고장성 식염수를 이용한 실험적 근육통에서의 통증 양상

손민균,김태민,서정수,김봉옥,윤승호 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.3

등척성 근수축이 체성감각 유발전위에 미치는 영향

손민균,김영경,송정영,복수경,조강희,김봉옥 대한재활의학회 2001 Annals of Rehabilitation Medicine Vol.25 No.1

Effects of Acute Low Back Pain on Postural Control

손민균,이상숙,송현탁 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.1

Objective To evaluate the changes in static and dynamic postural control after the development of acute low back pain.Methods Thirty healthy right-handed volunteers were divided into three groups; the right back pain group, the left back pain group, and the control group. 0.5 mL of 5% hypertonic saline was injected into L4—5 paraspinal muscle for 5 seconds to cause muscle pain. The movement of the center of gravity (COG) during their static and dynamic postural control was measured with their eyes open and with their eyes closed before and 2 minutes after the injection.Results The COGs for the healthy adults shifted to the right quadrant and the posterior quadrant during their static and dynamic postural control test (p<0.05). The static and dynamic instability index while they had their eyes closed was significantly increased than when they had their eyes open with and without acute back pain. After pain induction, their overall and anterior/posterior instability was increased in both the right back pain group and the left back pain group during the static postural control test (p<0.05). A right deviation and a posterior deviation of the COG still remained, and the posterior deviation was greater in the right back pain group (p<0.05).Conclusion The static instability, particularly the anterior/posterior instability was increased in the presence of acute low back pain, regardless of the visual information and the location of pain.

동작과 관련된 문장에 의한 대뇌운동피질의 활성화

손민균,김봉옥,김성겸,이혜진,최필순 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.2

Objective: To investigate the effect of action related visual and auditory stimuli on the motor evoked potential (MEP) of hand. Method: Right handed fifteen healthy adults without neurological deficit were included. Visual lingual stimulation was given on the computer monitor with the sentence and auditory lingual stimulation was given 10 repetitions of the above sentence using computer speaker with eyes closed. MEPs from transcranial and transcervical magnetic stimulation were recorded on the abductor pollicis brevis of the right hand. Results: The latency of MEPs was shortened and the amplitude of MEPs with transcranial magnetic stimulation after lingual stimulation (p<0.05). However, the latency and amplitude of with transcervical stimulation did not show significant changes. Conclusion: Cortical excitability was enhanced by action related visual or auditory stimuli. Exercise accompanied by visual or auditory lingual stimulation rather than simple exercise might be useful for facilitating cortical excitability. (J Korean Acad Rehab Med 2010; 34: 163-167)

Effect of Transcranial Direct Current Stimulation on Postural Stability and Lower Extremity Strength in Hemiplegic Stroke Patients

손민균,지성주,김영욱 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.6

Objective To evaluate the effect of anodal transcranial direct current stimulation (tDCS) over the lesioned leg motor cortex, which can enhance the strength and coordination of the contralateral lower extremity and furthermore, enhance the postural stability of the hemiplegic subject.Methods Anodal or sham stimulation on the lesioned cortex of a lower extremity was delivered to 11 ambulatory hemiplegic patients. The stimulation intensity was 2 mA. All subjects took part in two 10-minute tDCS sessions consisting of anodal stimulation and sham stimulation. The interval period between real and sham stimulation was 48 hours. The order was counter-balanced among the subjects. Before and after each stimulation session, static postural stability was evaluated with eyes opened and closed. Also, the isometric strength of the hemiplegic side of the treated knee was measured before and after each stimulation session. Repeated measure ANOVA was used to determine the statistical significance of improvements in postural stability and strength.Results There was significant improvement for overall stability index with eyes opened and closed after anodal tDCS (p<0.05). Isometric strength of the lesioned quadriceps tended to increase after anodal tDCS (p<0.05). Postural stability and quadriceps strength were not changed after sham stimulation.Conclusion Anodal tDCS has potential value in hemiplegic stroke patients to improve balance and strengthen the affected lower extremity.

