뇌졸중으로 인한 편마비 환자의 슬괵근 유연성과 보행능력에 대한 신경가동기법, 정적 신장기법 및 수축-이완기법의 즉각적 효과 비교

김용정 ( Yong Jeong Kim ),김택연 ( Taek Yean Kim ),김선엽 ( Suhn Yeop Kim ),오덕원 ( Duck Won Oh ) 대한물리의학회 2011 대한물리의학회지 Vol.6 No.4

Purpose:The purpose of this study is to compare the initial effect of nerve mobilization (NM), static stretching (SS), and contract-relax (CR) techniques to find the best method in improving hamstring flexibility and gait function in patients with hemiplegia. Methods:Eleven patients with hemiplegia were included in this study. Passive knee extension (PKE) range of motion and the sit and reach (SR) test were used to measure hamstring flexibility, while timed up and go (TUG) and the 10m walking (10MW) test were used to measure the subject`s gait. Measurements on each test were assessed prior to the experiment, immediately following the experiment, and 30 minutes after the experiment. Analysis of the results utilized a repeated measures analysis of variance to examine hamstring flexibility and the difference in walking ability. Results:The results suggest significant increases in NM, SS, and CR techniques as they relate to hamstring flexibility (p<.05) following (both immediate and 30 minutes post experiment) PKE range of motion and the SR test, but post-hoc showed no significant difference between the three techniques (p>.05). Additionally, the results suggest significant increases in NM, SS, and CR techniques as they relate to gait function (p<.05) following the TUG test, but found no significant difference in the 10MW test (p>.05). Post-hoc analysis between the three techniques suggests that only the NM technique significantly changed gait function. The time of TUG and 10MW test showed no significant difference between the three techniques before an experiment, just after an experiment, and 30 minutes following the experiment according to the measurement points in time (p>.05). Conclusion:This study suggests NM, SS, and CR techniques immediately improve hamstring length and flexibility while improving gait function in patients with hemiplegia.

한국판 공포-회피 반응 설문지의 신뢰도와 타당도

주명규 ( Myung Kyu Joo ),김택연 ( Taek Yean Kim ),김진택 ( Jin Taek Kim ),김선엽 ( Suhn Yeop Kim ) 한국전문물리치료학회 2009 한국전문물리치료학회지 Vol.16 No.2

초음파에 의한 전완 국소 온도와 정중 운동 신경전도 속도의 변화

전차선,김택연 대한정형도수치료학회 2006 대한정형도수물리치료학회지 Vol.12 No.1

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The purpose of this study was to determine the biophysical effects of continuous ultrasound on median local forearm temperature and motor nerve conduction velocities using frequencies of 3.0 MHz. SUBJECTS: Twelve healthy subjects (6 males, 6 females, age 22.30±2.41 yrs, weight 61.33±10.16 kg, height 167.58±8.04 cm) without a history of neurological or musculoskeletal injury to their dominant arm volunteered for this study. METHODS AND MATERIALS: Each subject received a total of five treatments, one each at .0, 0.5, 1.0 ,1.5, 2.0 W/㎠ of 3 MHz continuous ultrasound on the anterior surface of the middle area of dominant forearm for 10 minutes. Dependent measures for forearm local temperature and median motor nerve conduction velocity (MNCV) were taken pretreatment and immediately post-treatment. One-way ANOVA were used for each dependent measure. RESULTS: The posttreatment forearm local temperature were differed significantly (p<0.00l) between intensities of ultrasound. The posttreatment forearm local temperature of the ultrasound treated with 1.0 w/㎠, 1.5 w/㎠ and 2.0w/㎠ were significantly higher than 0.5 w/㎠ and 0.0w/㎠ of ultrasound (p<0.05). The posttreatment median MNCV were differed significantly from the respective pretreatment velocities (p<0.001). The MNCV of the ultrasound treated with 0.0 w/㎠ and 0.5 w/㎠ were significantly (p<0.05) slower than that observed pretreatment, while the three ultrasound intensities produced significantly increased posttreatment MNCV: 1.0 w/㎠ and 1.5 w/㎠ and 2.0 W/㎠. The posttreatment MNCV at 2.0 w/㎠ and 1.5 w/㎠ was significantly faster than that at 0 w/㎠, 0.5 w/㎠ and 1.0 w/㎠ (p<0.05), the MNCV at 1.0 w/㎠ was significantly faster than that associated with 0 w/㎠ and 0.5 w/㎠ of ultrasound (p<0.05). CONCLUSIONS: The decreased median motor forearm local temperature and MNCV of the ultrasound treated with 0.0 w/㎠ and 0.5 w/㎠ were attributed to the cooling effect by ultrasound transmission gel. Local forearm temperature and nerve conduction velocity were directly related to the intensity of ultrasound. Alterations in MNCV from ultrasound on healthy nerves appeared to be related to temperature changes induced by thermal effects of ultrasound.

