복횡근 강화운동이 체간 신전-굴곡 시 척추 분절 운동에 미치는 영향

김선엽,백인협 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.1

This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was peformed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 ㎝, and weight was 59.95 ㎏. 2) Spinal segment motion angle of T10/11 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.

요통 환자에 대한 물리치료방법의 적용 시간을 중심으로 한 기술적 연구

김선엽,채정병,권재확 대한정형물리치료학회 2001 대한정형도수물리치료학회지 Vol.7 No.1

Objective: The purpose of study was to compare physical therapy duration in relation tohealth care organization system in patients with low back pain. Subjects: Subjects of this study were 759 patients who are receiving physical therapy at 56 health care organization. Methods: Data were collected by questionnaire that had been completed by patients and physical therapist for two months. Physical therapy procedures consisted of modality application, manual therapy, active therapeutic exercise, and patient education. Physical therapy session duration was investigated for each physical therapy procedure. Data were analyzed in relation to the university hospital, hospital, and clinic. Results: The mean age of subjects was 42.84±15.46. There were no significant differences in age among three groups. The number of patients diagnosed with herniated disc were 244(32.15%) and with mechanical low back pain was 187(24.64%). the mean treatment duration per day was 53.22 minutes, and the longest treatment duration was 61.28 minutes at the university hospitals(p<0.001). The mean modality application duration was 42.17 minutes, and the longest application duration was 46.26 minutes at the university hospitals(p<0.001). The mean duration for manual therapy was 5.11 minutes, and the longest treatment duration was 5.97 minutes at clinics. The mean duration for active therapeutic exercise was 4.16 minutes. It was 7.60 minutes at the university hospitals, and 2.48 minutes at clinics. There was a significant difference in active therapeutic exercise duration between university hospitals and clinics(p<0.001). For modalities, hot packs(89.33%) and interferential current therapy(60.87%) were mostly applied. For manual therapy, Soft tissue mobilization(32.93%) and manipulation(14.10%) were mostly applied. In general, treatment application duration was longer at University hospital (p<0.05). For therapeutic exercise, exercise without equipment(18.84%) and muscle strengthening(16.73%) were mostly performed. The longest treatment duration for therapeutic exercise was 7.60 minutes at the university hospital(p<0.05). Conclusion: physical therapy session duration for low back pain was 53.22 minutes. Modality application constitutes 79%, manual therapy 10%, active therapeutic exercise 8% of total treatment duration. It is concluded that patients do not participate actively in treatment procedures.

발달장애 아동 어머니의 가정치료 참여도

김선엽,두정희 한국전문물리치료학회 1995 한국전문물리치료학회지 Vol.2 No.2

관절 가동운동(mobilization)이 관절 감수기(joint receptors)에 미치는 영향

김선엽 한국전문물리치료학회 1996 한국전문물리치료학회지 Vol.3 No.2

의도적인 견갑골 외전이 Sit-and-Reach Test에 미치는 영향

김선엽,지창연,김광수 대한정형물리치료학회 2000 대한정형도수물리치료학회지 Vol.6 No.1

Purpose : This study was done to examine the actual effect of the scapular position in these flexibility tests. The purpose of this study was to examine the differences between the measurement of SRT(Sit-and-Reach Test) without intentional abduction of the scapular (pre-test) and with intentional abduction of the scapular (post-test). The hypothesis is: 1. There is no differences in the SRT result of the pre-test and the post-test. 2. There is no differences in the HJA(Hip Joint Angle) result of the pre-test and the post-test. 3. There is no differences in the Spine Motion Test(SMT) result of the pre-test and the post-test. Method : The total 60 people (30 men, 30 women) were participated in this study. In the pre-test, the subjects were asked to sit on the examination table and try the SRT motion: and then the HJA, SRT and the SMT numerical values were taken. In the post-test, the subjects were instructed to intentionally bring the scapula outward from the midline: and the HJA, SRT and the SMT numerical values were taken. Result : In the pre-test, the SRT result averaged 34.17cm, and in the post-test, the SRT result averaged 36.68cm. The difference was about 2.81cm which showed a significant mean statistically (p<0.01). The measurement increased by 8.22%. The HJA was 85.9˚ in pre-test, and it was 85.5˚ in post-test, giving the 0.4˚ differences. Therefore, it didn't have a statistical mean (p>0.05). The SMT value was 69.28cm in the post-test, about 0.28cm decreased. Therefore, it didn't have a statistical mean(p>0.05). SRT values and HJA values were correlated (p<0.01). SMT values and SRT values (p<0.01), and SMT values and HJA values (p>0.05) were each in counter correlation. Conclusion : The result of the SRT without intentional scapular abduction (34.17cm) and with intentional scapular abduction (36.68cm) showed a significant increase about 8.22% (p<0.01). In SRT, the effect of the intentional scapular abduction on SMT showed no significant means, the pre-test value being 69.59cm and the post-test value being 69.28cm (p>0.05).

슬링(Sling) 시스템을 이용한 요부 안정화 운동

김선엽,권재확 대한정형물리치료학회 2001 대한정형도수물리치료학회지 Vol.7 No.2

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus., Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovaSc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

견관절부 장애의 치료를 위한 McConnell 테이핑 적용법

김선엽,김호봉 대한정형도수치료학회 2005 대한정형도수물리치료학회지 Vol.11 No.2

Most physical therapist that the effect of taping can only partially be explained by increased mechanical stability, However, that taping may have some proprioceptive influence. Shoulder taping is one intervention that has been used in the management of shoulder subluxation in patients who have had a cerebrovascular accident. Taping the scapula has been suggested as a method of improving both scapula position and muscular efficiency of the shoulder girdle. Scapular taping can be useful in cases of secondary impingement in which faulty positioning of the scapular during overhead movements causes impingement of the rotator cuff tendons. The taping must be accompanied by retraining exercises to reeducate the scapular muscles so that they position the scapular correctly during shoulder motions. A McConnell taping method developed by Jenny McConnell, and Australian physical therapist, uses a combination of taping and exercises. Her initial theory stated that the tape corrected patellar alignment to relieve pain and allow the patient to exercise to regain strength. Although taping techniques are commonly used in addition to exercise programmes in the rehabilitation of shoulder instability and secondary impingement syndrome, few studies exist on the effect of taping on the muscle activity of the shoulder joints. Therefore, the purpose of the this article was to review the influence of McConnell taping method on the muscular activity in shoulder muscles and joints.

건강관리 프로그램이 노인의 건강관리에 미치는 영향

김선엽,강희양 한국전문물리치료학회 1998 한국전문물리치료학회지 Vol.5 No.2

뇌종중 후 회복과 물리치료

김선엽,권오윤 한국전문물리치료학회 1995 한국전문물리치료학회지 Vol.2 No.2

경추부 장애와 신경근 조절 활동 변화와의 관련성에 대한 고찰

김선엽,이해정 대한정형도수치료학회 2006 대한정형도수물리치료학회지 Vol.12 No.1

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.