뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환

이 연구는 성인 편마비 환자를 대상으로 PLS (Posterior Leaf Spring) 착용이 기립 균형에 미치는 영향을 알아보는 것이었다. 신발만 착용하였을 때의 기립조건과 신발과 PLS를 동시에 착용한 기립조건의 평균평형지수가 맨발로 서 있을 때의 기립조건에 비하여 높았다. 그러나 신발만 착용한 기립조건과 신발과 PLS를 함께 착용한 기립조건하에서의 평균평형지수의 차이는 없었다. 따라서 편마비 환자의 기립균형과 관련하여 PLS만을 착용한 효과와 신

Physical therapists should under stand motor control models and apply various models to evaluation and treatment of neurologically impaired patients. Thus, this paper reviews motor control models and applications in clinical settings. Assumptions and limitations of reflex models, hierarchical models, and systems models are presented. This paper also delineates goals and dissatisfaction of neurologic rehabilitation approaches for neurologically impaired patients. Muscle reeducation approach, neurotherapeutic facilitation approach, and contemporary task-oriented approach are explained.

2000년 4월부터 10월까지 총 3회에 걸쳐 통영 연안해역 10개 정점 표층수와 저층수에서 종속영양세균, 대장균군세균, 균류의 계절별 분포를 조사하였다. 조사기간 중 미생물의 생균수는 평판계수법으로 측정되었고 종속 영양세균은 표층수에서 4월 3.1×102- 4.0×103cfu ml-1, 8월 2.7×103- 1.2×10-5 ml-1, 10월 1.3×

Despite research to treat delayed onset muscle soreness (DOMS), no effective treatment has been reported. The purpose of this study is to investigate the effect of a hold-relax technique and cryotherapy on DOMS. Thirty-three subjects were randomly assigned to one of three treatment groups: control, hold-relax technique, or hold-relax technique and cryotherapy. DOMS was induced in the non-dominant biceps muscle through repeated eccentric contractions. Resting elbow joint position, flexion and extension (universal goniometer), pain (Visual Analogue Scale; VAS), and WBC count (blood analysis) were measured one hour before DOMS was induced and 24, 48, and 72 hours after DOMS was induced. The data were analyzed by repeated measure of two-way ANOVA. The results of this study were summarized as follows: 1) While analysis showed no significant differences between groups in relation to a resting elbow joint position, there were significant differences over time, especially at 24, 48 hours after DOMS was induced compared with resting elbow joint position before DOMS was induced. 2) While analysis showed no significant differences between groups in relation to range of flexion, there were significant differences between range of flexion before DOMS was induced and range of flexion 72 hours after DOMS was induced. 3) There were no significant differences between groups or over time in relation to range of extension. 4) While analysis showed no significant differences between groups in relation to VAS, there were significant differences over time in different hours. 5) There were no significant differences between groups or over time in relation to WBC count. 6) There were no interactions between groups or over time in all variables. This results suggested that hold-relax technique and cryotherapy were not effective to reduce DOMS.

이 연구에서는 24마리의 Japanese White 토끼를 대상으로 양쪽 비골을 인위적으로 골절시킨 후 초음파치료가 골절의 치유에 효과가 있는지를 알아보았다. 초음파 치료 후 대조군의 비골과 실험군의 비골에서의 골소주 비율은 차이가 없었으며 초음파 주파수를 0.875 MHz로 하였을 때와 3 MHz로 하였을 때의 골소주 비율도 차이가 없었다. 따라서 초음파 치료는 토끼의 비골 골절의 치유 효과가 없었다. 그러나 다양한 주파수와 초음파 전달양식을 변화시켰

The purpose of this study was to determine the effect of varying levels of photobiostimulation treatment dosage on plasma -endorphin concentration in humans. The subjects of this study were 21 healthy men and women, who were students of the Department of Physical Therapy, College of Health Science, Seonam University. This study was performed from October 26, 1998 to November 5, 1998. All subjects were assigned to one of three groups: a 2.0 laser group, a 4.0 laser group, an 6.0 laser group. He-Ne laser (632.8 nm wave length) and infrared laser (820 nm wave length) of three different energy densities (2.0, 4.0, and 6.0 ) were applied on the Su-Sam-Ri (L I 10) and Hab-Gog (L I 4) of acupuncture points. Blood samples were taken at pre-treatment, 30 min's post-treatment and 60 min's post-treatment. The level of endorphin was measured by radio immuno assay. The data were analyzed by descriptive statistics and repeated measure two-way ANOVA. The results of this study were as follows: 1) The human plasma -endorphin concentrations were noted to significantly increase due to the energy densities of laser photobiostimulation (p<0.05). 2) The human plasma -endorphin concentrations were noted to significantly increase during the period after laser photobiostimulation (p<0.05).

