운동면과 어깨 관절 굽힘 각도가 어깨뼈 내밈 운동 시 어깨뼈 위쪽 돌림근에 미치는 영향

정성대 ( Sung Dae Choung ),원종혁 ( Jong Hyuck Weon ),정도영 ( Do Young Jung ) 대한물리의학회 2013 대한물리의학회지 Vol.8 No.1

PURPOSE: This study was to determine the effect of the plane of movement (sagittal plane vs. scapular plane) and shoulder flexion angle (90° vs. 130°) during scapular protraction exercises in healthy subjects by investigating the elecromyographic (EMG) activities of the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM). METHODS: Twenty-one healthy subjects participated in this study. Subjects performed maximal scapular protraction at the 90° or 130° shoulder flexion angles in the sagittal or scapular planes. Surface EMG was recorded from the SA and UT, and PM muscles. Dependent variables were examined by 2 (plane) × 2 (angle) repeated measures of analysis of variance (ANOVA). RESULTS: Significantly increased EMG activities in the SA and UT were found during scapular protraction exercise at the 130° shoulder flexion angle in the sagittal and scapular plane. Also, EMG activity of the PM significantly decreased at the 130° shoulder flexion angle in the sagittal plane and the 90° and 130° shoulder flexion in the scapular plane. CONCLUSION: we recommend scapular protraction exercise at the 90° shoulder flexion in the sagittal plane to selectively strengthen the SA muscle with limitation of upper trapezius activity and at the 130° shoulder flexion in the scapular plane to selectively strengthen the SA muscle with limitation of pectoralis major activity.

엄지발가락휨각도 측정을 위한 각도계의 신뢰도와 타당도

정성대(Sung-dae Choung),강선영(Sun-young Kang),김문환(Moon-hwan Kim),원종혁(Jong-hyuck Weon) 한국전문물리치료학회 2013 한국전문물리치료학회지 Vol.20 No.2

The purpose of this study was to investigate the reliability and validity of goniometer measurements of the hallux valgus angle (HVA) compared to radiographic measurements, which are the current standard. Twenty subjects (10 female, 10 male) were recruited for this study (40 feet). The HVA of the subjects was measured using goniometer and radiographic measurement. In three trials, measurements were taken of each subject by two examiners using goniometer and radiographic measurements using radiography in a standing position. The reliability of the measurements was investigated using intraclass correlation coefficients (ICC(3,1)), and the validity was tested using the Pearson product-moment correlation coefficient and an independent t-test. The intra-rater reliability of left and light HVAs were poor (ICC=.409 and .341, respectively). The inter-rater reliability of left and right HVAs were poor and moderate (ICC=.303 and .501, respectively). Left and right HVAs measured using goniometer and radiographic measurements were also poor and moderate (Pearson r=.246 and .544, respectively). These results suggest that goniometer measurements of the HVA are inaccurate and have unacceptable validity compared to radiographic measurements.

도수 촉진과 막대를 이용한 몸통의 전방 굴곡 운동에 따른 요추와 고관절 굴곡 각도의 변화

정성대 ( Sung Dae Choung ),박규남 ( Kyue Nam Park ),홍지아 ( Ji A Hong ),조민수 ( Min Sue Cho ),손동휘 ( Dong Hwi Son ),신헌석 ( Heon Seock Cynn ) 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.1

The purpose of this study was to identify the effects of manual facilitation and a stick on lumbar and hip joint flexion angles in subject with lumbar flexion syndrome during forward bending from a sitting position. Fifteen subjects with lumbar flexion syndrome were recruited for this study. As a pretest, all subjects performed three repetitions of bending the trunk forward until the tips of their fingers touched the target bar. After this pretest, the subjects practiced the forward bending of the trunk 10 times, using either manual facilitation or a stick. Then, as a posttest, all subjects repeated the pretest procedure. The flexion angles of lumbar spine and hip joint during forward bending in a sitting position were measured using a three-dimensional motion analysis system. A paired t-test was used to determine the statistical differences between pre-test and post-test flexion angles and pre- and post-test flexion angle differences between forward bending with manual facilitation and forward bending with a stick. The level of statistical significance was set at p=.05. The results of the study showed that the angle of the lumbar flexion decreased significantly and the bilateral hip flexion angle increased significantly when performing forward bending with stick and manual facilitation. Furthermore, the angle of lumbar flexion decreased significantly and the angle of bilateral hip flexion increased significantly in forward bending with a stick compared to forward bending with manual facilitation. The findings of this study indicate that both forward bending with manual facilitation and sticks could be used to prevent excessive lumbar flexion and increase hip flexion, and that forward bending with a stick is more effective than forward bending with manual facilitation for inducing lumbar spine and hip joint angle changes.

