기능성 위장질환의 종류에 따른 정신사회적 특성 및 삶의 질의 차이에 관한 연구

박승규,이상열,류한승,최석채,양찬모,장승호,염동한,이귀행,Park, Seung-Kyu,Lee, Sang-Yeol,Ryu, Han-Seung,Choi, Suck-Chei,Yang, Chan-Mo,Jang, Seung-Ho,Yeom, Dong Han,Lee, Kuy-Haeng 한국정신신체의학회 2021 정신신체의학 Vol.29 No.1

연구목적 본 연구에서는 기능성위장질환 환자를 과민성 대장 증후군, 기능성 소화불량, 기능성 변비, 기능성 흉부 작열감, 중복집단(두 개 이상의 기능성 질환이 중복)으로 분류하여 정신사회적 특성을 비교하고, 기능성위장질환 환자의 삶의 질과 연관된 요인들을 알아보고자 하였다. 방 법 일 대학병원 소화기 내과 전문의에 의해 기능성 위장질환으로 진단받은 환자 144명을 기능성위장질환 환자 집단으로 선정하였다. 인구통계학적 요인을 조사하였으며 정신사회적 요인을 평가하기 위해 Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF)를 사용하였다. 결 과 중복집단이 다른 집단에 비해 BDI-II 점수(F=11.09, p<0.001)와 BAI 점수(F=8.93, p<0.001)가 유의하게 높았다. 아동기 외상에서 정서적 방임(F=2.54, p=0.04)은 IBS 환자집단이 FD 환자 집단에 비해 유의하였다. FGID 환자에서 삶의 질은 우울증상(r=-0.196, p<0.01), 불안(r=-0.235, p<0.01), 아동기 트라우마(r=-0.222, p<0.01)와 음의 상관관계를 보였고, 사회적 지지(r=0.512, p<0.01), 회복탄력성(r=0.581, p<0.01)과는 양의 상관관계를 나타냈다. 결 론 연구결과 중복 환자 집단에서 우울, 불안이 유의하게 높았으며 아동기 외상에서 IBS 환자 집단이 FD 환자 집단보다 정서적 방임이 유의하게 높았다. 따라서 추후 기능성 위장질환 환자의 치료에 있어 정신사회적 요인에 대한 적극적인 개입이 요구된다고 하겠다. Objectives : The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. Methods : A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. Results : TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). Conclusions : Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

최적경로와 가중직교인자를 이용한 화자인식

박승규,배철수,Park, Seung-Kyu,Bai, Chul-Soo 한국음향학회 1992 韓國音響學會誌 Vol.11 No.2

최근, 많은 연구자들이 KLT를 이용한 통계적 처리방법으로 화자인식을 수행하고 있으나, 통계적 처리방법의 개인성 포함정도와 음성의 동적인 발성속도는 화자인식율의 저하요인이 되고 있다. 본연구에서는 각 화자의 직교인자에 개인성을 강조하기 위하여 화자의 고유치를 가중치로 한 가중직교인자와 음성의 동적인 시간특성을 정규화하는 DTW의 최적경로를 이용한 화자인식방법을 연구하였다. 이방법을 확인하기 위하여 종래의 통계적 처리에 의한 화자인식, 최적경로와 최적경로와 가중직교인자를 이용한 화자인식의 결과를 비교한 결과, 종래의 방법보다 우수한 화자인식율을 얻어 그 유효성을 확인하였다. Recently, many researchers have studied the speaker recognition through the statistical processing method using Karhunen-Loeve Transform. However, the content of speaker's identity and the vocalization speed cause speaker recognition rate to be lowered. This parer studies the speaker recognition method using weighted orthogonal parameters which are weighted with eigen-values of speech so as to emphasize the speaker's identity, and optimal path which is made by DWP so as to normalize dynamic time feature of speech. To confirm this method, we compare the speaker recognition rate from this proposed method with that from the conventional statistical processing method. As a result, it is shown that this method is more excellent in speaker recognition rate than conventional method.

편마비 환자의 계단과 경사로 오르기 동안 하지의 근 활성도 분석

박승규,천동환,Park, Seung-Kyu,Cheon, Dong-Whan 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.4

Purpose: The purpose of this study was to investigate the change of muscle activities during level walking, stairs and ramp climbing in hemiplegic patients. Methods: Eight hemiplegic patients were recruited and agreed to participate in this study. Muscle activity was measured by MP100 system (BIOPAC System Inc., Santa Barbara, CA, USA). Statistical analysis was used as a one-way repeated measure of ANOVA to know the difference according to the gait conditions (level walking, stairs and ramp ascending). Results: In the swing phase, muscle activity of rectus femoris muscle, with the side lower extremities affected, were generally significantly different in the stair and ramp ascending. In addition, biceps femoris muscle with unaffected side lower extremity was generally significantly different in the ramp ascending. In the swing phase, muscle activity of tibialis anterior muscle with unaffected side lower extremities was generally showed a significant difference in the ramp ascending. In the stance phase, climbing stairs and ramps showed an increase in the muscle activities. Further, climbing the stairs increased muscle activities of the gastrocnemius muscle. Conclusion: These findings indicate that compared with the level walking climbing stairs, ramps and muscle activities of lower extremity during each showed different results. It can be seen that in accordance with the terms of gait are different muscles group recruitment.