Motor Unit Number Estimation and Motor Unit Action Potential Analysis in Carpal Tunnel Syndrome

손민균,황선열,지성주,김영재,신현대 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.6

Objective To evaluate the clinical signifi cance of motor unit number estimation (MUNE) and quantitative analysis of motor unit action potential (MUAP) in carpal tunnel syndrome (CTS) according to electrophysiologic severity,ultrasonographic measurement and clinical symptoms. Method We evaluated 78 wrists of 45 patients, who had been diagnosed with CTS and 42 wrists of 21 healthy controls. Median nerve conduction studies, amplitude and duration of MUAP, and the MUNE of the abductor pollicis brevis were measured. The cross sectional area (CSA) of the median nerve at the pisiform and distal radioulnar joint level was determined by high resolution ultrasonography. Clinical symptom of CTS was assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). Results The MUNE, the amplitude and the duration of MUAP of the CTS group were signifi cantly diff erent from those found in the control group. The area under the ROC curve was 0.944 for MUNE, 0.923 for MUAP amplitude and 0.953 for MUAP duration. MUNE had a negative correlation with electrophysiologic stage of CTS, amplitude and duration of MUAP, CSA at pisiform level, and the score of BCTQ. The amplitude and duration of MUAP had a positive correlation with the score of BCTQ. The electrophysiologic stage was correlated with amplitude but not with the duration of MUAP. Conclusion MUNE, amplitude and duration of MUAP are useful tests for diagnosis of CTS. In addition, the MUNE serves as a good indicator of CTS severity.

편마비 환자에서 견관절 아탈구에 대한 기능적 자기자극 치료의 효과

손민균,조강희,윤상진,이태성,이광재 대한재활의학회 2007 Annals of Rehabilitation Medicine Vol.31 No.1

Objective: To evaluate the effects of functional magnetic stimulation (FMS) on shoulder subluxation following hemiplegia due to stroke or traumatic brain injury. Method: Twenty-four hemiplegic patients were participated in this study as FMS group (12 subjects) and FES (functional electric stimulation) group (12 subjects). FMS or FES were applied on the supraspinatus and posterior deltoid muscle area for 20 minutes, 5 days a week for 3 weeks. The effect of treatment was evaluated by assessment of the degree of shoulder subluxation using radiologic measurements, pain threshold and pain tolerance pressure, range of motion of the shoulder, muscle power and spasticity. Results: The degree of shoulder subluxation was signifi- cantly decreased after 3 weeks in both groups, and the FMS group improved more than the FES group. However there were no differences between two groups significantly. There was no significant effect of disease duration on change of shoulder subluxation. The ranges of motion of shoulder were increased in FMS group significantly. Pain threshold and pain tolerance pressure were increased in pectoralis major and infraspinatus muscles shortly after FMS application. Conclusion: This study suggests that the FMS could be applied effectively in preventing and reducing the shoulder subluxation in patient with hemplegia irrespective of disease duration. (J Korean Acad Rehab Med 2007; 31: 48-55)

Spasticity and Electrophysiologic Changes after Extracorporeal Shock Wave Therapy on Gastrocnemius

손민균,Young-Jae Kim,조강희,Seon Lyul Hwang 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.5

Objective To evaluate the spasticity and electrophysiologic effects of applying extracorporeal shock wave therapy (ESWT) to the gastrocnemius by studying F wave and H-refl ex. Method Ten healthy adults and 10 hemiplegic stroke patients with ankle plantarflexor spasticity received one session of ESWT on the medial head of the gastrocnemius. The modified Ashworth scale (MAS), tibial nerve conduction, F wave, and H-refl ex results were measured before and immediately after the treatment. The Visual Analogue Scale (VAS) was used during ESWT to measure the side eff ects, such as pain. Results There were no significant effects of ESWT on the conduction velocity, distal latency and amplitude of tibial nerve conduction, minimal latency of tibial nerve F wave, latency, or H-M ratio of H-reflex in either the healthy or stroke group. However, the MAS of plantarfl exor was signifi cantly reduced from 2.67±1.15 to 1.22±1.03(p<0.05) after applying ESWT in the stroke group. Conclusion After applying ESWT on the gastrocnemius in stroke patients, the spasticity of the ankle plantarfl exor was significantly improved, with no changes of F wave or H-reflex parameters. Further studies are needed to evaluate the mechanisms of the antispastic effect of ESWT.

척수손상 환자에서 교감신경피부반응과 심박간 변화

손민균,김봉옥,홍주형,윤승호 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.6

삽입전위의 정량적 평가

손민균,홍주형 大韓再活醫學會 1997 Annals of Rehabilitation Medicine Vol.21 No.5