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

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.

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.

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.

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.

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.

뇌졸중환자의 동적 균형 평가를 위한 sit-to-walk의 신뢰도 연구

김다연,최종덕,기경일,Kim, Da-Yeon,Choi, Jong-Duk,Ki, Kyong-Il 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.5

Purpose: The purposes of this study were to evaluate the correlation of clinical tools for assessment of balance and ability of gait, in order to discriminate the phases of sit-to-walk movement of patients with stroke using the motion analysis system, and to investigate the reliability of the phase of sit-to-walk movement according to functional ability of patients with stroke. Methods: Twenty -one patients participated (men 17, women 4) in this study. Sit-to-walk movement of all patients was recorded by the motion analysis system. Berg Balance Scale, Timed Up and Go test, Functional Reach Test, 10 meter Walk Timed Test, and Performance-Oriented Mobility Assessment were used as functional assessment tools. Results: The results of this study showed significant correlation between the phase I, II, IV and total phase duration of sit-to-walk movement and functional assessment tools. In addition, the intraclass correlation coefficient (ICC) showed high reliability in accordance with the functional ability of patients with stroke (Pearson's r 0.93 to 1.00). Conclusion: In conclusion, there is high reliability between measures of the phase of sit-to-walk movement of chronic stroke patients and the clinical assessment tool. Results of this study suggest that measurement of the phase of sit-to-walk movement can be used significantly as an intervention and a clinical tool for patients with stroke.

계단 오르기 동안 지면 접촉 조건에 따른 뇌졸중 환자의 근활성도 비교

윤혜진,오덕원,김경환,기경일,Youn, Hye-Jin,Oh, Duck-Won,Kim, Kyung-Hwan,Ki, Kyong-Il 대한고유수용성신경근촉진법학회 2010 PNF and Movement Vol.8 No.2

Purpose : This study aimed to investigate the effect of differing ground contact conditions on the eletromyographic(EMG) activity in rectus femoris, biceps femoris, tibialis anterior, gastrocnemius medialis during step-up activity in patients with hemiparesis. Methods : 10 hemiparetic patients performed step-up activity on three different ground contact conditions: entire ground contact, 2/3 ground contact, 1/3 groud contact. Result : The EMG activities of gastrocnemius medialis significantly changed on 1/3 ground contact(p<.05). However, no significant changed rectus femoris, biceps femoris, tibialis anterior between three differing ground contact conditions (p>.05). Conclusion : This study provides that EMG activities of gastrocnemius medialis significantly changed on different ground contacts. Therefore, this method can be used to strengthen the gastrocnemius medialis.

만성뇌졸중 환자에 시각적 되먹임 트레드밀 보행 훈련이 보행과 균형 능력에 미치는 효과

김지선,안진환,이현희,박효정,기경일,Kim, Ji-Seon,Ahn, Jin-Hwan,Lee, Hyeon-Hee,Park, Hyo-Jeong,Ki, Kyong-Il 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.2

Purpose: This study compares the effects of treadmill gait training accompanied by visual feedback and general treadmill gait training on the gait and balance ability of patients with chronic stroke. Methods: A total of 11 patients with chronic stroke were randomly divided into either the treadmill gait training accompanied by visual feedback group (six patients) or the general treadmill gait training group (five patients). The gait and balance ability of the two groups were measured before and after the interventions using the functional reach test, the Timed Up and Go (TUG) test, Berg's balance test, and the Biodex balance test. The treadmill gait training accompanied by visual feedback group performed the exercise under the supervision of a therapist after first being provided with a hat and a goal that was devised for the purpose of providing visual feedback information. The interventions were applied to the respective groups for four weeks. For the statistical analysis, we conducted a Mann-Whitney test to compare the results between the two groups. Additionally, the Wilcoxon test was used to compare the results from before and after the intervention in each group. Results: The treadmill gait training accompanied by visual feedback group showed a significant difference in terms of the functional reach test after the intervention when compared to the general treadmill gait training group (p<0.05). Although there was no significant difference, the treadmill gait training accompanied by visual feedback group showed a larger improvement in the TUG test, Berg's balance test, and the Biodex balance test than the general treadmill gait training group (p>0.05). Conclusion: The results of this study suggest that treadmill gait training accompanied by visual feedback can be used as a beneficial intervention scheme for the recovery of the gait and balance ability of patients with chronic stroke.