뇌졸중 환자의 상지기능에 영향을 미치는 요인

방요순(Yoo-Soon Bang),김희영(Hee-Young Kim),이문규(Moon-Kyu Lee) 한국콘텐츠학회 2009 한국콘텐츠학회논문지 Vol.9 No.7

본 연구는 뇌졸중 후 상지기능의 관련 요인과 각 요인의 상대적 영향력을 알아보기 위해 시행되었다. MMSE-K(Mini Mental State Examination Korean version) 24점 이상인 100명의 뇌졸중 환자를 대상으로 하였다. 상지기능은 성별, 우세손, 뇌손상 원인, 뇌반구 손상부위, 신체마비 부위, 언어장애 유무와는 유의한 차이가 없었으나(p>0.05), 아탈구 유무는 상지기능에 유의한 차이를 보였다(p<0.05). 상지기능은 상지근력(Manual Muscle Testing), 고유수용성감각(Proprioception), 근 긴장도(Modified Ashworth Scale), 장악력(Grip strength), 통증(Visual Analog Scale)과 상관관계를 보였다(p<0.05). 위의 변수를 모두 포함하여 분석하면 77.6%의 상지기능 설명력을 보였고 이 중 상지근력이 가장 높은 설명력을 보였다. 뇌졸중 환자의 상지기능 재활을 위해서는 특히 상지근력 강화와 더불어 고유수용성감각, 근 긴장도, 장악력, 통증 그리고 아탈구 유무의 관련 요인들을 포괄적으로 중재에 포함시켜야 할 것으로 사료된다. This study was carried out to identify the factors which correlated with upper limb function after stroke and to analyze the effect of related factors on upper limb function. The 100 stroke patients(MMSE-K>24) were participated. The upper limb function according to gender, hand dominance, stroke type, affected location, site of paralysis, speech disorder showed no significant difference, and show significant difference according to shoulder subluxation. The upper limb muscle strength(Manual Muscle Testing), proprioception, muscle tone(Modified Ashworth Scale), grip strength(Dynamometer), pain(Visual Analog Scale) showed significant correlations with upper limb function. These predictors explained 77.6% of the upper limb function and the most significant affecting factor of upper limb function was upper limb muscle strength. In conclusion, the upper limb muscle strengthening will be effective strategy to improving the upper limb function and considering the proprioception, muscle tone, grip strength, pain, subluxation will be helpful to develop the strategies.

지역사회 노인의 신체활동 참여와 우울 및 신체 기능과의 관계

방요순(Yoo-Soon Bang),김희영(Hee-Young Kim),허명(Myung Heo) 한국콘텐츠학회 2009 한국콘텐츠학회논문지 Vol.9 No.10

본 연구는 지역사회 노인의 신체활동 참여에 따른 우울과 신체 기능을 알아봄으로서, 신체 활동을 노인의 지속적인 우울 경감 및 신체기능 증진을 위한 중재 방안으로 고려하기 위해 기초 자료를 제공하고자하였다. 65세 이상 노인 79명이 참여 하였으며, 한국형 노인 우울 척도(KGDS), 한국형 간이 정신 상태검사(MMSE-K), 젭슨 손 기능 검사(Jebsen hand function test), 악력계(Dynamometer), 5회 일어서기검사(Five time sit-up test)를 이용하여 노인의 우울과 인지 및 신체 기능(손 기능, 장악력, 하지 근력)을 측정하였다. 연구 결과 노인의 우울감이 높을수록 장악력은 낮았고, 신체 활동에 참여한 노인은 참여하지 않은 노인에 비해 더 높은 신체 기능과 더 낮은 우울감을 보였다. 이는 신체 활동이 노인의 우울 경감 및 신체기능 증진과 관련을 나타내므로 신체 활동을 노인의 우울 상태 및 신체 기능의 예측과 관리의 전략으로 고려할 것을 제안하는 바이다. The purpose of this study was to determine the relationships with physical activity and depression and body function in elderly. Methods: Total 79 elderly(over 65years old) were participated in this study. A Korean Form of Geriatric Depression Scale(KGDS), Mini-Mental State Examination(MMSE-K), Jebsen hand function test, dynamometer, five time sit-up test were used to measure the depression and cognition, body function(hand function, grasp power, lower extremity strength). Results: Physical activity participated group shows higher in the body function and lower in the depression than non participated group. Conclusion: The findings of this study indicate that the physical activity is helpful to indicate and manage the depression and body function in elderly.

