목적 : 본 연구는 운전에 필요한 인지기능의 저하를 판별하기 위해 영국에서 개발된 뇌졸중 운전자 적격성 검사(Stroke Drivers’ Screening Assessment; SDSA)를 우리나라의 뇌졸중 운전자들의 운전적격성을 판단하기 위한 인지기능 평가도구로 사용하는 것이 타당한지를 확인하기 위해 수행되었다. 연구방법 : 영국의 SDSA 원판을 한국의 교통 환경에 적합하도록 한국형 뇌졸중 운전자 적격성 검사(Korean Stroke Drivers’ Screening Assessment; K-SDSA)로 수정하여 정상 고령운전자를 대상으로 검사를 시행하여 영국의 정상 고령운전자와 비교하였다. 이후 실제 뇌졸중 운전자들을 대상으로 K-SDSA를 시 행하여 이들을 적격 및 부적격 집단으로 판별한 후 자동차 시뮬레이터를 이용하여 두 집단 간 운전수행 능력을 비교하였다. 결과 : 한국과 영국의 정상 고령운전자의 판별점수는 집단간 유의한 차이가 없었으며 뇌졸중 운전자를 대상으 로 한 자동차 시뮬레이터 수행에서는 도심, 국도 및 고속도로 구간의 다양한 운전상황에서 K-SDSA 부적격 판단집단이 적격집단보다 운전수행 능력이 낮은 것을 확인할 수 있었다. 결론 : K-SDSA가 비교적 간단한 절차를 통해 한국 뇌졸중 운전자들의 운전수행 능력을 예측할 수 있는 평가도구로서 타당함을 확인하였다. 본 연구는 뇌졸중 환자들이 운전을 재개하기 전에 K-SDSA 평가도 구를 이용하여 운전수행에 필수적인 인지기능을 보유하고 있는지를 평가하는 것이 중요하며, 이를 통해 그들의 안전운전을 예측할 수 있음을 시사한다.

목적 : 본 연구의 목적은 손가락 폄근에 실시한 근전도 유발 전기자극 치료가 편마비 환자의 손기능 회복에 미치는 영향을 알아보고자 하였다. 연구 방법 : 20명의 뇌졸중 환자를 무작위로 EMG-stim군과 대조군에 각각 10 명씩 배정하였다. EMG-stim 군은 하루에 30분씩 2회, 주 5일, 10주 동안 (총 100회) 손가락 폄근에 EMG-stim 치료를 실시하였다. 반면, 대조군에게는 어떠한 치료도 실시하지 않았다. 손 기능을 검사하기 위하여 치료 전·후에 적분 EMG, 관절 운동 범위, 퍼듀 페그보드 검사를 EMG-stim군과 대조군 모두 실시하였다. 결과 : 치료 전·후 EMG-stim군은 적분 EMG, 관절 운동 범위, 퍼듀 페그보드 검사에서 유의하게 개선되었다(p<.05). 그러나 대조군은 유의한 차이가 나지 않았다(p>.05). 또한 집단 간 비교에서 EMG-stim 군은 대조군에 비하여 모든 종속 변수에서 유의하게 개선되었다(p<.05). 결론 : 본 연구에서 장기간 동안 집중적으로 실시한 EMG-stim 치료는 뇌졸중 환자의 손기능 회복에 효과적이라는 결론을 내릴 수 있다.

This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

Median frequency can be regarded as a valid indicator of local muscle fatigue. As local muscle fatigue develops, the muscle fiber conduction velocity decreases, the fast twitch fibers are recruited less, and consequently the median frequency shifts toward the lower frequency area. The aim of this study was to test the characteristics of the median frequency according to exercise load (30% and 60% of MVC on the biceps brachii, 40% and 80% of MVC on the vastus lateralis) during the fatiguing isometric exercise. Thirteen healthy male volunteer students of Yonsei University were recruited. After the testing maximal voluntary isometric contraction, three variables (initial median frequency, regression slope, fatigue index) from the regression line of MDF data were measured in each exercise load. The results showed that the regression slope and fatigue index were significantly different for the biceps brachii, but not for the vastus lateralis initial MDF was not significant difference according to the exercise load on both muscles. The regression slope and fatigue index could monitor physiologic muscle change during fatiguing isometric exercise. The results showed that two MDF variables reflect the local muscle fatigue according to the exercise load.

Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of to and to . The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.

The purpose of this study was to compare the difference of joint position sense between measurements. Fourteen healthy male subjects were recruited for this study. The elbow joint position senses were measured using angle reproduction test. The elbow joint position sense was assessed with three experimental conditions: ipsilateral reproduction test in open-chain condition, contralateral reproduction test in open-chain condition, ipsilateral reproduction test with weight in open-chain condition and ipsilateral reproduction test in closed-chain condition. The angular difference between stimulus position and the reproduced position (angular error) was calculated in all testing conditions to examine the accuracy of the joint position sense. One way ANOVA was used to compare the error angles in all experimental conditions. The error angles between measurements were significantly different in elbow joint. The error angles was smallest in ipsilateral reproduction test with weight in open-chain condition and was greatest in the contralateral reproduction test in open-chain condition. Findings of this study indicate that testing methods, types of task, existence of resistance should be considered in clinical assessment for the joint position sense.

This study tested whether repeated measurement of median frequency (MDF)-related variables could express the muscle power changes during a 12-week DeLome strengthening program, by using consecutive overlapping FFT (Fast Fourier transformation) and integrated EMG (IEMG) from surface EMG data for isometric and isotonic exercise. To evaluate the effect of training, the following were recorded every 3 weeks for the elbow flexors and knee extensors of 5 healthy male volunteers: MVC, lRM, limb circumference, and surface EMG during isometric MVC or isotonic contraction at 10RM load. From the EMG data, IEMG and variables from a regression analysis between MDF and time were obtained. MVC, lRM, IEMG, and initial MDF increased linearly over the training period. The fatigue index and slope of the regression line increased temporarily until the 6th week and decreased thereafter. From these results, there appeared to be enhanced neural recruitment of fast twitch fibers in the first 6 weeks and continued enhancement in the recruitment and hypertrophy of fast twitch fibers, which led to increased fatigue resistance, over the last 6 weeks. Accordingly, the MDF and IEMG analysis technique could demonstrate the effect of the program detected significant changes in both isometric and isotonic contractions. EMG analysis methods can be used to estimate the electrophysiological and histological changes in skeletal muscles during a strengthening program.

The purpose of this study was to investigate the effect of functional strengthening exercise on static and dynamic standing balance in a child with cerebral palsy. The subject was a 7 year old boy with diplegia whose Gross Motor Function Measure (GMFM) score was 80% along with G1 of the lower extremities in Modified Ashworth Scale. The subject was ambulatory with some degree of limitation and demonstrated muscle weakness and strength asymmetry in the lower extremities. A changing criterion design for a single-subject research was used for this study. The functional strengthening exercise consisted of lower extremity ergometer exercise and knee exercise with grading movement in standing position, each for 20 minutes, which lasted 18 sessions for 6 weeks. A knee extensor strength test on both extremities and standing balance test were conducted after each functional strengthening exercise. Two types of standing balance were tested: one leg stance test and functional reach test. One leg stance test was to evaluate static standing balance, and functional reach test was to evaluate dynamic standing balance. The results showed that the functional strengthening exercise had some positive effects on improvement of both static and dynamic standing balance, and there was a positive correlation between the knee strength and standing balance.

The purpose of this study was to investigate the effect of knee exercises on the onset times of vastus medialis oblique muscle (VMO) and vastus lateralis muscle (VL) and in healthy subjects. Fifteen subjects (7 men, 8 women) in a mean age of 26.4 years participated in the study. Electromyographic (EMG) signals were recorded from the VMO and VL under four exercises. Knee exercises consisted of open kinematic terminal knee extension, straight leg raising, isometric hip adduction exercise, and closed kinematic terminal knee extension. No significant differences were found in the onset times of EMG activities of VMO and VL in the four exercises. There were also no significant differences among the exercises. These results coincided with previous studies that found no difference between onset of VMO and VL. However, it is difficult to say that there is no difference between onset of VMO and VL in healthy subjects. To confirm this results, further researches that follow same on set determination metod and exercises are needed. Not only is the study of onset time of muscle needed, but also the studies of the amount of activation and the rate of increase of muscle activation are needed.