Back extension exercises have been used for rehabilitation of the injured low back, prevention of injury, and fitness training programs. However, excessive loading on low back can exacerbate existing structural weakness. The purpose of this study was to compare muscle activity of low back muscles during back extension exercises. Twenty healthy male subject s were evaluated. Electromyographic (EMG) activities of low back muscles at L1 and L5 level were recorded during seven different back extension exercises and two reference tasks by surface EMG and saved for data analysis. Reference tasks of lifting 20% and 40% of their body weight were included for comparison. The result were as follows: 1) Single-arm extension and single-leg extension exercises on quadruped position appeared to constitute a low-risk exercise for initial extensor strengthening. 2) When arm extension was combined with contralateral leg extension on quadruped position, EMG activities of low back muscles were increased. 3) EMG activity of low back muscles was highest during the trunk extension exercises on prone position. 4) EMG activities of low back muscles during arm and leg extension exercises on quadruped position were less than those of reference task of lifting 40% of their body weight. These result s have important implications for progressive back extensor muscle strengthening exercises in patients with back pain.

The purpose of this study was to compare the effects of anterior walker and posterior walker on gait parameters and body alignment of children with cerebral palsy. The intraclass correlation coefficient was .99 for intertester reliability. Intratester reliability was between .96 and .99. The use of posterior walker increased gait velocity and facilitated more upright posture. The measurement of joint angle program was found to be reliable to measure range of motion. This study has a limitation of generalizing the results to all children with cerebral palsy. Research is required to investigate the effect of posterior walker on energy efficiency.

본 증례연구는 복합손상을 가진 척수손상환자의 재활치료과정을 소개하여 유사한 사례의 치료에 도움이 되고자 하는 것이다. 증례연구의 대상자인 26세의 남자환자는 흉수 4번 완전손상과 사고 당시 전기화상에 의한 좌측하박 절단과 우측손의 정중신경이 마비되었다. 치료초기에는 일상생활동작 검사에서 MBI (Modified Barthel Index) 점수가 22점으로 독립적으로 가능한 것은 거의 없었고, 기능적으로도 모든 도움이 필요한 상태였으나 재활치료결과 독립적

The purpose of this case study was to introduce botulinum toxin A injection in cerebral palsy. Spasticity can be managed using a variety of methods. Eliminating aggravating sources, promoting stretching and bracing, and positioning are the least invasive methods of treatment. Botulinum toxin A injection is a relatively recent method of spasticity management in children with cerebral palsy. A 3-year old boy was evaluated for possible botulinum toxin injection to promote left side function. The patient had left hemiparetic cerebral palsy. He walked with bilateral intoning, much worse on the left than on the right and with excessive plantar flexion on the left. Botulinum toxin A was injected into the left medial gastrocnemius, with the goals of improving quality of gait. Finally, botulinum toxin treatment of would improve the motor function and ambulatory status in cerebral palsy by hypertonicity, spasticity, dynamic contracture and athetoid movement.

The objective of this study was to identify pulmonary functional variations in relation to postural changes, lapse after changing position, and the use of abdominal band in the cervical cord injured. The subjects of this study were 19 quadriplegic patients who had been admitted to the department of the Rehabilitation Hospital, College of Medicine, Yousei University, from April, 1997 through May 3, 1997. A spiroanalyzer was used to measure pulmonary function in supine, standing, time after changing position, and recording to the position, application method, and tightness of the abdominal band. The data were analyzed by the repeated measure one-way ANOVA, and Wilcoxon signed rank test. The findings were as follows: 1. All phase of the patients' pulmonary function improved significantly in supine posture in contrast to standing (vital capacity by and expiratory reserve volume by ). 2. The longer the time lapsed from supine posture to standing, the patient's expiratory reserve volume, maximum ventilation volume, vital capacity, and forced expiratory volume increased. 3. When the patient lay in supine position, the maximum ventilation volume, vital capacity, and the forced vital capacity increased then the center line of the abdominal band was placed along iliac crest; on the other hand, when the patient was standing, placing the bottom line of the abdominal band along iliac crest increased the maximum ventilation volume, vital capacity, and forced expiratory volume. 4. In placing the abdominal band in the patients, leaving space between the top and bottom lines of the band helped increased in maximum ventilation volume, vital capacity, and forced vital capacity for patient in supine as well as in standing. 5. When placing the abdominal band to patients in supine posture, reducing the length of the band by 2.5% along the patient's waist line increased the patients' vital capacity, while reducing the length by 10% to patients in standing increased the maximum ventilation volume. The abdominal band should be placed in such a way that the bottom part of the band should be more tightly fastened while leaving enough room for a hand to be placed in between the body and the band for the top part of the hand. It should also be noted that in a supine position, the bottom line of the band should be placed along the iliac crest, while in standing, the center line should be placed along the iliac crest. The length of the band should also be reduced by 2.5% of the waist line in supine position, and in standing, the length should be reduced by 10%. It should also be noted that the pulmonary function of the patients should be measured at least 10 minutes after one position change.

The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

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.

When applying FES to patients, proper evaluation must be performed prior to treating patient. Patients with thoracic lesions between are suitable for FES. However, these patients must have excitability of the leg muscles. Thus, excitability testing is an essential part of the screening program(stimulation at 80V gives a response). Before standing or walking is attempted the patients must perform restrengthening exercise, so that the Quadriceps muscle group minimum strength is 40 Nm (corresponding to a manual grade of F+ to G). After that walking and standing can be attempted. The effects of FES are as follows: prevents pressure sores; development and maintenance of muscle properties; prevents disuse atrophy and contractures.

The use of electricity to evoke s skeletal muscle response is FES, which is a form of functional electrical stimulation. In the case of the damaged spinal cord, the technique can supply stimulation to the lower moter neurons and their muscle fiber, which have been disconnected from control of the higher nervous system. Recent advances in electronics, particularly miniaturization, have made possible the design of much improved systems of electrodes and stimulaters for FES. Clinical research has followed two main lines: the use of FES in the upper extremities for producing functional hand rehabilitation in quadriplegics and in the lower extremities for producing standing and gait in paraplegics.