본 연구의 목적은 알츠하이머질환(Alzheimer’s disease: AD) 동물 모델을 대상으로 트레드밀 운 동(Treadmill exercise: TE)과 환경강화(environmental enrichment: EE) 처치가 인지기능, 근 기능, 및 밀 착연접 단백질 발현에 미치는 영향을 확인하는데 있다. AD 동물 모델을 제작하기 위해 aluminum chloride(AlCl3)를 90일간(40mg/kg/하루) 투여 하였으며 동시에 TE(10-12m/min, 40-60min/day) 혹은 EE에 노출시켰다. 그 결과 AlCl3 투여에 의한 인지기능 저하와 근 기능 감소가 TE와 EE에 의해 완화된 것 으로 나타났다. 또한, TE와 EE는 AD 질환에서 나타나는 β-amyloid(Aβ), alpha-synuclein 및 tumor necrosis factor-α(TNF-α) 단백질의 발현 증가를 감소시킨 것으로 나타났다. 게다가 TE와 EE는 AlCl3 투여에 의해 감소된 밀착연접 단백질(Occludin, Claudin-5 및 ZO-1)의 발현을 통계적으로 유의하게 증가시킨 것으로 나타났다. 마지막으로 Aβ 단백질과 밀착연접 단백질과의 상관분석을 실시한 결과 부적 상 관관계(Occludin: r=-0.853, p=0.001; Claudin-5 : r=-0.352, p=0.915; ZO-1 : r=-0.424, p=0.0390) 로 나타났다. 따라서 이를 종합해 보면 TE 혹은 EE 처치는 AD에 나타나는 병리학적 특징들을 일부 완화 시켜 인지기능과 근 기능을 일부 개선 시킬 수 있는 효과적인 운동 방법이라고 생각된다.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

본 연구는 4주간의 동계훈련기간 중 산수유 추출물을 섭취시켜 간 기능, 근 손상 및 혈중 피로물질에 미치는 영향을 구명하기 위하여 남중 축구선수 20명을 대상으로 동계훈련+산수유 추출물 섭취군(10 명), 동계훈련군(10명)으로 구분하여 실시하였다. 동계훈련은 1일 오전, 오후, 야간운동으로 구분하여 주 6 일, 4주간 실시되었으며, 운동강도는 70-95%HRR로 수행되었다. 산수유 추출물은 매일 아침과 저녁 식사 후 각각 80 mL(1일 160mL)를 4주간 섭취시켰으며, 측정된 자료의 그룹 내 변화는 대응표본 T검정, 그룹 간 차이는 변화율을 산출 한 뒤 독립표본 T검정을 이용하여 비교 분석하였다. 그 결과 혈중 피로물질의 젖산은 동계훈련+산수유 추출물 섭취군에서 유의하게 감소하였으며(p<.05), 동계훈련군 보다 동계훈련+산수유 추출물 섭취군이 유의하게 감소하였다(p<.05). 암모니아는 동계훈련+산수유 추출물 섭취군(p<.05), 동계훈련군(p<.001) 모두 유의하게 증가하였다. 근 손상지표의 CK는 동계훈련+산수유 추출물 섭취군이 유의하게 감소하였으며(p<.05), LDH는 동계훈련+산수유 추출물 섭취군(p<.001), 동계훈련군(p<.05) 모두 유의하게 감소하였다. 간 기능 효소 중 AST(p<.01), ALT(p<.05)는 동계훈련+산수유 추출물 섭취군이 유의하게 감소하였으며, AST는 동계훈련군 보다 동계훈련+산수유 추출물 섭취군이 유의하게 감소하였다. 동계 훈련 시 피로에 쉽게 노출 될 수 있는 선수들에게 있어 산수유 추출물 섭취는 항피로의 역할을 하는데 긍정적인 영향을 미치는 것으로 사료된다.

