CDMA망에서의 유선망 계획 및 설계 방법

오덕원 대한전자공학회 1997 대한전자공학회 심포지엄 논문집 Vol.- No.-

뇌졸중 환자에 대한 감각 훈련: 뇌졸중 재활의 중요한 기초

오덕원,박현주,심선미 한국신경근육물리치료학회(구 한국신경근육재활학회) 2015 한국신경근육재활학회지 Vol.5 No.1

In stroke rehabilitation, motor deficits have traditionally been in great attention owing to their influences on functional recovery, and in such reason, therapeutic focus of a variety of approaches should include the concepts of motor relearning. However, clinicians’ interest was not in sensory rehabilitation after stroke despite its essential role to guide normal motor control during daily routine tasks. Accordingly, this study aimed to demonstrate beneficial information for stroke rehabilitation to clinicians as well as provide the description about natures of sensory deficits after stroke and their effects to rehabilitation. Evidences support the effects of sensory rehabilitation therapy to improve sensory ability and hand function of patients with post-stroke hemiparesis. In particular, improvement of discriminative sense and proprioception may be more helpful to increase the level of functional activity. Although many studies have suggested the effects of various treatment methods to enhance sensory function, there was no actually apparent description about the effect size of a sensory re-education using rehabilitation approaches and its influence on physiological mechanism of sensory system. Recent systemic review focused on the necessity of further studies for defining the evaluation criteria with treatment-specific base in subject selection and the assessment of treatment effects appropriately. In general, the benefits of non-specific sensory stimulation have been well known in clinical setting; however, it’s not clear whether it can promote sensory function constantly. Therefore, further studies must be taken under special efforts to develop effective treatment methods for improving sensory deficits of patients with post-stroke hemiparesis. This study provides valuable information for future studies that explore favorable therapeutic solutions of sensory impairments after stroke.

척수손상 환자에 대한 호흡운동치료 전략 : 문헌 고찰

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2016 한국신경근육재활학회지 Vol.6 No.1

In people with spinal cord injury (SCI), the paralysis of respiratory muscles directly results in the weakness of respiratory function and increased level in diaphragmatic fatigue, demonstrating the features of restrictive diseases. If there are no appropriate therapeutic strategies for its management, respiratory failure can be exacerbated over time, and complications are much likely to worsen physical function, being frequently regarded as life-threatening condition. Therefore, pulmonary rehabilitation should be considered as important health issues to facilitate functional recovery of people with SCI, especially in cervical injury. Following SCI, the function of paralyzed chest wall musculature is compensated by abdominal movements, and thereby respiratory efficiency is remarkably reduced by this abnormal mechanism. This is indicative of intensive respiratory training to improve breathing pattern, gas exchange, and oxygen consumption. In particular, given that people with cervical cord injury are so susceptible for respiratory failure with higher risk of respiratory complications, pulmonary rehabilitation must be a critical step in the pathway to ameliorate their symptoms and facilitate functional recovery. Respiratory muscle training is inevitable for enhancing physical function of people with SCI as well as increasing breathing capacity, and particularly in cervical cord injury, and it also may be helpful to prevent respiratory complications. This study was designed to describe comprehensive knowledge about the management of respiratory problems in people with SCI. This study provides useful information for clinicians and researchers that explore the best therapeutic way to manage respiratory symptoms of people with SCI. Further studies need to evidence the effectiveness of various therapeutic approaches to treat their respiratory problems.

뇌졸중 후 보행 재활의 최신 경향 : 상향식 접근과 하향식 접근

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2020 한국신경근육재활학회지 Vol.10 No.2

As neurological rehabilitation has been increasingly developed, there is a rapid close in gap between neuroscientific information and clinical application. Also, a variety of concepts have been established to apply therapeutic techniques in stroke rehabilitation, which are based on bottom-up and top-down approaches. Therefore, clinicians need to understand valuable knowledge with regard to the natures of these approaches, and know the current use of treatment techniques. Based on recent trend, advanced technology highlights to develop new neuromechanical tools and robot-assisted devices for improved rehabilitation effects and functional recovery. Despite inadequate evidences in clinical setting, these approaches are known to facilitate brain plasticity and functional recovery, thereby allowing developing specific devices and more efficient control system. Focusing on scientific interests to control the pathophysiology of neural plasticity after stroke and operate them in controlled environment, data on specific effects from treatment are promptly collected as treatment outcomes. This supports the great benefits of patient-therapist-specific approaches. Therefore, the understandings of bottom-up and top-down approaches are necessary to build the present and future concepts in treatment. This paper aims to provide valuable information about current trends in gait rehabilitation after stroke, including bottom-up and top-down approaches.

