보행훈련방법이 편마비 환자의 보행요소와 족저압에 미치는 영향

김은정,황보각,권혁철 대구대학교 특수교육재활과학연구소 2009 再活科學硏究 Vol.27 No.2

이 연구는 뇌졸중으로 인한 편마비 환자에게 보행훈련방법을 달리하였을 때, 일반적인 지면과 트레드밀, 불안정면을 이용한 보행훈련이 보행요소와 족저압에 미치는 영향을 알아보기 위하여 편마비 환자 30명을 지면과 트레드밀, 불안정면 보행훈련군으로 무작위 배정하고 각 치료군들은 주 5회, 8주 간의 보행훈련을 실시하였다. 실험 전과 후, 보행요소를 알아보기 위하여 보행속도, 보장, 보각과 족저압을 측정하여 수집된 자료를 분석하여 다음과 같은 결과를 얻었다. 이 연구의 결과를 종합해 보면 보행훈련방법에 따라 지면 보행훈련은 보행속도와 족저압 전족부, 트레드밀 보행훈련군은 보행속도와 보각, 족저압 중족부, 불안정면 보행훈련군은 보행속도와 보장, 보각에서 유의한 증가를 보였다. 이러한 결과는 뇌졸중으로 인한 편마비 환자에게 보행훈련방법을 달리함에 따라 많은 영향을 끼치어, 환경의 변화와 다양한 과제에 대한 적절한 반응을 만들어 낼 수 있음을 의미하며, 기능 회복의 임상적 접근에서 치료 중재의 시점과 기간, 제공되는 환경, 과제의 선택에 대한 광범위한 연구가 필요할 것으로 생각되어진다. Purpose : This study was performed for effects of gait component and plantar foot pressure on gait training way needed in gait with hemiplegic patients caused by cerebrovascular accident. Methods : Three groups of adult hemiplegia(n=30) were allocated randomly in this study : group I(TGT : treadmill gait training), group II(USGT : unstable surface gait training) and group III(SGT : surface gait training). The gait training was provided to experimental groups for 8 weeks(5 times a week). Measurements of pre and post experiment were gait velocity, step length, toe out angle, foot plantar pressure which demonstrate temporal-spatial parameter of gait component. Results : The results of this study showed that in comparison of pre and post changes of gait training, SGT group has statistically significant differences in gait velocity, metatarsal area of foot plantar pressure, TGT group has statistically significant differences in gait velocity, toe out angle, midfoot of foot plantar pressure. USGT group has statistically significant differences in gait velocity, step length, toe out angle. Conclusion : These results mean gait training resulted by gait training way provides effective gait, with stroke, and therefore proper response about environmental changes and various tasks could be made.