목적 : 작업치료중재를 통한 유방암 환자의 신체기능과 근 활성도 및 삶의 질에 미치는 효과를 알아보고자 하였다. 연구방법 : 본 연구는 유방암 환자 15명을 대상으로 스트레칭, 치료적 활동 및 일상생활활동으로 구성된 작업 치료중재 프로그램을 40분씩 주 2회 총 12주 동안 실시하였다. 신체기능은 한국판 간이 피로 평가지 (Korean version of Brief Fatigue Inventory; BFI-K), 기본 호흡곤란 지표(Baseline Dyspnea Index; BDI)를, 근 활성도는 surface Electromyoghraphic (sEMG)를, 그리고 암 치료 관련 기능적 평가 - 유방 암(Functional Assessment Cancer Therapy-Breast; FACT-B)를 통하여 삶의 질을 측정하였다. 결과 : 신체기능에서 피로도와 호흡곤란 정도는 감소하였으며(p<.01), 근 활성도는 앞쪽․중간 어깨세모근, 큰가슴 근의 복장갈비머리 부분, 가시아래근에서 유의하게 증가하였다(p<.05). 삶의 질은 총점과 하위 영역 중 Physical Well-Being(PWB), Functional Well-Being(FWB), Breast Cancer Subscale(BCS)가 통계적 으로 유의한 차이를 나타냈다 (p<.001). 결론 : 중재 후 신체기능과 근 활성도, 삶의 질 모두에서 향상을 보였으며 이는 작업치료 중재가 유방절제 술 환자의 회복에 도움이 될 것으로 생각된다.

Background:Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.Objects:This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.Methods:Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions.Results:The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05).Conclusion:These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n1=25) and a control group (CG, n2=23). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.

Objective : The purpose of this study was to investigate the effects of Expiratory Muscle Strength Training (EMST) on the suprahyoid muscle activation and swallowing function of stroke patients.Methods : This study randomly assigned 21 stroke patients to an experimental group and a control group. Four-week EMST was performed at resistance of 70% of the maximum expiratory pressure with the experimental group and at resistance of 20% of that with the control group. Evaluation was conducted using surface Electromyographic (sEMG), Videofluoroscopic Dysphagia Scale (VDS), and Penetration-Aspiration Scale (PAS) based on Videofluoroscopic Swallowing Study (VFSS).Results : There was a statistically significant difference in the activation of the suprahyoid muscles using sEMG of the experimental group (p<.05) while there was no significant difference in that of the control group. Both group showed significant difference in the pharyngeal phase of VDS and PAS. Also in the comparison of variation in VDS and PAS before and after the intervention, there were statistically.Conclusion : Finding from this study confirmed that EMST applied 70% maximum expiratory resistance would be a remedial method which could help activate pharyngeal dysphagia patients’ suprahyoid muscles and improve swallowing function.

This study aimed to determine the effect of lower trapezius muscle strengthening exercises on pain, neck disability index (NDI), cervical range of motion (ROM), and lower trapezius muscle strength in patients with unilateral neck pain. Following baseline measurements, the subjects (N=40) with unilateral neck pain were randomized into one of two 5 weeks exercise intervention groups: a experimental group (EG, n1=20) that received strength training of the lower trapezius muscles or a control group (CG, n2=20) that received routine physical therapy program. Each group participated in the intervention for 30 minutes, 3 times a week, for 5 weeks. All participants performed 2 repetitions of each intervention per day. The numeric pain rating scale for pain, NDI, ROM, and lower trapezius strength were recorded both pre- and post-intervention for both groups. Paired t-tests were used to determine significant changes post-intervention compared with pre-intervention and independent t-tests were used to analyze differences in the dependent variables between the 2 groups. After the 5-weeks intervention, both groups experienced significantly decreased pain and disability level (p<.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p<.05). The EG that received strength training of the lower trapezius muscles showed greater improvements in pain and functional disability level, cervical rotation, and lower trapezius strength than the CG (p<.05). These results suggest that a lower trapezius strengthening exercises reduce neck pain and neck disability level and enhance cervical ROM and lower trapezius strength level in patients with unilateral neck pain.

The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia. Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.

