이 논문의 주목적은 정상인을 대상으로 각기 다른 3가지의 (체중의 1.5 %, 3.0 %, 9.0 %) 부하를 통해서 자세의 불균형을 유발시켰을 때 나타나는 postural movement patterns을 기술하기 위한 연구이다. 연구대상의 허리중심에 체중부하를 주어 균형이 뒤로 이동하게 하여, surface EMG(표면 근전도)를 통하여 Tibialis anterior(Ta), Gastrocnernius(Gc), Quadriceps femoris(Q
The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.
For the purpose of clarifying to what degree the mothers of developmentally delayed children are involved in treating their child at home. 193 mothers were sampled from 220 mothers of developmentally delayed children below 12 years of age who have visited one of four institutions: the Rehabilitation Hospital of Yonsei Medical Center, Inchon Severance Hospital, Disabled Welfare Center in Myongil-dong, and Nambu Disabled Welfare Hall. The study period was from Mar. 25, 1995 through Apr. 15, 1995. A questionnaire survey was conducted listing the characteristics of the developmentally delayed children, their mothers, mother's satisfaction with their therapists, and the actual conditions of the home treatment. 1. The mothers who treat their child at home for more than 31 minutes a day show a high involvement score, while the mothers of those who give treatment for less than 30 minutes a. day show a low involvement score. That is, the longer the treatment, the greater the involvement score. This indicates a statistically significant result(p<0.01). 2. In cases where a child's father is involved in the home treatment, his/her mother discloses a statistically high involvement score(p<0.001). 3. The result of analysis of cases where other family members, relatives or friends (fathers excepted) reveals a statistically significant high involvement score(p<0.05) for the mother. 4. Mothers in general represent a statistically significant high involvement in home treatment. In the meantime, the mothers in a nuclear family show a higher involvement home treatment than mothers in an extended family(p<0.01). 5. Among those respondents who think that home treatment is helpful and that mothers' involvement in home treatment is helpful, the mothers record a statistically significant high involvement score(p<0.05). When seen from the above perspectives, it seems of much significance that fathers and other relatives or family members play an important role in enhancing the involvement of mothers in home treatment. One point to note here is that providing a long home treatment time is crucial. Therefore, it is recommended that family members have access to rehabilitation treatment for training developmentally delayed children or their care giver; and moreover, we needed to carry out family training or at least arrange for meetings between the family members and medical personnel involved in the child's rehabilitation.
The purpose of this study was to investigate the effectiveness of mental practice in increasing accuracy of performance during motor task. Forty healthy students aged 17 years were randomly assigned to two groups. The experimental group(n=20) performed mental practice; the control group(n=20) performed nothing. The task was dotting. No significant change was seen between pre and post test subtest results following mental practice sessions(p>0.05). The experimental group's accuracy improved a little but this was not valuable statistically(p>0.05). We could not prove that mental practice was effective in increasing accuracy of motor task performance.
The purpose of this study was to assess the concurrent validity and reliability of goniometric measurement of joint motion. Subjects were 40 healthy university students. Measurements were performed by 4 inexperienced physical therapy students. Four different instruments were used and three readings were taken with each instrument in random order making a total of 12 readings for flexion of the right elbow of each subject. Goniometers used were 1. universal 2. fluid-based goniometer/inclinometer 3. digital LCD goniometer 4. electronic goniometer/torsiometer. The results were as follows: Concurrent validity was highest (r= .94) with the universal and digital LCD tools. Interrater reliability (Pearson Product Moment Correlation) was good for each tool. Interrater reliability calculated by ICC(2,1) was highest (.96) with the tensiometer and lowest (.78) with the digital LCD goniometer. Intrarater reliability calculated by ICC was excellent () for all instruments. These results show that concurrent validity, intrarater and interrater reliability are very good in the used of all four types of goniometers/inclinometer/tensiometer, even with inexperienced raters. These results confirm the almost universal reliance on hand held goniometers for joint measurement by physical therapists as being a reliable practice. Further research should be done clinically with actual patients.
