슬링(Sling) 시스템을 이용한 경부 안정화 운동

권재확,조미주,박민철,김선엽 대한정형물리치료학회 2002 대한정형도수물리치료학회지 Vol.8 No.2

Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. 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, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

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.

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.

견부통 환자에 대한 물리치료방법의 적용 시간을 중심으로 한 기술적 연구

김선엽,채정병,권재확,Kim, Suhn-Yeop,Chae, Jung-Byung,Kwon, Jae-Hoak 대한물리치료과학회 2002 대한물리치료과학회지 Vol.9 No.4

Objective: The purpose of this research was to use data for furnish quality physical therapy service. The research subjects were admitted shoulder pain patients treated with physical therapy that was to grasp physical therapy method as distinguishing application time. Subject: Total number of distributed questionnaire was 563 persons that was to utilized physical therapy room of 56th medical institution and distributed it to each physical therapist in charge. Method: The research used questionnaire in order to research itemized treatment application time that is according to physical therapy method to applicated with shoulder pain patient. The research contents is to received shoulder pain diagnosis period, total duration of utilizing physical therapy room, the number of times per week to used physical therapy room, etc. And we had physical therapist recording the time of application physical therapy method come under the items. Result: The average treatment time was 59.2 minutes at all patients. During this time, 39.7 min was modality treatment. Active movement treatment was only 7.1 min. Total treatment time was longest in general hospital at 64.9 min, it was shortest in clinical hospital at 53.3 min. Treatment time was difference as hospital scale(p<0.001). Active movement treatment time was longest in general hospital at 11.5 min. The average treatment time was 4.5 min in clinical hospital. Therefore, it was related to hospital scale(p<0.05). The average of manual therapy time by physical therapist was 7.5 min. General hospital was linger at 8.6 min than clinical hospital at 6.7 min(p<0.05). Patient of 90.2 % were treated to hot pack, ultra-sound treatment was next as 50.1%. Active strengthening exercise was most carrying out of the active treatment as 25.4 %. Active sensorimotor exercise was practiced only 28 persons of 5.0 %. Most joint mobilization (38.4 %) was used of the passive manual therapy items, next to soft tissue mobilization (33.0 %), and next to manual distraction therapy(14.0 %).