뇌졸중 환자의 상지 체감각 자극을 통한 감각, 손 기능, 자세조절 및 일상생활수행력의 변화

송보경,Song, Bo-Kyung 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.5

Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

기능적 팔뻗기 중심의 상지 훈련이 편마비 환자의 체간조절과 일상생활동작수행능력에 미치는 영향

송보경 ( Bo Kyung Song ),정상미(교신저자) ( Sang Mi Chung ),김미영 ( Mi Young Kim ) 대한신경치료학회 2011 신경치료 Vol.15 No.1

Purpose In this study, we were trying to find out effect of improved trunk control and ADL performance through upper limb training as functional reaching in the upper limb. Method We selected 12 stroke patients randomly in hospital, who have a problem with their upper limb, trunk and ADL performance. But we excluded 1 stroke patient to discharge in study period suddenly. The patients were divided into conservative training group and the functional reaching training group. In conservative group, we applied only general occupational therapy, but in functional reaching training group, we applied upper limb training as functional reaching instead of general occupational therapy. To compare each group we used several assessment tools such as MBI, total TIS, static TIS, dynamic TIS and coordinative TIS. Result We reached out results as follows. 1) In functional reaching training group, there was statistically reliable in total TIS, dynamic TIS, MB!. 2) We compared changes in before and after training and found that there was relationship among assessment outcomes. Especially, static TIS showed relationship on both group. Conclusion Functional reaching training has influences on trunk control and ADL performance. Especially, functional reaching training group offered static trunk control ability more than conservative training group.

시지각 및 체감각 손상을 동반한 뇌졸중 환자의 체감각 중심 훈련이 자세정렬과 체간기능에 미치는 영향

송보경 ( Bo Kyung Song ) 한국고령친화건강정책학회 2011 대한고령친화산업학회지 Vol.3 No.1

연구목적: 시지각 및 체감각 손상을 동반한 좌측 편마비 환자의 능동 체감각 훈련이체감각과 체간기능과 자세정렬에 어떠한 변화가 있는지 알아보고자 한다. 연구방법: 본 연구는 단일사례 연구로 연구의 기간 및 대상은 2010년 10월부터 11월 1달간 00병원에 입원한 환자 중 독립적으로 앉은 자세를 유지하고 치료내용을 이해할 인지수준을 가진 좌측 편마비 환자 중 편측 무시와 같은 시지각 손상과 피부, 근육감각손상 및 체간기능에 제한이 있는 환자 1명을 대상으로 하였다. 연구도구로는 시지각 검사인 알버트 검사, 별지우기 검사 및 집, 시계 그리기 검사와 체감각검사 그리고 체간기능 검사인 Trunk Impairment Scale(TIS)을 사용하여 2010년 10월부터 11월까지 4주간 12회 매회 60분간 치료를 시행하여 전, 후의 변화를 비교하였다. 연구결과: 환자의 감각기능은 피부감각 및 고유 감각에서 점수가 호전되었고 인체인식력은 차이가 없었다. 편측 무시의 알버트 검사가 치료 전 4분 32초에서 40초 61로 별지우기 검사는 4분 32초에서 1분 31초로 향상되었고 좌측수행시간은 알버트검사가 2분 12초에서 12초 37로 별지우기검사는 2분 45초에서 15초 37로 수행속도가 향상되었다. TIS에서 정적체간 점수가 4점에서 10점으로 전, 후 차이가 나타났다. 결론: 4주간의 치료를 통해 마비측의 피부감각, 고유감각에 향상이 있었으나 입체인식력에는 변화가 적었으나 시지각 인식력은 수행시간 및 왼쪽의 과제수행의 수행시간이 초기보다 향상되었다. 체간기능은 정적체간에서 향상을 보였으나 동적 및 협응 체간기능에서 영향을 보이지 않았다. Objective: In this study, we have tried to find out the effect of improved postural alignment in sitting posture and trunk control through somatosensory training. Methods: We selected single left hemiplegia with stroke patients in hospital, who have a problem with visual neglect and somatosensory function. To compare result of before and after, we used several assessment tools such as albert cancellation test, star cancellation test, house and clock test for visual neglect, somatosensory test and total TIS, static TIS, dynamic TIS and coordinative TIS. We applied somatosensory training focused on functional activity. Researchs: We reached out results as follows. 1) We compared changes in before and after training and found that there was relationship among assessment outcomes. Especially, cutaneous sense, performance time of albert cancellation test and cancellation test, and static TIS showed relationship in patient. Conclusion: Somatosensory training influenced on visual perception, postural alignment and on trunk control. Especially, somatosensory training offered static trunk control ability more than before.