The purpose of this study was to determine whether high voltage pulsed current stimulation (HVPCS) would enhance wound healing in neuropathic rabbits. Ten rabbits were assigned to either an experimental or a control group. The wounded part around the peripheral neuropathy of the experimental rabbits was stimulated for two hours twice a day for six days under the following conditions: pulse frequency 80 pps, pulse duration , and stimulation intensity 30~40 V. The results indicated that there was no difference in the wound closure between the experimental and control groups. The two groups showed similar aspects in collagen and reticulum, which were observed by colored Masson's trichome. While the rabbits in the control group had more or less thick fibers, the rabbits in the experimental group had thin and branched-shape fibers. The rabbits in the experimental group showed both strong responses in the shaping of elastic fibers and the increased aspects in fibroblast when compared with the control group.

The Posterior Leaf Spring (PLS) has been used for hemiplegic patients in order to help their walking and to increase their balance function. Past studies have mainly focused on the PLS's influence on patients' walking without taking balance function into consideration. The purpose of this study was to identify the immediate effect of PLS on the standing balance in hemiplegic patients. Fifteen hemiplegic patients participated in this study: 10 men and 5 women, with an average age of 53.8 years. Standing balance was measured using a computerized dynamic posturography device under three conditions namely bare-foot standing, standing in shoes without PLS, and standing in shoes with PLS. The results were as follows: 1) The composite equilibrium scores of patients who stood in shoes only and stood in shoes with PLS were higher than those of patients who stood bare-foot. 2) There were no statistical difference in the composite equilibrium scores between the standing condition of patients who stood bare foot and that of patients who stood in shoes with PLS. In conclusion, it is not clear whether or not the PLS affects the standing balance of hemiplegic patients. Further study is required to determine the precise effect of the PLS on standing balance in hemiplegic patients who are not wearing shoes. This is particularly relevant in Korea culture where custom demands the removal of shoes when entering any house or even many restaurants.

Noninvasive low intensity ultrasound has been shown to be an effective means of accelerating bone fracture repair in both animal and clinical studies. The effects of ultrasound stimulation on bone repair after fibular osteotomy were assessed in a rabbit fibular fracture model. Bilateral closed fibular fractures were made in skeletally mature male White Japanese rabbits. In this study, 24 subjects were randomly divided into 2 groups: experimental group 1 (n=12), and experimental group 2 (n=12). Experimental group 1 received 0.875 MHz continuous ultrasound and Experimental group 2 was treated with 3 MHz continuous u1trasound. The ultrasound intensity was 50 and treatment time was 10 minutes for every session in both groups. In each rabbit, one fibula served as a control and the other was subjected to ultrasound treatment 5 times per week for 3 weeks. After 3 weeks, rabbits were sacrificed and the ratios of the area between the trabeculae and bone marrow of the fibulae were calculated. At the end of the experimental period, 14 of the 24 rabbits were excluded due to complications from surgery or inadequate fracture status for this study. There was no statistically significant difference in the trabeculae area between experimental leg and control leg in experimental group 1 and experimental group 2 (p>0.05). And there was also no statistic-statistically significant difference between experimental group 1 and experimental group 2 according to ultrasound treatment frequencies, 0.875 MHz and 3 MHz (p>0.05). These data suggest that in Japanese white rabbits, low intensity ultrasound stimulation does not facilitate fracture repair nor is there any difference in fracture repair results between ultrasound frequencies, 0.875 MHz and 3 MHz.

The pain is common among individuals with physical disabilities. It can interfere with therapy since patients with pain can become uncooperative and reluctant to move. This paper reviews the natural physiological mechanisms that can reduce pain perception, and considers physiological mechanisms which contribute to clinical pain by describing how the pain system changes its sensitivity depending upon the body's needs. The peripheral and central mechanisms contributing to sensitised nociceptive system are described with reference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous 'on-going'-projected and referred pain. It is suggested that in some chronic pain the nociceptive system maintains a state of sensitivity despite the absence of on-going tissue damage and under such circumstances the nociceptive system itself may have become dysfunctional. Such situations are often initiated by damage to nervous tissue which results in changes in the activity and organization of neuronal circuits within the central nervous system. The ability of the nociceptive system to operate in a suppressed state is also discussed with reference to pain modulation. The physical therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.