It is important to find the effective position for cough and sputum clearance in respiratory physical therapy. The purpose of this study was to compare the changes in peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and peak cough flow (PCF) related to functional level and measurement position in patients with Duchenne muscular dystrophy. Twenty one subjects were classified into three functional levels, and measurements was undertaken in three different measurement positions (upright sitting, 45˚ reclining and supine). Vitalograph PEF/FEV DIARY was used to measure PEF and FEV1, and Ferraris Pocket Peak was used to measure PCF. Mixed two-way analysis of variance and Bonferroni post-hoc test were used for statistical analysis. The results of the study were as follows: 1) Significant main effects for measurement position were found. 2) PEF was the highest in upright sitting, followed by 45˚ reclining, and supine in order. 3)FEV1 in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 4) PCF in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 5) No significant main effects for functional level were found in PEF, FEV1, and PCF. 6) No significant functional level by measurement position interactions were found in PEF, FEV1, and PCF. Therefore, it is concluded that upright sitting and 45˚ degree reclining positions are recommended for effective cough and sputum clearance.

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second (FEV1), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/FEV1 DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and FEV1 between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and FEV1 increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and FEV1, and reducing VAS during forced expiration in patients with chronic low back pain.

목적 : 본 연구의 목적은 손가락 폄근에 실시한 근전도 유발 전기자극 치료가 편마비 환자의 손기능 회복에 미치는 영향을 알아보고자 하였다. 연구 방법 : 20명의 뇌졸중 환자를 무작위로 EMG-stim군과 대조군에 각각 10 명씩 배정하였다. EMG-stim 군은 하루에 30분씩 2회, 주 5일, 10주 동안 (총 100회) 손가락 폄근에 EMG-stim 치료를 실시하였다. 반면, 대조군에게는 어떠한 치료도 실시하지 않았다. 손 기능을 검사하기 위하여 치료 전·후에 적분 EMG, 관절 운동 범위, 퍼듀 페그보드 검사를 EMG-stim군과 대조군 모두 실시하였다. 결과 : 치료 전·후 EMG-stim군은 적분 EMG, 관절 운동 범위, 퍼듀 페그보드 검사에서 유의하게 개선되었다(p<.05). 그러나 대조군은 유의한 차이가 나지 않았다(p>.05). 또한 집단 간 비교에서 EMG-stim 군은 대조군에 비하여 모든 종속 변수에서 유의하게 개선되었다(p<.05). 결론 : 본 연구에서 장기간 동안 집중적으로 실시한 EMG-stim 치료는 뇌졸중 환자의 손기능 회복에 효과적이라는 결론을 내릴 수 있다.

The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance (R²=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

목적 : 본 연구는 만성 뇌졸중 환자를 대상으로 자세 조절이 일상생활동작 수행능력과 근 긴장도 변화 및 상지기 능 수행에 어떠한 영향을 미치는지 알아보고자 하였다． 연구방법 : 본 연구를 위하여 국립재활원에 입원한 41명의 뇌졸중 환자를 대상으로 모든 환자들은 자세조절 평가 척도(Postural Assessment Scale stroke, PASS), 일상생활동작 수행능력 측정 도구(Modified Barthel Index, MBI), 긴장도 사정 척도(Tone Assessment scale, TAS), Fugl-Meyer 평가 척도(Fugl-Meyer Assessment scale－upper extremity) 등을 이용하였고 자료 분석은 피어슨 상관분석(pearson correlation coefficient), 단계적 다중 회귀분석(stepwise multiple regression）을 실시하였으며 내적 일치도를 알아보기 위하여 Cronbach's alpha Coefficient를 구하였다． 결과 : PASS항목에서 가장 기능이 좋은 것은 지지하여 서기로 나타났으며，가장 기능이 낮은 것은 환측으로 서기였고，MBI항목에서 가장 기능이 좋은 것은 의자／침상 이동이며， 가장 기능이 낮은 것은 목욕하기로 나타났다．PASS의 모든 항목은 MBI, FM-UE, TAS와 유의한 상관관계(r=-33~91, p<.05~01）가 있으며，FM-U/E와 MBI(r=.35, p<.05), TAS- 안정(r=.-40, p,<．0.1), 연합항목(r=-.39,p<.05)에서 유의한 상관관계가 있는 것으로 나타났다．내적 일치도는 Cronbach's a=.86로 높게 나타났으며，PASS의 합과 자세유지 항목 (r=.90 p<.01)의 합，자세변화 항목(r=.93,p<.01)의 합은 유의한 상관관계가 있었으며，자세유지 항목의 합과 자세변화 항목의 합 간에는 유의한 상관관계(r=.69,p<.01)가 있었다．PASS 항목 중 누운자세에서 건측으로 돌기와 바닥에서 볼펜집어 올리기가 각각 ADL과 상지 기능을 예견하는데 가장 중요한 변수(R2=.95, R2=.56)임을 알 수 있었다． 결론 : PASS는 일상생활동작 수행 능력과 근 긴장도 및 상지기능수행 간에 유의한 상관관계가 있는 것으로 나타나 뇌졸중 환자의 기능적 독립성을 예측할 수 있는 지표가 될 수 있을 것이다．

