흉골 자기공명영상 검사 시 호흡 등 환자 움직임에 의한 인공물 발생을 최소화하는 것은 어렵다. 하지만 자기공명영 상 검사는 타 영상 검사와 비교해 흉골 병변을 발견하는 데 있어 진단적 가치가 높은 장점이 있다. 따라서 본 연구에 서는 환자의 검사 자세 및 딥러닝 기법을 통해 최적의 검사 방법을 도출하고자 한다. 자세 별 영상 변화를 확인하기 위해 바로 누운 자세, 엎드린 자세, 유방 코일을 사용한 엎드린 자세로 진행하였으며, 고식적 기법의 영상과 Deep Resolve Boost(DRB) 기법을 적용한 영상을 비교 관찰하였다. 모든 대상에게 같은 조건으로 각 영상을 2회씩 획득 한 후 전반적인 영상 품질을 기준으로 정성적으로 평가하였고, DRB의 적용 여부에 따른 신호 대 잡음비의 변화 정도를 정량적으로 평가하여 개선 정도를 산출하였다. 정성적 평가에서 DRB 적용 여부와 무관하게 엎드린 자세, 유방 코일을 사용한 엎드린 자세, 바로 누운 자세 순으로 높은 점수를 얻었으며, DRB를 적용한 영상이 고식적 기법 의 영상보다 높은 점수를 얻었다. 또한 정량적 평가를 통해 유방 코일을 사용한 엎드린 자세, 엎드린 자세, 바로 누운 자세 순으로 높은 개선 정도를 확인하였다. 본 연구를 통해 흉골 검사 시 DRB 기법을 적용하는 것은 영상의 질을 높이는 방법임을 확인하였다. DRB를 적용하지 못하는 환경에서는 될 수 있으면 엎드린 자세를 적용하는 것을 권고하며, DRB를 적용할 수 있는 환경에서는 환자 측 인자를 고려하여 엎드린 자세와 유방 코일을 사용한 엎드린 자세를 모두 적용할 수 있다.

Background: Neck pain is a major health problem in developed countries and has a lifetime prevalence of 50%. Major problems include a reduced cervical range of motion, muscle stiffness, dysfunction, postural changes, and decrease in psychosocial level. Objects: This study aimed to investigate the effects of applying the upper trapezius inhibition dynamic taping to patients with chronic neck pain on their neck pain, functional level, cervical range of motion, psychosocial level, and neck posture. Methods: The study design was a randomized controlled trial. A total of 40 patients with neck pain participated in this study and were randomly assigned to a Dynamic Taping group (n = 20) or Sham Taping group (n = 20). In both groups, basic intervention cervical pain control therapy and shoulder stabilization exercise program were performed. In addition, dynamic taping and sham taping were applied to participants in the Dynamic Taping and Sham Taping groups to inhibit the trapezius muscle, respectively. All interventions were performed three times a week and a total of 12 times for 4 weeks, and the participants’ neck pain, functional impairment level, cervical range of motion, psychosocial level, and neck posture were measured and compared before and after the intervention. Results: Both groups showed significant differences in neck pain, functional level, cervical range of motion, psychosocial level, and neck postural before and after the intervention (p < 0.05). Moreover, there were significant differences between the two groups regarding the functional level and neck posture (p < 0.05). Conclusion: Inhibition dynamic taping of the upper trapezius muscle suppression is an effective method with clinical significance in reducing pain in individuals with chronic neck pain and improving the functional level, cervical range of motion, psychosocial level, and neck posture.

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group (n1=7) and conventional postural vertical training (CPVT) group (n2=7). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject’s postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured preand post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

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.

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 investigate the effect of visual feedback on the postural control of stroke patients, by systematically varying conditions of visual feedback [eye-open condition (EO) vs. eye-closed condition (EC)], and base-support (both-side support, affected-side support, and unaffected-side support). In this study, we allocated 41 stroke patients with no damage in the cerebellum and visual cortex who can walk at least 10 meters independently, and 35 normal adults who have no experience of stroke to the control group. Both groups were asked to perform a "sit-to-stand" task three to five times, and their postural control ability was measured and compared in terms of asymmetric dependence (AD) instead of the traditional symmetric index (SI) in the literature. The results showed that although both subject groups maintained better postural control in the EO condition than in the EC condition, the patient group appeared to be more stable in EC than in EO when they were required to perform the task of the support condition given on the affected side. These results implied that visual feedback can impair stroke patients' postural control when it is combined with a specific support condition.

