The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group (n1=14) and the general neurodevelopment therapy (NDT) group (n2=16). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.
The purpose of this study was to investigate the effects of visual cue deprivation during sideways
treadmill training in individuals with stroke. Twenty-eight stroke patients were divided into two groups, and each group participated in a sideways treadmill training session for 20 minutes, three times per week for 4 weeks. The eyes close group (15 subjects) performed this treadmill training with visual cue deprivation, while the eyes open group (13 subjects) performed it without visual cue deprivation. Gait function was measured in both groups before and after the training sessions with the Biodex Gait Trainer 2, which determined walking speed, distance, step length, and time on each foot. Balance was measured before and after each training period in both groups using the Five-Times Sit-to-Stand Test (FTSST), the Timed Up and Go test (TUG), and the seven-item Berg Balance Scale-3P (7-item BBS-3P). The eyes close group showed significantly improved gait function, walking speed, distance, step length, and time on each foot after training (p<.05). The eyes close group showed improved balance ability, FTSST, TUG, and 7-item BBS-3P test after training (p<.05). The findings indicated that sideways treadmill training with visual cue deprivation positively affects gait ability of stroke patients. Therefore, sideways treadmill training with visual cue deprivation may be useful for the recovery of gait ability of stroke patients.
This study was conducted to develop a Han-sik database as well as to assess the effects of Han-sik on dietary quality among Koreans. The Han-sik database was developed by a focus group composed of food and nutrition specialists considering the results of Han-sik perception surveys conducted in previous studies for frequently consumed dishes. Among the 1,322 dish items identified in the 4th (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES), 973 items (73.6%) were classified as Han-sik. Han-sik usage was defined as the percentage of Han-sik items of all individually consumed dish items in the dietary data of 22,113 subjects who participated in a 24-hour diet recall in the 4th (2007-2009) KNHANES. Dietary quality was evaluated based on adherence to the Korean Food Guidance System (KFGS), which was calculated as the percentage of the number of servings consumed in each food group out of recommended servings according to age and sex. Mean usage of Han-sik was 80.1% and was higher in older age groups, rural areas, as well as in households at the lowest income level. Han-sik usage was also higher on weekdays as well as for breakfast. Adherence to the KFGS was significantly higher for grains, meat · fish · egg · beans, vegetables, and fruits (p<0.001) but lower for milk · dairy products and oils · fats · sugars (p<0.001) across the quartiles of Han-sik usage. The results of this study indicate that Han-sik usage is high among Koreans. Further studies are needed to update the Han-sik database as well as investigate the association between health-related factors and Han-sik use.
This study is to develop a mathematical analysis model to grasp the behaviors of cartels. Cartels are formed tacitly and cause tremendous damage to consumers in modern society which is composed of advanced industry structure. The government authorities have instituted the leniency programs to respond cartels. However, cartels will continue unless there are legal sanctions against cartels based on an accurate analysis of leniency programs. The proposed cartel equilibrium analysis model is a mathematical behavior model which is based on the existing methods and the prison’s dilemma of game theory. Therefore, the model has a form of pay off matrix of two players. We use a iterated polymatrix approximation (IPA) method to deduct a Nash equilibrium point. The model is validated by an empirical analysis as well.
특허권자의 특허권은 혁신적 기술 개발을 위한 유인장치이자 보호장치로 필요하고, 동시에 제네 릭권자의 복제권은 특허권 남용에 따른 고가의 독 점 공급 문제를 해결하기 위해 필요하다. 따라서 특 허권자의 보호와 제네릭권자의 보호 사이에 균형 을 이루는 제도 마련이 요구된다. 특히 제약분야와 농업분야는 R&D를 통한 신제품 개발을 장려하기 위해 특허권을 보호해야 하지만, 한편 좋은 제품의 대중화를 위해 제네릭업자를 보호해야하는 바, 제 네릭 의약품과 제네릭 GMO관련 규제가 시급한 현 실이다.
제약분야에서는 미국은 Hatch-Waxman Act 로 신약개발 특허권자와 제네릭 제약업자 간의 균 형을 이룬 제도가 실행되고 있다. 우리나라의 경우 한∙미 FTA로 특허권자에 대한 보호조치인 통지 제도가 도입되었고, 허가-특허연계제도 역시 도입 될 예정이다. 그러나 우리나라의 경우 제약산업이 제네릭업자임을 감안할 때, 특허권자를 과도하게 보호하는 허가-특허연계제도에 대하여 제네릭 제 약업자를 보호하는 특허권 남용에 따른 손해배상 제도와 같은 제도가 필요할 것이다.
