뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과

김주오,이병희 한국콘텐츠학회 2020 한국콘텐츠학회논문지 Vol.20 No.6

The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke. 본 연구는 뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행 및 상지 기능에 미치는 효과에 대해서 알아보았다. 신경계 손상 환자가 있는 병원을 기반으로 해서 하지 근력 강화에 대한 연구 방법을 만들어서 진행하였고, 무작위대조시험을 적용하였다. 24명의 뇌졸중 환자를 두 군으로 분류하였다. 하지 근력 강화 프로그램그룹 (Lower extremity strengthening program group, LESPG) (12명)과 트레드밀 훈련그룹 (Treadmill trainig group, TTG) (12명)으로 실험하였다. LESPG는 마비측에 하지 근력 강화프로그램을 수행하였다. TTG는 하루 30분 동안 트레드밀 운동을 적용하였다. 평가 도구는 일어나서 보행 검사(Timed Up and Go test, TUG), 기능적 보행평가 (Functional Gait Assessment, FGA) 및 뇌졸중 상지 기능검사 (Manual Function Test, MFT)를 적용하였다. 균형, 보행 및 상지 기능에 대한 두 군 간의 TUG, FGA 및 MFT 점수는 LESPG가 TTG보다 유의한 차이가 있었다(p<.01). 4주간의 하지 근력강화 프로그램의 효과는 뇌졸중 후 편마비 환자의 균형, 보행 및 상지 기능에 효과가 있었다.

골절 고정용 금속판 사용후 재질의 변화에 관한 연구

김주오,전철홍,심용석,김상수,최정기 圓光大學校 醫科學硏究所 1991 圓光醫科學 Vol.7 No.1-2

To estimate causative factors leading to failure of internal fixation devices, we performed mechanical, metallurgical and X-ray diffractional studies of plates. The study included three unused, six used, and broken one during implantation to the fractured femurs. Inner surfaces of used or broken plates revealed increased cracks and conversion of metal crystal from austenite to martensite structures, which implied that the plates became brittle. The ultimate tensile strength of used plates was increased and it meaned that the stress during implantation within the body did not weaken the ultimate tensile strength of the plates, rather made them stiff and hard. The used or broken plates were proved to lose their original ductility during implantation and became hard and brittle.

대퇴골 분쇄상 간부 골절에서의 골수 내 금속판을 이용한 고정 - 1예 보고 -

김주오,정문수,박봉주 대한골절학회 2007 대한골절학회지 Vol.20 No.4

대퇴 간부 분쇄상 골절은 주 골절편의 피질골 접촉면이 적어서 불안정하여 골수내정만으로 안정성를 얻기가 어렵다. 특히 골다공증이 존재하는 경우에 한 개의 측면 금속판과 나사를 통한 고정은 나사못과 피질골 사이의 고정 실패로 인하여 불유합을 야기할 수 있다. 이에 광범위한 연부조직의 박리를 줄이고 해부학적 정렬을 이루며, 안정된 골 고정을 위해 골수 내 금속판을 조합한 이중 금속판 고정술을 시행하여 성공적인 치료를 할 수 있다.

