간행물

한국전문물리치료학회지 KCI 등재 Physical Therapy Korea

권호리스트/논문검색
이 간행물 논문 검색

권호

제17권 2호 (2010년 5월) 10

1.
2010.05 구독 인증기관 무료, 개인회원 유료
To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were 0˚, 45˚, and 90˚. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was 0˚, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was 90˚, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.
4,000원
2.
2010.05 구독 인증기관 무료, 개인회원 유료
This study was undertaken to develop the scapulometer, a measuring tool for scapular winging, and to determine the reliability of scapulometer. Thirty subjects with scapular winging greater than 2 cm participated in this study. Two examiners measured scapular winging using the scapulometer. Standardized measurement position of each subject was as follows: neutral position of shoulder and wrist, flexion of elbow, and cuff weight of 5% and 10% of body weight (BW) to neutral wrist. The interrater and intrarater reliability were calculated with an intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and standard error of measurement (SEM) at 5% BW and 10% BW. The level of scapular winging was tested between 5% BW and 10% BW with a paired t-test. The interrater reliability was shown to be high at 5% BW (ICC(2,k)=.955, 95% CI=.900~.979, SEM=.07) and at 10% BW (ICC(2,k)=.968, 95% CI=.930~.985, SEM=.06). The intrarater reliability was shown to be high at 5% BW (ICC(2,k)=.921, 95% CI=.842~.961, SEM=.09) and at 10% BW (ICC(2,k)=.906, 95% CI=.813~.954, SEM=.10). The level of scapular winging was significantly different between 5% BW and 10% BW. Conclusively, it is demonstrated that the scapulometer is an objective and qualitative measurement tool for scapular winging.
4,000원
3.
2010.05 구독 인증기관 무료, 개인회원 유료
The aim of this study was to determine the effect of action observational physical training (AOPT) on manual dexterity and corticomotor facilitation in stroke patients. Ten hemiparetic patients participated in this study. Each subject was asked to participate the three conditions; base condition (Base), physical training (PT), AOPT. Participants were asked to observe the action in the video that a therapist moved the blocks during the AOPT conditions. Corticomotor facilitation was determined in three conditions by monitoring changes in the amplitude of motor-evoked potentials (MEPs) elicited in hand muscles by transcranial magnetic stimulation. MEP responses were measured from the first dorsal interosseous after participants attended to three conditions. For the manual dexterity, Box and Block test (BBT) was used. The results of present study were summarized as follows: MEPs amplitude significantly tended to be larger than PT and Base condition. The scores of BBT in the AOPT condition were also significantly larger than other conditions. In conclusion, this finding of present study indicates that physical training for observation of an action is beneficial for enhancing a dexterity of paretic arm in stroke patients.
4,000원
4.
2010.05 구독 인증기관 무료, 개인회원 유료
The purpose of this study was to investigate the most effective and comprehensible method for the assessment of resting scapular position (RSP) and pain level (PL) in unilateral shoulder pain (USP). Fifty volunteers with USP were involved in the study. Resting scapular assessments of the patients' pain sides (PS) and non-pain sides (NPS) were evaluated. The assessment tools for RSP are: 1) sternal notch (SN) to coracoid process (CP) distance 2) 3rd thoracic spinous process (T3S) to posterolateral angle of acromion (PLA) distance 3) scapular index 4) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance 5) supine measurement of pectoralis minor (PM) distance 6) standing PM distance 7) PM index (PMI) and 8) PM pain. The paired t-test was used to compare PS and NPS in RSP. Pearson correlation analysis was used to confer a relationship between the PL and RSP. The results of this study indicated that: 1) all the variables between the PS and NPS for RSP were statistically significant(p<.05) and 2) the PMI showed the strongest relationship in the correlation analysis between RSP and PL(p<.05, r=.37). Therefore, it can be concluded that there is a relationship between PMI and PL and it is suggested that an assessment tool using PMI to diagnose shoulder pain would be clinically effective.
4,000원
5.
2010.05 구독 인증기관 무료, 개인회원 유료
The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity (FM-U․L/E). The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (β=.420~.862) had slightly more power in predicting trunk control than the . TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study clearly indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.
4,000원
6.
2010.05 구독 인증기관 무료, 개인회원 유료