뇌졸중 후 편마비 환자에게 적용된 과제지향훈련 효과의 체계고찰 연구

송보경 ( Bo-kyung Song ),김아란 ( Ah-ran Kim ),김준수 ( Jun-soo Kim ),서성재 ( Sung-jae Seo ),손준희 ( Jun-hee Son ),신희덕 ( Hee-duck Shin ),정지원 ( Ji-won Jung ),양병일 ( Byung-il Yang ) 대한신경치료학회 2019 신경치료 Vol.23 No.2

Purpose The purpose of this study is to analyze the functional improvement through task-oriented training of stroke patients and to suggest the clinical application effect of task-oriented training through systematic review. Methods From the period of 2011 to 2016, we searched the papers which received the original text downloading service among domestic journals and theses published in e-journals. Major search terms were “task-oriented” by searching “stroke” A total of 108 papers were searched by using appropriate combinations of the words “upper extremity”, “lower extremity”, “gait”, “mental”, “sense” and “Seventeen papers were selected for inclusion and exclusion criteria. Results A total of 17 studies were classified according to body function and task performance included in the framework of occupational therapy execution system. The results were as follows: 10 studies (58.8%) on neuromuscular movement, 2 (11.8%), and 5 (29.4%) were related to daily life activities. The results of the study showed that task-oriented training was effective in improving the function of stroke patients. Conclusion Task-oriented training showed a positive change in functional recovery of stroke patients, suggesting that task-oriented training is needed for stroke patients. Therefore, in future research, it is necessary to study the task-oriented training development of stroke patients. Based on this, we will give how clinicians help occupational performance and body functions through more systemic review, and will be able to suggest evidences future intervention direction for patients following intervention effect.

뇌졸중 환자의 감각훈련이 신체인식력에 미치는 영향

송보경 ( Bo Kyung Song ) 고령자.치매작업치료학회 2008 고령자.치매작업치료학회지 Vol.2 No.2

체감각 자극 훈련이 편측무시 환자의 감각, 공간무시 및 신체인식력에 미치는 효과

송보경(Bo-Kyung Song) 한국엔터테인먼트산업학회 2012 한국엔터테인먼트산업학회논문지 Vol.6 No.4

본 연구의 목적은 편측무시를 동반한 뇌졸중 환자에게 6주간 상지 체 감각 자극 훈련이 감각, 편측무시 및 신체 인식력에 어떠한 영향을 미치는지 알아보고자 하였다. 이를 위해 뇌졸중 환자 중 편측무시가 있는 9명을 대상으로 6주간 주 5회 물리, 작업치료 및 주 3회의 체감각 자극 훈련을 실시하여 다음과 같은 결과를 얻었다. 편측무시 환자의 마비측 전완부의 접촉감지(TDT), 마비측 전완부의 두점구별(TPD), 비마비측의 검지손가락 끝을 제외한 부위의 두점구별(TPD), 입체인식(ST), 알버트검사(AT), 별지우기검사(SCT)와 신체시각화 및 공간 개념 검사(BVSC)에서 치료 후의 유의한 차이를 보였다. 이상의 결과로 볼 때 상지 체감각 자극훈련은 편측무시를 동반한 뇌졸중 환자의 마비측 접촉감각, 두점 구별, 입체인식 및 신체인식력 증진에 도움을 주었다고 사료된다. This study investigated the effect of somatosensory stimulation such as facilitation of reaching and somatosensory of upper limb on tactile sense, spatial neglect and postural orientation. The subject were 9 stroke patients in the Bobath Memorial Hospital, who has problem with unilateral neglect. Somatosensory stimulation for the hand was carried out eighteen times, three times a week for six weeks, together with 40 minutes preservative treatment. To compare unilateral neglect group, we used assessment tools such as tactile detection thresholds (TDT), two point discrimination on affected side (TPDas), unaffected side (TPDus), stereognosis (ST), Albert Test (AT), Star Cancellation Test (SCT), Body Visualization Space Concepts test (BVSC) and Finger Localization-Naming Test (FLNT). In unilateral neglect group, somatosensory stimulation for hand significantly improved TDT(forearm), TPDas(forearm), TPDus(except for index finger tip), ST. AT, SCT and BVSC (p<0.05). To Conclude, Somatosensory stimulation for hand influenced tactile sense, two point discrimination on paretic side (forearm) and non-paretic side (forearm, thernar, hypothernar, thumb tip), stereognosis and body orientation.

