측방보행 훈련이 급성기 뇌졸중 환자의 균형 자신감, 낙상 효능감, 낙상 위험도에 미치는 영향: 무작위 대조 예비 연구

주민철,정경만,Joo, Min-Cheol,Jung, Kyeoung-Man 한국의료질향상학회 2021 한국의료질향상학회지 Vol.27 No.1

Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.

휠체어 이동 및 조작 훈련을 통한 모의 대피훈련 향상 활동의 효과

주민철,정유진,채수민,조성태,Joo, Min-Cheol,Jung, Yu-Jin,Chae, Su-Min,Cho, Sung-Tae 한국의료질향상학회 2020 한국의료질향상학회지 Vol.26 No.2

Purpose: The purpose of this study was to determine the effect of simulation evacuation training improvement activity through wheelchair skill training. Methods: The study included 40 patients with early stroke who were randomly allocated to a wheelchair skill training group (Experimental group, n=20) and a general exercise group (Control group, n=20). Both groups performed the exercise 3 times a week for 3 weeks. Outcomes were assessed using Wheelchair Skills Test Skills Performance (WSTSP), Wheelchair Skills Test Skills Safety (WSTSS) and Wheelchair Propulsion Velocity (WPV). Results: After 3 weeks of training, both groups showed significantly improved WSTSP, WSTSS and WPV (p<.01 in both groups). However, the WSTSP, WSTSS and WPV in the experimental group were very significantly better than in the control group (p<.01). Conclusion: These findings indicate that wheelchair skill training may be effective at improving wheelchair skill ability and wheelchair propulsion velocity in stroke patients who cannot walk independently. Therefore, short-term wheelchair skill training could be useful for patient safety in simulated evacuation situations.

의료정보 표준화 동향

주민철,조상욱,이용덕 한국정보과학회 2008 정보과학회지 Vol.26 No.6

Changes in the Muscarinic Receptors on the Colonic Smooth Muscles of Rats with Spinal Cord Injury

주민철,김용성,최을식,오정택,Hyun Joon Park,이문영 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.5

Objective To investigate changes in (1) the colonic response to acetylcholine (Ach), (2) the muscarinic (M)receptors in the colon, and (3) the levels of colonic contraction-related proteins after a spinal cord injury (SCI). Method We divided 16 Sprague-Dawley rats into 2 groups: the control group and the SCI group. A spinal cord transection was performed surgically at the T10 vertebral level. After 1 week, the entire colon was divided into 2segments, the proximal and distal colon. Each segment was mounted in a longitudinal or circular muscle direction in a 10-ml organ bath. We determined the intergroup differences as percentage changes in contractility after Ach treatment alone, Ach treatment with M2 receptor antagonist (AQ-RA741) pretreatment, and Ach treatment with M3 receptor antagonist (4-DAMP) pretreatment. Western blot analyses were performed to determine the expression level of RhoA, and heat shock protein 27 (HSP27). Results Compared to the control rats, the SCI rats showed an increased response to Ach along both the directions in the proximal colon (p<0.05). Compared to the control group, in the SCI group, the Ach response was signifi cantly diff erent in the proximal segment under AQ-RA741 pretreatment (p<0.05) and in the distal segment under 4-DAMP pretreatment (p<0.05). Findings of the western blot analyses showed a signifi cant decrease in the level of protein gene product 9.5 in the proximal and distal colon and a signifi cant increase in the level of RhoA and HSP27 in the proximal colon of the SCI rats. Conclusion Our results suggest that changes in colonic contractility after SCI are partly attributable to changes in the M receptor subtypes.

척수 손상 흰쥐의 대장에서 테트로드톡신 민감성 억제 신경계의 변화

주민철,이승회,오정택,조향정,박효인,임유현,최석채,이문영 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.4

Objective: To investigate the effect of spinal cord injury (SCI) on contractions of whole colonic preparation isolated from rats under the inhibition of nitrergic inhibitory neural system using tetrodotoxin (TTX). Method: Twenty Sprague-Dawley rats were used. A complete spinal cord transection was performed surgically at the T10 cord level in spinal cord injured group. After 1 week of operation, sensory and motor functions were assessed and colon was removed under anesthesia for in vitro motility study. Whole colon was divided into four segments: proximal, two mid colon and distal colon. Each segment of colon was mounted with longitudinal direction in a 10 ml organ bath. After 1 hour of equilibration, frequency, area under the curve of spontaneous contraction and the response to acetylcholine (Ach), KCl and TTX were measured in each segment. Also the responses to Ach and KCl response under TTX pretreatment were measured. Results: Enhanced contractile response to KCl solution (40 mM), TTX (1 μM) and Ach (10−6 M) was observed in both group. There was no statistical difference in spontaneous, Ach and KCl induced contraction between control and SCI rats, but TTX induced contraction was decreased in SCI group than control group (p<0.05). In addtion, the Ach and KCl responses under the TTX pretreatment were significantly decreased in SCI group than control group (p<0.05). Conclusion: These results suggest that the change of colonic contractility after the SCI is caused by at least partly from the change of TTX related inhibitory neural system. (J Korean Acad Rehab Med 2010; 34: 387-393)

하지마비 환자에서 수근관증후군의 초음파적 소견

주민철,양충용,김태진,송재은,박순아,조해중,길은영,신용일 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.2

