편마비 환자의 견관절 아탈구 교정을 위한 새로운 신전형 팔걸이의 효과

윤용순,정복희,장인수,최준섭 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.2

Objective: To test the effectiveness of the METS (modified extension-type sling) in reducing subluxation in patients with hemiplegic shoulders, and to assess the functional support of METS as the angle of the elbow changes. Method: Sixteen flaccid hemiplegics were assessed by the anteroposterior shoulder radiographs. Three parameters, vertical distance (VD), horizontal distance (HD) and joint distance (JD), were measured on both affected and unaffected sides before and after the fitting of the METS and the Bobath sling. Three parameters were also measured in each elbow flexion angle (0o, 30o, 60o, 90o) after the fitting of the METS and extension-type sling with a forearm cuff to evaluate the effectiveness in the dynamic condition. Results: In the Bobath sling, the mean values of VD and JD reduced significantly (p<0.05), but on the contrary, HD increased significantly (p<0.05). In the METS, VD and JD reduced significantly (p<0.05), and there were no changes in HD (p>0.05). In the Bobath sling, VD, HD and JD were different from the unaffected side (p<0.05), but in the METS, three parameters were not different from the unaffected side (p>0.05). As the elbow flexion angle increased with the METS, three parameters were not different from the unaffected side (p>0.05), but with the extension-type sling with a forearm cuff, VD and JD were different from the unaffected side (p<0.05). Conclusion: The METS was more effective not only in the reduction of the hemiplegic shoulder subluxation, but also in the maintenance of reduction as the elbow flexion angle changes within various activities. (J Korean Acad Rehab Med 2010; 34: 150-157)

Balloon Dilatation for an Esophageal Stricture by Long-Term Use of a Nasogastric Tube: A Case Report

윤용순,Jong Yun Kim,이광재,유기삐,Mi Sook Lee 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.4

In the present report, we describe a case of long-term follow-up esophageal stricture occurring in a patient with nasogastric tube use. A 63-year-old man who had experienced dislocation of the 6th and 7th cervical vertebrae as the result of an external injury received treatment at another hospital and was admitted to the rehabilitation department of our hospital. After he exhibited normal swallowing in a videofluoroscopic swallowing test, the nasogastric tube was removed and oral feeding with a dysphagia diet was initiated. However, during oral feeding, the patient complained of swallowing difficulties in his lower throat. An esophagogastroduodenoscopy was performed to examine the lesions below the pharynx and a 2-mm stricture was observed. A balloon dilatation was performed for a total of 9 times to extend the stricture. After the procedure, the patient was able to easily swallow a normal diet through the esophagus and the vomiting symptoms disappeared. An esophagography showed that the diameter of the esophageal stricture was 11 mm.

뇌졸중 환자의 견관절 아탈구에 대한 변형삼각형 보바스 팔걸이의 영향

윤용순,김제환,이경아,임진택,엄보영,장인수,임호용,정복희 대한재활의학회 2004 Annals of Rehabilitation Medicine Vol.28 No.5

preference during walking because of reciprocal arm swing and protecting the hemiplegic upper extremity from trauma. Conclusion: The results indicated MTBS and MTBSDS were more effective on shoulder subluxation in stroke patients. Further study on the development of slings for decrement of lateral displacement is recommended.

Effect of Epidural Electrical Stimulation and Repetitive Transcranial Magnetic Stimulation in Rats With Diffuse Traumatic Brain Injury

윤용순,조강희,김은실,이미숙,이광재 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.3

Objective To evaluate the effects of epidural electrical stimulation (EES) and repetitive transcranial magnetic stimulation (rTMS) on motor recovery and brain activity in a rat model of diffuse traumatic brain injury (TBI) compared to the control group.Methods Thirty rats weighing 270–285 g with diffuse TBI with 45 kg/cm2 using a weight-drop model were assigned to one of three groups: the EES group (ES) (anodal electrical stimulation at 50 Hz), the rTMS group (MS) (magnetic stimulation at 10 Hz, 3-second stimulation with 6-second intervals, 4,000 total stimulations per day), and the sham-treated control group (sham) (no stimulation). They were pre-trained to perform a single-pellet reaching task (SPRT) and a rotarod test (RRT) for 14 days. Diffuse TBI was then induced and an electrode was implanted over the dominant motor cortex. The changes in SPRT success rate, RRT performance time rate and the expression of c-Fos after two weeks of EES or rTMS were tracked.Results SPRT improved significantly from day 8 to day 12 in the ES group and from day 4 to day 14 in the MS group (p<0.05) compared to the sham group. RRT improved significantly from day 6 to day 11 in ES and from day 4 to day 9 in MS compared to the sham group. The ES and MS groups showed increased expression of c-Fos in the cerebral cortex compared to the sham group.Conclusion ES or MS in a rat model of diffuse TBI can be used to enhance motor recovery and brain activity.

뇌줄중 후 상지의 근골격계 문제

윤용순,김은실,이광재 대한뇌신경재활학회 2016 뇌신경재활 Vol.9 No.1

Musculoskeletal problems in the upper extremity after stroke are common conditions affecting the shoulder, elbow, wrist and hand, which are often symptomatic. These symptomatic conditions include complex regional pain syndrome type 1, secondary adhesive capsulitis of the shoulder, spasticity, secondary mechanical injuries, which often presents simultaneously in combined nature, so that one targeted treatment is not always successful. Musculoskeletal pain and complication is one of the reasons, for patients not being possible to start or participate in the daily regular rehabilitation programs actively after stroke.