The purpose of this study was to determine the effects of transcutaneous electrical nerve stimulation(TENS) on delayed onset muscle soreness(DOMS). Twenty males performed eccentric exercise of the elbow flexor. Subjects were randomly assigned to one of three groups: 1) a group (=7) that received low frequency TENS (7 Hz), 2) a group (=7) that received high frequency TENS (500 Hz), 3) a control group (=6) that received no treatment. DOMS was induced in a standardised fashion in the non-dominant elbow flexor of all subjects by repeated eccentric exercise. Treatments were applied immediately following exercise and again at 24 hours and at 48 hours after. Subjects attended on three consecutive days for treatment and measurement of elbow flexion, extension and resting angle(universal goniometer), and pain(Visual Analogue Scale; VAS) on a daily basis. Measurements were taken after treatment. Analysis of results using repeated measures analysis of variance(ANOVA) and post hoc tests were as follows: 1) there were between groups differences in pain value at 48 hours after (p<0.05), 2) one-way ANOVA with repeated measurement for pain, resting angle, flexion angle and extension angle revealed significant differences within low frequency TENS group, 3) one-way ANOVA with repeated measurement for flexion angle revealed significant difference within high frequency TENS group.

The ability to maintain an upright position during quiet standing is a useful motor skill. The Sensory Organization Test (SOT) is a timed balance test that evaluates somatosensory, visual, and vestibular function for maintenance of upright posture. The Fugl-Meyer Sensorimotor Assessment (FMSA) balance subscale is the functional status assessment that indicates amount of assistance needed during various balance tasks. Functional Independence Measure (FIM) is the functional status assessment tool and FIM can be used clinically as an outcome measure. The purpose of this study was to see if the SOT can be used as a evaluation tool to measure hemiplegic patients' balance ability. Thirty-six patients with hemiplegia participated in this study. SOT scores were significantly correlated with FMSA balance scores and FIM scores(p<0.05). However correlation coefficients were not so high (r=0.60, and r=0.51, respectively). Therefore, further study is needed to verify the SOT's usefulness when physical therapists are evaluating for hemiplegic patients' balance ability.

Several studies have evaluated the effects of types of relative frequency and delay interval of knowledge of results(KR) on motor skill learning independently. The purpose of this study was to determine more effective types of KR relative frequency and KR delay interval for motor learning. Forty-six healthy subjects (15 female, 31 male) with no previous experience with this experiment participated. The subjects ranged in age from 20 to 29 years (mean=23.9, SD=0.474). All subjects were assigned to one of four groups: a high-instant group, a high-delay group, a low-instant group, and a low-delay group. During the acquisition phase, subjects practiced movements to a target (400 mm) with either a high (83%) or low (33%) KR relative frequency, and with either an instantaneous or delayed (after 8s) KR. Four groups were evaluated on retention (after 3min and 24hr) and transfer (450 mm) tests. The major findings were as follows: (1) there were no between-group differences in acquisition and short-term retention (p>0.05, (2) a low (33%) KR relative frequency during practice was as effective for learning as measured by both long-tenn retention and transfer tests, compared with high (83%) KR practice conditions (p<0.05), (3) delayed (8s) KR enhanced learning as measured by both long-term retention and transfer tests, compared with instantaneous KR practice conditions (p<0.05), and (4) there were no interactions between KR relative frequency and KR delay interval during acquisition, retention, and transfer phases. The results suggest that relatively less frequent and delayed KR are more effective types for motor learning than more frequent and instantaneous KR.ㅂ

The patients with hemiplegia show different body weight distribution as compared to normal subjects. These patients load their body weight more on sound leg than affected leg. The purpose of this study was to examine the effect of foot placement under three conditions: forward, intermediate, and backward placement, on body weight distribution and time needed to rise while assuming sit-to-stand. Fourteen patients with hemiplegia participated in the study. Their body weight distributions during sit-to-stand under the three different conditions were measured by a limb loader and time needed to rise was measured by a stopwatch. The data were analysed by the repeated measure of one-way ANOVA. Statistical Analysis demonstrated that body weight distribution was less asymmetric in backward foot placement. The difference of body weight bearing rate between sound leg and affected leg was significantly decreased as foot placement moved from forward to backward. These results show that backward foot placement during sit-to-stand make patient with henuplegia distribute their body weight more evenly on the lower extremity.

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.