Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was , , respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.
Korea will soon experience a high demand for medical rehabilitation specialists, if it tries to deliver advanced health welfare service. In order to medical rehabilitation manpower policies, this study attempts to analyse, estimate and plan a long-term supply for physiatrists, physical therapists, and occupational therapists. The study analysed both national and foreign statistical data of manpower supply for medical rehabilitation specialists. A structured category of questionnaire was developed to survey the opinions of regarding the supply for rehabilitation specialists in Korea. Based on the above data, the demand of and supply for each specialists were estimated for long term up to the year 2030. Based on the comparative analysis results of the future demand and supply, the author intended to develop a new supply plan for the three specialist categories. The major findings of the supply plan are as follows : First, the replied proper mean ratios of rehabilitation professionals(physiatrists : physical therapists occupational therapists) appeared 1 : 5.93 : 3.59, and there is no significant difference between interprofessionals (p>0.05). Secons, the estimated demand for rehabilitation services by interprofessionals appeared significant difference among the interprofessionals (p<0.05).
The purpose of this study was to asses and compare the effects of superficial heating on the pain threshold at limbs in healthy adult and adult hemiplegia. We used hot pack for superficial heat and applied to healthy adult(n=12) and adult hemiplegia(n=12) on lumbar region. Pain treshold was quantatively measured by an electrical stimulator and measured before hot pack application, immediatly and post 30 minutes after hot pack application on the distal parts of limbs(styloid process of radius, medial malleoulus of tibia). The results were as follows 1) A statically significant defference in pain treshold were not found at limbs of healthy adult and adult hemiplegia that have an affected side and a non-affected side before hot pack application, immediatly and post 30 minutes after hot pack apllication(p>0.05). 2) In comparance of pain threshold of upper and lower limbs in the all subjects, pain threshold was significantly increase at lower limbs(p<0.01). 3) In comparance of pain threshold of limbs between healthy adult and adult hemiplegia, pain threshold was showed a significant defferance at the upper and lower limbs of affected side before hot pack application(p<0.05, p<0.01).
The purpose of this study was to compare acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) with conventional transcutaneous electrical nerve stimulation(C-TENS) for crossover effect in healthy subjects. Forty subjects recieved ALTENS(20 persons), C-TENS(20 persons) to one upper extremity. Each technic was applied to the motor point of the wrist extensor muscle group for twenty-minutes. With the subject placed in supine the technics were applied at 80 Hz, 2-10 mA(ALTENS) and 10 Hz, 4-12 mA(C-TENS). Results revealed: (1) a significant difference between the pretreatment and posttreatment in each group(p<.05) (2) no significant difference between ALTENS and C-TENS(p>.05). In conclusion, there was no difference between ALTENS and C-TENS for crossover effect.
The purpose of this study was to determine whether the biomechanical variables of the walking patterns of the obese children compared with those of normal children would revealing significant differences. Normal(N=25) and obese(N=19) subjects were screened based on a health record which was examined to eliminate any subjects who had any pathological condition related to their gait. Data for a minimum of 5 repeated walking trials were collected using a stop watch and a tape measure. Basic kinematic analyses yielded data based on the following variables : stride length divided by leg length, and cadence divided by leg length. This measurement data was classified by the Obesity Index calculated from by height, weight data. Results showed no significant difference among normal, obese and subjects(p>.05). Difficulties in formulating the experimental condition and poor equipment quality are thought to be reason for the inconclusive results. Future studies might include medical complications such as tibia vara, genu valgum, other diseases caused by obesity.
Weight bearing training on the involved leg is impotant for ambulation and activities of daily living in ambulatory hemiplegic patients. Traditionally, physical therapists have relied on exercise therapy and subjective evaluation. The goal for this study was to measure lower extremity weight distribution in standing with ten hemiplegic pations(M:8, F:2) and to determine the traing effect on symmetrical standing posture using a "Limloader". The Limloader is a machine designed for training symmetrical weight bearing posture. The results showed that the ability to keep the center of gravity within the limits for balance was improved significantly but the ability to adjust weight bearing on the involved leg was not (p<0.05). This study demostrated that hemiplegics can improved their symmetrical weight bearing ability using sensory biofeedback.
The purposes of this study were to measure skin temperature and blood flow on the contralateral upper extremity when heat is applied to one upper extremity, were to compare the effect of contrast bath. The subjects were 38 healthy adults with no history of peripheral vascular disease. The subjects of contrast bath were 18 persons and the subjects of warm bath were 20 persons. The subjects of one group were seated with their right arm in water() up to the mid-forearm. The subjects of the other group were seated with their right arm up to the mid-forearm in water which was changed from warm to cold using the contrast bath technique. The continually changing temperatures and blood flow were measured by an independent observer at intervals of 10, 15, 20, 25 and 30 minutes respectively after the start of the procedure. The results were as follows. The temperature of the warm bath group rose 4.28% over the pre-experimental temperatures and the temperature of the contrast bath group rose 3.41%. There was no statistically significant difference between the two groups. The blood flow of the warm bath group rose 8.31% over the pre-experimental blood flow and the blood flow of the contrast bath group rose 17.24%. There was a statistically significant between the two groups 20 minutes after the start of the procedure. Thus the contrast bath is a more effective method than the warm bath to increase blood flow.
The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.
The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on sympathetic tone in healthy subjects. Stimulation in the conventional and burst modes was applied to the skin of the forearm overlying the median nerve. TENS was applied for 20 minutes at an intensity sufficient to produce a perceptible though not uncomfortable sensation and no muscle contracion of the forearm musculature. The change in sympathetic tone was measured with skin temperature. Skin temperature was measured at the index finger and on the volar surface of the forearm in the stimulated limb. The conventional and burst modes did not change the skin temperature at any of the two measurement sites. We conclude that TENS, as applied in this study, does not influence sympathetic tone. Further research is needed to assess the sympathetic effects of TENS on patient groups, long term treatment and other modalities.
This paper reviews physiological changes in the nervous system of patients with hemiparesis that may contribute to muscle weakness. 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 weakeness. This role is compared with the lesser role that spasticity of the antagonist muscle group appears to play in determining the weakness of agonist muscles. The contribution of other factors that result in mechanical restraint of the agonist by the antagonist is discussed relative to muscle weakness in patients with hemiparesis. More studies on patients with hemiparesis are required to assess what role muscle strength training should play in rehabiliting patients after a stroke.
지금까지의 내용을 요약하면 먼저, 인체의 각 관절 주위에는 관절의 움직임과 위치를 파악하는 감지기 역할을 하는 기계적 감수기가 있다. 이러한 감수기는 크게 네가지로 구분되어지는데 대개 I형 감수기, II형 감수기 등의 용어를 사용한다. 각각의 감수기의 특성(표 2.)을 알아보면, 루피니(Ruffini)감각기와 유사한 모양을 하고 있는 I형 관절감수기는 주로 운동의 속도(speed)와 방향(direction)을 감지(detection) 하며, 파시니안(P