인지운동 이중과제 훈련이 뇌졸중 환자의 보행과 균형 기능에 미치는 영향: 무작위 대조군 예비연구

심선미 ( Sun Mi Sim ),오덕원 ( Duck Won Oh ) 한국전문물리치료학회 2015 한국전문물리치료학회지 Vol.22 No.2

The purpose of this study was to evaluate the effect of dual-task training with cognitive effort on the walking and balance functions of chronic stroke patients. The study included 14 chronic stroke patients, who were randomly divided into the experimental group (EG) and control group (CG), each with 7 patients. The EG performed the dual-task training with cognitive effort 3 times a week, 30 minutes for 4 weeks, where as the CG performed single-task training three times a week, for 30 minutes for 4 weeks. Outcome assessments were made with 10 m walk test, timed up and go test, 6 minutes walk test, and Berg balance scale. In within-group comparison, subjects from the EG showed significant differences in all variables (p<.05), while subjects from the CG showed only significant differences in 6 minutes walk test, and Berg balance scale (p<.05). Further, there was significant difference in the improvement rate of 10 m walk test. The findings suggest that the dual-task with cognitive effort may be beneficial for improving walking and balance functions of patients with chronic stroke.

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.

바로 누운 자세에서 하지 등척성 수축이 정상 성인의 반대측 체간 근활성도에 미치는 영향

박현주 ( Hyun Ju Park ),심선미 ( Sun Mi Sim ),최종덕 ( Jong Duk Choi ),오덕원 ( Duck Won Oh ) 한국전문물리치료학회 2012 한국전문물리치료학회지 Vol.19 No.3

This study aimed to investigate whether isometric lower limb exercise can activate contralateral trunk muscles and whether the magnitude of muscle activation is related to lower limb movement in sitting. This study included 25 healthy young subjects (20 males and 5 females). The magnitude of trunk muscle activation was measured using surface electromyography (EMG) during hip flexion, extension, adduction, and abduction, and a significant difference was observed in the activation levels of trunk muscles among the tests (p<.01). The EMG activity of the multifidus (MF) and erector spinae (ES) muscles on the contralateral side were significantly greater during hip extension. However, the activation levels of the contralateral internal oblique (IO) and rectus abdominis (RA) muscles were greatest during hip flexion. The MF : ES EMG ratio was significantly greater during hip isometric during hip isometric flexion and abduction compared to hip extension and adduction. There was no significantly difference in the IO : RA ratio during the isometric contractions toward different directions. These findings indicate that isometric lower limb exercise can elicit trunk muscle contraction on the contralateral side and may therefore be helped for developing contralateral trunk muscle strength in individuals undergoing rehabilitation.

분열형 효모에서의 mas2⁺ 유전자의 세포 내 기능

신상민(Sang Min Sin),차재영(Jae Young Cha),하세은(Ha Se Eun),심선미(Sun Mi Sim),김형도(Hyoung Do Kim),이정섭(Jung Sup Lee),박종군(Jong Kun Park) 한국생명과학회 2009 생명과학회지 Vol.19 No.1

유전자 발현의 조절은 세포주기 조절에 중요한 역할을 한다. 본 연구에서 새로운 mas2? (mitosis associated protein) 유전자는 인간의 SMARCAD1와 상동성을 갖고 분열형 효모인Schizosaccharomyces pombe (S. pombe)에서 gene-specific PCR방법에 의해서 분리하였다. 분리된 유전자는 SNF2 도메인이 위치해 있고, 이것은 염색체 재구성에 관련되어 있다. adh1?을 이용한 mas2? 전사체의 발현량 분석은 mas2?의 발현수준은 S. pombe에서 격막 형성 전에 가장 높았다. mas2? 완전돌연변이의 세포분열은 26와 35℃에서 지연되는 현상이 보였고, 다수의 다중 격막이나 핵분열이 일어나지 않는 세포들을 발견하였다. 세포들을 완전배지인 YES에서 증식을 증가시키기 위해서 배양했을 때, 정상과 다른 형태의 표현형을 가진 mas2? 완전돌연변이 세포들이 증가했다. 이런 표현형들은 mas2? 유전자의 과발현에 의해서 감소하였다. Mas2 단백질은 S. pombe의 핵내에 위치하였다. 이런 결과들은 mas2?가 인간의 SMARCAD1과 상동성을 갖고 있고, 염색체 재구성과 격막 형성 조절에 사용된다는 것을 나타낸다. The regulation of gene expression plays an important role in cell cycle controls. In this study, a novel mas2? (mitosis associated protein) gene, a homolog of human SMARCAD1 was isolated and characterized from a fission yeast Schizosaccharomyces pombe (S. pombe) using gene-specific polymerase chain reaction. The isolated gene contained a complete open reading frame capable of encoding 922 amino acid residues with a typical promoter, as judged by nucleotide sequence analysis. It was also found that an SNF2 domain is located, which is involved in the chromosome remodeling. The quantitative analysis of the mas2? transcript against adh1? showed that the expression level of mas2? is high before septum formation in S. pombe. When mas2? null mutant cells were grown at 27 and 35℃, the cytokinesis of mas2? null mutant was greatly delayed and a large number of multi-septate and mis-segregated cells were produced. In addition, the number of multi-septate cells significantly increased. When cells were cultured in YES rich medium to increase proliferation, the abnormal phenotypes mas2? null mutant dramatically increased. These phenotypes could be rescued by an overexpression of the mas2? gene. The Mas2 protein localized in the nuclei of S. pombe, as evidenced by Mas2-EGFP signals. These results suggest that the mas2? is homologous to human SMARCAD1 gene and involved in septum formation and chromosome remodeling control.