ICF를 이용한 재가 장애인의 방문 물리치료 효과 및 환경 요인 분석

박승규,허재원,양대중,강정일,이준희,Park, Seung-Kyu,Heo, Jae-Won,Yang, Dae-Jung,Gang, Jeong-Il,Lee, Jun-Hui 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.4

Purpose: The purpose of this study is to analyze the home-stay disability's activity, as well as the participation domains and the environment factor domains of international classification of functioning (ICF), in order to examine the effect of the home visiting physical therapy and the disability's activity. Methods: A total of 211 home-stay disabled subjects with brain lesions or crippled disorder, living in 5 cities and districts of Jeollanam-do, underwent 90 minutes of home visiting physical therapy per week during a 6-month period, and using the ICF checklist, evaluated the subject's activity and participation domains and environmental factor domains. Results: The performance qualifier showed a significant statistical change in the movement, self-care, domestic life, interpersonal interactions and relationships, community, society and civic life domains (p<0.05); and the capacity qualifier showed a significant change only in the mobility domains in the before and after of the home visiting physical therapy (p<0.05). The barrier factor in the order of services, systems and policies domains, product and technology domains, and attitude domains it influenced significantly in the performance (p<0.05), and in the facilitator factor in the order of product and technology domains, support and relationships domains, services, systems and policies domains it influenced significantly in the performance of the disabled (p<0.05). Conclusion: The visiting physical therapy can help in the improvement of the activity and participation of the home-stay disabled subjects, and for the accurate evaluation of the home-stay disabled subjects, it is considered that an evaluation including various environmental factors, such as ICF, must be fulfilled.

근전도-생체되먹임 훈련이 무릎넙다리통증의 기능적 능력과 Q-각에 미치는 영향

박승규,강재영,Park, Seung-Kyu,Kang, Jae-Young 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.2

Purpose: The purpose of this study was to investigate the effect of closed kinetic chain exercise using EMG-biofeedback for selective training of the vastus medialis oblique on functional ability and Q-angle in subjects with patellofemoral pain syndrome. Methods: Thirty participants who met the criteria were included in this study. Participants were randomly allocated to the control group (Group I, n=10), closed kinetic chain exercise group (Group II, n=10), and closed kinetic chain exercise using EMG-biofeedback group (Group III, n=10). Intervention was performed in three groups, three times per week, for a period of six weeks. Kujala patellofemoral score and Q-angle were measured before and after the experiment. Results: Some significant differences in kujala patellofemoral score were observed in group II and group III, compared with group I (p<0.01). There was no significant difference on in Q-angle at knee flexion angle $0^{\circ}$. However, some significant differences in Q-angle at knee flexion $60^{\circ}$ were observed in group III, compared with group I (p<0.01). Conclusion: Closed kinetic chain exercise using EMG-biofeedback that provides real-time biometric information on selected muscles in order to increase the efficiency of treatment may be helpful in improvement of functional ability and Q-angle in patellofemoral pain syndrome.

가정방문물리치료가 재가장애인의 일상생활동작과 기능에 미치는 영향

박승규,지혜영,허재원,Park, Seung-Kyu,Ji, Hey-Young,Heo, Jae-Won 대한물리치료학회 2011 대한물리치료학회지 Vol.23 No.2

Purpose: The purpose of this study was to provide basic data for the effectiveness and the necessity of home visiting physical therapy through examining performance ability and functional changes in daily life activities by investigating the life of disabled persons living at home. Methods: After selecting 100 people with physical disabilities greater than level 3 and brain damage related disabilities living in Youngam-Gun, we conducted mobility tests according to a Modified Bathel Index (MBI), the Berg Balance Scale (BBS), and floor and bed movements? for Activities of Daily Living evaluation. We did this before the experiment and after doing home visiting physical therapy for 90 minutes at a time, once a week for 6 months Results: 1) Persons who live in a bed are higher than those who live in a floor. There was a significant difference between persons who live in a floor and those who live in a bed in the change in MBI and BBS scores after home visiting physical therapy. 2) Those with a musculoskeletal disorder had a significantly different change in MBI and BBS according to the type of disease and kind of disability. Those with neuropathy had a significantly different change in MBI. Those with physical disabilities showed a significant difference in MBI and BBS. Conclusion: A home visiting physical therapist can cause an improved performance ability and lead to the ability of disabled persons living at home to carry out activities of daily livingin a large part and the study for brain lesion disabilities except physical disabilities and stroke which occupy large proportion of disabled persons should be done.

