Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.

목적 : 본 연구는 대학생을 대상으로 강의실의 의자 형태와 앉은 자세에 따른 근골격계 통증에 대해 알아보고자 하였다. 연구방법 : 재학 중인 대학생 84명을 대상으로 2014년 3월부터 6월까지 사용하고 있는 강의실 의자에 대한 적합도 측정과 설문을 실시하였다. 결과 : 강의실에서 사용되는 의자 중에는 좌면의 높이, 깊이, 너비가 적절하지 못한 의자가 있었고 학생들은 허리, 어깨, 목 등에 통증을 느끼고 있는 것으로 나타났다. 성별, 나이에 따른 통증 정도의 차이는 나타나지 않았으나 고학년인 경우 1학년보다 허리 부위에 통증을 더 느끼는 것으로 나타났다. 의자의 형태에 따라 허리 부위의 통증에 차이가 있었으며, 스 툴형 의자를 사용하는 경우 허리 통증을 더 많이 느끼는 것으로 나타났다. 그러나 앉은 자세에 따른 통증 정도의 차이는 나타나지 않았다. 결론 : 앞으로 강의실 의자 형태를 보다 적합한 것으로 변경할 필요가 있으며 학생들에게는 올바른 앉는 자세에 대한 적극적인 인식 교육이 실시되어야 한다.

The purpose of this study was to investigate the activity of the transverse abdominal muscle resulting from changed posture by measuring the thickness of the transverse abdominal muscle in a supine posture, a slouched sitting posture, and an erect sitting posture. The subjects of the study were 28 patients with cerebral palsy. All their transverse abdominal muscles at the end of inhalation were measured at supine, slouched sitting (S sitting) and erect sitting (E sitting) postures by using ultrasonography, and then their dynamic sitting balance was measured at S sitting and E sitting postures by using BioRescue. For the statistical analysis, the Kruskal-Wallis test and the Wilcoxon signed-rank test were used to compare the differences among each the postures. The results were as follows. The thickness of the transverse abdominal muscle when comparing the supine posture and the S sitting posture showed no statistically significant difference. But the E sitting posture showed a statistically significant difference as compared with the others. In addition, the dynamic sitting balance in comparing the S sitting and E sitting postures showed a significant difference. In conclusion, the E sitting posture has a more positive effect on postural control and balance than generally taking the S sitting posture, for the sitting posture of a patient with cerebral palsy. It is suggested that patients with cerebral palsy mainly experiencing a sedentary life or being in a wheelchair should be seated in the E sitting posture during their daily life, and it may be necessary to continue to monitor and manage the proper E sitting posture.

목적 : 본 연구는 수동 휠체어를 사용하는 편마비 환자를 대상으로 휠체어의 바른 자세 교육을 제공하여 휠체어에 앉았을 때 압력 분포, 휠체어 사이즈의 적합성과 사용자의 만족도를 조사하였다. 연구방법 : 부산 D의료원에서 치료 중이며, 현재 수동 휠체어를 사용하고 있는 편마비인 뇌졸중 환자 38명을 대상으로 하였다. 연구 설계는‘한 그룹 사전평가–사후평가’를 사용하였다. 중재로 사용된 휠체어 자세 교육은 자세 교육 및 상담, 발 받침대 조절과 시트쿠션 및 삽입물 제공에 대한 내용이 포함되었다. 연구도구는 엉덩이 압력 측정을 위한 CONFORMat, 신체계측을 위한 줄자, 사용자의 만족도 측정을 위한 QUEST 2.0을 사용하였다. 결과 : 엉덩이 압력은 비마비측과 마비측의 최대압력 차이가 감소하였으며, 뒤쪽에 치우쳤던 최대압력이 앞쪽으로 분산되었다(p＜.05). 휠체어 표준치와 대상자 실측치의 오차가 좌석의 넓이와 깊이, 발판, 등받이와 팔걸이 높이의 모든 항목에서 유의한 차이로 감소하였다(p＜.01). 휠체어 기기와 서비스의 모든 항목에서 중재 후 만족도가 유의하게 증가하였다(p＜.01). 결론 : 휠체어 자세 교육이 엉덩이 압력, 휠체어 사이즈의 적합성과 사용자의 만족도에 긍정적인 영향을 미쳤다. 이와 같은 휠체어 자세 교육은 환자들의 욕창을 예방하며, 휠체어 사용 시 안전성을 제공하여 자세 유지에 도움이 될 것이다. 앞으로 임상에서는 휠체어를 사용하는 사람들에게 사용 초기에 앉기 자세 교육과 휠체어에 대한 맞춤 서비스를 제공해야 할 것이다.