다감각 자극 훈련이 편마비 환자의 자세조절 능력에 미치는 영향

송보경 ( Bo Kyung Song ),정상미(교신저자) ( Sang Mi Chung ),문제강 ( Je Kang Moon ) 대한신경치료학회 2011 신경치료 Vol.15 No.1

Purpose In this study, we have tried to find out the effect of the multi-sensory training on the postural control after the stroke. Method We selected IQ stroke patients in rehabilitation hospital. The patients were divided into the Experimental group made of 6 patients and the conservative training group made of 4 patients. For those patients in the Experimental group, the multi-sensory training was carried out twenty times in the four-week period for five times a week and 30 minutes together with the preservative treatment. For those patients in the conservative training group, only the preservative treatment was carried out. Also, the cognitive function and the ability of postural control were evaluated. Result For those in the Experimental group, the multi-sensory training was statistically important for MMSE-K, MIDI and MID2 (p<.05). Also, there was a statistically important difference for MTD 1 and MID2 in regard to the changes before and after the treatment in both groups (p<.05). Conclusion The multi-sensory training for the chronic stroke patient sinfluenced the cognition and the ability of postural control. Also, there was an important difference in regard to the ability related to the postural control in the before and after comparison between both groups. As a result, it seems that the multi-sensory training would become helpful for the ability related to the postural control.

뇌졸중 환자의 장애 특성에 따른 접촉 감각 자극이 두점 구별, 손 기능 및 일상생활수행력에 미치는 효과

송보경 ( Bo Kyung Song ) 대한물리의학회 2012 대한물리의학회지 Vol.7 No.4

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL`s. And we also found relationship among somatosensory, hand function, and ADL performance.

서울특별시 공공의료기관 물리치료사의 직무 만족도에 관한 조사연구

문제강,송보경,황병용,Moon, Je-Kang,Song, Bo-Kyung,Hwang, Byong-Yong 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.2

Purpose: The purpose of this study was to investigate (1) job satisfaction, (2) general characteristics and (3) working fields of 57 physical therapists at public health centers in the Seoul Metropolitan area. Methods: We distributed questionnaires to 57 physical therapists and collected completed questionnaires from 51 We analyzed the data using frequency analysis, independent t-tests and analysis of variance. Results: The results were as follows; 1) General characteristics of participants were 68.6% female, 64.7% over 35 years old, 43.1% working over 10 years in the public health centers. 2) Most (56.8%) participants treated 20~29 patients a day 66.7% were regular staff members and 33.3% irregular ones. 3) Participants, who worked at the public health center and who worked at the Seoul Metropolitan affiliated organization, showed a sense of dignity about their job. 4) Regular staff members showed a higher satisfaction rate with interpersonal relations than irregular ones. Satisfaction in the work place was greatly increased in those over 40 years old. Conclusion: Because the number of patients who visit physical therapists in Seoul Metropolitan public health centers have been increasing, it is necessary to improve the level of satisfaction of physical therapists so that there will be better physical therapy services.

30일 이상 90일 미만의 발열 영아에서 경험적 항생제 사용에 영향을 미치는 요소

변정희,송보경,김영아,고훈,유석동,임택진,박수은,Byun, Joung-Hee,Song, Bo Kyung,Kim, Young A,Ko, Hoon,Yoo, Suk dong,Lim, Taek Jin,Park, Su Eun 대한소아감염학회 2018 Pediatric Infection and Vaccine Vol.25 No.2

Purpose: This study investigated the factors affecting the use of empirical antibiotics in febrile infants from 1 month to less than 3 months. Methods: We retrospectively reviewed the medical records of hospitalized previously healthy infants with fever in Pusan National University Children's Hospital from January 2010 to December 2016. Clinical features, laboratory findings and antibiotic therapy were analyzed. Respiratory viruses were identified by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) and were reported after 1-3 days. Enterovirus were identified by real time polymerase chain reaction (PCR) and were reported in several hours. Results: The 129 of 366 subjects used empirical antibiotics and 237 patients didn't used empirical antibiotics. Empirical antibiotics were used more frequently when the fever was longer before admission, respiratory symptoms and ill being appearances were present and C-reactive protein was elevated. The rate of readmission was low in the group not used empirical antibiotics. Most of the patients detected by enterovirus PCR in cerebrospinal fluid didn't used empirical antibiotics. The results of respiratory virus multiplex RT-PCR showed no difference in the use of empirical antibiotics. Conclusions: In our study, empirical antibiotic prescriptions were affected not respiratory virus multiplex RT-PCR but enterovirus PCR. If multiplex RT-PCR were reported more rapid turn around time, it will affect antibiotic use.