농업분야도 미국 몬산토社의 GMO 특허제품인 RR콩의 특허만료로 인한 제네릭 GMO관련 논의가 진행되고 있다. 이에 관하여 미국은 제약관련 특허 권자와 제네릭권자의 균형을 이룬 것으로 평가되 는 Hatch-Waxman Act를 준용하자는 논의가 있 으나, 우리나라의 경우 제약분야의 입법도 미비하 여 준용하기 어려운 점, 국내법의 GMO관련 법안 이 통일성이 부족한 점, 제네릭 GMO 및 제네릭 신 품종에 대한 규정이 미흡한 점을 고려할 때, 현 시 점에서 우리나라는 GMO관련 국내법을 먼저 정비 한 후 제네릭 GMO에 관한 규정 도입을 논해야 할 것이다.
This study aimed to investigate the influence of shoe heel height and muscle fatigue on static and dynamic balance in young women. Thirty women who were used to wearing high heels volunteered to participate in this study. The shoe heel heights were 0 ㎝ and 7 ㎝. And ankle plantar flexor fatigue was experimentally induced. Static and dynamic balance were measured using the one leg standing test (OLST) and the star excursion balance test (SEBT) in anterior, posteromedial, and posterolateral directions, respectively. Values in the OLST (shoe heel height 0 ㎝, 28.83±3.24 sec to 26.12±6.13 sec; and 7 ㎝, 24.75±7.09 sec to 16.86±9.32 sec) and the SEBT in anterior (shoe heel height 0 ㎝, 71.02±4.57% to 69.50±3.66%; and 7 ㎝, 64.17±3.53% to 59.61±4.06%) and posteromedial (shoe heel height 0 ㎝, 92.01±5.61% to 90.38±7.10%; and 7 ㎝, 83.09±7.29% to 76.83±9.28%) directions were significantly reduced when fatigue-inducing exercise was performed (p<.05). Furthermore, within these parameters, there were significant interaction effects between shoe heel height and fatigue condition (p<.05). These findings suggest that shoe heel height and muscle fatigue contribute to some changes in static and dynamic balance in young women, probably leading to negative effects on physical function during a variety of activities of daily living.
The purpose of this study was to determine the effectiveness of sit-to-stand training on unstable surfaces in individuals with stroke. Nineteen subjects with chronic stroke were divided into two groups: an experimental group (10 subjects) and a control group (9 subjects). They received 30 minutes of Neuro-developmental therapy (NDT) treatment, and sit-to-stand exercise for 15 minutes three times a week for four weeks. During the sit-to-stand training, the experimental group performed on an unstable AIREX balance pad, but the control group performed on a stable surface. Balance ability and weight-bearing distribution during quiet standing were measured before and after training period using the 7-item Berg balance scale-3P (BBS-3P) and the Five-times-sit-to-stand test (FTSST). In addition, the muscle strength of the knee extensor was evaluated before and after the training period. The results were as follows: 1) The weight-bearing distribution forward of the affected leg, increased significantly in the experimental group after the four-week intervention (p<.05), 2) The 7-item BBS-3P and FTSST increased significantly in the experimental group after the four-week intervention (p<.05), 3) The knee extensor muscle strength in both groups increased significantly after the four-week intervention (p<.05). In conclusion, the results of this study did not show that the sit-to-stand training on an unstable surface was more effective than on a stable surface. However, the results suggested that sit-to-stand training is effective in the balance training of stroke patients.
목적 : 본 연구는 상호작용식 메트로놈(Interactive Metronome; IM)을 이용한 작업치료가 편마비 뇌성마비 아동의 신체 양측 협응과 균형 능력, 상지기능에 미치는 효과를 검증하기 위한 개별 실험 연구이다.
연구방법 : 선천성 뇌성마비로 진단 받은 편마비 아동 1인을 대상으로, 개별실험 연구방법(single-subject experimental research design) 중 ABA 설계를 사용하였다. 총 20회기로 매주 2회기씩 10주간 진행하였다. 기초선 4회기는 중재 없이 양측 협응을 평가하였고 중재기 12회기는 상호작용식 메트로놈을 이용한 중재를 1일 1회 40~45분씩 실시한 후 양측 협응을 평가하였다. 재기초선 4회기는 중재 없이 양측 협응을 평가하였다. 중재전과 후의 균형검사를 실시하였고, 중재 전, 중, 후에는 상지기능 검사를 실시하여 변화를 알아보았다.