Functional electrical stimulation (FES) training of the knee extensors is a useful way to rehabilitate the ability to stand and walk. However, training using FES has not been able to solve the problem of fatigue; clinical application of FES quickly produces muscle fatigue, due to the continuous activation of the muscles of the lower extremity. Therefore, reduction of muscle fatigue is an important factor in increasing the effectiveness of FES training in paraplegia. Intermittent high frequency alternating stimulation is a method that combines the advantages of high frequency (leading to strong muscle contractions) and alternating stimulation (reducing muscle fatigue), thereby continuously strengthening muscles. It is not known whether low frequency simultaneous stimulation results in stronger muscle contraction than high frequency alternating stimulation. This study compared the effectiveness of high frequency alternating stimulation with low frequency synchronized stimulation. Muscle power using FES on the quadriceps of 20 normal subjects were compared. Intermittent high frequency alternating stimulation did not produce more powerful muscle contraction than intermittent low frequency synchronized stimulation, because the muscle characteristics differed individually. Significant individual variation according to muscle characteristics was founded when applying FES. Accordingly, when physical therapists use FES to treat patients, they must be aware of individual variation in muscle characteristics.

The purpose of this study was to identify the differences in pulmonary functioning after respiratory exercise with IPPB (Intermittent Positive Pressure Breather) in patients with progressive muscular dystrophy (PMD). The subjects were 46 patients with PMD who were admitted to the Rehabilitation Medicine Department of Youngdong Severance Hospital. The subjects were assigned into one of 2 groups. The control group received comprehensive treatments such as ROM exercise, deep breathing exercise, moist hot packs, and ultrasound twice a day while admitted at the Rehabilitation Medicine Department. Unlike the control group, the subjects at the experimental group received respiratory exercise treatment with IPPB. The subjects were admitted for 10~19 days, and the average length of hospital stay was 12.2 days. Pulmonary functioning was evaluated at admission and discharge by SENSOR MEDICS. The data were analyzed by a paired t-test and a independent t-test. The results were as follows: 1) The change of each parameter of pulmonary function tests were significantly improved in all groups after respiratory exercise treatment during admission (p<0.05). 2) By comparing the change of each parameter of pulmonary function tests between the experimental group and control group, the parameters of vital capacity (VC), forced vital capacity, forced vital capacity predicted (FVCP) and forced expiratory volume in 1 second (FEV1) were significantly improved in the experimental group which had received the pulmonary exercise treatment with IPPB (p<0.05). In conclusion, this study suggests that the pulmonary exercise treatments with IPPB facilitated improvement in the pulmonary functioning for the PMD patients during their hospital stay.

In this study, the antioxidative activity and functional food activities of water and ethanol extracts from Pinus densiflora root were examined. It was more effective to use ethanol than water when extracting phenolic compounds. The extracted phenolic compounds from Pinus densiflora root for biological activities were examined. The phenolic compounds extracted with water and 80% EtOH were 1.86±0.04 mg/g and 6.85±0.16 mg/g, respectively. DPPH free radical scavenging activity of water and EtOH were each 86% and 85% at 100 μg/mL phenolics, respectively. ABTS radical decolorization activity was 48% in water and 68% in EtOH at 200 μg/mL. Antioxidant Protection Factor (PF) were 1.74 PF in water and 1.96 PF in EtOH at 50 μg/mL. TBARs of water and EtOH were 93% and 98%, respectively at 100 μg/mL. The inhibition activity on xanthine oxidase was 83.7% in water extracts and 79.6% in ethanol extracts. Inhibition on xanthine oxidase of water and ethanol extracts showed a higher inhibition effect than allopurinol. The inhibition activity on α-glucosidase was 14.8% in water extracts and 91.6% in ethanol extracts. The result suggests that P. densiflora root extracts may be useful as as functional food material.