목적 : 본 연구는 뇌졸중으로 인한 편마비 환자들을 대상으로 앉은 자세에서 지지면의 안정성 변화가 상지기능 수준과 체간근육의 활성도에 미치는 영향을 알아보고자 하였다. 연구방법 : D광역시 ○○재활병원에 내원중인 편마비 환자 15명(남 9명, 여 6명)을 대상으로 앉은 자세에서 양발지지, 손상측지지와 비손상측지지를 사용하여 지지면의 안정성 변화를 중재하였다. 상지기능 수준은 Korea Employment Agency for the Disabled (KEPAD) 다차원 상지기능 작업표본검사로 측정하였고 체간근육의 활성도는 표면근전도를 사용하여 측정하였다. 결과 : 앉은 자세에서 세 가지 지지방법 간에 상지기능 수준을 비교한 결과 양발지지가 손상측지지에 비해 상지기능에 유의한 차이를 보였으나 비손상측으로 지면을 지지한 경우와 비교에서는 유의한 차이를 보이지 않았다. 체간근육의 활성도를 비교한 결과에서는 유의한 차이를 보이지 않았다. 결론 : 본 연구를 통해 임상에서 편마비 환자에게 앉은 자세로 작업수행을 할 경우 양발로 지면을 지지하는 것이 상지기능 수준에 긍정적인 영향을 미친다는 것을 알 수 있었다. 따라서 작업치료사는 환자에게 양발로 지면을 지지하도록하여 자세 안정성을 극대화시킨다면 기능적인 상지의 움직임을 촉진시킬 수 있을 것이다.

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion ). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

The purpose of this study was to investigate the kinematic and kinetic changes that may occur in the pelvic and spine regions during cross-legged sitting postures. Experiments were performed on sixteen healthy subjects. Data were collected while the subject sat in 4 different sitting postures for 5 seconds: uncrossed sitting with both feet on the floor (Posture A), sitting while placing his right knee on the left knee (Posture B), sitting by placing right ankle on left knee (Posture C), and sitting by placing right ankle over the left ankle (Posture D). The order of the sitting posture was random. The sagittal plane angles (pelvic tilt, lumbar A-P curve, thoracic A-P curve) and the frontal plane angles (pelvic obliquity, lumber lateral curves, thoracic lateral curves) were obtained using VICON system with 6 cameras and analyzed with Nexus software. The pressure on each buttock was measured using Tekscan. Repeated one-way analysis of variance (ANOVA) was used to compare the angle and pressure across the four postures. The Bonferroni's post hoc test was used to determine the differences between upright trunk sitting and cross-legged postures. In sagittal plane, cross-legged sitting postures showed significantly greater kyphotic curves in lumbar and thoracic spine when compared uncrossed sitting posture. Also, pelvic posterior tilting was greater in cross-legged postures. In frontal plane, only height of the right pelvic was significantly higher in Posture B than in Posture A. Finally, in Posture B, the pressure on the right buttock area was greater than Posture A and, in Posture C, the pressure on the left buttock area was greater than Posture A. However, all dependent variables in both planes did not demonstrate any significant difference among the three cross-legged postures (p>.05). The findings suggest that asymmetric changes in the pelvic and spine region secondary to the prolonged cross-legged sitting postures may cause lower back pain and deformities in the spine structures.

