관찰형태에 따른 동작관찰 훈련이 뇌졸중 환자의 안정성 한계와 동적보행능력에 미치는 영향

양용필,김수진 대한물리의학회 2017 대한물리의학회지 Vol.12 No.1

PURPOSE: The purpose of this study was to determine the effect of action observation with observation type on the limits of stability and dynamic gait ability in stroke patients. METHODS: The 20 stroke patients who participated in this study were randomly divided into two experimental groups who underwent training three times a week for 4 weeks. Their balance was tested as the limit of stability with Biorescue. Their Dynamic gait ability was tested with the Dynamic Gait Index (DGI) before the intervention, and after 4 weeks. Independent and paired t-tests were used to analyze the results. RESULTS: The results confirmed the limit of stability on the moving areas of the paralyzed and non-paralyzed sides. The limit of stability and dynamic gait index measurements confirmed that the moving area showed a significant difference after the intervention in the whole movement observation group (p<.05), but the partial movement observation group showed no significant difference (p>.05). A significant difference was also noted for the comparison between the both groups after the interventions (p<.05). The functional walking ability showed a significant difference when compared to the ability before the intervention, as determined by the changes in scores obtained for the dynamic gait index (p<.05). CONCLUSION: Interventions utilizing whole movement confirm that training improves stability and functional walking ability in stroke patients with disabilities in balance and walking ability.

머리척추각의 변화에 따른 목 주변근육의 활성도와 가슴우리 가동성에 미치는 영향

양용필,서동열 한국산학기술학회 2023 한국산학기술학회논문지 Vol.24 No.1

본 연구는 머리척추각의 변화에 따른 목 주변 근육들의 활동 양상과 가슴우리 가동성을 확인하여 앞쪽머리자세가신체 구조와 기능에 미치는 영향을 확인하고자 하였다. 연구 참여자들은 건강한 20대 성인 남녀 50명으로 선정하였다. 대상자들의 머리척추각을 측정하여 기준각도로 설정하고, 기준각도에서 10% 감소한 각도와 20% 감소한 각도에서 각각목빗근과 위등세모근의 근활성도를 측정하였다. 동시에 가슴우리 가동성을 확인하기 위해 최대 들숨시 앞뒤직경과 가로직경을 측정하였다. 연구 결과에서는 머리척추각의 변화에 따라 목빗근과 위등세모근의 근활성도는 모두 각도별 유의한차이를 보였다. 머리척추각의 변화에 따른 가슴우리 가동성에서는 각도의 변화에 따라 앞뒤직경은 유의한 차이를 보였고, 가로직경의 변화에서는 유의한 차이를 보이지 않았다. 따라서, 머리척추각이 감소할수록 목 주변 근육의 과도한 근활성도를 나타내었고, 가슴우리 가동성에서도 앞뒤직경에 제한된 변화가 나타났다. 이는 앞쪽머리자세가 호흡과정에서 목주변 근육들의 과도한 활성으로 인해 가슴우리의 앞뒤직경의 변화만으로 나타내어 제한된 가동성을 보인다고 할 수 있다. 이러한 변화는 호흡기능에 부정적인 영향을 줄 수 있으며 앞쪽머리자세를 보이는 환자들에게 목 주변 근육들의 과도한 활동을 억제하고 가슴우리의 전체적인 움직임을 촉진할 수 있는 훈련방법이 필요할 것으로 사료된다.

편마비 환자의 반 쪼그려 앉기(semi-squat)동작 시 양하지 지지면의 형태가 하지 근활성도와 체중분포에 미치는 영향

양용필,노정석 한국전문물리치료학회 2012 한국전문물리치료학회지 Vol.19 No.1

This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.