팔꿉관절 가쪽위관절 통증 환자에서 근위방향 가능적 마사지를 이용한 노쪽 손목 폄근 신장운동이 통증과 근력에 미치는 효과

정성대(Sung-dae Choung),하성민(Sung-min Ha),김수정(Su-jung Kim),박규남(Kyue-nam Park),권오윤(Oh-yun Kwon) 한국전문물리치료학회 2012 한국전문물리치료학회지 Vol.19 No.1

The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia, Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.

젊은성인 엄지발가락가쪽휨증의 발허리발가락관절 각도와 엄지벌림근의 관계

강선영,정성대,김문환,전혜선,Kang, Sun-Young,Choung, Sung-Dae,Kim, Moon-Hwan,Jeon, Hye-Seon 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.2

Purpose: The aim of this study was to investigate relationship between the angle of the first metatarsophalangeal joint (1st MPJ) and the dimensions of the abductor hallucis; dorso-plantar (DP) thickness, medio-lateral (ML) width, and cross-sectional area (CSA), in subjects with and without hallux valgus. Methods: Sixty feet, mean (SD) age of 22.5 (2.1) years old, were included in this study (hallux valgus = 30; control = 30). An X-ray device was used for measurement of the angle of the 1st MPJ, and an ultrasound system was used for determination of mean (SD) DP thickness, ML width, and CSA of the abductor hallucis muscle in each foot from three trials. Results: The results showed the DP thickness, ML width, and CSA of the abductor hallucis did not differ significantly between subjects with and without hallux valgus. In addition, the correlations between the angle of the 1st MPJ and DP thickness, ML width, and CSA of the abductor hallucis showed poor correlation (Pearson r=-0.09, -0.20, and -0.18, respectively). Conclusion: Based on these findings, we speculate that morphological changes to the abductor hallucis muscle cannot be representative of the angle of the 1st MPJ, and also cannot be used in differentiation between subjects with and without hallux valgus.

헤드 마운티드 디스플레이 착용이 목 관절가동범위와 목 근육 두께 및 통증에 미치는 융합연구

오소현,정성대,심재훈,양노열,Oh, So-Hyun,Choung, Sung-Dae,Shim, Jae-Hoon,Yang, No-yul 한국융합학회 2020 한국융합학회논문지 Vol.11 No.9

본 연구는 헤드 마운티드 디스플레이(Head-Mounted Display; HMD) 사용이 건강한 젊은 성인들의 목관절가동범위(CROM)와 목 근육 두께 및 통증에 미치는 영향을 분석하였다. HMD 군(남자 16명, 여자 7명)은 HMD를 착용하고 30분 동안 정해진 영상을 시청하도록 하였다. 대조군(남자 15명, 여자 8명)은 HMD군과 동일한 자세로 HMD 착용없이 30분 동안 앉아있게 하였다. 실험 전·후에 목관절가동범위, 위등세모근과 어깨올림근의 두께와 압력통증역치를 측정하고 대응표본 t검정과 독립 t검정으로 분석하였다. HMD 군의 목관절가동범위와 양쪽 위등세모근과 어깨올림근의 압력통증역치는 사전 검사 보다 유의하게 감소하였고(p<.05), 양쪽 위등세모근의 두께는 유의하게 증가하였고(p<.05). 반면에, 대조군은 목관절가동범위, 근육 두께 및 압력통증역치에서 유의한 차이가 없었다(p>.05). 분석 결과, 장시간 HMD 사용은 목관절가동범위와 압력통증역치를 감소시키고 근육을 비대하게 하여 목과 어깨의 근골격계 질환을 야기할 수 있으므로, 본 연구는 올바른 자세를 유지하며 적절한 시간 동안만 HMD를 사용할 것을 권장한다. The purpose of this study was to evaluate the effects of wearing Head-Mounted Display (HMD) on the cervical range of motion (CROM), neck muscle thickness, and pain in healthy young adults. The HMD group(male=16, female=7) was asked to perform sitting comfortably in a backless chair with hands on their knees with the HMD was worn on their heads to watch the video for 30 minutes. The control group(male=15, female=8) was asked to sit in the same posture as the HMD group for 30 minutes. CROM, neck muscle thickness, and pressure pain threshold (PPT) of both the upper trapezius and levator scapulae were measured before and after intervention. CROM and PPT of the upper trapezius and levator scapulae in the HMD group were significantly decreased and the thickness of the muscles in the HMD group were significantly increased more than in the pre-test (p<.05). There was no significant difference in CROM, muscle thickness, and PPT in the control group. Wearing HMD for a long time can cause a decrease in CROM and PPT and an increase in muscle thickness, and there is a risk of developing musculoskeletal disorders in the neck and shoulder. Therefore, this study recommends maintaining the correct posture of the neck and shoulder and using HMD only for an appropriate time.