슬관절 반월상연골판의 구조 및 운동

김주오,전철홍 대한슬관절학회 1991 대한슬관절학회지 Vol.3 No.2

The menisci serve several important biomechanical functions in the knee. ANATOMY The medial meniscus is semicircular and is narrower than the nearly circular lateral meniscus. In prenatal period the menisci are very cellular and highly vascularized throughout the subtances. After skeletal maturity, the peripheral vascularized connective tissue constitutes from outer 1/3 of the total width. This vascular zone attach the meniscus to the joint capsule and probably provides the oxygen and nutrition to the outermost portion of the meniscus. The remaining (termed the midsubstance) is made up of avascular, aneural, and alymphatic fibrocartilage consisting of cells (fibrochondrocytes) surrounded by the abundant extracellular matrix. The extracellula matrix is composed mainly of Type 1 collagen, with small quantities of proteoglycans, matrix glycoproteins and elastin. The appearance of the fibrochondrocyte is similar to chondrocyte, yet they synthesize a fibrocartiagenous matrix. MOVEMENTS OF THE MENISCUS Flexion causes the meniscus to slide posteriorly in the tibial plateau. Because of its tight fixation to the joint capsule and medial collateral ligament, the medial meniscus is considerably less mobile fhan the lateral meniscus. With extreme flexion the posterior horn of the medial meniscus is compressed between femur and tibia and can be injured easily. A combination af sudden uncontrolled rotation and flexion-extension motion cause the injury of the meniscus, usually longitudinal tear in the medial meniscus and transverse or langitudinal tear in the lateral meniscus.

대퇴골 전자간 골절수술시 압박고 나사 고정과 감마정 고정의 비교

김주오,임한기,오재일,유상문 대한골절학회 2001 대한골절학회지 Vol.14 No.2

Purpose : To compare and analyze the operative results of compression hip screw with those of gamma nail in the treatment of intertrochanteric fracture of femur. Materials and Methods: We performed retrospective analysis of intertrochanteric fracture of femur using the compression hip screws on 16 cases(stable 8 cases, unstable 8 cases) and compared the results with those of 21 cases(stable 5 cases, unstable 16 cases) of Gamma nail fixation. All the 37 cases were operated between April 1992 and May 1997 and followed for minimal 12 months. We permitted earlier weight bearing for the Gamma nail inserted group(1 week vs 3 weeks). We evaluated the operation time, bleeding amount, intraoperative and postoperative complications, bone union time, neck-shaft angle, and functional assessment by follow up radiographs and clinical results. Results: The average operation time was shorter in the Gamma nail group than in the compression hip screw group (97±23.3 compared with 117±35.9 minutes; p$lt;0.05). The average amount of bleeding was lesser in the Gamma nail group than in the compression hip screw group (592 compared with 712 ml: p$lt;0.05). The fracture union time and clinical function of two groups showed no statistically significant difference(p$gt;0.05). During Gamma nail insertion, crack was developed in one femoral shaft which was united after bed rest and delayed weight bearing. Postoperative complications were coxa vara in 3 cases(1 case on Gamma nail, 2 cases on CHS) and cutting out of lag screw in 3 cases(1 case on Gamma nail, 2 cases on CHS), but showed no statistically significant difference between two groups(p=0.781). Conclusion: Early weight bearing can be encouraged for the Gamma nail group and this seemed to be beneficial for the old patients. The Gamma nail fixation is considered as a useful method for the patients with intertrochanteric fracture if it is managed with proper technique.

트레이드밀 전방, 후방 보행 시 속도와 경사도에 따른 하지 근활성도의 변화

김주오,인태성,Kim, Ju-O,In, Tae-Sung 대한물리치료과학회 2017 대한물리치료과학회지 Vol.24 No.1

Purpose: The purpose of this study was to investigate the changes in the activity of the thigh muscle(rectus femoris, vastus medial/ lateralis, hamstring medial/lateralis) which are caused by the change cf lower extremity muscle activity to speed and inclination during forward and backward walking on the treadmill. Method: Twenty healthy young adults were recruited. The subjects were given a warm-up for 1 minute at the speed of 2.0km/h before exercise, and 2km/h to 4km/h from 10% to 4km/h in the frontal and backward walking. Result: In the present study, it was found that the muscle activity of the lateral broad and inward wide muscles increased when the treadmill was backward for 40 seconds without training. And the femur and the muscle were significantly different from 10% to 4km/h(p<.05). Conclusion: These findings suggest that in the treadmill, it is effective in increasing the leg strength in the backward walking than in the forward walking. And it was concluded that muscle activity increased at 4km/h when the speed was 2km/h when backward walking.