머리전방자세가 턱관절의 최대 개구량과 관자근 및 깨물근의 근활성도와 비대칭률에 미치는 영향

양용필(Yong-Pil Yang),서동열(Dong-yel Seo) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.3

본 연구는 머리전방자세가 증가함에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도, 근육의 비대칭률에 미치는 영향을 알아보고자 진행하였다. 연구 참가자들의 머리척추각을 측정하여, 연구의 선정요구를 충족시키는 머리척추각이 50° 이상인 대상자 50명(23.10±2.73세)을 선정하였다. 머리전방자세를 증가시키기 위해 머리척추각을 0%, 10%, 20%를 감소시켜 Control Ⅰ, Control Ⅱ, Control Ⅲ으로 설정하였다. 각 조건에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도와 비대칭률의 변화를 측정하였다. 연구 결과, 머리척추각의 감소에 따라 최대 개구량은 유의하게 감소하였다(p<.001). 조건 변화에 따른 근활성도 변화를 측정한 결과, 오른쪽 관자근과 깨물근 및 왼쪽 관자근의 근활성도는 감소하였으며(p<.001), 왼쪽 깨물근의 근활성도도 감소하였다(p<.01). 조건 변화에 따른 근육의 좌우 비대칭률을 측정한 결과 좌우 관자근의 비대칭률, 좌우 관자근과 깨물근을 더한 근육의 비대칭률은 증가하였다(p<.01). 본 연구결과는 턱관절 부위에 대한 치료 전략과 종합적 진단을 세우고, 턱관절 장애 치료를 위해 사용된 도수치료와 치료적 운동의 이론적 근거를 제시하는 데 도움이 될 것으로 사료된다. This study examined the effects of the forward head posture on the maximum mouth opening of the jaw joint and the muscle activity and asymmetry of the temporalis and masseter. The craniovertebral angle was measured in 50 subjects (23.10±2.73 years) who met the selection requirements of the study. The maximum mouth opening, muscle activity, and muscle asymmetry were measured by reducing 0%, 10%, and 20%. As the craniovertebral angle decreased, the maximum mouth opening decreased (p<.001), the muscle activity of the right and left temporalis decreased (p<.001), and the muscle activity of the left temporalis also decreased. (p<.01). The asymmetry rate of the added muscles of the left and right temporalis, left and right temporalis, and masseter increased according to the change in condition (p<.01). The results of this study are expected to help establish a treatment strategy and comprehensive diagnosis for the temporomandibular joint and present a theoretical basis of manual therapy and therapeutic exercises used for the treatment of TMD.

동작관찰이 뇌졸중 환자의 환측 상지 기민성에 미치는 영향: 단일사례연구

양용필 ( Yong Pil Yang ),김지현 ( Ji Hyun Kim ),한미란 ( Mi Ran Han ),김은비 ( Eun Bi Kim ) 대한물리의학회 2012 대한물리의학회지 Vol.7 No.1

Purpose:The purpose of present study was to determine effects of action observation training on upper limb function after stroke. Training was progressed to imitation and intensive training after observation to required action in ADL. Methods:Among the single case study was used to ABA design. pre base line(A) was only collected participant information without intervention in 5 times. action observation intervention(B) was carried out 10 times and 5 times to base lime(A) after intervention. Results:Results indicated that 10-second test, box and block test, manual function test was increased when compared action observation intervention(B) to pre base line(A). Conclusion:To stroke action observation training was evaluated gross manipulation, dexterity and upper limb function in related with ADL. action observation training benefits were maintained after intervention(B) and showed improvement on upper limb function of stroke.

시각적 되먹임 훈련이 편마비 환자의 균형능력에 미치는 영향

정우식,김병길,김은비,신예지,양용필,황기경,이홍균,Jeong, Woo-Sik,Kim, Byung-Kil,Kim, Eun-Bi,Shin, Ye-Ji,Yang, Yong-Pil,Hwang, Ki-Kyung,Lee, Hong-Gyun 대한고유수용성신경근촉진법학회 2010 PNF and Movement Vol.8 No.2