결과 : 상호작용식 메트로놈 훈련을 통한 중재 결과, 양측 협응과 균형능력이 유의하게 향상되었고, 양측 협응의 향상에 따른 중재 전, 중, 후의 상지기능은 향상을 보였으나 유의하지 않았다.
결론 : 상호작용식 메트로놈 훈련이 편마비 뇌성마비 아동의 양측 협응과 균형능력 향상에 효과가 있다는 것을 확인하였고 편마비 뇌성마비 아동의 양측 협응과 균형 훈련의 중재방법으로 사용될 임상적 기초 자료로 활용될 수 있을 것이다.
The purpose of this study was to determine differences in perception of weight management, balanced food intake, knowledge of obesity, and nutrition knowledge in university students. The average weight and height of male subjects were 175.0±5.7cm and 69.1±11.8kg, whereas those of female subjects were 161.7±5.0cm and 51.7±6.9kg, respectively. Average scores for balanced food intake were not significantly different between male and female students. The total number of correct answers for obesity knowledge was not significantly different according to gender, but four responses related with losing weight showed higher perception scores in females compared to males (p〈0.05). The total number of correct answers for nutrition knowledge was not significantly different between males and females. The average BMI of male and female subjects were 22.5±3.44 and 19.7±2.21, respectively, ranged in normality. Self-evaluation of body shape was mostly in the normal or standard range in both males and females, but females showed a higher perception rate of chubby or fat than males. The percentages of interest in weight management was 36.0% in males and 50.8% in females, with higher interest in female subjects (p〈0.01).
목적 : Tetrax(Tetrax Portable Multiple System)를 이용하여 맨발, 운동화, 킬힐의 착용에 따라 균형능력에 차이가 있는지를 알아보고자 한다.
연구방법 : 본 연구는 2010년 8월 31일~9월 7일 D대학에 재학 중이고, 연구참여에 동의한 여학생 20명을 대상으로 평가를 실시하였다. 균형평가는 Tetrax를 통해 시각과 체성 감각의 유무, 머리의 좌우와 앞뒤의 변화를 요구하는 8개의 자세에서 검사를 시행하였고, 맨발, 운동화, 킬힐은 무작위 선정하여 시행하였다.
결과 : 킬힐을 착용했을 때 안정성 지수(Stability index)가 맨발 또는 운동화 착용보다 높았고, 체중 분포 지수(Weight distribution index)는 정상치 범위보다 낮았으며, 낙상 지수(Fall index)는 위험범위에 속하였다.
결론 : 킬힐을 착용했을 때 맨발이나 운동화보다 자세불안정으로 인하여 낙상 위험이 높은 것으로 나타났다.
In recent years China has experienced two forms of extreme macroeconomic imbalance: an expenditure imbalance in the sense of very high investment and very low consumption, giving rise to rapid capital accumulation; and an imbalance between expenditure and production, producing external imbalance, i.e. a huge surplus on the current account of the balance of payments. This paper explores the current state of the external imbalance in China, and reviews the factors underlying the pre-2008 rising and the post-2008 drop in China’s current account surplus. The paper says that China’s current account surplus must be modest in recent years. However, despite the fact that China’s recent current account is likely to stay below its precrisis range, it is too early to conclude that “rebalancing” has been truly achieved in China. Certainly, the policy thrust of the 12th Five Year Plan is very much focused on raising household income, boosting consumption, and facilitating an expansion of the service sector. In the coming years, if these ongoing structural reforms are implemented, China does have the potential to hand-off from an investment-driven to a consumption-driven decline in its external imbalance.
목적 : 본 연구의 목적은 균형능력에 문제가 있는 만성 뇌졸중 환자를 대상으로 과제 지향적 활동의 실험군과 보존적 작업치료의 대조군과의 중재결과를 비교하여 일상생활동작의 수행 능력과 균형능력, 만족도에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 2000년 7월부터 2008년 6월까지 뇌졸중 진단을 받고 서울 △병원에서 입원 치료를 받은 대상자 중 본 연구 목적에 맞는 실험군 18명 대조군 15명을 대상으로 실시하였다. 모든 중재는 훈련받은 2인의 작업치료사가 3개월 동안 주 5회, 1일 30분씩 시행하였고, 실험군은 과제 지향적 활동으로, 대조군은 신경발달치료를 기반으로 한 보존적 작업치료로 중재하였다. 중재 전·후 일상생활동작과 균형능력, 작업수행 만족도는 Berg Balance Scale(BBS), Canadian Occupational Performance Measure(COPM), Functional Independence Measure(FIM)으로 측정하였다. 결과 : 중재 후 과제 지향적 활동의 실험군(p<.001)과 보존적 작업치료를 받은 대조군(p<.01)의 균형능력과 일상생활동작 수행능력, 환자의 만족도 모두 중재 전보다 유의하게 향상되었다. 중재 후 집단 간 비교에서는 균형능력(p<.05)과 환자의 만족도(p<.01)에서 실험군이 대조군보다 유의하게 향상되었다. 일상생활동작 수행능력에서는 집단 간 차이를 보여주지 못했다(p>.05). 결론 : 본 연구 결과에 근거하여 과제 지향적 활동이 보존적 작업치료보다 만성 뇌졸중 환자의 일상생활동작 수행능력과 균형능력, 만족도를 향상하는데 도움이 될 것으로 보인다.