목적 : 본 연구의 목적은 시각되먹임 제공 및 차단으로 시행된 자세수직훈련의 효과를 비교함으로써, 시각되먹임을 차단한 자세수직훈련이 뇌졸중 밀기증후군 환자의 기능회복 및 일상생활동작에 어떠한 영향을 미치는지 알아보고 자 하였다. 연구방법 : 본 연구는 개별사례 교차중재 연구설계 중 대상자간 다중기초선을 이용하였으며, 밀기증후군 환자 3명 을 대상으로 하였다. 기초선 측정은 대상자 1이 4회, 대상자 2가 7회 그리고 대상자 3이 10회였으며, 치료회기는 대상자 1이 14회, 대상자 2가 11회 그리고 대상자 3이 8회였다. 치료중재는 대상자 1이 14회, 대상자 2가 11회 그 리고 대상자 3이 8회였다. 밀기증상의 기능회복 평가는 밀기 증후 척도, 일상생활동작을 평가하기 위하여 바델지 수 및 실험 전∙후 대칭적인 서기자세를 평가하기 위하여 근전도기로 양측 중둔근에서 근활성도를 측정하였다. 결과 : 시각되먹임을 차단한 자세수직훈련이 적용되었을 때 대상자 1, 2, 3의 밀기 증후 척도는 각각 기초선과 비교 하여 52.4%(5.3점에서 2.8점), 36.4%(4.4점에서 1.6점) 및 23.6%(3.6점에서 0.9점) 향상되었다. 시각되먹임을 제공한 자세수직훈련은 42.9%(5.3점에서 2.3점), 26.1%(4.4점에서 1.2점) 및 13.2%(3.6점에서 0.5점) 향상되었다. 대상자 1, 2, 3의 바델지수는 각각 기초선과 비교하여 22.4%(44.3점에서 54.1점), 15.5%(44.7점에서 51.6 점) 및 15.8%(51.5점에서 59.6점) 향상되었다. 시각되먹임을 제공한 자세수직훈련은 17.0%(44.3점에서 51.8점), 11.4%(44.7점에서 49.8점) 및 14.8%(51.5점에서 59.1점) 향상되었다. 또한 실험 전과 비교하여 실험 후 환측의 중둔근 근활성도가 더 크게 향상되었다. 결론 : 교대로 적용된 치료중재 결과를 통하여 시각되먹임을 차단한 자세수직훈련이 시각되먹임을 제공한 자세수직훈련보다 밀기증후군 환자의 기능회복 및 일상생활동작능력에 더 효과적인 것으로 나타났다. 향후에는 많은 대상자를 포함시키고 오랜 기간 동안 적용한 연구들이 계속 이어져야 할 것이다.

This study examined whether any changes by mental task types on postural control in chronic stroke persons. Sixteen chronic stroke persons (mean age=53.75 yr) and sixteen age-and gender-matched healthy controls (mean age=54.44 yr) took part in this study. Participants randomly performed three different tasks on the stable and unstable surfaces. The no mental task was to stand while holding a 100 g weight in each hand, the arithmetic task (mental task) was to perform a silent 1-backwards counting while standing and holding a 100 g weight in each hand, and the simple task (mental task) was to stand and hold with both hands a tray (200 g) on which a glass filled with water has been placed. Sway path and sway velocity of the center of pressure (COP) were measured to assess standing postural control by task performance using the force platform. According to the results, in stroke group, total sway path and total sway velocity of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable surface (p<.05), and sway path (anteroposterior AP, mediolateral ML) of COP, total and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the unstable surface (p<.05). Especially, sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In healthy control group, sway path (AP, ML, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable and unstable surface (p<.05), and sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In conclusion, the findings of this study showed that arithmetic and simple task improved standing postural control for chronic stroke patients and the type of arithmetic and simple tasks were critical factor that reduced standing postural sway in dual-task conditions. Future research should determine whether dual-task conditions, including simple task, would be effective as a training program for standing postural control of stroke patients.

