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다발성감각운동자극 치료가 뇌졸중 환자의 보행과 낙상위험도에 미치는 효과: 무작위배정예비임상시험
임재길,Lim, Chaegil 대한통합의학회 2019 대한통합의학회지 Vol.7 No.2
Purpose : To determine whether an advanced rehabilitation therapy combined with conventional rehabilitation therapy consisting of sensorimotor exercises that would be superior to a usual treadmill training in gait ability and fall risk in subacute stroke patients. Methods : Thirty subjects randomly assigned to either multi-sensorimotor training group (n=19) or treadmill training group (n=18). Both groups first performed conventional physical therapy for 30 min, after which the multi-sensorimotor training group performed multi-sensorimotor training for 30 min, and the treadmill training group performed treadmill gait training for 30 min. Both groups performed the therapeutic interventions 5 days per week for 8 weeks. Gait ability was evaluated using the GAITRite system and Fall risk was measured using the Biodex Balance system before intervention and after 8 weeks. Results : There were no intergroup differences between demographic and clinical characteristics at baseline (p>.05). Both groups showed a significant improvement in gait ability (p<.05) and Fall risk (p<.05). In particular, the multi-sensorimotor training group showed more significant differences in gait velocity (p=.05), step length (p=.01) and stride length (p=.014) than the treadmill training group. Conclusion : The multi-sensorimotor training program performed on multiple types of sensory input had beneficial effect on gait ability. A large-scale randomized controlled study is needed to prove the effect of this training.
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엉치엉덩관절 통증환자에 관절가동술과 깔창적용이 보행능력, 근활성도와 통증 미치는 효과 : 무작위배정예비임상시험
임재길 한국체육과학회 2020 한국체육과학회지 Vol.29 No.3
This study was to compare the effects of joint mobilization, Treadmill with insole, and joint mobilization and treadmill with insole on gait ability and muscle activity in patients with sacroiliac joint pain. 24 patients randomly assigned to joint mobilization group(n=8), treadmill with insole group(n=8), or joint mobilization and treadmill with insole group(n=8). Each groups were conducted 30 minutes a day, two days a week for four weeks. Gait ability(cadence, stance phase(heel strike, mid stance, propulsion)) was measured using Gateview AFA-50 and Muscle activity was evaluated using electromyography, and pain was evaluated using visual analogue scale before intervention and after 4 weeks. All groups were significant differences in cadence and pain in intragroup(p<.01). In stance phase, only joint mobilization and treadmill with insole was significant differences in heel strike, mid stance, and propulsion in intragroup(p<.01). also all groups were no significant differences EMG in intragroup (p>.05). Multiple comparisons between intervention methods were significant differences on cadence and stance phase in intergroup(p<.05). In joint mobilization and treadmill with insole group, Cadence was significantly improved than other groups(p<.01) and mid stance was significantly improved in joint mobilization group than other groups(p<.05). All the interventions improve sacroiliac joint pain and cadence. joint mobilization are effective changes in mid stance. This study can be used as a basic data for prevention of injury, posture correction and gait therapy in patients with sacroiliac joint pain, as well as chronic low back pain.
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Effects of trunk control robot training on balance and gait abilities in persons with chronic stroke
임재길 물리치료재활과학회 2020 Physical therapy rehabilitation science Vol.9 No.2
Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension- training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.
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미국 지방정부 재정파산의 원인 분석 -파산승인 도시를 중심으로-
임재영(林栽永) 한국지방자치학회 2019 韓國地方自治學會報 Vol.31 No.2
최근의 경기침체로 인한 여러 지방정부의 재정부실 문제로 지방파산제에 대한 대중의 관심이 높아졌다. 박근혜 정부 또한 지방파산제 도입을 고려하면서 정치권의 관심 또한 높아졌다. 이에 맞춰 지방파산제를 둘러싼 쟁점을 논의하고자 하는 학계의 다양한 시도도 전개되었다. 특히 미국의 지방파산제를 이해하려는 노력이 많았고, 따라서 주로 제도의 역사와 절차에 주목했다. 이러한 노력에도 불구하고, 아직까지 왜 미국의 일부 지방정부가 재정파산을 했는지에 대한 체계적인 학술적 논의는 진행되지 않았다. 본 논문은 대공황을 기점으로 2008년에서 2017년 사이 재정파산한 미국의 지방정부 사례를 살펴보고, 나아가 파산원인을 도출하였다. 이는 향후 파산제 도입 시 고려되어야 할 사항을 사전에 점검하고, 나아가 한국의 적용 가능성을 파악하는 데 유용한 시사점을 제공할 것이다. 또한 한국정부에서 파산제를 도입하지 않더라도, 지방 재정위기의 원인을 파악하는데 용이할 것이며, 이는 궁극적으로 지방경쟁력을 강화하는데 기여할 것이다. The Great Recession reawakened the public"s interest in fiscal distress of local governments and local bankruptcy. The central government in Korea also tried to introduce local bankruptcy in Korea. Several studies have explored issues surrounding local bankruptcy, In particular, they focused mainly on American local bankruptcy, its history, and procedures. Still, there are few studies examining what causes some local governments to declare bankruptcy, based on several cases. This articles examines American local governments that have had court-approved bankruptcy between 2008 and 2017, with the exception to Orange County having unique causes of bankruptcy. In doing so, the study will help policymakers further their understanding of local bankruptcy as an institution. Even if Korea may not adopt the system, the study"s findings will be still beneficial for those that want to avoid fiscal malpractices and improve their fiscal shape. Ultimately, the study will offer lessons for local governments in their pursuit of strengthening competitiveness.
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