척수손상자의 일상생활적응에 관한 연구

손경현,김찬규,방요순,Son, Kyung-Hyun,Kim, Chan-Kyu,Bang, Yoo-Soon 대한물리치료과학회 2003 대한물리치료과학회지 Vol.10 No.1

The purpose of this study was to evaluate the problem on activities of daily living ; the problem which spinal cord injured patients have when they adapt in daily living ; Subjects were 113 members who used the hospital which is located in Kwangju-city from November 20, 2001 to May 20, 2002. The evaluation of the ADL was performed according to MBI and collected data were statistically analysed by SPSS PC for paired Chi-square test T-test, One way ANOVA and Duncan's post-hoc test. The result's were as follows; 1. Modified Barthel Index average mark was $63.77{\pm}33.60$ points and MBI score distribution according to characteristics of injury is as following. 1) A patient who had long duration of injury, small injury region, incomplete paralysis in paralysis degree, paraplegia in paralysis type got high MBI score as statistical and significantly(p<0.05). 2. Society adaptation state by characteristics of spinal cord injured is an following. 1) After lapse of time of disease, a patient who is injured for a long term present surrounding environmental problem, a patient who is injured for a short term shows psychological problem. In society activity, as lapse of time of disease is long, patient did many hobby activity and same private club, on the other hand as lapse of time of diseases is short, the others appeared high and significantly as statistical(p<0.01). 2) In society activity by injury region, cervical injury and thoracic injury did more hobby activity than lumbar injury and in lumbar injury same private club or religion life appeared higher than thoracic injury of cervical injury significantly as statistical(p<0.01). 3) In walk method by paralysis degree Complete paralysis had more wheelchair life than incomplete paralysis(p<0.01). 4) In serious problem by paralysis type psychological problem in quadriplegia and surrounding environmental problem in paraplegia appeared high and significantly as statistical(p<0.01). 3. In society adaptation state by MBI score difference between variables appeared but it wasn't significantly.