The purpose of this study was to compare the effects of one proprioceptive neuromuscular facilitation technique and static stretching on calf muscle tightness. The subjects consist of 9 hemiplegics, and 9 quadriplegics. The eighteen subjects were randomly divided into 3 groups: prorioceptive neuromuscular facilitation(6 persons), static stretching(6 persons) and control(6 persons). Contract relax antagonist contract and static stretching techniques were applied continuously for twenty minutes each. Of the many proprioceptive neuromuscular facilitation techniques, only the contract relax antagonist contract technique was applied. The static stretching technique was applied with the subject placed in standing on a seventy degree inclined tilt table for twenty minutes. A wedge was placed under the feet to obtain maximum dorsiflexion. Wedge thickness varied with each subject. Results revealed: (1) a significant difference between the experimental and the control groups(p<0.05). (2) a significant difference between contract relax antagonist contract and static stretching groups(p<0.05). (3) At day five, the final increments were: contract relax antagonist contract , static stretching (meanstandard deviation).
The purpose of this study was to determine a more effective method for shoulder pain reduction. Forty-five normal subjects were randomly assigned to one of 3 groups a control group, an acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) group, and a silver spike point(SSP) group. Each person in the ALTENS and SSP groups was measured for pressure pain threshold before and after a 20 minute treatment. The control group was also checked for pressure pain threshold before and after a 20 minute period but no "treatment" was given. The major findings were as follows ; 1)The ALTENS and SSP groups showed significant differences before and after treatment but the control group showed no significant difference. 2)When the three groups were compared, the only significant difference was between the SSP group and the control group. As mentioned above, it may be concluded that both ALTENS and SSP therapy were effective in reducing shoulder pain when measured directly after treatment. However, SSP did not show any superior effect. Further study should be done to determine the effective the maintained pain reduction with post-treatment time lapse.
Spasticity has been defined as a motor disorder characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting in hyperexcitability of the stretch reflexes as one component of the upper motor neuron syndrome. Weakness and loss of dexterity, however, are considered to be more disabling to the patient than changes in muscle tone. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakness. This paper considers both the neural and mechanical components of spasticity and discusses, in terms of clinical intervention, the implications arising from recent research. Investigations suggest that the resistance to passive movement in individuals with spasticity is due not only to neural mechanisms but also to changes in mechanical properties of muscle. The emphasis is on training the individual to gain control over the muscles required for different tasks, and on preventing secondary and adaptive soft tissue changes and ineffective adaptive motor behaviours.
When applying FES to patients, proper evaluation must be performed prior to treating patient. Patients with thoracic lesions between are suitable for FES. However, these patients must have excitability of the leg muscles. Thus, excitability testing is an essential part of the screening program(stimulation at 80V gives a response). Before standing or walking is attempted the patients must perform restrengthening exercise, so that the Quadriceps muscle group minimum strength is 40 Nm (corresponding to a manual grade of F+ to G). After that walking and standing can be attempted. The effects of FES are as follows: prevents pressure sores; development and maintenance of muscle properties; prevents disuse atrophy and contractures.
Physical therapists use assumptions about motor control in every aspect of their work in treating stroke patients. An understanding of the recovery process after stroke, some neural mechanism of recovery and therapeutic model is critical factor for physical therapist to evaluate and obtain a higher final stage of recovery. The purpose of this article was to review the recovery process after stroke, some neural mechanism of recovery, the role of rehabilitation in the process of recovery, therapeutic model and its limitation. This article will help understanding of recovery process. evaluation, and treatment of the stroke patients. Each therapeutic method consists of a different set of assumptions and they are not completely independent of one another. Therefore specializing in any techniques of physical therapy will not be enough to treat stroke, so we are in need of integrated approach and objective measurement instrument to adequately evaluate and treat stroke patients.
The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the Convex-Concave Rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joints are treated be using a gliding technique.