편마비 환자에 대한 후방보행 훈련이 보행 속도와 균형 능력에 미치는 영향

기경일,김선엽,오덕원,김경환,Ki, Kyong-Il,Kim, Suhn-Yeop,Oh, Duk-Wyon,Kim, Kyung-Hwan 대한물리치료과학회 2009 대한물리치료과학회지 Vol.16 No.2

Background: The ability for backward walking is considered to be necessary for the neuromuscular control and maintenance of balance in daily ambulatory activity. This study aimed to determine the effect of backward walking training on the walking speed and balance control in patients with hemiplegia. Methods: Fourteen patients with hemiplegia were randomly allocated to an experimental and control groups of seven patients each. For the experimental group, we performed both conventional training and backward walking training, and conventional training only for the control group. The conventional training programs for the 2 groups were conducted for 30 min, twice a day, 5 times a week for 4 weeks, and backward walking training for the experimental group was conducted for 30 min, 3 times a week. The outcomes were assessed using the functional reach test (FRT), timed up-and-go (TUG) Test, and the 10 meter walk time test (10mWT). Result: A comparison of the FRT, TUG test, and 10mWT scores obtained before and after the 4-week treatment revealed statistically significant differences (p<.05) for the experimental group; however, there was no such difference in the case of the control group (p>.05). On assessment after the 4-week treatment, statistically significant differences were noted in the TUG test and 10mWT scores of the experimental group (p<.05). Conclusion: Our findings suggest that backward walking training is an effective clinical strategy for improving the walking speed and functional mobility of patients with hemiplegia.

엉덩관절 각도에 따른 PNF 하지굴곡패턴운동이 체간 근활성도에 미치는 영향

기경일,조혁신,심선미,박현주,차현규,Ki, Kyong-Il,Cho, Hyuk-Shin,Sim, Sun-Mi,Park, Hyun-Ju,Cha, Hyon-Gyu 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.3

Purpose : The purpose of this study was to analyze the effects of proprioceptive neuromuscular facilitation (PNF) leg flexion patterns according to the hip joint angle on electromyographic activity of the trunk. Methods : Thirty healthy adults volunteered to participate in this study. Subjects were required to complete following the PNF leg flexion patterns on three different hip joint flexion $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$. An surface electromyogram (SEMG) was used to record the electromyographic activities of the trunk muscle in rectus abdominis, internal oblique abdominal, external oblique abdominal, erector spinae. The data were analyzed using the a repeated measures of one-way ANOVA with post-hoc Bonferroni's correction. Result : The results of this study are summarized as follows: The EMG activities of internal abdominal oblique and elector spinae muscle showed a statistically significant difference (p<.05). Conclusion : The result show that electromyographic activity of the trunk muscles significantly changed on PNF leg flexion patterns with difference hip joint angle. Therefore, this study used to basis for the intervention of the trunk muscle strength and stabilization.

뇌졸중 환자의 비마비측 슬관절 등척성 수축시 각도와 운동 방향이 마비측 대퇴사두근 활성도에 미치는 영향

기경일(Kyong-il Ki),김선엽(Suhn-yeop Kim),오덕원(Duck-won Oh),최종덕(Jong-duk Choi),김경환(Kyung-hwan Kim) 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.2

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were 0°, 45°, and 90°. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was 0°, the electromyographic activities of the paralytic medil aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was 90°, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted

스마트폰 어플리케이션을 이용한 뇌졸중 환자의 보행 평가 가능성

안보라,기경일,우영근 대한고유수용성신경근촉진법학회 2018 PNF and Movement Vol.16 No.1

Purpose: Smartphones, which are widely used worldwide to detect acceleration and position, have been used in the area of rehabilitation medicine in recent clinical research studies and tests. The aim of the present study was to determine the feasibility of using a smartphone application based on center of movement (COM) displacement to measure gait parameters in stroke patients in the clinical field of rehabilitation medicine. Methods: The study consisted of 30 stroke patients. The COM was measured using a smartphone application, Gait Analysis Pro, during a 6-m walk. Each patient performed three 6-m walking trials, and the smartphone application measured gait duration, gait speed, step length, cadence, and vertical and lateral displacement of the COM. The Kolmogorov–Smirnov test was conducted to determine the normality in gait parameters, and a repeated one-way analysis of variance (ANOVA) was performed to determine the consistency among the three trials. A p value of 0.05 was considered statistically significant in all the tests. Results: In all the measured parameters, the smartphone application showed a normal distribution, as shown by the results of the Kolmogorov–Smirnov test. There were no significant differences among the three repetitive walking trials. Conclusion: These results suggest that the smartphone application can be used for evaluating gait in stroke patients, as well as in healthy adults. However, prior to using the smartphone application in the clinical field, further research involving three-dimensional gait analysis is needed to enhance the confidence level of the findings.

