteristics of data assimilation. One had been occurred in the Western Pacific from 16 to 25 October, 2015, and the other had affected Korean Peninsula from 22 to 29 August, 2012. In the simulation results, the typhoon track between background (BGR) and assimilation (3DV) run were significantly different when the track appeared to be rapidly change. The surface wind speed showed large difference for the long forecasting time because the GPS-RO data contained much information in the upper level, and it took a time to impact on the surface wind. Along with the modified typhoon track, the differences in the horizontal distribution of accumulated rain rate was remarkable with the range of -600~500 mm. During 7 days, we estimated the characteristics between daily assimilated simulation (3DV) and initial time assimilation (3DV_7). Because 3DV_7 demonstrated the accurate track of typhoon and its meteorological variables, the differences in two experiments have found to be insignificant. Using observed rain rate data at 79 surface observatories, the statistical analysis has been carried on for the evaluation of quantitative improvement. Although all experiments showed underestimated rain amount because of low model resolution (27 km), the reduced Mean Bias and Root-Mean-Square Error were found to be 2.92 mm and 4.53 mm, respectively.

노인에서의 미세수술에 의한 재건술 (Microsurgical Reconstruction in Elderly Patients)

  • 전명곤;박봉권;안희창
    • Archives of Reconstructive Microsurgery
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    • 제9권1호
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    • pp.1-5
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    • 2000
  • The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

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PNF의 Sprinter Pattern을 통한 하지의 근 활성도가 균형능력에 미치는 영향 (Effect of Lower Limb Muscle Activity on Balancing through Sprinter Patterns of PNF)

  • 정우식;정재영;김찬규;정대인;김경윤
    • 한국콘텐츠학회논문지
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    • 제11권3호
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    • pp.281-292
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    • 2011
  • 본 연구는 PNF 중 스프린터 패턴 적용 시 하지의 근 활성도가 균형 능력에 미치는 영향을 알아보고자 다음과 같이 실시하였다. 편마비 환자 24명을 대조군과 실험군으로 나누어 실험군에 주 3회, 6주 동안 PNF의 상 하지 패턴의 결합인 스프린터 패턴(Sprinter pattern)을 실시하였다. 하지 근활성도는 내 외측광근, 내 외측슬괵근, 외측비복근의 활동전위의 실효치 값을 분석하였다. 균형 능력 검사는 FICSIT-4, FSST, MTD-Balance system 이용하여 측정하였다. 운동 적용 방법에 따른 측정 시점에 대한 대조군과 실험군의 유의성 검정은 Two-way repeated measure ANOVA를 실시하였고, 각 측정 항목들 간의 상관관계를 알아보기 위하여 Pearson correlation으로 분석하였다. 그 결과, 스프린터 패턴의 적용은 마비측 하지의 근 활성도를 증가시켜 정적 및 동적 균형능력을 향상시키는데 효과가 있었음을 확인할 수 있었다. 따라서 마비측 하지의 효율적 근동원을 위한 치료적 중재프로그램으로 적극적인 활용과 함께 다양한 운동 패턴들과 결합시켜 새로운 중재를 개발할 필요가 있을 것으로 생각된다.

일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성 (Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma)

  • 박용면;염석란;정진우;한상균;조석주;류지호;김용인;정성운
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.5-11
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    • 2009
  • Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.

First Report of Myiasis Caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in a Diabetic Foot Ulcer Patient in Argentina

  • Olea, Maria Sofia;Centeno, Nestor;Aybar, Cecilia Adriana Veggiani;Ortega, Eugenia Silvana;Galante, Guillermina Begona;Olea, Luis;Dantur Juri, Maria Julia
    • Parasites, Hosts and Diseases
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    • 제52권1호
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    • pp.89-92
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    • 2014
  • Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucum$\acute{a} $n Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female's oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease.

