Since ultrasound has different reflections depending on components of organization, analysis of ultrasound images of skeletal muscle can offer both quantitative and qualitative reports as concerns skeletal muscle structure. This study is focused on the ultrasound method for evaluating the structural characteristics of skeletal muscle and also conducted to examine its practicality. After obtaining images of the elbow flexors from an ultrasound image device with 88 normal subjects whose ages were between twenty and seventy years old (44 men and 44 women), muscular density and white area index (WAI) which indicated structural characteristics of skeletal muscle were analyzed with gray scale analysis. The study examined correlations between subject's age and items which obtained from measuring ultrasound images and the differences in relations to sex and age. Muscular density and WAI had a high correlation with age and were significantly increased in men and women with greater age. The quantitative evaluation method of skeletal muscle structure which analyzed the ultrasound images has high practicality because it is a non-invasive method which complements physical therapy diagnosis and research methods and promotes functionality evaluation.

Osteoporosis is the most prevalent metabolic bone disease and is characterized by diminished bone strength predisposing to an increased risk of fracture. Thus, this study was performed (1) to examine the effect of aquatic exercise on osteoporosis caused by an ovariectomy in the rats, and (2) to elucidate involvement of histopathologic findings in mediating these actions. The results of this study were as follows: 1. Body weight of the subjects increased after the experiment. There was a statistically significant difference (p<.05) between Group I (sham operated) and Group II (control group). 2. In respect to the length, circumference and weight of the femur, there was no statistically significant difference between the control group and the other groups (p>.05). 3. With the osteocalcin level used as one of the bone formation indexes the bone mineral density increased in every group in comparison with the control group, and in particular, there was a statistically significant difference between Group III and Group IV. The above results suggest that aquatic exercise treatment is effective in the prevention and treatment of osteoporosis.

The purpose of this study was to evaluate the effects of pulsed ultrasound on wound healing and observe during the wound healing process the distribution of mast cells according to histopathologic findings. Eighty Sprague Dawley rats which were divided into 4 groups received full thickness skin wounds on the back. Each of the 5 animals was sacrificed immediately and then sacrificed again 1, 3, 6, and 12 days after injury. Specimens from the wounds were removed during healing and routinely processed with a hematoxylin-eosin stain and a toluidine blue stain. The authors then observed the distribution of mast cells under a light microscope. The results of this study were as follows: The rate of wound healing and the length of the wounds of the pulsed ultrasound group II was significantly faster than group I on day 6 and day 12 (p<.001). Group III showed the most significant effect after12 days (p<.001). Group IV also showed a significant effect at 12 days (p<.01). A low-intensity ultrasound .5 resulted in a fast healing rate. During the wound healing process mast cells had a tendency to decrease in the acute inflammatory phase. During the wound healing process mast cells were thought to contribute to the healing of the wound.

Motor skill learning can be acquired implicitly without consciousness of what is being learned. The purpose of this study was to examine the characteristics of implicit motor learning in young and elderly people using a perceptual-motor task. Forty normal young and elderly subjects participated. A modified version of the Serial Reaction Time Task (SRTT) using six blocks of twelve perceptual motor sequences was administered. The paradigm consisted of the first random sequence block followed by the four patterned blocks and another random block. In each block, the go signal consisted of an asterisk displayed in the one of the four parallel arrayed boxes in the middle of the screen. Subjects were instructed to push the corresponding response buttons as quickly as possible. Young subjects demonstrated shorter reaction times during the consecutive patterned blocks reflecting appropriate learning accomplished. Elderly subjects were able to learn a perceptual-motor task with implicit knowledge, but the performance was lower than that of the young persons. These results indicated that implicit sequence learning is still preserved in elderly adults, but the rate of learning is slower.

2000년부터 2002년까지 통영 바다목장 해역 5개 정점표층수와 저층수에서 종속영양세균의 개체수를 평판계수법으로 측정하여 종속영양세균군집의 계절별 변동추이를 비교 분석하고, 우점종을 선별하여 동정하였다. 7월과 8월의 하절기에 채수한 해수에는 봄 혹은 가을 및 겨울에 채수한 해수에 비하여 모든 정점에서 훨씬 더 많은 종속영양세균이 검출되었다. 저층수에 비하여 표층수에서 종속영양세균의 수가 더 많았으나 동절기(2001년 12월과 2002년 2월)에는 해

The purposes of this study were to find correlations among Fugl-Meyer Assessment scale, gait speed, and Timed Up & Go test (TUG) and to predict gait ability from subscales of Fugl-Meyer Assessment scale. The study population consisted of 30 stroke patients referred to the Department of Rehabilitation Medicine in the Bundang Jaesang General Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and gait speed (m/s), TUG (s). The data were analyzed using independent t-test, Pearson product moment correlation analysis and stepwise multiple regression. The results revealed that all items of Fugl-Meyer Assessment scale, except passive joint range of motion were significantly correlated with gait speed and TUG. In particular, sensation score, lower extremity motor and coordination score have a significant correlation with gait speed and TUG (p<.05). The sensation score and lower extremity motor score were important factors in comfortable gait and maximal gait speed. Their power of explanation regarding comfortable gait and maximal gait speed were 63.0% and 65.0%, respectively. The sensation score and lower extremity coordination score were important factors in TUG. Their power of explanation regarding TUG was 55.0%. These results showed that Fugl-Meyer Assessment scale is significantly correlated with gait speed and TUG. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict gait ability of patients with stroke. Further study about gait speed and TUG by change of Fugl-Meyer Assessment score is needed using a longitudinal study design.

Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle , FOV 220 mm, matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

The purpose of this study was to analyze the effects of three different pelvic tilts on sit-to-stand ativities and to suggest a new therapeutic approach for movement reeducation in patients who have difficulty with sit-to-stand activities. The three different pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To analyze the kinematic component of STS, a motion analysis system (Zebris) was applied to the ankle, knee, hip joint, and thigh-off area. Also, to determine the onset time of muscle contraction, surface electrodes were placed to the rectus femoris muscle (RF), the vastus lateralis muscle (VL), the biceps femoris muscle (BF), the tibialis anterior muscle (TA), the gastrocnemius muscle (GCM), and the soleus muscle (SOL). One-way repeated ANOVA was used for the statistical analysis. First, significant differences were found in kinematic variables for the hip, knee, ankle joint, and thigh-off among the three activities. Second, there was significant difference in muscle activation pattern in TA. VL. and BF among three activities. In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity: (1) Changes in knee and ankle joints should be prioritized and recruitment order differences in VL and RF can be generated to accomplish abnormal STS activity. (2) APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated.

The purpose of this study was to analyze the effects of three different pelvic tilts on a sit-to-stand (STS) and to suggest a new assessment approach based on biomechanical analysis. The three difrent pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To determine the onset time of muscle contraction surface electrodes were applied to the rectus femoris muscle (RF), vastus lateralis muscle (VL), biceps femoris muscle (BF), tibialis anterior muscle (TA), gastrocnemius muscle (GCM), and soleus muscle (SOL). The ICC was used for functional linkage analysis. The findings of this study were as follows. First, significant differences were found in kinematic variables and in muscle activation pattern among the three activities. Second, the results of functional integrated analysis revealed that recruited muscle activation patterns changed when the thigh-off was viewed as a reference point. Third, there were independent functional units between the thigh-off and the VL and between the thigh-off and the RF in the functional linkage analysis. The VL and RF acted as prime mover muscles, and more postural adjustment muscle recruitment was required as the demand of postural muscle control increased (PPT STS, APT STS, and CPT STS in order). In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity. APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated. However, excessive APT would change the muscle activation patterns of BF and SOL and require additional postural muscle control to cause abnormal control patterns.

Therapeutic ultrasound is commonly applied for deep heating in physical therapy setting. However, it is difficult to determine the exact application dosage and to confirm the immediate heating effect. Microwave Radio-Thermometer (MRT) can measure the temperature by the electromagnetic energy in the microwave region of the object that emits above absolute zero temperature. MRT was used for early diagnosis of breast cancer since it was not harmful, non-invasive, and non-ionizing to the human body. The purposes of this study were to investigate how accurately 1.1 GHz RTM (RES Ltd. Russia) measures the change of average temperature in the tissue, and to determine the depth of temperature change measurement. Therapeutic ultrasound was applied (continuous wave for 5 minutes, 1 MHz, intensity of 1.5 [in vitro] and 1.0 [in vivo]) in four different conditions: (1) 30 cases of in vitro specimen of pork, (2) 30 cases of in vitro specimen of pork ankle joint, (3) 10 cases of in vivo canine thigh, and (4) 30 cases of in vivo human body. Intraclass Correlation Coeffients (ICC[3,1]) between average needle probe thermometer below surface and MRT temperature was revealed as followed: (1) Before ultrasound application ICCs ranges above .8 in specimen of pork (15 mm underneath the skin) and above .82 in specimen of pork ankle joint (10~30 mm underneath the skin). (2) After ultrasound application ICCs ranges above .7 in both specimens of pork and pork ankle joint. (3) Before ultrasound application ICCs ranges above .8 in canine thigh (20 mm underneath the skin). (4) After ultrasound application ICCs ranges above .82 in canine thigh. The temperature of the human body increased significantly with the mean of in muscle tissue and with the mean of in joint (p<.00). It was revealed that the average depth of temperature measurement of the tissue by MRT was in between 10 and 35 mm, and determined that the proper temperature measurement band was .

In most of the medical literature that discusses the common problem of movement in patients with cerebral lesions. This critical problem is ascribed to a mechanism involving uninhibited neural activity. The goals of neurological physical therapy are focus on reduce of muscle hypertonicity, facilitates muscle activities, and improve of performance in living environment. A variety of studies suggest that spasticity is a distinct problem and separate from the muscle weakness. It has become increasingly recognized that the major functional deficits following brain damage are largely due to negative features such as muscle weakness and loss of performance rather than spasticity. Adequate recruitment of prime mover, not release was able to carry out the movement tasks well. The strengthening exercise of spastic limbs on changes in muscle properties and performance skill, the repeated motor practice has been identified as crucial for motor recovery. This article support the concept that strengthening is an appropriate intervention to improve the quality of physical function in patients with central nervous system lesions. Further studies and therapeutic approaches should be efforts at improving motor neuron recruitment in agonist rather than reducing activity in antagonists while retraining muscle strengthening.

We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained left hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.

The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 and 500 ) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 and 500 until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 and 500 until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 and 500 until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 than the group with 500 (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 ultrasound intensity than those treated with 500 intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 to 500 is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.