푸시업플러스 시 근전도 바이오피드백을 이용한 전거근의 선택적 강화

전용진 ( Yong Jin Jeon ),정성대 ( Sung Dae Choung ),김시현 ( Si Hyun Kim ),신헌석 ( Heon Seock Cynn ) 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.1

Push-up plus has been advocated for increasing the activity of the serratus anterior muscle, the most critical scapular stabilizer. However, no previous study has reported the possibility of compensatory motion on the part of the pectoralis major, which could substitute for the action of the serratus anterior during push-up plus. The aim of the current study was to investigate the immediate effect of electromyography (EMG) biofeedback of the pectoralis major muscle on the pectoralis major, upper trapezius, and serratus anterior muscles during push-up plus. Fourteen healthy young subjects voluntarily participated in this study; each subject performed push-up plus from the quadruped position, in two conditions (i.e., with or without visual and auditory biofeedback). Surface EMG was used to measure pectoralis major, serratus anterior, and upper trapezius activity. A paired t-test was used to determine any statistically significant difference between the two conditions. Additionally, effect size was calculated to quantify the magnitude of EMG biofeedback in each muscle. Visual and auditory feedback reduced pectoralis major muscle activity significantly (p=.000) and increased the serratus anterior muscle activity significantly (p=.002), but did not induce a significant difference in upper trapezius muscle activity (p=.881). Thus, it is concluded that the visual and auditory feedback of pectoralis major muscle activity can be used to facilitate serratus anterior muscle activity during push-up plus.

엄지발가락가쪽휨증의 발가락벌리기 운동 시 초음파 영상을 이용한 시각적 피드백의 효과

강선영 ( Sun Young Kang ),정성대 ( Sung Dae Choung ),심재훈 ( Jae Hoon Shim ) 한국전문물리치료학회 2016 한국전문물리치료학회지 Vol.23 No.3

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than 15° angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

5분 동안 바로 앉은 자세와 구부린 앉은 자세 시 허리 관절재위치 오류의 비교

지명기(Myung-ki Ji),정성대(Sung-dae Choung),박규남(Kyue-nam Park),권오윤(Oh yun Kwon) 한국전문물리치료학회 2013 한국전문물리치료학회지 Vol.20 No.2

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion 0°). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

가상현실을 이용한 흡기근 저항운동이 흉곽 움직임 제한이 있는 여성환자의 가로막 움직임과 호흡기능에 미치는 영향

장명수 ( Myung-soo Jang ),정성대 ( Sung-dae Choung ),심재훈 ( Jae-hoon Shim ),홍성태 ( Seong-tae Hong ) 대한물리의학회 2019 대한물리의학회지 Vol.14 No.1

PURPOSE: This study was conducted to analyze the effects of virtual reality inspiratory muscle training and conventional inspiratory muscle training on diaphragm movement and pulmonary function in patients with thoracic restriction. METHODS: This study measured diaphragm movement, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and thoracic mobility (upper, middle, and lower trunk) under two different conditions. Forty young women between 19 and 24 years of age who had no history of orthopedic symptoms for the last 6 months were divided into experimental and control groups. The experimental group performed virtual reality inspiratory muscle training and diaphragm breathing, and the control group performed conventional inspiratory muscle training and diaphragm breathing. RESULTS: The control group showed a significant increase in all dependent variables except for lower trunk mobility and PEF. The experimental group showed a significant increase in all dependent variables except for lower trunk mobility. Particularly, the experimental group showed significant increases in diaphragm movement (p<.05), FVC (p<.05), FEV1 (p<.05), and PEF (p<.05) relative to the control group. CONCLUSION: We recommend inspiratory muscle training with a virtual reality program over conventional training to improve diaphragm movement and pulmonary function in patients with thoracic restriction.