Rottweiller에서 발생한 무균성 농성 육아종성/육아종성 피부증후군(SPGS) (A Sterile Pyogranuloma/Granuloma Syndrome (SPGS) in a Rottweiler Dog)

  • 김연주;정아영;김재훈;엄기동;이근우;오태호
    • 한국임상수의학회지
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    • 제21권4호
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    • pp.402-405
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    • 2004
  • 5년령의 암컷 Rottweiler가 하악 및 슬와림프절의 비대, 입주변부의 미란성 피부병변과 우측 후지와 경부에 다수의 구진과 결절의 증상으로 내원하였다. 식욕부진을 제외하고는 전신적으로 특이한 증상은 없었으며, 개인 동물병원에서 cephalexin과 carprofen을 처치하였으나 호전을 보이지 않았다. 혈액검사 결과, 미약한 빈혈과 심한 림프세포 증다증을 보였으며, 생화학적검사에서는 AST수치가 증가한 것을 제외하고는 모두 정상이었다. 피부 세포학적 검사에서 세균이 소수 관찰되었다. 피부조직병리학 검사에서 다발성의 농성육아조성 병변과 미만성 지방염의 특징이 관찰되었다. 특수염색으로 Brown and Brown gram [B+B], periodic acid-Schiff [PAS], Ziehi-Neelsen [ZN] acid-fast, Giemsa 염색을 실시하였으나 원인체를 발견하지 못했다. 따라서 무균성 농성 육아종성/육아종성 피부증후군으로 진단하였고 enrofloxacin과 prednisolone의 병용투여에 양호한 치료반응을 보였다. Rottweiler에서 발생한 나타난 SPGS를 최초로 증례보고한다.

롤러 신발과 조깅 슈즈 신발 착용 후 보행 시 지면반력의 형태 비교 분석 (The Effects of Wearing Roller Shoes on Ground Reaction Force Characteristics During Walking)

  • 채원식
    • 한국운동역학회지
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    • 제16권1호
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    • pp.101-108
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    • 2006
  • The purpose of this study was to compare GRF characteristics during walking wearing jogging and roller shoes. Twelve male middle school students (age: $15.0{\pm}0.0\;yrs$, height: $173.6{\pm}5.0\;cm$, weight: $587.6{\pm}89.3\;N$) who have no known musculoskeletal disorders were recruited as the subjects. Kinematic data from six S-VHS camcorders(Panasonic AG456, 60 fields/s) and GRF data from two force platform; (AMII OR6-5) were collected while subjects walked wearing roller and jogging shoes in random order at a speed of 1.1 m/s. An event sync unit with a bright LED light was used to synchronize the video and GRF recordings. GRF data were filtered using a 20 Hz low pass Butterworth. digital filter and further normalized to the subject's body weight. For each trial being analyzed, five critical instants and four phases were identified from the recording. Temporal parameters, GRFs, displacement of center of pressure (DCP), and loading and decay rates were determined for each trial. For each dependent variable, paired t-test was performed to test if significant difference existed between shoe conditions (p <.05). Vertical GRFs at heel contact increased and braking forces at the end of initial double limb stance reduced significantly when going from jogging shoe to roller shoe condition. Robbins and Waked (1997) reported that balance and vertical GRF are closely related It seems that the ankle and knee joints are locked in an awkward fashion at the heel contact to compensate for the imbalance. The DCP in the antero-posterior direction for the roller shoe condition was significantly less than the corresponding value for the jogging shoe condition. Because the subjects tried to keep their upper body weight in front of the hip to prevent falling backward, the DCP for the roller shoe condition was restricted The results indicate that walking with roller shoes had little effect on temporal parameters, and loading and decay rates. It seems that there are differences in GRF characteristics between roller shoe and jogging shoe conditions. The differences in GRF pattern may be caused primarily by the altered position of ankle, knee, and center of mass throughout the walking cycle. Future studies should examine muscle activation patterns and joint kinematics during walking with roller shoes.