This study is performed to investigate the difference of the spinal stability system with and without low back pain. There were 9 participants with low back pain and 9 asymptomatic subjects to be recruited, they were measured thoracic and lumbar curvature, trunk muscle activation in upright sitting postures and slump sitting, back muscle endurance, and lumbar proprioception. Spinal curvature and surface electromyography of 4 trunk muscles were measured in an upright sitting postures and slump sitting in 18 subjects. The result of the study was that there were significant differences between the groups in spinal curvature (p<.05), significantly higher external oblique activity and less internal oblique in the low back pain group than the healthy subjects (p<.05), and significantly less proprioception in the low back pain group (p<.05). But there was not a significant difference between the trunk muscle endurance groups. According to the result, the low back pain group had greater thoracic extension and higher global muscle activity in the upright sitting posture and less proprioception. This study was useful to suggest postural training for normal muscle activation, selective muscle strengthening to prevent chronic deterioration, and helpful in making a treatment plan to indicate a synthetic care method that includes increasing proprioception.

이 연구의 목적은 뇌성마비 아동에게 앉은 자세에서 현수를 이용하여 체중지지를 해주었을 때 상지기능에 어떠한 영향을 미치는지 알아보는 것이다. 연구대상자는 뇌성마비 아동 5명과 뇌종양 아동 1명이었다. 연구대상자에게 harness를 착용하여 부분적 체중지지를 하기 전과 착용한 상태에서 손 뻗기 동작을 3차원 동작분석기를 이용하여 어깨관절과 손뻗기 동작에 걸린 시간을 측정하였고, Box and Block 검사를 실시하여 체중지지 전과 착용 시 상지 기능을

For spinal flexibility measurements to be meaningful to clinicians or researchers, they must have a normative information and an understanding of how different variables affect spinal range of motion (ROM). Normal spinal ROM measurements are influenced to differing degrees by many factors. These factors include age, gender, time of day, leisure activities, previous history of low back pain, warming up, and the techniques with which normative data are collected. The additional variables of standing height, ratio of standing height to sitting height, and obesity had not been previously studied extensively and were shown to have a significant effect on flexibility in the sagittal plane. These relationship cannot be explained easily. Thus, the purpose of this study was to determine the relationship between spinal flexibility and individual factors (weight, standing height, and ratio of standing height to sitting height) that influence it. Fifteen healthy subjects between the ages of 20 and 27 years were studied. Two physical therapists measured independently the spinal forward bending ROM in the sagittal plane by Remodified Schober test and Finger-to-floor test. In order to determine the statistical significance of the result the Pearson's correlation was applied at the .05 level of significance. The results of this study were as follows: 1) Significant relationship was not identified between spinal flexibility and weight. 2) Significant relationship was not identified between spinal flexibility and standing height. 3) Significant relationship was not identified between spinal flexibility and ratio of standing height to sitting height.

연구의 배경 앉은 자세에서 일어서기는 일상생활동작중 흔한 동작중의 하나이다. 노인들을 포함한 많은 환자들은 앉은 자세에서 일어서기에 어려움이 있고 속도가 감소한다. 이 연구의 목적은 다른 두 속도로 앉은 자세에서 일어서는 동작을 실행할 때 최대 지면반발력의 세개의 요소를 비교하는 것이다. 대상자 22명의 건강한 성인 (20-36세)을 대상으로 하였다. 실험방법 앉은 자세에서 일어서기동작 수행중 최대 지면반발력을 측정하기 위하여 힘판을 사용하였다. 대상자

앉은 자세를 장시간 유지하면 허리의 만곡에 변화가 오면서 통증이 발생하게 된다. 본 연구에서는 양반 앉은자세에 서 SPINE-GUARD(허리 안정화 벨트) 착용이 허리뼈의 코브각과 허리통증 그리고 몸통 굽힘각도의 변화에 미치는 영 향에 대해 알아보았다. 대상자 15명(남자)은 2주 동안 주 5회 매회 90분씩 벨트를 착용한 채로 영화를 감상하거나 강 의를 들었다. 허리뼈의 코브각은 착용전 48.36±14.57에서 착용후 28.09±11.63로 유의한 감소를 보였다(p<0.05). 통 증은 착용전 4.53±2.36이고, 착용후 2.733±2.153로 유의하게 감소하였다(p<0.05). 몸통의 굽힘각도 또한 착용전 82.33±20.30에서 착용 후 70.2±19.43로 유의한 감소를 보였다(p<0.05). 이것으로 보아 SPINE-GUARD의 착용은 허리뼈의 코브각 및 몸통굽힘각도의 변화 그리고 통증의 감소에 영향을 주는 것으로 사료된다.