성인 편마비 환자의 균형 및 운동 기능평가를 위한 신뢰도 연구

정지운(Jung Jee-Woon),김희수(Kim Hee-Soo) 대한치료과학회 2016 대한치료과학회지 Vol.8 No.1

Objective: The aim of this study was to examine inter-rater reliability of the TIS(Trunk Impairment Scale), K-BBS (K-Berg Balance Scale) and RMI (Rivermead Mobility Index) based on video clips. In additions, the test-retest reliability of the K-BBS, TIS and RMI was evaluated according to the 1st test and 2nd test. Method: We evaluated the 33 hemiplegic patients video (male 22, female 11, range of age 53.45±2.45) with stroke for intra-rater reliability. Six experienced physical therapists and one medical doctor attended education sessions about the scoring system. They scored simultaneously by watching the video clips that recorded another therapist’s examination with patients. To examine the test-retest reliability, it was measured twice on 14 separate days. Intraclass correlation coefficients (ICC)s were analyzed to determine the intra-rater and test-retest reliability. Results: Test-retest reliability values of TIS was .908 were also high, intraclass correlation coefficient (ICC3,1) varying from .979-.993. Intra-rater reliability values of the TIS, K-BBS and RMI were mostly high, varying from .931-.993, .976-.996, 1.000-1.000. Conclusion: The TIS, BBS and RMI were shown to be reliable tools to measure quantity and quality of functional status for hemiplegic patients. Video scoring was time-consuming, but was found to offer many advantages; the possibility to review performance, to use special trained raters for scoring and less demanding assessment for the patients. In addition, research on the reliability and validity of the assessment tool for objective assessment and treatment of patients should be continued in the future.

뇌성마비 아동의 대동작운동기능 수준에 따른 흉곽발달 양상

정지운,고주연,Jung, Jee Woon,Ko, Joo Yeon 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.5

Purpose: The purpose of this study was to provide quantitative data regarding development of the chest wall in children with cerebral palsy (CP) according to Gross Motor Function Classification System (GMFCS) levels and age using the radiological image diameter measurement method. Methods: Subjects included 112 children with CP and 110 healthy children, All of the children underwent simple chest x-ray. The diameters of the upper chest ($D_{apex}$) and lower chest ($D_{base}$) were measured on the anteroposterior (AP) view of a chest x-ray, and the $D_{apex}$ to $D_{base}$ ratio was calculated. Chest wall ratios were compared among children with CP at GMFCS levels I ~ III, GMFCS levels IV and V, and healthy children. Results: The results showed significant differences between the upper and lower chest wall diameters of children with CP at GMFCS levels IV and V, and healthy children (F=4.54, p=0.01; F=3.20, p=0.04). Results of comparison between the chest wall ratios of children with CP and healthy children, showed that the upper chest walls of healthy children were significantly larger in children younger than 48 months (p<0.05), and both the upper and lower chest walls of healthy children were significantly larger compared to children with CP in children older than 48 months (p<0.05). Conclusion: Radiographic measurement for examination of chest wall development is relatively simple, and the results yield quantitative data on development of the chest wall for children with CP. In addition, therapeutic interventions may be considered based on the results.

뇌졸중 환자의 동적 균형 및 몸통 균형에 대한 GAS와 FAC상관관계 연구

안병태(An byeung-Tae),정지운(Jung Jee-Woon) 대한치료과학회 2021 대한치료과학회지 Vol.13 No.1

Objective: Neurological intervention for neurological patients requires Evidence Base of Practice and should be able to judge its effectiveness by evaluating the outcome of the treatment. The verification of the treatment effect should be able to evaluate whether or not the treatment goal has been achieved, and a Goal Attainment Scaling (GAS) evaluation tool can be used. Correlation between TIS and BBS in stroke patients according to FAC We would like to investigate the correlation with GAS a tool for evaluating achievement of treatment goals. Methods: TIS of inpatients at C General Hospital in Gyeonggi-do. BBS. FAC. Before GAS treatment. Statistical analysis was performed based on the evaluation data after treatment. Results: As a result of the analysis, GAS had a significant correlation with changes in TIS and BBS and FAC Conclusion: There is a correlation between TIS and BBS according to the FAC. The higher the FAC index, the higher the correlation with TIS and the GAS achievement index.