신경박리가 말초 신경내 미세혈관에 미치는 영향에 관한 실험적 연구

김주오 全南大醫大 1981 전남의대학술지 Vol.18 No.2

한 환자에서 발생한 복직근 내 신경초종과 흉부 지방종: 증례 보고

김주오,안기용,봉황세,이규정,Kim, Ju-Oh,An, Ki-Yong,Bong, Hwang-Se,Lee, Kyu-Jung 대한근골격종양학회 2014 대한골관절종양학회지 Vol.20 No.2

한 환자에게 동시에 발생한 흉부 지방종과 복부 복직근 내 신경초종 1예의 경험을 보고하고자 한다. 신경초종은 드물게 보이는 양성 종양이며 신경 조직에서 유발하는 것으로 주로 사지 굴곡부의 말초신경에서 발생한다. 저자들은 63세 남자환자에서 복부 복직근 내 발생한 신경초종과 흉부의 지방종을 동시에 경험하여 이를 보고하고자 한다. We experienced a case of 63 years old male patient who had synchronous rectus abdominis intramuscular schwannoma and chest wall lipoma. Schwannoma is rare benign tumor which derived from nerve sheath and mainly peripheral nerve of flexor part. The authors report rare synchronous schwannoma and lipoma development.

Effect of upper extremity coordination exercise during standing on the paretic side on balance, gait ability and activities of daily living in persons with stroke

김주오,이병희 물리치료재활과학회 2017 Physical therapy rehabilitation science Vol.6 No.2

Objective: The purpose of this study was to determine the effect of upper extremity coordination exercise (UECE) during standing on the paretic side on balance, gait ability and activities of daily living (ADL) in persons with stroke. Design: A randomized controlled trial. Methods: A total of 27 patients with hemiplegic diagnosis after stroke were divided into two groups. Fourteen patients were in the study group and 13 patients were in the control group. The study group received conventional physical therapy and UECE during standing on the paretic side. The control group received conventional physical therapy and simple upper extremity exercise (SUEE). Subjects in both groups were given upper extremity training for 30 minutes per day, five times a week for 4 weeks. Initial evaluation was performed before treatment and reevaluated 4 weeks later to compare the changes of balance, gait ability and ADL (Korean version of modified Barthel index, K-MBI). Results: Both groups showed a significant effect for balance, gait ability and ADL (p<0.05). In the Independent t-test, between both groups showed a significant effect for balance and gait ability except ADL (p<0.05). Conclusions: In this paper, we investigated the changes in balance, walking, and ADL through UECE. We found significant changes in the study group and the control group. Results of the present study indicated that UECE during standing on the paretic side for 4 weeks had an effect on balance, gait ability and ADL (K-MBI) in persons with hemiplegia after stroke.

하지 석고 붕대의 체중 부하 감소효과의 비교

김주오,최승준,임한기,유상문 대한골절학회 2001 대한골절학회지 Vol.14 No.4

Purpose: We compared and evaluated the unloading effect and the availability of four different types of lower limb casts. Materials and Methods: The subjects were ten healthy men who had no gait disturbances, neuromuscular disorder, and deformities of lower extremities. The mean age was 25.2years (22-29) and the mean weight was 62.6㎏ (53.9-69.1). The trials consisted of patellar tendon bearing (PTB) casts, short leg casts, long leg extension casts, and long leg 30° flexion casts. In each experiment, ten sets of measurements were taken with all subjects wearing four different types of lower limb casts and walking on a flat surface indoors. The load cell was placed on the sole of the foot and wrapped with casts so that we could measure the pressure of the sole during gait. The percentage of load reduction was calculated by comparing pressure of the soles and the bottom of the casts. Results: The unloading effects of the PTB, the short leg, the long leg extension, and the long leg 30° flexion casts were 23.8%, 19.5%, 25.5%, 27.9% of the loading. No significant difference of unloading effect was demonstrated between each four different types of lower limb casts (P$gt;0.05). Conclusion: Notwithstanding the clinical success of the lower limb casts in below-knee fractures, the unloading effect of the casts was limited and any type of the casts did not show better unloading effects.