일어서기 동작시 편마비 환자의 보행 속도에 따른 체간과 하지 근 활성 형태의 비대칭성에 관한 연구

박현주 ( Hyun Ju Park ),오덕원 ( Duck Won Oh ),최성진 ( Sung Jin Choi ),장현정 ( Hyun Jeong Jang ),심선미 ( Sun Mi Sim ),조혁신 ( Hyuk Shin Cho ) 한국전문물리치료학회 2012 한국전문물리치료학회지 Vol.19 No.2

This study aimed to identify the asymmetry observed in the electromyography (EMG) activity patterns of selected trunk and thigh muscles between the affected and unaffected sides during the sit-to-stand movement in ambulatory patients with post-stroke hemiparesis. This study included 20 patients with post-stroke hemiparesis. The differences between stroke fast walkers (≥8 m/s, 11 subjects) and stroke slow walkers (<8 m/s, 9 subjects) were compared. The activation magnitude and onset time of the multifidus, lumbar erector spinae, hamstrings, and quadriceps during the sit-to-stand movement were recorded through surface EMG. Moreover, the EMG activation magnitude and onset time ratios of each bilateral corresponding muscle from the trunk and leg were measured by dividing the relevant values of the unaffected side by those of the affected side. In all the subjects, the activation magnitudes of the multifidus, hamstring, and quadriceps on the affected side significantly decreased compared to those on the unaffected side (p<.05). The onset time of muscle activity in the affected side was markedly delayed for the multifidus and quadriceps during the task (p<.05). The activation magnitude ratios of the quadriceps were markedly decreased in the stroke slow walkers as compared to those in the stroke fast walkers. These findings indicate that the asymmetry in the multifidus, hamstring, and quadriceps muscle activation patterns in patients with post-stroke hemiparesis may be due to the excessive muscle activation in the unaffected side to compensate for the weakened muscle activity in the affected side. Our findings may provide researchers and clinicians with information that can be useful in rehabilitation therapy.

상지신경가동화기법이 편마비 환자의 상지 기능에 미치는 효과

차현규,오덕원,조혁신,기경일,심선미,박현주 대구대학교 특수교육재활과학연구소 2012 특수교육재활과학연구 Vol.51 No.1

본 연구는 상지신경가동화기법이 뇌졸중 환자의 상지기능에 미치는 효과를 평가하기 위해 실시되었다. 본 연구에 20명의 뇌졸중 환자가 참여하였다. 연구 대상은 뇌졸중 환자를 실험 군과 대조군으로 각각 10명씩 무작위로 배정하였다. 모든 환자들은 보존적 물리치료를 받았으며, 실험군에게 추가적으로 상지신경가동화기법이 10분 동안 시행되었다. 본 연구의 상지 평가 도구는 상지 운동 능력 평가(양적/질적), 상지 기능 검사(시간/기능), 장악력이 포함되었다. 측정은 중재 전, 4주 후 2번 실시하였다. 중재 후 실험군에서 상지 운동 능력 평가(양적 /질적), 상지 기능 검사(기능), 장악력에서 유의한 차이를 보였다(p < .05). 또한 대조군에서는 상지 운동 능력 평가(양적/질적)에서만 유의한 차이를 보였다(p < .05). 두 군 간의 중재 전과 중재 후의 상지 기능 평가 비교에서 상지 운동 능력 평가(양적/질적), 상지 기능 검사(기능), 장악력 검사에서 유의한 차이가 있었다(p < .05). 이는 상지신경가동화기법이 뇌졸중 환자의 상지 기능에 긍정적인 영향을 미친다는 것을 의미한다. 앞으로 이러한 연구 결과를 일반화시키는 것이 필요할 것이라고 사료된다. The purpose of this study was to determine the effect of upper limb nuerodynamic mobilization technique on perceived upper limb function in patients with poststroke hemiparesis. 20 patients with post-stroke hemiparesis were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 10 patients in each group. All subjects received a routine physical therapy. The mobilization technique of the upper limb neurodydnamic was performed for 10 min in the case of the EG subjects. The upper limb assessment tools of this study involved the motor activity log(MAL) (Quantity/Quality), manual function test(MFT) (Timing/Function), grip strength. The measurements were recorded 2 times: before the intervention and after 4 week the intervention. In the case of the EG subjects, the variables measured after the intervention significantly differed from MAL Quantity/Quality) and MFT (Function), grip strength measured before the intervention (p < .05). Also, in the case of the CG subjects, the variables measured after the intervention significantly differed from MAL (Quantity/Quality) (p < .05). In addition, there were significant differences in MAL(Quantity/Quality) and MFT(Function), grip strength at post test between the 2 groups (p < .05). The findings indicate that upper limb neurodynamic mobilization technique exerts a positive effect on upper limb function in patient with post stroke-hemiparesis. Further studies are required to generalize the result of this study.