시각적 자극 높이가 뇌성마비 아동의 보행에 미치는 영향

김아람(Kim A Ram),정지운(Jung Jee Woon),고태성(Ko Tae Sung) 대한치료과학회 2017 대한치료과학회지 Vol.9 No.1

Objective: The purpose of this study was to investigate the influence on walking according to the position of the head and the stability of the torso when visual stimulation are provided from the head (upper), and the foot (lower). Method: When walking the treadmill to five children with cerebral palsy capable of independent walking, visual stimulation is provided at a distance of 60 cm horizontally from the head (upper) and feet (lower) of the child to identify the walking element. Results: Stride length was higher when the height of the visual stimulus was located on the head (upper), and the step width was lower when the visual stimulus was provided on the head (upper) And Cadence was low when visual stimuli were provided in the head (upper). Conclusion: It is believed that walking ability can be improved when the visual stimulus height is provided in the head (upper) than when the height is provided in the foot (lower) for children with cerebral palsy.

시간차 회상 훈련을 병행한 운동프로그램이 치매노인의 일상생활동작, 우울, 인지에 미치는 영향

이호산나(Lee Hosanna),김형근(Kim Hyung Geun),정지운(Jung Jee Woon),김성신(Kim Sung-Shin) 대한치료과학회 2019 대한치료과학회지 Vol.10 No.2

Objective: The purpose of this study was to compare the effects of exercise program combined with spaced retrieval and exercise program to show the effects on elderly people with dementia by presenting them to clinics and welfare facilities such as long-term care facilities. Method: This study was conducted in 20 elderly patients with dementia and randomly assigned to exercise program combined with spaced retrieval and exercise program. After screening the subjects for compliance with the criteria, Before starting the experiment, activites of daily living, depression, and nitive evaluation were performed. After 8 weeks, 3 times per week, 40 minutes per intervention, and 4 and 8 weeks, respectively K-MBI, GDSSF-K and MMSE-K were used to evaluate the differences between the experimental and control groups. Results: There was no statistically significant difference in the daily activities, depression, and cognitive scores between the groups of exercise program combined with spaced retrieval and exercise program group. However, there was a significant difference between the two groups after training (p<.05). Particularly, there was statistically significant difference in post-training cognitive evaluation (MMSE-K) only in the exercise program combined with spaced retrieval group (p<.05) Conclusion: This study suggests that exercise program combined with spaced retrieval is more effective in improving cognitive ability. This suggests that the exercise program combined with spaced retrieval is more effective.

장애아동의 치료 시 자세에 따른 물리치료사의 허리 근육 활성도 변화

김선정(Kim Seon Jeong),이주상(Lee Ju Sang),정지운(Jung Jee Woon),이형진(Lee Hyung Jin) 대한치료과학회 2016 대한치료과학회지 Vol.8 No.2

To evaluate the waist muscle activity changes depending on the distance of the child with disabilities and physical therapist. Method: we were classified in physical therapist treatment posture when the child with disabilities lying down, sitting, and standing. And classified posture measured the erector spinae muscle activity. The muscle activity was analyzed using one-way ANOVA. Results: The average of right erector spinae muscle activity is, Lying=48.82 ± 9.95 %, Sitting=39.01 ± 8.73 %, was a Standing=29.54 ± 6.90 %(p<.05). The average of left erector spinae muscle activity is, Lying=47.85 ± 8.85 %, Sitting=39.74 ± 8.68 %, was a Standing=30.50 ± 7.84 %(p<.05). Conclusion: In order to improve the working environment of physical therapists need to devise a way to increase the height of the treatment units. Therapists need to be encouraged to keep themselves right back erected posture.

뇌성마비 아동의 활동 중심으로한 하지 근력 강화 운동 효과

김지훈(Kim Jie-Hoon),고주연(Ko Ju-Yeon),정지운(Jung Jee-Woon) 대한치료과학회 2015 대한치료과학회지 Vol.7 No.2

Objective: The purpose of this study was to examine the effects of activity-focused strengthening in the lower extremity in children with cerebral palsy. Method: The study participants were sixteen children with Gross Motor Function Classification System (GMFCS) Levels Ⅰ, Ⅱ, and Ⅲ for cerebral palsy undergoing training at ‘P priviate center.’ They undertook training once daily for 50 minutes, two days per week, for 8 weeks. Gross Motor Functional Measure 88 (GMFM-88) was used for function measurements, and the onset time of lower extremity muscle contracture was determined by electromyography (EMG). The onset times of contracture of the rectus femoris, biceps femoris, tibialis anterior and soleus were determined during a sit-to-stand exercise. Results: All GMFCS level Ⅰ, Ⅱ, and Ⅲ children showed significant improvement in GMFM-88 Items C, D, and E after the experiment. GMFCS level Ⅱ children showed onset times of muscle contracture comparable to those of typical children. Conclusion: Activity-focused strengthening training in the low extremity can improve GMFM-88 scores in GMFCS level Ⅰ, Ⅱ, and Ⅲ children with cerebral palsy and the onset time of muscle contracture in GMFCS level Ⅱchildren