만성 뇌졸중 환자들의 기능 향상을 위한 새로운 접근방법 : ‘신경근육 조절 및 재설정’ 개념의 이론적 배경

오덕원,원상희,박현주,강태우,심재훈 한국신경근육물리치료학회(구 한국신경근육재활학회) 2017 한국신경근육재활학회지 Vol.7 No.2

In stroke rehabilitation, a final goal addresses the successful return to premorbid life and community re-integration, which includes functional recovery and active participation in everyday activities. Individuals with post-stroke hemiparesis have been characterized by sensory and motor paralysis, decreased strength and endurance, spasticity, loss of dexterity, and cognitive deficit. These factors contribute to producing a variety of functional problems in gross and fine motors. In particular, reduced standing balance and walking dysfunction are major components to hinder independence in daily life after stroke; therefore, the recovery of walking function is considered as ultimate goal in stroke rehabilitation. Based on neurophysiological knowledge, numerous traditional approaches such as neurodevelopmental treatment, proprioceptive neuromuscular facilitation, and Brunnstrom and Rood approaches have been commonly used to restore their function, providing theoretical conception and therapeutic procedures to manage stroke patients. Taken under research-based results, recent trends have proven clinical efficacy of task-oriented training, which demonstrates motor learning principles and its contributions in neurological rehabilitation. However, despite training effects, adding basic procedures including the correction of joint malalignment and restoration of kinetic linkage of the body did not have great interest as possible option for reinforcing functional gains in stroke. It requires the development of more organized therapeutic approach based on resolving leading causes to functional problems. Novel concept of ‘Neuromuscular Control and Reset (NCR)’ provides possible mechanism of problem-solving strategies for detecting neutral positions of misaligned joints and keeping them by resetting the ability of neuromuscular control, which facilitates optimal motor control patterns in safe and effective templates. It comprises specific processes to address the correction of pathological joint mechanics, recovery of movement mechanics, and improvement of functional activities. This study describes the theoretical background for applying the NCR concept to regain the level of functional performance of patients with post-stroke hemiparesis.

만성 뇌졸중 환자들의 보행능력 증진을 위한 치료 전략에 대한 고찰

오덕원,원상희 한국신경근육물리치료학회(구 한국신경근육재활학회) 2017 한국신경근육재활학회지 Vol.7 No.1

Following stroke, long-lasting symptoms require specific procedures to improve functional level in everyday life, with aiming of assuring independent daily activities. Based on this principle, the recovery of ambulatory capacity is one of the most important objectives in stroke rehabilitation. Recently, a progress in scientific knowledge highlights neuromechanical approaches and applied technologies (robot-assisted walking system and functional electrical stimulation) to support functional recovery of patients with post-stroke hemiparesis. Although various therapeutic techniques for stroke rehabilitation have successfully used in clinical setting, such techniques are kinds of different and contradict each other in many way. Given that their effects have been reported to be similar, major principles in stroke rehabilitation approaches often cannot be obviously illustrated for clinical use. Recent knowledge has introduced two ways to improve functional disability of stroke patients: Bottom-up and top-down. In general, conventional approaches, including Bobath and proprioceptive neuromuscular facilitation, may be characterized by the bottom-up approach, while top-down approach can be described by the use of task-oriented training focusing on functional training based on principles of motor learning. In stroke rehabilitation, recent consensus highlights functional aspects of the patients and reintegration to premorbid life, and then top-down approach focusing on the effects of functional training supports current prospective to manage their own symptoms and functional disability. However, the effects of musculoskeletal disparity after stroke have not been in full consideration, even though joint malalignment and muscle imbalance is one of major contributing factors to impede normal movement patterns. Such fact indicates that a combination of top-down approaches and musculoskeletal techniques to facilitate normal movement is better alternative to support functional improvement in stroke rehabilitation. Therefore, introduction of novel concepts needs to establish appropriate clinical reasoning and decision-making strategies for stroke rehabilitation in future. This study aimed to demonstrate comprehensive knowledge related to neurophysiological mechanism and therapeutic approaches to improve walking function of patients with post-stroke hemiparesis.

스포츠 선수의 어깨손상의 기능적 검사

오덕원 대한스포츠물리치료학회 2010 대한스포츠물리치료학회 워크숍 Vol.2010 No.1

근력 약화: 뇌졸중 재활에서의 중요한 관점

오덕원 한국신경재활학회 2012 한국신경근육재활학회지 Vol.2 No.2

지역사회 보행: 뇌졸중 재활에서 치료 계획 및 임상 의사결정을 위한 최종 목표

오덕원 한국신경재활학회 2013 한국신경근육재활학회지 Vol.3 No.1

뇌졸중 환자들의 균형 능력 평가를 위한 임상적 검사 : 문헌 고찰

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2018 한국신경근육재활학회지 Vol.8 No.1

Balance is one of essential components to improve functional level after stroke, which is complicated motor skill depending on multi sensory-motor process and interaction between environmental factor and functional condition. After stroke, neurological impairments lead to the decrease in functional level and produce compensatory strategy in order to ensure an independence in daily activities. Because of such variety in this aspect, precise evaluation should be performed to identify the problems of each patients in motor, sensory, and cognition as well as functional implications, which is helpful to establish individualized program in stroke rehabilitation. Tools to evaluate balance function should be adequately valid, and selected by reflecting personal characteristics of patients with stroke. Therefore, many evaluation tools have been developed to demonstrate balance function. Laboratory tests are difficult to be commonly used in clinical setting, benefits are to offer quantitative data on balance reaction and performance. Also, clinical tests provide valuable data to understand postural impairment and function disability of patients with stroke. Accordingly, this study aimed to describe balance mechanisms and strategies as well as evaluation methods of balance function in stroke. Focus was to demonstrate clinical tests to readily use in clinical setting.