The purpose of this study was to investigate the most effective and comprehensible method for the assessment of resting scapular position (RSP) and pain level (PL) in unilateral shoulder pain (USP). Fifty volunteers with USP were involved in the study. Resting scapular assessments of the patients' pain sides (PS) and non-pain sides (NPS) were evaluated. The assessment tools for RSP are: 1) sternal notch (SN) to coracoid process (CP) distance 2) 3rd thoracic spinous process (T3S) to posterolateral angle of acromion (PLA) distance 3) scapular index 4) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance 5) supine measurement of pectoralis minor (PM) distance 6) standing PM distance 7) PM index (PMI) and 8) PM pain. The paired t-test was used to compare PS and NPS in RSP. Pearson correlation analysis was used to confer a relationship between the PL and RSP. The results of this study indicated that: 1) all the variables between the PS and NPS for RSP were statistically significant(p<.05) and 2) the PMI showed the strongest relationship in the correlation analysis between RSP and PL(p<.05, r=.37). Therefore, it can be concluded that there is a relationship between PMI and PL and it is suggested that an assessment tool using PMI to diagnose shoulder pain would be clinically effective.

목적 : 뇌졸중 환자를 대상으로 4점 척도인 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke: PASS) 와 5점 척도인 버그 균형 척도(Berg Balance Scale, BBS)를 3점 척도로 단순화시켜 원본 PASS, BBS와 특성을 비교하고 신뢰도 및 타당도를 알아보고자 하였다. 연구방법 : 만성뇌졸중 환자 62명을 대상으로 PASS(0-1-2-3)는 PASS-3Level(0-1.5-3)로 BBS( 0-1-2- 3-4)는 BBS-3Level(0-2-4)로 기록하여 비교하였다. PASS-3L과 BBS-3L 평가의 측정자내·측정자간 신 뢰도는 급간내 상관계수를(ICC3,1), 절대적 신뢰도는 표준 오차 측정(Standard Error Measurement: SEM)과 최 저 실제 차이(Small Reference Differences: SRD)를 이용하였고, 내적 일치도를 알아보기 위하여 Cronbach’s α 계수를 구하였다. PASS(PASS-3L), BBS(BBS-3L)의 동시 타당도와 수정된 바델 지수(Modified Barthel Index, MBI)와 퓨글 마이어 운동(Fugl Meyer-Motor: FM-M)과의 수렴 타당도를 알아보기 위하여 피어슨 상관 분석을 하였다. 결과 : PASS-3L과 BBS-3L의 검사 재검사 신뢰도는 각각 ICC = .96, .96, 측정자간 신뢰도는 각각 ICC = .95, .94이었다. PASS-3L과 BBS-3L의 SEM은 각각 .99, 1.55, SRD는 1.74, 4.30, Cronbach's α계수는 .77, .85로 신뢰도가 높게 나타났다. PASS-3L의 동시 타당도는 PASS(r=.93), BBS(r=.75), BBS-3L(r=.80)과 유의한 관 련이 있었고, BBS-3L은 PASS(r=.80)와 BBS(r=.93)와 유의한 상관관계가 있었다(p<.01). PASS-3L의 수렴 타당도는 MBI(r=.60), FM-M(r=.42)과 유의한 관련이 있었고, BBS-3L은 MBI(r=.79), FM-M(r=.48)와 유 의한 상관관계가 있었다(p<.01). 결론 : 2개의 단순화된 PASS-3L과 BBS-3L은 PASS, BBS와 비교하여 매우 높은 신뢰도와 타당도를 보여 뇌졸 중 환자의 균형을 평가하는데 적합하다고 할 수 있다.

It is important to find the effective position for cough and sputum clearance in respiratory physical therapy. The purpose of this study was to compare the changes in peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and peak cough flow (PCF) related to functional level and measurement position in patients with Duchenne muscular dystrophy. Twenty one subjects were classified into three functional levels, and measurements was undertaken in three different measurement positions (upright sitting, 45˚ reclining and supine). Vitalograph PEF/FEV DIARY was used to measure PEF and FEV1, and Ferraris Pocket Peak was used to measure PCF. Mixed two-way analysis of variance and Bonferroni post-hoc test were used for statistical analysis. The results of the study were as follows: 1) Significant main effects for measurement position were found. 2) PEF was the highest in upright sitting, followed by 45˚ reclining, and supine in order. 3)FEV1 in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 4) PCF in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 5) No significant main effects for functional level were found in PEF, FEV1, and PCF. 6) No significant functional level by measurement position interactions were found in PEF, FEV1, and PCF. Therefore, it is concluded that upright sitting and 45˚ degree reclining positions are recommended for effective cough and sputum clearance.