기립 종골각의 좌우 차에 의한 소아의 척추 측만증에서 족부 보조기의 적용

윤용순,윤석봉,최준섭,최쥴리,유기삐,곽수현,강지영 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.1

Objective: To evaluate the effect of custom molded foot orthosis without heel lift in scoliosis patients who had different pelvic height caused by inequality of RCSPA (resting calcaneal stance position angle). Method: We retrospectively reviewed the medical data of all patients who had been prescribed custom molded foot orthosis without heel lift in our institution from 2005 to 2009 and chose 38 scoliosis patients with Cobb's angle (≥10o) and different pelvic height (≥5 mm) caused by inequality of RCSPA (≥2o). Radiologic findings of whole spine AP and RCSPA were measured pre and post treatment and compared. Results: Twenty two females and sixteen males were included in this study. Their mean age was 7.76±3.72 years. Their mean period of wearing orthosis was 14.11±3.25 months. Initial average Cobb's angle of 13.18±3.16o were reduced to 7.42±3.45o (p<0.001). Initial difference of height between right and left iliac crest of 0.87±0.26 cm reduced to 0.55±0.28 cm (p<0.01) and angle of pelvic inequality of 3.98±1.55o reduced to 2.54±1.27o (p<0.05). Initial difference of RCSPA between right and left of 3.69±1.54o decreased to 1.69±1.54o (p<0.01). Each parameter has significantly reduced 12 months after the wearing of the custom molded foot orthosis in scoliosis patients whose age was 9 or below, whose Cobb's angle at 15o or lower. Conclusion: The custom molded foot orthosis without heel lift was effective for scoliosis patients, who had different pelvic height caused by inequality of RCSPA. (J Korean Acad Rehab Med 2010; 34: 66-73)

편마비 환자의 상지 기능 증진을 위한 다중 관절 기능적 전기자극 - 협응성 수의운동과 단일 관절 근육전기자극 치료의 비교

윤용순,강지영,김정화 대한노인병학회 2008 Annals of geriatric medicine and research Vol.12 No.2

Background: To assess the efficacy of functional electrical stimulation (FES) with multi-joints coordinate movement compared to electric muscular stimulation for mono-joint movement in enhancing the upper extremity motor and functional recovery of hemiplegic survivors. Methods: Forty patients with hemiplegia were divided into two groups. The FES group received FES to produce hand grip, elbow flexion, elbow extension and hand release in sequence with voluntary movement. Control group received electrical stimulation to produce wrist extension without voluntary movement. All groups received for 20 minutes per session, twice a day, 5 days a week during 4 weeks and under the same occupational and physical therapies during 4 weeks. Outcomes were assessed in a blinded manner with the upper extremity component of the Fugl-Meyer Motor Assessment, the self-care component of the Modified Barthel Index (MBI), Upper extremity muscle strength, Wolf Motor Function Test (WMFT), spasticity, and Range of motion (ROM) of shoulder before and after treatment. Results: There were significant improvements of the power at shoulder & elbow flexion, WMFT, Fugl-Meyer, hand grip, and MBI in both group (p<0.05). ROM of shoulder, the power of wrist extension, and pinch improved only at the FES group (p<0.05). The FES group had better effects at WMFT, Fugl-Meyer, hand grip, pinch, MBI, shoulder ROM, and spasticity after treatment (p<0.05). Conclusion: This study showed that FES and multi-joints coordinate movements are better than electric muscular stimulation for mono-joint movement to enhance the upper extremity functional recovery in hemiplegia.

뇌졸중 환자의 연하 장애에 대한 기능적 전기자극의 효과

윤용순,임진택,윤석봉,엄보영,강지영,임호용,정복희,김정화 대한재활의학회 2006 Annals of Rehabilitation Medicine Vol.30 No.5

Development and Application of a Newly Designed Massage Instrument for Deep Cross-Friction Massage in Chronic Non-Specifi c Low Back Pain

윤용순,Ki-Pi Yu,이광재,Soo-Hyun Kwak,Jong Yun Kim 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.1

Objective To introduce a newly designed massage instrument, the Hand Grip T-bar (HT-bar) and use it to relieve chronic non-specifi c low back pain (nLBP) through deep cross-friction massage (roptrotherapy). Method 22 subjects (9 males and 13 females, aged 51.6±6.7) with chronic nLBP were allocated randomly to a Roptrotherapy group (n=12) and a Transcutaneous Electrical Nerve Stimulation (TENS) group (n=10). The Roptrotherapy group received deep cross-friction massage with the HT-bar, which was made of metal and had a cylinder for increasing weight and grooves for an easy grip. It was applied across the middle and lower back for 20minutes a day, 3 days a week for 2 weeks. Th e TENS group received TENS for 20 minutes a day, 5 days a week for 2weeks. Th e outcome was measured on the pain numeric rating scale (PNRS), by the Oswestry disability index (ODI),and by the Roland & Morris Disability Questionnaire (RMDQ) at pre-treatment, at immediate post-treatment and 2 weeks later. Th e application of the HT-bar was assessed by a questionnaire to 19 therapists. Results At post-treatment, immediately and 2 weeks later, both groups showed signifi cant improvement in PNRS,ODI and RMDQ. During the two weeks after post-treatment, however, the Roptrotherapy group improved in PNRS,ODI and RMDQ, but the TENS group did not. Over 80% of the therapists responded that the HT-bar was useful and comfortable. Conclusion Th is study suggests that deep cross-friction massage can be a benefi cial therapeutic technique and that the HT-bar can be a useful instrument in deep cross-friction massage for chronic nLBP patients.

편마비 환자에서 견관절 아탈구에 대한 견갑골 측방 주행 검사의 적용

윤용순,정승석,이경아,김제환,임진택 대한재활의학회 2003 Annals of Rehabilitation Medicine Vol.27 No.6