The purpose of this study is to examine the influence of a horse riding simulator and galvanic vestibular stimulation on improving the ability to balance posture and proprioception. Thirty healthy adults participated and were randomly assigned to a horse riding simulator group (=10), galvanic vestibular stimulation (GVS) group (=10), control group (=10). Experiment groups were trained 3 times per week over 6 weeks. The ability to balance posture was measured by force plate and proprioception was measured by Joint position sense. The following results were obtained. the changes of balance index were significant interaction in each group in accordance with the experiment time in 0, 3 and 6 weeks (p<.05). All groups showed the most decreasing pattern compared with the control group. But was not statistically significant. Proprioception was significant interaction in each group in accordance with the experiment time (p<.05). All groups showed the most decreasing pattern compared with the control group. The above results indicated that the 6 weeks horse riding simulator and galvanic vestibular stimulation training demonstrated positive effects in the ability to balance posture and proprioception. These results suggest that the horse riding simulator and galvanic vestibular stimulation training could be therapeutic intervention that can improve balance and postural control.
The purpose of this study was to determine the effects of weight shift training with joint mobilization on the ankle joint passive range of motion (PROM), balance capacity and gait velocity in hemiplegic patients. Fourteen subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with seven subjects in each group. The EG received weight shift training with joint mobilization in the paretic leg's subtalar joint in order to increase ankle dorsiflexion. The CG received general physical therapy training. Both groups received training five times a week over a period of two consecutive weeks. The figures for PROM of ankle dorsiflexion on the paretic leg, the functional reach test (FRT), the timed up and go (TUG) test, and gait velocity were recorded both before and after the training sessions for both groups. The EG's results in gait velocity, the FRT and the TUG test improved after training (p<.05). The PROM of ankle dorsiflexion improved both in the EG and the CG (p<.05), the EG demonstrated a significantly higher increase (p<.05) than that of the CG. The results of this study suggest that increased joint mobilization positively affects balance and gait velocity of hemiplegic patients. Further studies with a greater sample size are necessary in order further prove the accuracy of the results of this study.
The purpose of this study was to evaluate the effects of bridging stabilization exercise on balance ability and gait performance in elderly women. The subjects of this study were thirty-one elderly women over 65 years old in HongSung-Gun Senior Citizen Welfare Hall. The subjects were randomly assigned into one of three groups (trunk stabilization exercise on the mat, whole body vibration, and Swiss ball) and participated in each exercise program three times a week for 4 weeks. Each exercise began in the bridging position. The dynamic balance and gait were measured by limit of stability area using force plate, Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). The results were as follows: 1) The limit of stability in three groups increased significantly in anterior-posterior and medial-lateral lean after 4-weeks intervention (p<.05). 2) There were no significant differences in the limit of stability among three groups after 4-weeks intervention (p>.05). 3) The BBS and TUG in three groups increased significantly after 4-weeks intervention (p<.05). 4) There were significant differences among three groups in BBS. Post-hoc test showed that Swiss ball exercise group was significantly higher than the mat and whole body vibration groups. 5) There were no significant differences TUG among three groups after 4-weeks intervention (p>.05). In conclusion, this study suggested that 4 weeks of the bridging stabilization exercises were effective on balance and gait in all three groups. Particularly Swiss ball exercise group showed higher improvement than two other exercise groups (mat, whole body vibration group).
본 연구에서는 유아들을 대상으로 BGA 교육프로그램이 좌우뇌균형 발달에 어떠한 영향을 미치는지를 실제 실험을 통하여 밝혀보는데 목적이 있었으며, 연구의 대상은 2010년 9월부터 2011년 2월까지 원아 60명(실험군 30명, 대조군 30명)에게 BGA 검사와 뇌파측정을 바탕으로 검증하였다. BGA 교육 프로그램은 일주일에 3회씩 6개월 동안 진행하였으며 1회교육시간은 30분 동안 실시하였다. 분석의 결과로 첫째, BGA 교육 실시 후 좌우뇌 편차에 긍정적인 영향을 미쳤으며, 둘째, BGA 교육프로그램이 좌우뇌균형지수에 유의미한 변화를 미쳤다.