뇌성마비 아동의 체간 전기 자극이 대동작운동기능과 체간근 활성화에 미치는 영향

정지운,송 브라이언 병 한국장애인재활협회 2012 재활복지 Vol.16 No.1

This study was designed to determine the effectiveness of functional electrical stimulation over the trunk in improving gross motor function and trunk muscle activity in children with cerebral palsy who displayed poor trunk control. The subjects were 20 children with cerebral palsy, who were in the age of 26 to 80 months and were randomized into two groups, functional electrical stimulation and control group. Both group had neuro-developmental technique(NDT) treatments for 4 weeks, Experimental group had additional Functional Electronic Stimulator(FES) over the abdomen and posterior back muscles. The control group had additional Transcutaneous Electronic Nerve Stimulator(TENS) over the abdomen and posterior back muscles. The gross motor function and trunk muscle activity was measured before and after the program. Surface electromyography studies were used on the trunk muscles activity while they were sitting before and after treatment. Gross motor function score-Gross Motor Function Measure(GMFM) was also used to evaluate the sitting posture. The following results were obtained. First, in comparison of the changes of muscle activity before and after experiment, experimental group was increased more than control group but there was significant difference between the two groups(p<.05). Second, in comparison of change of GMFM before and after experiment, experimental group and control group were increased in the all areas, but there was significant difference in sitting areas between the two groups(p<.05). This study suggests that functional electrical stimulation showed it can affect the sitting posture ability and trunk muscle activities. Therefore, it can be useful in trunk functional rehabilitation for the children with cerebral palsy. 본 연구는 앉기 자세와 체간근 조절의 어려움이 있는 뇌성마비 아동을 대상으로 체간근육에 기능적 전기 자극 적용 후 체간근 활성량과 대동작 기능에 미치는 영향에 대하여 연구하였다. 연구 대상은 평균 연령이 26월 이상부터 80개월 미만인 20명의 뇌성마비 아동을 대상으로 실험군과 대조군 각각 10명씩 무작위 배정을 하였다. 실험군과 대조군은 4주간 신경발달치료를 받았고, 실험군은 복부와 배부신전근에 기능적 전기 자극 치료를 추가적으로 적용하였다. 대조군은 경피신경자극과 신경발달치료를 적용하였다. 각 대상자는 실험전과 후에 체간 활성도와 대동작 운동기능을 측정하였고, 체간근 활성도는 표면 근전도를 통해 실험 전·후 앉기 자세동안 측정하였다. 대동작 운동기능 평가는 대동작 기능평가를 통해 측정하였고, 다음과 같은 결과를 얻었다. 첫째, 기능적 전기 자극이 뇌성마비 아동의 체간근 활성화에 미치는 효과를 알아보기 위해 실험 전․후 체간근 활성화의 변화를 비교해 본 결과, 실험군의 경우 체간근육 모두 활성도가 유의하게 증가하였고,(p<.05). 또한 두 집단 간 모든 체간 근육 중 오른쪽 목신전근을 제외한 체간근육에서 유의한 차이가 있었다(p<.05). 둘째, 기능적 전기 자극이 뇌성마비 아동의 대동작 기능 변화에 미치는 효과를 알아보기 위해 실험 전․후 대동작 기능평가의 변화를 비교해 본 결과, 실험군과 대조군의 모든 영역에서 점수가 증가하였고 실험군의 경우 모든 영역에서 유의하게 증가하였다(p<.05). 또한 두 집단 간 차이를 비교한 결과 앉기 영역에서만 유의한 차이가 있었다(p<.05). 이와 같은 결과로 볼 때, 뇌성마비 아동의 체간 기능적 전기 자극치료는 체간근 활성도와 대동작 기능에 치료적 효과를 제시하고 있으므로 뇌성마비 아동의 근 활성도 그리고 기능적 움직임 발달을 위한 재활치료서 적절하게 활용될 수 있다.