무릎관절 각도가 발목 근육의 근전도 활동에 미치는 영향

유경석,김택연 대한정형도수치료학회 2006 대한정형도수물리치료학회지 Vol.12 No.1

The purpose of this study was to investigate the influence of the various knee angles and ground state on the muscular activities and fatigue of the ankle muscles by integrated electromyograms (iEMG) and median frequency of tibialis anterior (TA), peroneus longus (PL), flexor digitorum longus (FDL) and gastrocnemius (GC). Ten healthy male subjects were participated into stable and balance ball sessions at four angles of knee joint. The surface electromyograms (sEMG) were recorded from the TA, PL, FDL and GC on stable and balance ball with full weight bearing at four knee angles of 0˚, 15˚, 30˚ and 45˚. The time serial data of the surface electromyographic signals were transformed into integrated and frequency serial data by fast fourier transformation. On the stable ground, the iEMG signals of the TA, PL, FDL and GC were significantly higher at 45˚ and 30˚ of knee angles than 0˚ and 15˚ of knee flexion (p<0.05). On the balance ball, the iEMG of the TA, PL, FDL and GC were significantly higher at 45˚ and 30˚ of knee angles than 0˚ and 15˚of knee flexion (p<0.05). The median frequency of the TA, PL, FDL and GC were significantly lower at 45˚ and 30˚ of knee angles than 0˚ and 15˚ of knee on the stable ground (p<0.05). On the balance ball, also the median frequency of the TA, PL, FDL and GC were significantly lower at 45˚ and 30˚ of knee angles than 0˚ and 15˚ of knee flexion (p<0.05). The iEMG of the TA, PL, FDL and GC were significantly higher on the balance ball at 0˚, 15˚, 30˚ and 45˚ of knee angles compared with stable ground. The median frequency of the TA, PL, FDL and GC were significantly lower on the balance ball at 0˚, 15˚, 30˚ and 45˚ of knee angles compared with stable ground. These results indicate that the ground conditions and angles of the knee joint involved to muscular activities and fatigue of ankles muscles, may performed at first on stable ground and then balance ball in order to 0˚, 15˚, 30˚ and 45˚ of knee flexion.

Dysfunction Syndrome을 가진 만성 요통환자의 요천골도수교정에 의한 자세의 변화 : 증례 보고 2

전차선,유경석,김택연 대한정형물리치료학회 2003 대한정형도수물리치료학회지 Vol.9 No.2

본 case study는 척추 관절에 변화를 일으켜 근육의 변화와 통증에 변화가 있는 지를 알아보기 위하여 dysfunction syndrome을 가진 5명의 만성 여성 요통환자의 single group에 Geenman의 impulse technique(glade5)을 1회 적용 후 Pain Scale와 IBS -2000를 사용하여 검사 하였다. - Pain Scale는 0 ~ 100 단계로 나누어 환자에게 직접 아픈 정도를 기입하게 하고 치료 후 재검사와 통증의 변화 정도를 기입하게 하였다. -lBS-2000는 체형 진단기로써 레이저를 이용하여 인체 근육의 경사도를 등고선으로 나타내는 측정기로서 주로 근 Balance와 체형의 균형을 알아보는 기구이다. 측정 방법은 후두-견봉의 각도, C7-견봉의 각도, L4 -S2의 각도, 전 후만의 비, 척추의 기울기를 측정하였다. 자료 분석은 Pained T - test을 하였다. 이 측정치의 결과로 Dysfunction syndrome을 가진 요통환자의 척추 및 근 평형성의 다음과 같은 결과를 얻었다. 1. 주관적인 통증 변화는 교정 전 407.07 였고, 교정 후 309.24로 p<0.05를 보여 유의한 차이가 있었다. 2. 객관적인 측정으로써 후두 -견봉의 각도 변화는 교정 전 왼쪽 362.60, 오른쪽 373.16 였다. 교정 후 왼쪽 33.704.31, 오른쪽 353.05로 p>0.05를 보여 각도의 변화는 보이나 유의한 차이를 보이지 못 하였다. 3. C7 -견봉 각도의 변화는 교정 전 왼쪽 173.73, 오른쪽 175.30 였다. 교정 후 왼쪽 162.55, 오른쪽 172.07로 p>0.05를 보여 각도의 변화는 보이나 유의한 차이를 보이지 못 하였다. 4. 요추 골반의 각도 변화는 왼쪽 19.58 2.75, 오른쪽 20.13 2.75 였다. 교정 후 왼쪽 19.793.33, 오른쪽 21.094.51로 p >0.05를 보여 각도의 변화는 보이나 유의한 차이를 보이지 못하였다. 5. 척추의 전·후만 깊이의 변화는 교정 전 TTD는 2.20 1.44cm , TLD는 2.070.53cm 였고 교정 후 TTD는 2.19 0.49cm , TLD는 1.880.11cm 로 수치의 변화를 보이나 p>0.05로 유의한 차이는 없었다. 6. 척추의 전·후만 비의 변화는 교정 전 TTDR은 0.560.20, TTDR은 0.430.02 였고 교정 후 TTDR은 0.630.02, TLDR은 0.350.02로 변화를 보이나 유의한 차이는 없었다. 7. 척추의 기울기의 변화는 교정전 XD/YD는1.720.77, 교정 후 0.900.41로 수치의 변화는 보이나 유의한 차이를 보이지 못하였다. 전체적인 평형성의 수치를 보이나 유의한 차이는 보이지 못 하였다.