Balance is a complex motor skill that depends on interactions between multiple sensorimotor processes and environmental and functional contexts. Many rehabilitation specialists believe that balance assessment under multitask conditions may be a more sensitive indicator of balance problems and falls than balance assessment in a single-task context. Functional Gait Assessment has many tasks that allow for testing under multitask conditions. The purpose of this study was to determine the concurrent validity between the Functional Gait Assessment (FGA), Berg Balance Scale (BBS), and Timed "Up & Go" Test (TUG) in patients with stroke. One hundred and five participants with at least 3 months post stroke and able to walk at least 6 m with or without a mono cane, participated in this study. Concurrent validity between the FGA, BBS, and TUG was assessed using Spearman rank order correlation. The FGA correlated with the BBS (r=.80, p<.01) and TUG (r=-.77, p<.01). The good and moderate correlation between the FGA, BBS, and TUG establishes the concurrent validity of the FGA in patients with stroke. These measures provide clinicians with valuable information about patients' functional balance capabilities.
This study was to investigate the positive effects of specially designed trunk-stabilization exercise program on lower extremity balance of elderly with history of leprosy. In this participants, lower extremity functions has been undermined by the development of damage in peripheral nerves. A total of 40 elderly with history of leprosy were divided into 2 groups of equal size (): a group that participated in the exercise program, and a control group that did not exercise but did continue to engage in normal daily activities (including walking). The exercise group exercised for 60 minutes 2 days a week for 12 weeks. Static balance ability was measured by asking study participants to a one leg standing test: dynamic balancing ability was measured with a tandem walking test and a timed up-and-go test. The participants in the exercise program and the control group were tested before and after completion of the exercise program for comparison, and then divided according to their ability to feel sensory in the soles of their feet into the categories of normal sensory group: group with sensory loss in one foot: and group with sensory loss in both feet. The participants in the exercise program showed a positive, statistically significant difference in static balance compared with the control group (p<.05) as measured using the one leg standing test. Similarly, the participants in dynamic balance (p<.05) as measured using the tandem walking and timed up-and-go tests. Finally, these improvements were related to the severity of sensory loss in the soles of the feet for all study participants.
◉ 목적: 본 연구의 목적은 골 형성 부전증(Osteogenesis Imperfecta)을 가진 여자 대학생에게 인터액티브 메트로놈(Interactive Metronome) 중재를 제공하였을 때, 균형(Balance) 능력과 작업수행의 변화를 알아보기 위함이다.
◉ 연구 방법: 본연구는선천성골형성부전증을가진여대생을대상으로ABA 설계를적용하였으며, 2010년06월 29일부터 2010년 07월 30일까지 4주 동안 주 3회, 총 12회기의 중재를 실시하였다. 중재 이전 4회, 중재 이후 4회씩 테트락스(Tetrax)와 한 발 서기 검사를 사용하여 기초선 및 유지기를 측정하였으며 매 회기 마다 두 검사를 통해 균형의 변화를 측정하였다. 사전/사후 검사로는 BOT-2 (Bruinks-Oseretsky Test of Motor Proficiency-2)와 COPM(Canadian Occupational Performance Measure)을 사용하였다. 연구 종료 한 달 후에 테트락스와 한발 서기를 통해 후속평가를 실시하였다.
◉ 결과: 중재 이후, 1. 테트락스 평가에서 다양한 주파수에서의 자세 동요 강도를 나타내는 푸리에 지수(Fourier Index)가 감소하였다. 2. 한 발 서기 검사의 수행 시간이 증가하였다(눈을 뜬 경우와 눈을 감은 경우). 3. 인터액티브 메트로놈 Pre/Post Test에서 운동과제평균치(MS)는 108.3ms에서 36.7ms로 시간이 감소하였으며, 적중 퍼센트(SRO)는17.7%에서33.0%로증가하였다. 4. BOT-2 균형영역의각항목점수가증가하였다. 5. COPM에서 과제 수행도는 평균 1.6점, 과제 만족도는 평균 2.7점이 증가하였다.
◉ 결론: 본 연구는 인터액티브 메트로놈 중재가 골 형성 부전증 대상자의 균형 능력 향상에 효과가 있는 것을 확인하였다.