고유수용성신경근촉진법의 들어올리기가 반대측 하지의 근활성도에 미치는 영향

곽선규,기경일,김다연,김기용,윤혜진,Kwak, Seon-Kyu,Ki, Kyong-Il,Kim, Dae-Yeon,Kim, Ki-Yeong,Youn, Hye-Jin 대한고유수용성신경근촉진법학회 2012 PNF and Movement Vol.10 No.4

Purpose : The purpose of present study was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) lifting on contralateral leg muscle activities in a seated position. Methods : Twenty healthy subjects were recruited for this study. Lifting was performed from each of the three position. An surface electromyogram (EMG) was used to record the EMG activities from vastus medialis (VM), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius medialis (GM) in contralateral leg muscle. The data were analyzed using a repeated measures of one-way analysis of variance (ANOVA) with post-hoc Bonferroni's correction to determine the statistical significance. Results : The results of this study were summarized as follows: In comparison to the start position, percentage maximal voluntary isometric contraction (%MVIC) values of the VM, TA and GM demonstrated a significantly higher activities in the end position(p<.05). Conclusion : The result shows that contralateral leg muscles activities significantly more increase in the end position when PNF lifting was applied. Therefore, this study will be used to prove effect of indirect approach for the stability and strengthening in patients with leg impairments.

슬관절 각도에 따른 교각운동이 하지근 활성도에 미치는 영향

김경환,기경일,윤혜진,Kim, Kyung-hwan,Ki, Kyong-il,Youn, Hye-jin 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.1

Purpose : The purpose of this study was to assess the effects of the lower extremity muscle activity on bridging exercise according to the knee joint angle. Methods : Twenty-five healthy adults volunteered to participate in this study. Subjects were required to complete following four bridging exercises; knee joint flexion $120^{\circ}$, $90^{\circ}$, $60^{\circ}$, $45^{\circ}$. Surface electromyography from selected lower extremity muscles was normalized to maximum voluntary isometric contraction. Muscle activity was measured by QEMG-4 system (LXM 3204, Laxtha Korea). A repeated measures of one-way ANOVA was used to determine the influence of bridging exercise on muscle activity for each muscle and descriptive statistics was used to determine muscle ratio. Results : The biceps femoris of all bridging exercises showed significantly(p<.05). The vastus medialis and lateralis of all bridging exercises showed significant excepted $120^{\circ}$(p<.05). The rectus femoris of all bridging exercises showed no significant. Median of vastus medialis/rectus femoris ratio of $120^{\circ}$ was 2.03, $90^{\circ}$ was 2.16, $60^{\circ}$ was 2.67, $45^{\circ}$ was 4.10. Median of vastus lateralis/rectus femoris ratio of $120^{\circ}$ was 1.70, $90^{\circ}$ was 1.70, $60^{\circ}$ was 2.08, $45^{\circ}$ was 2.58. Median of vastus medialis/vastus lateralis ratio of $120^{\circ}$ was 1.26, $90^{\circ}$ was 1.50, $60^{\circ}$ was 1.52, $45^{\circ}$ was 1.47. Conclusion : Angular motion decreasing with knee joint flexion made increase biceps femoris and vastus medialis activation. This result will be use knee joint stabilizing exercises during bridging or unstable surface training and biceps femoris strength training.