Purpose : The purpose of present study was to determine effects of a visual feedback training on balance ability in poststroke hemiparetic subjects. Methods : Fourteen chronic stroke patients participated. Participants were randomly divided into either visual feedback training group(7 experimental group, 7 control group). All of participated were inpatients at local rehabilitation center and had been receiving a traditional rehabilitation program, five days a week. Exprimental group have additionally undergone for four weeks, three days a week, the visual feedback training but control group was not received any additional program except the traditional rehabilitation program. The Berg Balance Scale(BBS), the FICSIT-4, the MTD-balance system to measure a balance ability were carried out twice before and after training. Results : After participation in the program, subjects of visual feedback training demonstrated a significant improvement in the scores of the BBS, the FICSIT-4, the MTD-Balance system. The control group had no change on the any tests. After the training, the result to improve significantly in visual feedback training group compared to post-test of control group were the score of BBS and the FICSIT-4 and the MTD-Balance system. Conclusions : The present study suggests that the visual feedback training program may become a useful strategy for enhancing balance ability in the rehabilitation of stroke patiens.

속도변화 보행 훈련이 만성 뇌졸중 환자의 심폐기능에 미치는 영향

서동열(Dong-Yel Seo),양용필(Yong-Pil Yang) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.5

본 연구는 보행 훈련시 심박수의 변화에 따라 보행속도를 조절하여 뇌졸중 환자의 심폐기능의 변화를 알아보고자 하였다. 대상자는 만성 뇌졸중 환자 20명을 무작위로 실험군과 대조군으로 분류하여 연구를 진행하였다. 실험군은 심박수 측정기를 착용한 상태로 트레드밀에서 심박수의 변화에 따라 보행속도를 증가 또는 감소시키면서 보행훈련을 실시하였고, 대조군은 대상자의 주관적인 속도에 의해 보행훈련을 실시하였다. 보행훈련 사이에 10분 간격으로 1분씩 휴식시간을 부여했으며 주 3회씩 총 6주간 중재를 실시하였다. 대상자들의 중재이후의 변화를 살펴보기 위하여 폐활량(VC), 호기예비용적(ERV), 흡기예비용적(IRV) 노력성 폐활량(FVC), 1초간 노력성 호기량(FEV1), 최대 호기 속도(PEF)를 측정하여 심폐기능의 변화를 확인하였다. 연구결과 폐활량, 흡기예비용적, 호기예비용적에서 집단과 시기사이에서 상호작용을 나타내었으며 주효과인 집단 및 시기 간 유의한 차이도 나타났다(p<.05), 1초간 노력성 호기량, 노력성 폐활량, 최대 호기속도에서는 그룹과 시기사이에서 상호작용이 나타나지 않았다. 주 효과에서는 집단 간 유의한 차이를 보이지 않았으나(p>.05) 시기 간에는 유의한 차이를 보였다(p<.05). 연구결과 보행과정에서 심박수의 변화에 따라 속도를 변화시켜 훈련을 시행할 경우 심폐기능의 유의한 향상을 보인 것으로 보아 보행 훈련시 속도변화를 통해 훈련을 할 경우 심폐기능의 유의한 변화를 이끌어 낼 수 있을 것으로 판단된다. This study examined the changes in the cardiopulmonary functions of stroke patients by adjusting the s heart rate during walking training. This study was conducted on 20 chronic stroke patients. The experimental group conducted walking training by varying the walking speed according to the change in heart rate on the treadmill. In contrast, the control group conducted walking training by the subjective speed of the subject. The walking training was conducted for 32 minutes, three times a week, for a total of six weeks. The changes after the intervention of the subjects were determined by measuring the VC, ERV, IRV, FVC, FEV1, and PEF. The study revealed interactions between the groups and timing in the VC, ERV, and IRV(p<.05). There were no interactions between the groups and timing in FEV1, FVC, and PEF. The main effects showed no significant differences between the groups (p>.05) but showed significant differences between periods (p<.05). These results suggest that the cardiopulmonary function was improved significantly when the training was conducted by changing the pace of the heart rate in the walking process, leading to significant changes in the cardiopulmonary function.