The purpose of this study was to investigate the effects of Evjenth-Hamberg stretching on the active range of motion (ROM) of the hip joint and the pennation angle of the semitendinosus muscle. Eighty healthy adults participated in this study. The active ROM of the hip joint was measured by a goniometer and the pennation angle of the semitendinosus muscle was measured by ultrasonographic imaging (USI). Both ROM and pennation angle were recorded before and after the static stretching and the Evjenth-Hamberg stretching, respectively. Data were analyzed using paired t-lest and independent t-test at p<.05. The results were as follows: 1) The active ROM of the hip joint increased significantly after both stretching interventions compared with the baseline (p<.001). However, the active ROM of the hip joint increased significantly in Evjenth-Hamberg stretching compared with static stretching. 2) The pennation angle decreased significantly after both stretching interventions compared with the baseline (p<.001). However, the pennation angle decreased significantly in Evjenth-Hamberg stretching compared with static stretching. 3) Reliability data showed that there was a high consistency in USl measurements (ICC=.978). Our findings suggest that the Evjenth-Hamberg stretching was more effective than static stretching in increasing the active ROM of the hip joint and decreasing the pennation angle of the semitendinosus muscle.
4,000원
7.
2010.05 구독 인증기관 무료, 개인회원 유료
The Functional Independence Measure (FIM) is widely used to determine the dependency of activity of daily living in rehabilitation patients. The purposes of this study were to evaluate the unidimentionality of the FIM physical items and to analyze the validity of cross-functional levels in stroke survivors in Korea. Thirteen physical items of FIM were rated according to an ordinal scale of a 7-level classification. Two hundred and seventy-nine patients participated in the study (age range 18~92 years and 57% male). Six items-eating, bladder control, bowel control, transfer to and from the bed/wheelchair, transfer to and from the toilet, and bathing-showed misfits with the Rasch model. The most difficult item was 'bathing', the easiest item was 'bowel control'. Although there were several differences within functional levels, the hierarchical order of item measures was rather similar. 'Bathing' was the most difficult in high level patients (above 60), however 'stairs' was most difficult in the middle level (41~60) group. In the low level group (below 40), 'toileting' was the most difficult. In conclusion, the present study has shown several differences of item difficulty among functional levels. This result will be useful in planning interventions, and developing rehabilitation programs for stroke survivors.
4,000원
8.
2010.05 구독 인증기관 무료, 개인회원 유료
In chronic ambulatory hemiplegic patients, structural changes might be developed at both ankles possibly due to unequal and repetitive weight bearing on tendons and ligaments. We examined ankles by sonography to find out structural changes of tendons and ligaments of both ankles in ambulatory hemiplegic patients. Nineteen ambulatory hemiplegic patients over 1 year were included as study subjects. All subjects had no previous trauma or disease history in their ankle joints and they were able to walk independently or with supervision but had spastic ankles with equinovarus tendency. We examined both ankle joints by sonography to see joint effusion and measure width, thickness, and area of tendons of the tibialis anterior, tibialis posterior, and Achilles, and also ligaments of the anterior talofibular and calcaneofibular. We compared sonographic features of the hemi-side ankle with the sound-side ankle. There were no significant differences between hemi-side and sound-side ankles in almost all measured parameters of tendons and ligaments. However, the width of the hemi-side tibialis posterior tendon (8.61±1.37 mm) was narrower than the sound-side tendon (7.24±1.52 mm). With the amount of active joint motion and weight bearing possibly preventing ligament and tendon atrophy even though marked weakness, spasticity occurred during the chronic hemiplegic phase.
4,000원
9.
2010.05 구독 인증기관 무료, 개인회원 유료
The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.
4,000원
10.
2010.05 구독 인증기관 무료, 개인회원 유료
This study purposed to analyze difference in the perception of service quality between physical therapy patients and physical therapists and to provide basic materials for maintaining high service quality that meets patients' expectation in each service area. For this study, we conducted a questionnaire survey with physical therapy patients and physical therapists in Jeju from the 6 to 30 of January, 2010. In the survey, we received 133 questionnaires from patients and 125 from physical therapists, and used them in analysis. The instrument used in this study to measure service quality was prepared by the researcher through adapting and supplementing the SERVQUAL model developed by Parasuraman et al (1991). For our physical therapy environment, and it consisted of a total of 23 questions in five areas, namely, tangibility, reliability, responsiveness, assurance, and empathy. Patients' perception of service quality was high in order of reliability, assurance, empathy, responsiveness, and tangibility. In four areas with exception of reliability, quality perceived by patients was lower than that perceived by physical therapists, and particularly in responsiveness(t=2.82, p=.00) and empathy(t=2.02, p=.04), the difference between patients and physical therapists was statistically significant. In order to reduce the difference in the perception of service quality between patients and physical therapists, it is considered necessary to enhance physical therapists' perception of service quality and to prepare measures for improving service equality so that services would be provided through respectful communication with maintaining the dignity of patients, rather than focusing on disease.
4,000원