뇌손상 흰쥐에서 기억과 학습훈련이 해마의 신경 성장인자에 미치는 영향

허명(Myoung Heo),방요순(Yoo-Soon Bang) 한국콘텐츠학회 2009 한국콘텐츠학회논문지 Vol.9 No.2

본 연구는 뇌손상 흰쥐에서 기억과 학습훈련을 통해 인지기능회복과 해마의 신경 성장인자에 미치는 영향을 알아보고자 하였다. 뇌손상은 Sprague-Dawley계 흰쥐 36마리를 중대뇌동맥(middle cerebral artery)을 폐색하여 유발하였고, 실험 군들은 3개 군으로 분류하였다; 실험 군 Ⅰ은 뇌손상유발 군(n=12), 실험 군 Ⅱ는 뇌손상 유발 후 트레드밀훈련 군(n=12), 실험 군 Ⅲ은 뇌손상 유발 후 기억과 학습훈련 군(n=12)으로 나누었다. 인지기능 검사를 위해 수중모리스미로 습득검사와 파지검사를 실시하였으며, 조직학적 검사는 해마조직의 BDNF(brain-derived neurotrophic factor) 면역조직화학 반응을 관찰하였다. 수중모리스미로 습득 검사(Morris water maze acquisition test)는 시간과 군사이의 교호작용이 유의한 차이가 나타났고(p<.001), Ⅲ군에서 9일에서 12일째까지 원형도피대를 찾는 시간이 Ⅰ, Ⅱ군에 비해 단축되었다. 수중모리스미로 파지검사(retention test)는 군 사이에서도 유의한 차이가 나타났으며(p<.001), 13일째 Ⅲ군에서 원형도피대가 있었던 사분원에 배회하는 시간이 가장 길었다. 조직학적 검사는 Ⅲ군에서 7일째 해마조직의 CA1에서 BDNF의 면역조직화학반응이 Ⅰ, Ⅱ군에 비해 면역양성반응의 증가를 관찰하였다. 뇌손상 흰쥐에서 기억과 학습훈련이 신경성장인자 발현 변화와 이로 인한 신경연접 가소성의 변화를 통해 인지기능회복에 더 좋은 영향을 주었다. This study was to investigate the effects of restoring cognition function and neurotrophic factor in the hippocampus according to memory and learning training in rats affected by brain injury. Brain injury was induced in Sprague-Dawley rats(36 rats) through middle cerebral artery occlusion(MCAo). And then experiment groups were randomly divided into three groups; Group Ⅰ: Brain injury induction(n=12), Group Ⅱ: the application for treadmill training after brain injury induction(n=12), Group Ⅲ: the application for memory and learning training after brain injury induction(n=12). Morris water maze acquisition test and retention test were performed to test cognitive function. And the histological examination was also observed through the immunohistochemistric response of BDNF(brain-derived neurotrophic factor) in the hippocampus. For Morris water maze acquisition test, there were significant interactions among the groups with the time(p<.001). The time to find the circular platform in Group Ⅲ was more shortened than in Group Ⅰ, Ⅱ on the 9th, 10th, 11th and 12th day. For Morris water maze retention test, there were significant differences among the groups(p<.001). The time to dwell on quadrant circular platform in Group Ⅲ on the 13th day was the longest compared with other groups. And as the result of observing the immunohistochemistric response of BDNF in the hippocampus CA1, the response of immunoreactive positive in Group Ⅲ on the 7th day increased more than that of Group Ⅰ, Ⅱ. These results suggested that the memory and learning training in rats with brain injury has a more significant impact on restoring cognitive function via the changes of neurotropic factor expression and synaptic neuroplasticity.

교대근무 여부에 따른 성인 남성의 주간 졸림증과 피로도

손경현(Kyung-Hyun Son),김수근(Soo-Geun Kim),진영우(Young-Woo Jin),김성효(Sung-Hyo Kim),김순영(Soon-Young Kim),방요순(Yoo-Soon Bang),권순석(Sun-Seog Kweon),신민호(Min-Ho Shin),정슬기(Seul-Ki Jeong),남해성(Hae-Sung Nam) 대한직업환경의학회 2005 대한직업환경의학회지 Vol.17 No.3

상지 운동학습에 의한 뇌졸중 환자의 일상생활동작 수행능력의 변화

방요순,손경현 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.2

The purpose of this study was to investigate the changes of the activities of daily living (ADL) by the motor learning program for upper extremity in stroke patients. The subjects were sixty-two members who were treated at the department of occupational therapy. The ADL were measured with Functional Independence Measure (FIM). The result's were as follows; 1. The ability to perform daily activities after treatment was significantly increased independent of age, gender, cause, affected side and speech disability (p<.01). The differences between the pre-treatment and the post-treatment was no significant correlation to sex, cause, affected side and duration of treatment, but the speech disability was significant. Therefore the pre-treatment scores and post-treatment scores were significantly different. 2. The variation of the pre-treatment and the post-treatment in the detail item to the performance of daily life of the stroke patients through the upper extremity motor learning program was significantly increased in self-care, sphincter control, locomotion, mobility, communication and social cognition (p<.01). Consequently, The motor learning program for upper extremity significantly improved the performance level of all ADL areas in stroke patients.

만성 요통환자의 치료를 위한 치료용 볼 운동의 효과

이은영,방요순,고자경 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.3