Objective: To assess the diagnostic value of ultrasonography for the median nerve, the state of life style activities and the pain degree of upper extremities in paraplegics with carpal tunnel syndrome (CTS). Method: Eighteen wheelchair ambulators with spinal cord injury who had neurological level below T2 were studied. Patients with peripheral or central neuropathies were excluded. Patients were assigned to either the electrodiagnostic CTS (group CTS, 7) or electrodiagnostically negative (group non- CTS, 11), and healthy volunteers (15) were classified as control group. The cross sectional area of the median nerve (MN-CSA) at carpal pisiform level was ultrasonographically measured. The degree of painful restriction to execute ADL by hands (TR-ADL), the pain grade (visual analog scale, VAS) of upper extremities and revised version of Korean spinal cord independence measure (KSCIM-R) for functional level were measured and analyzed. Results: Nine hands (14.3%) of 7 patients out of 34 hands had CTS in electrodiagnostic study. There were significant difference among groups in TR-ADL hours (CTS group; 5.0 vs non-CTS group; 10.2, p<0.05), VAS (4.1 vs 2.0, respectively, p<0.05), and no statistical difference in KSCIM-R (68.4 vs 52.1, p>0.05), MN-CSA (12.3 mm2 vs 7.9 mm2 vs control group; 8.0 mm2, p<0.05). Using the ROC curve, the cut-off value of MN-CSA produced 8.5 mm2 providing a diagnostic sensitivity of 77.8% and specificity of 59.6%. Conclusion: The ultrasonographic measurement of the median nerve may be a useful non-invasive screening test for the diagnosis of CTS in paraplegic patients with wrist pain.

고위험군 신생아의 뇌간 청각유발전위 검사 및 시각유발전위 검사

주민철,김동훈,임성일,서혜정,이석재 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.3

전기자극이 척수손상 대장의 pCaldesmon 발현에 미치는 영향

주민철,한용재,김태진,유수진,김용성,이문영 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.2

Objective: To find out whether electrical stimulation affects intracellular signaling mechanisms that link the biochemical and mechanical events of smooth muscle contraction. Method: A total of 31 adult Sprague-Dawley female rats were divided into 3 groups: control group, spinal cord injury (SCI) only group, and spinal cord injury with electrical stimulation (SCI+ES) group. Complete spinal cord transection was performed surgically at T10 cord level. The electrode for electrical stimulation was implanted into sacral spinal cord region (S2-4). Electrical stimulation was applied 4 hours per day from the day of operation. Results: In SCI+ES group, the weights of fecal pellet were significantly higher from the 3rd day of post-operation to the 6th day than the SCI only group. The numbers of pERK 1/2 immunoreactive cells significantly increased in all colon segments of the SCI+ES group but had decreased in the SCI only group. Western blot showed the stronger bands of phosphorylated ERK1/2 in all colon segments and also phosphorylated caldesmon in mid or distal colon segments in the SCI+ES group. Conclusion: These results suggest that electrical stimulation to sacral plexus region activate phosphorylation of ERK1/2 and caldesmon which leads to improvement of bowel function by promotion of secretion or motility in the colon. Objective: To find out whether electrical stimulation affects intracellular signaling mechanisms that link the biochemical and mechanical events of smooth muscle contraction. Method: A total of 31 adult Sprague-Dawley female rats were divided into 3 groups: control group, spinal cord injury (SCI) only group, and spinal cord injury with electrical stimulation (SCI+ES) group. Complete spinal cord transection was performed surgically at T10 cord level. The electrode for electrical stimulation was implanted into sacral spinal cord region (S2-4). Electrical stimulation was applied 4 hours per day from the day of operation. Results: In SCI+ES group, the weights of fecal pellet were significantly higher from the 3rd day of post-operation to the 6th day than the SCI only group. The numbers of pERK 1/2 immunoreactive cells significantly increased in all colon segments of the SCI+ES group but had decreased in the SCI only group. Western blot showed the stronger bands of phosphorylated ERK1/2 in all colon segments and also phosphorylated caldesmon in mid or distal colon segments in the SCI+ES group. Conclusion: These results suggest that electrical stimulation to sacral plexus region activate phosphorylation of ERK1/2 and caldesmon which leads to improvement of bowel function by promotion of secretion or motility in the colon.

아급성기 뇌졸중 환자에서의 상지 재활 로봇 치료의 효과

주민철,박효인,노세응,김지희,김현준,장철환 대한뇌신경재활학회 2014 뇌신경재활 Vol.7 No.2

Objective: To investigate the effects of robot-assisted arm training on motor and functional recovery of upper limb in patients with subacute stroke. Method: Thirty one subacute stroke patients were randomly divided into 2 groups. Robot-assisted arm training group received robot-assisted therapy using ArmeoⓇSpring (Hocoma Inc., Zurich, Switzerland) for thirty minutes per day and five times every week during four weeks while control group received conventional arm training with same duration and frequency as robotic group. Outcome measures were used manual muscle test (MMT) for motor strength, Fugl-Meyer assessment (FMA), Manual function test (MFT) for arm function, Korean-modified Barthel index (K-MBI) for activities of daily living, Korean-mini mental state examination (K-MMSE) and Computerized Neuro-Cognitive Function test software-40 (CNT-40) for cognitive function. All recruited patients underwent these evaluations before and after four weeks robot-assisted arm training. Results: Robot-assisted training on upper limb after subacute stroke showed improvement on motor strength, arm function, and activities of daily living. But change values in terms of MMT, FMA, MFT, K-MBI exhibited a no statistically significant difference compared with conventional group (p>0.05). Conclusion: In patients with upper limb deficits after subacute stroke, Robot-assisted arm training was considered to facilitate motor and functional recovery of upper limb. But robot-assisted arm training did not significantly improve motor and arm function at 4 weeks compared with conventional arm training group. Further research is required about the comparison of conventional rehabilitation therapy group and the questions about the duration, severity of stroke.

선천성 근성 사경의 보존적 치료 결과와 초음파 소견

주민철,길은영 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.2