PNF 하지굴곡패턴운동이 체간근육 활성도에 미치는 영향

김경환,기경일,윤혜진,Kim, Kyung-Hwan,Ki, Kyong-Il,Youn, Hye-Jin 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.3

Purpose : The purpose of this study was to analyze the effect of PNF lower extremity flexion pattern on the eletromyographic (EMG) activity in rectus abdominis, internal oblique abdominal, external oblique abdominal, erector spinae. Methods : Twenty-six healthy adults volunteered to participate in this study. Subjects were required complete following two PNF lower extremity patterns; flexion-adduction-external rotation with knee flexion (D1) and flexion-abduction-internal rotation with knee flexion (D2). A paired t-test was used to determine the influence of the PNF two patterns on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratio. Results : The D1 pattern was showed significant rectus abdominis (p<.05) and Median of internal oblique/rectus abdominis ratio was 2.23 and internal oblique/external oblique ratio was 1.53. The D2 pattern showed significant erector spinae (p<.05) and Median of internal oblique/rectus abdominis ratio was 3.06 and internal oblique/external oblique ratio was 1.72. Conclusion : The D1 pattern made rectus abdominis activation increase. The D2 pattern made erector spinae activation increase. As compared D1 and D2 pattern on trunk muscle activation, it's will be useful decision making for the trunk muscle strength and stabilization.

편측무시 환자에게 실시간 초음파 영상을 이용한 왼쪽 몸통 굽힘 패턴을 적용한 과제지향적 훈련의 효과 -단일 사례 연구

김지선,기경일,강태우 대한고유수용성신경근촉진법학회 2019 PNF and Movement Vol.17 No.1

Purpose: This study investigates the effects of task-oriented training for a left trunk flexion pattern using real-time ultrasound imaging in a stroke patient with unilateral neglect symptoms. Methods: This study used the ABA experimental design, which is a single-subject research method among individual case research methods. For the ABA experimental design, changes in the degree of unilateral neglect, balance ability, and the thickness of the lateral abdominal muscle were visually analyzed during the baseline process, in the intervention period, and after the intervention. The experiments were performed 24 times in total for 8 times in each of the 3 periods. The unilateral neglect was measured using the Albert test, balance ability was measured using the Berg balance test, and the thickness of the lateral abdominal muscle was measured using ultrasound imaging. The subject was a 50-year-old male patient with unilateral neglect caused by right cerebral hemorrhage. He performed task-oriented training for a voluntary left trunk flexion pattern using real-time ultrasound imaging during the intervention period. Results: The result of comparing the data collected during the intervention period with the data point average of the baseline process showed that balance ability improved and the tendency line was above the baseline. The tendency line of unilateral neglect was below the baseline and showed a decreasing tendency. The thickness of the lateral abdominal muscle showed an increasing trend and the tendency line was above the baseline. Conclusion: The results of this study suggest that the task-oriented training for left trunk flexion pattern using real-time ultrasound imaging has a beneficial effect on balance ability, the degree of unilateral neglect, and the strength of the lateral abdominal muscle in unilateral neglect patients.

편마비 환자들의 지역사회 보행능력 평가를 위한 임상적 검사: 문헌고찰

박현주,오덕원,기경일 한국신경재활학회 2013 한국신경근육재활학회지 Vol.3 No.2

지연성 근육통 유발 후 유지-이완 기법이 통증과 관절가동범위에 미치는 영향

김지선,우영근,기경일,Kim, Ji-Seon,Woo, Young-Keun,Ki, Kyong-Il 대한고유수용성신경근촉진법학회 2016 PNF and Movement Vol.14 No.1

Purpose: The purpose of the present study was to compare the effects of both general hold-relax techniques and hold-relax techniques using pumping on pain due to delayed muscle pain and on the range of motion (ROM) of joints. Methods: Thirty-nine young adult males and females were randomly assigned either to a hold-relax technique application group of 20 subjects or to a group of 19 subjects with hold-relax techniques applied using a pumping application. Tenderness thresholds, the ROM of joints, and pain intensities were measured on the biceps of the nondominant arm of the subjects in both groups before exercises were performed to induce delayed muscle pain. Tenderness thresholds were again measured 24hours, 48hours, and 72 hours after inducing delayed muscle pain. The relevant intervention methods were applied to the two groups after conducting the measurement at 48hours. As a statistical analysis method, repeated measure ANOVAs were conducted to examine the tenderness thresholds, ROMs of elbow joints, and pain intensities in the individual groups at the time points. Results: At 48 hours and 72 hours after application of the interventions, the general hold-relax technique application group showed greater changes in the tenderness thresholds, the ROMs of elbow joints, and the pain intensities than did the group applying hold-relax techniques using a pumping application (p>0.05). Conclusion: Based on the results of the present study, the application of hold-relax techniques is thought to have beneficial effects on pain resulting from delayed muscle pain and on limited ROMs of joints.