This study was carried out to help the comprehensive rehabilitation of spinal cord injuries by measuring propulsion force and endurance exerted on wheelchair handrims, and predicting the differences among three different rear axle positions. The BTE (Baltimore Therapeutic Exerciser) work simulator was used on 9 paraplegia to test the force and endurance during wheelchair propulsion. The 141 large wheel of the BTE work simulator and a standard wheelchair with removed handrims were used for simulating wheelchair propulsion. The neurological and demographical characteristics of the patients were collected by personal interviews and direct examinations. The Kruskal-Wallis test was used to compare force and endurance among the groups. The strongest maximum isometric strength was produced when the rear axle of the wheelchair and the acromion process were on the same coronal plane. Although there were no significant differences statistically, moving the rear axle forward did result in greater isotonic strength. The research suggests that better functional activity of persons with paraplegia is possible when the rear axle of the wheelchair is appropriately adjusted.
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.
The purposes of this study were to investigate the accomodations for the disabled children of the elementary schools in Suwon and to give helpful information to the parents and teachers for the improvement of the independence of disabled children at school. We measured the ramps, toilets, doorways and other accomodations in 64 elementary schools according to the checklists. The checklists of these facilities were based on the legal requirements of "The Act for the Benefit of the Disabled, Elderly and Pregnant Women". The data was analyzed by descriptive statistics and the test. None of the investigated schools satisfied all the legal requirements of the facilities. Fifteen elementary schools had adequate accomodations for the disabled children which allowed them to move independently from the entrance of the school to their classrooms located on the first floor. Only eight of fifteen schools had elevators to access their classrooms upstairs. The schools were divided into two groups according to their construction dates; before and after April 11th 1998, when "The Act for the Benefit of the Disabled, Elderly and Pregnant Women" took effect. There were statistically significant differences in the number of toilets, the width of the toilet entrance, and the slope of the ramps between the two groups (p<.05). We suggest that the accomodations for the disabled children need to be established on a systematic and on-going basis in the future. The teachers and administrators should be more aware of the legal requirements for appropriate accomodations for the disabled children.
The purpose of this study was to assess the effects of ultrasound on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced in 26 female Sprauge-Dawley rats by the subcutaneous injection of a single dose of .1 mL of Complete Freund's Adjuvant (CFA) (1 mg of Mycobacterium Butyricum suspended in .1 paraffin oil) into the right hind paw. After confirming inflammatory edema and arthritis in the paw 2 weeks later, the arthritic rats were divided into 3 groups, i.e., a control group, a pulsed ultrasound group (Group A), and a continuous ultrasound group (Group B) with 8 rats placed in each group. The rats in Group A were treated with pulsed ultrasound at 1 MHz frequency with .5 intensity in 1 : 4 mode for 3 minutes. The rats in Group B were treated with continuous ultrasound at 1 MHz frequency with 2 intensity in the continuous mode for 3 minutes. The ultrasound treatment was done in the left and right ankles for 2 weeks. Clinical, radiographic and histopathologic findings were then evaluated before and after treatment and yielded the following results. 1. No significant difference was present in body weight between the control group and the treated groups. 2. A statistically significant decrease in the edema of the paw was seen in the rats in Group A that was treated with pulsed ultrasound by 26~29 days after the treatment started (p<.05). 3. According to radiological examination, Group A showed the lowest score in arthritis scale which means it showed a tendency to suppress arthritic inflammation of the left and right hind paws. However, no statistically significant difference was present in the score between the control group, Group A and Group B. 4. According to histopathologic findings, the degree of infiltration by inflammatory cells and hypertrophy of the synovium were less in Group A compared with the control group and Group B. The results of the study show that rats that were treated with the pulsed ultrasound effectively suppressed adjuvant arthritis. However, more effort is needed to objectively prove the effectiveness of ultrasound by developing more sensitive testing methods that could quantitatively evaluate the treatment effects of acute rheumatoid arthritis and by trying out different ultrasound treatment methods.
The purposes of this study was to evaluate the effect of low power GaAsAl laser on tissue contraction in a linear incision wound on rat skin. The linear incision wound was made on the midline of the backside in the experimental animals. Low power laser applications with different intensities such as 3, 6, or 10 mW were applied to the experimental animals twice a day for 10 days. On either the seventh or tenth postoperative day, the quantitative analysis of the inflammatory reaction surrounding the linear incision wounds on the rats were performed using enzymatical analysis of myeloperoxidase (MPO) activity. The number of neutrophil was from a normal blood sample that was obtained from the normal experimental animals. Each concentration of neutrophil showed .04-.62 unit activity of MPO. Therefore, the 6 unit activity of MPO per neutrophil was unit. On the 7th and 10th post operative day, non treated tissues demonstrated increased MPO activity as compared to that of normal tissue. These data indicated that the inflammatory reaction of tissue was induced after wound induction and the MPO activity were increased in the inflammed tissues. While both 3 mW or 6 mW intensity of laser treatments did not affect the tissue MPO activity, 10 mW intensity of laser treatment significantly decreased the tissue MPO activity on the 7th and 10th post operative day. These data demonstrated that only 10 mW intensity of laser treatment successfully suppressed tissue inflammatory reaction after wound induction. In conclusion, these findings suggested that 10 mW of GaAIAs laser treatments effectively suppressed the inflammatory reaction of tissue that was induced during the wound healing process.
The purpose of this study was to provide information on driving characteristics in persons with spinal cord injury through basic statistic analysis of the survey results. The survey was administered to 44 drivers with spinal cord injury. The subjects' general, neurologic and driving characteristics were analyzed, as well as the degree of difficulty in using their vehicles between tetraplegia and paraplegia. The results were as follows: thirty-five (79.6%) of forty-four respondents was men. The average age was 35.0 years old and the age at the time of injury was 29.0 years old. Their neurologic characteristics were tetraplegics 12 (27.3%) and paraplegics 32 (72.2%). Among complete lesions, the highest level those who could drive independently was C7. All the vehicles were equipped with special devices, including "power steering", "automatic transmission" and "hand controls". The vehicles for cervical cord injury were equipped with "grip bars" as well as for the degree of difficulty in using their vehicles, all the subjects felt that "moving the wheelchair in and out of their vehicles" was too difficult for them to do. We suggest that the driver training should be an essential part of the rehabilitation program for patients with spinal cord injuries to maximize their mobility in the community. This training seems to be essential in order to modify the standards of the Handicapped Drivers Ability Test and to aid the driver rehabilitation program in the health insurance payment system. Also, the driver rehabilitation training program should include instruction in that moving wheelchairs in and out of vehicles.
The purpose of this study was to investigate the changes of the activities of daily living (ADL) by the motor learning program for upper extremity in stroke patients. The subjects were sixty-two members who were treated at the department of occupational therapy. The ADL were measured with Functional Independence Measure (FIM). The result's were as fol1ows; 1. The ability to perform daily activities after treatment was significantly increased independent of age, gender, cause, affected side and speech disability (p<.01). The differences between the pre-treatment and the post-treatment was no significant correlation to sex, cause, affected side and duration of treatment, but the speech disability was significant. Therefore the pre-treatment scores and post-treatment scores were significantly different. 2. The variation of the pre-treatment and the post-treatment in the detail item to the performance of daily life of the stroke patients through the upper extremity motor learning program was significantly increased in self-care, sphincter control, locomotion, mobility, communication and social cognition (p<.01) Consequently, The motor learning program for upper extremity significantly improved the performance level of all ADL areas in stroke patients.
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.