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.

Anticipatory postural adjustments is an example of the ability of the central nervous system to predict the consequence of the mechanical effect of movement on posture and helps minimize a forth coming disturbance. The aim of this study was to evaluate the sequence of activation of the trunk muscles during the performance of hip and shoulder movement and to determine the relationship between anticipatory activity and subjects' motor and functional status in subjects with hemiplegia post stroke. Twenty-four poststroke hemiparetic patients enrolled in this study. Electromyographic activity of the lumbar erector spinae, latissimus dorsi, and of the obliquus internus muscles was recorded bilaterally during flexion of both arm and from the rectus abdominis, obliquus externus, and obliquus internus muscles during flexion of both hip. Onset latencies of trunk muscles were partially delayed in the subjects with hemiplegia post stroke (p<.05). With upper limb flexion, the onset of erector spinae muscle and latissimus dorsi muscle activity preceded the onset of deltoid on both side respectively (p<.05). A similar sequence of activation occurred with lower limb flexion. Also the onset of external oblique muscle and rectus abdominis muscle activity preceded the onset of rectus femoris muscle on both side (p<.05). Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in delayed onset between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance (R²=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

목적 : 본 연구는 만성 뇌졸중 환자를 대상으로 자세 조절이 일상생활동작 수행능력과 근 긴장도 변화 및 상지기 능 수행에 어떠한 영향을 미치는지 알아보고자 하였다． 연구방법 : 본 연구를 위하여 국립재활원에 입원한 41명의 뇌졸중 환자를 대상으로 모든 환자들은 자세조절 평가 척도(Postural Assessment Scale stroke, PASS), 일상생활동작 수행능력 측정 도구(Modified Barthel Index, MBI), 긴장도 사정 척도(Tone Assessment scale, TAS), Fugl-Meyer 평가 척도(Fugl-Meyer Assessment scale－upper extremity) 등을 이용하였고 자료 분석은 피어슨 상관분석(pearson correlation coefficient), 단계적 다중 회귀분석(stepwise multiple regression）을 실시하였으며 내적 일치도를 알아보기 위하여 Cronbach's alpha Coefficient를 구하였다． 결과 : PASS항목에서 가장 기능이 좋은 것은 지지하여 서기로 나타났으며，가장 기능이 낮은 것은 환측으로 서기였고，MBI항목에서 가장 기능이 좋은 것은 의자／침상 이동이며， 가장 기능이 낮은 것은 목욕하기로 나타났다．PASS의 모든 항목은 MBI, FM-UE, TAS와 유의한 상관관계(r=-33~91, p<.05~01）가 있으며，FM-U/E와 MBI(r=.35, p<.05), TAS- 안정(r=.-40, p,<．0.1), 연합항목(r=-.39,p<.05)에서 유의한 상관관계가 있는 것으로 나타났다．내적 일치도는 Cronbach's a=.86로 높게 나타났으며，PASS의 합과 자세유지 항목 (r=.90 p<.01)의 합，자세변화 항목(r=.93,p<.01)의 합은 유의한 상관관계가 있었으며，자세유지 항목의 합과 자세변화 항목의 합 간에는 유의한 상관관계(r=.69,p<.01)가 있었다．PASS 항목 중 누운자세에서 건측으로 돌기와 바닥에서 볼펜집어 올리기가 각각 ADL과 상지 기능을 예견하는데 가장 중요한 변수(R2=.95, R2=.56)임을 알 수 있었다． 결론 : PASS는 일상생활동작 수행 능력과 근 긴장도 및 상지기능수행 간에 유의한 상관관계가 있는 것으로 나타나 뇌졸중 환자의 기능적 독립성을 예측할 수 있는 지표가 될 수 있을 것이다．