뇌졸중 환자의 누운 자세에서 앉기 동작의 생체 역학적 분석

박승규,양대중,강정일,이준희,윤종혁,Park, Seung-Kyu,Yang, Dae-Jung,Kang, Jung-Il,Lee, Jun-Hee,Yoon, Jong-Hyeouk 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.2

Purpose: This study was conducted in order to suggest an effective method of daily life movement training for stroke patients by comparison and analysis of the biomechanic characteristics of sitting up from a lying posture in stroke patients and healthy elderly participants. Methods: Fifteen stroke patients and 15 age-matched elderly participants were included in the study. The movement of sitting up from a lying posture was divided into three stages, and the differences in muscle activity in the sternocleidomastoid (SCM), rectus abdominis (RA), external oblique (EO), and rectus femoris (RF) during the movement were analyzed. Results: Subjects in the experimental group showed slower speed than those in the control group. In the neck joint, the change of angle in movement showed a larger decrease at all stages in the experimental group than in the control group; the movement also decreased in stages I and II in the upper trunk joint. The movement also showed a statistically significant decrease in stage II in the lower trunk, pelvic, and hip joints. The SCM showed higher activity in the control group than in the experimental group, showing a statistically significant difference; the RA showed high activity in the experimental group. The RF showed higher activity in the control group than in the experimental group, showing a statistically significant difference. Conclusion: From the results obtained above, increasing movements in the neck, pelvic, and hip joints and strengthening of lower body muscles are required in order to improve the ability for getting up from a lying posture in stroke patients.

편마비 환자에서 발 교정구의 적용이 체중분포과 균형에 미치는 영향

박승규,강양훈,Park, Seung-Kyu,Kang, Yang-Hun 대한물리치료학회 2012 대한물리치료학회지 Vol.24 No.4

Purpose: We investigated the effect of postural stability and balance with foot orthotics in hemiplegic patients. Methods: The subjects enrolled in this study were 16 hemiplegic patients who were examined for balance ability, weight distribution, and limits of stability with or without foot orthotics insole. Balance was measured according to a stance position by BIORESCUE: static balance open eyes (SEO), static balance close eyes (SEC), dynamic balance open eyes (DEO), dynamic balance close eyes (DEC), right and left weight distribution (RLWD), anterior and posterior weight distribution (APWD) and limit of stability (LOS). The data were analyzed with SPSS window version 18.0 (IBM Co., Armonk, NY, USA). Results: The results were of significant changes to the SEO (p<0.05), RLWD (p<0.05), APWD (p<0.05), and LOS (p<0.05). The SEC, DEO and DEC were not found to be statistically significant. Conclusion: It was found that foot orthotics affected the balance for hemiplegic patients. Therefore, it is thought to help fall prevention to measure the balance ability.

질환에 따른 기능장애 요소의 이해와 물리치료

박승규,김상엽,Park, Seung-Kyu,Kim, Sang-Yeob 대한물리치료과학회 1999 대한물리치료과학회지 Vol.6 No.3

We are approaches various painful diseases in clinic. Although same disease, it is different to acute, subacute and chronic stage of disease. Therefore, to understanding of tissue anatomy, pathology and physiology is necessary to under-standing pattern of diseases. It is duty work that choice of hot or ice, electrotherapy, choice of adaptable frequency and mathod of exercise therapy etc. During treatment it is important method to choose to treat the client. As treating the client by exercising or treating when the client is resting and seeing if anything else is a problem etc. So what I have approached some of the treatment that a physical therapist could miss during treatment.

재가 장애인의 운동관련 구조손상 영역 및 활동과 참여 영역의 상관관계 분석

박승규,허재원,Park, Seung Kyu,Heo, Jae Won 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.2

Purpose: The purpose of this study was to examine the impairments of body structures, activity limitation, and participation restriction. In addition, we wanted to provide basic data on correlation between impairments of body structures, activity, and participation in Disabled Persons Living at Home. Methods: After selection of 128 people with physical disabilities more than the third level and brain damage disabilities living at home, we conducted testing for impairments of body structures, activity, and participation, according to the ICF checklist. Results: Impairments of body structures was highest in the upper and lower extremity. 2) Mobility, domestic life, and self care were more limited. 3) Also, the structure related to movement showed correlation with mobility, domestic life, and self care. Conclusion: We observed differences in participation and activities of persons with disabilities Living at Home depending on the impairments of body structures. After thorough review of the status of Disabled Persons Living at Home, we decided to appropriate support and social services.