본 연구는 코마개의 사용 여부에 따라 MRI 영상을 분석함으로써 숨 참기의 정확도를 향상할 도구로써 코마개가 실 효성이 있는지 검증하고자 하였다. 이를 위해 수검자에게 코마개가 없는 자연 호흡과 코마개를 사용한 구강 호흡 상태에서 호기 후 숨 참기를 지시하고 MRI 영상을 획득하였다. 영상은 2D 경사 자기장 에코 시퀀스로 획득하였고 초당 1장씩, 총 15장을 얻어 숨 참기 상태를 분석하였다. 숨 참기의 상태를 정량적으로 평가하기 위해 우측 폐 면적 을 측정하였다. 그리고 첫 번째 영상의 폐 면적을 기준으로 나머지 영상들에서 폐 면적의 절대 오차값을 구해 비교하 였다. 더불어 첫 번째 영상을 기준으로 나머지 영상들의 기하학적 유사도를 평가하기 위해 SSIM 값을 계산하였다. 실험 결과, 자연 호흡 상태에서 절대 오차는 평균 216.79 ㎟로 나타났다. 반면, 코마개를 사용한 구강 호흡의 경우 평균 55.94 ㎟로 나타나 자연 호흡과 비교하여 약 74.19% 감소하였다. SSIM 값은 자연 호흡 시 평균 0.7, 구강 호흡 시 0.76으로 나타나 기하학적 유사도가 약 6% 향상되었다. 이는 코마개 사용 시 호흡의 초기 상태를 잘 유지함 으로써 숨 참기의 정확도가 향상되어 능동적으로 호흡 상태를 조절할 수 있는 도구로써 충분한 가치가 있음을 증명한 다. 따라서 복부 MRI 검사에서 호흡에 따른 인공물을 개선하는 데 코마개가 도움을 줄 수 있으며 영상 개선 및 업무 효율을 높이는 도구로써 충분히 활용할 수 있다.
Purpose: 본 연구의 목적은 4주기간동안 횡격막 호흡을 적용한 기구 필라테스 운동이 20대 성인의 유연성, 복부 근 두께, 근육량, 체지방, 호흡에 미치는 영향에 대해 알아보고자 하는 것이다.
Methods: 근골격계 질환이 없는 대상자 35명을 대상으로 수행하였으며, 횡격막 호흡을 하는 그룹과 횡격막 호흡을 하지 않는 그룹으로 나누었으며, 두 그룹 모두 필라테스를 수행하였다. 실험에 사용한 기기로는 Ultrasonography(US), Pulmonary function tests(FEV1 / FVC), Bioeletic Impedance Analysis, Sit and reach test를 사용하였다. 정규성 검증을 실시한 후, 반복측정분산분석 (repeated measures of ANOVA)를 사용하여 운동 전, 호흡을 적용한 운동, 호흡 비적용 운동을 비교하였다. 사후 분석을 위해 Fisher’s LSD를 실시하였다.
Results: 필라테스 운동은 복근의 두께와 유연성에 긍정적인 영향을 미쳤습니다. SaR test는 운동 전과 호흡을 적용한 운동과 호흡을 적용하지 않은 운동 사이에 유의한 유의성을 보였다(P <0.05). 근육두께 측정 TRA, EO, IO 모두 운동 전보다 호흡 적용 운동과 비호흡 운동에서 유의한 차이가 있었고(P <0.05), TRA와 IO에서는 추가 시간 사이에 유의한 차이가 없었다. 호흡하지 않는 운동(P >0.05). 그러나 EO에서는 호흡운동을 추가한 시간과 호흡운동을 하지 않은 시간 사이에 유의한 차이가 있었다( P <0.05).
Conlusion: 결론적으로, 횡격막 호흡을 이용한 필라테스 운동과 횡격막 호흡이 없는 필라테스 운동은 복근의 두께와 유연성에 긍정적인 영향을 미치는 것으로 나타났다. 그러나 횡격막 호흡과 비횡격막 호흡 사이에는 큰 차이가 없었다.
Background: To restore the trunk function of stroke patients who tend to experience trunk weakness, a single exercise intervention is usually applied. However, problems with the trunk remain even after such an intervention. To overcome this challenge, combining other intervention methods with an exercise is suggested during training. Objectives: To investigate the effect of breathing based abdominal draw-in technique on the thickness of the transversus abdominis muscle and trunk control in stroke patients. Design: Randomized controlled study. Methods: After designating a group that will perform the abdominal draw-in technique as Experimental Group I and another group that will perform the breathing based abdominal draw-in technique as Experimental Group II, the thickness of the transversus abdominis muscle and the trunk impairment scale (TIS) of the subjects were measured as pre-tests before the interventions and as post-tests after the six week intervention period. Results: In the within group comparison, there was a significant change in the thickness of the transversus abdominis muscle for both groups while the subjects performed the abdominal draw-in technique; a significant change was also noted in their TIS (P<.05) (P<.01). However, in the inter-group comparison, a significant difference was found only in the TIS between the two groups (P<.05). Conclusion: After the application of the breathing based abdominal draw-in technique, an efficient contractile response was observed even in the muscles around the abdomen of the subjects, which indicates that this technique is an intervention method that can more effectively improve trunk control.
Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM (n1=10) and DBM (n2=9) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.
Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.