환경강화가 뇌손상 흰쥐의 해마에서 BDNF 발현과 기능변화에 미치는 영향

임창훈,황보각 대구대학교 특수교육재활과학연구소 2008 특수교육재활과학연구 Vol.47 No.2

This study aims to find out whether or not neuro-trophic factors are expressed in rats whose brain was damaged by the evironmental enrichment. This study was analyzed with experimental animals. For this study, mature male Sprague-Dawley family rats, which are 7-9 weeks old, 250-300g in weight, healthy and having no trouble neurologically, were randomly selected and had an operation under anesthesia to remove the somatomotor area of rata. After conducting an operation of rats, the rats were randomly divided into two groups to raise them: 3 rats of the experimental group to be raised in the environment-reinforced cage, and 3 rats of the control group to be raised in the standard cage. BNDF expression was inspected in the hippocampus of rats with immunohistochemistry on 1, 3, 7, 14 days after operation. As a result of the inspection, BDNF expression and dendrite increased in the hippocampus of rats in the environment- reinforced cage, BDNF was synthesized for recovery of damage, and, as the time passes by, the number increased. And the effect is presumed to be continuous for regeneration due to changes of morphological changes of cranial nerves. neurological behavior tests(Postural Reflex Test, Beam-Walking Test) were showed that the experimental group which underwent evironmental enrichment cage had the highest neurological behavior test score except for the day 1 group. On the basis of such results, it is considered that reinforced environment leads to an increase of the expression of neuro-trophic factors, thus advances performance and becomes a part of various mechanisms which disclose plasticity of the central nervous system. In conclusion, environment enrichment is an effective treatment for patients of brain injury. 뇌손상 질환의 장애를 가진 환자들의 치료에는 다양한 방법들이 사용되어지고 있다. 뇌손상의 회복과 관련하여 현재에는 기능적인 측면뿐만 아니라 뇌신경의 형태학적 구조가 재생된 뇌가소성을 말하고 있다. 그래서 강화된 환경이 뇌의 가소성과 관련이 있는 신경영양물질 중 BDNF 발현에 영향을 미치는지 규명하며, 기능적 변화에도 영향을 주는지 확인하여 다양한 뇌질환 환자들의 치료방법 중 가정에서 강화된 환경의 일상생활을 통해 기능적 회복과 시간, 경제적 측면에서 효과적이며 간편한 치료방법을 재활 전문가들에게 제안하고자 하였다.

장시간 컴퓨터 사용자의 경부압력통증역치 변화 분석

황보 각(Gak Hwang-Bo) 한국콘텐츠학회 2008 한국콘텐츠학회논문지 Vol.8 No.6

비정상적인 자세로 인하여 근골격 관련 문제들이 호발하고 있다. 잘못된 자세습관, 특히 장기간 컴퓨터 사용으로 인하여 두부와 경부근육에 불균형으로 인하여 일상생활에 장애를 초래하고 있다. 컴퓨터의 사용은 짧게는 수분에서 길게는 몇시간 이상 사용하는 다양한 시간적 요소가 있으므로, 본 연구에서는 장시간의 컴퓨터 사용이 경부 근육의 압력 통증 역치의 변화량에 미치는 영향을 알기 위하여 정상적인 신체를 지닌 남.녀 대학생 20명을 대상으로 승모근과 흉쇄유돌근, 후두하근, 측두근을 선정하여, 3시간 6시간 9시간 12시간 15시간에 따른 근육들의 압력 통증 역치를 측정하고 비교 평가한 결과, 성별 및 시간, 좌측과 우측에 따른 차이가 있는 것을 알 수 있었고, 대부분의 경우 장기간 컴퓨터 사용자에 있어서 경부와 두부의 근육들 사이 압력통증역치간의 유의한 차이가 있는 것으로 나타났다(p<.05). Poor posture of the neck and head has long been recognized as a factor contributing to the onset and perpetuation of pain in the head and neck region. This study were to evaluate the change of the neck pressure pain threshold in long term computer users. To elucidate change of the neck pressure pain threshold in long term computer users, the effect of computer using time(3, 6, 9, 12 and 15 hours) on neck pressure pain threshold were studied in 20 subjects. Neck pressure pain threshold were recorded 3, 6, 9, 12 and 15 hours group, and evaluated by pressure algometry to Trapezius muscle, Sternocleidomastoidius muscle, Suboccipitalis muscle and Temporalis muscle. Neck pressure pain threshold was significantly larger in 15 hours group(p<.05). But relation between neck pressure pain threshold in male group and female group were not significant differences(p>.05).

퇴행성 슬관절염 환자의 KWOMAC 항목간의 상관관계 연구

황보각,배성수,Hwang-Bo, Gak,Bae, Sung-soo 대한고유수용성신경근촉진법학회 2004 PNF and Movement Vol.2 No.1

Purpose : The purpose of this study is to demonstrate the correlation of pain, stiffness, and physical function by analyizing the KWOMAC socre of the patients with degenerative knee OA, is the most common disease among senior population. Method : 100 degenerative knee OA patients, diagnosed at the hostpital or clinic located in Degu and Kyung-buk province were participated in the study. Result : This study results in following conclusions. 1. Degenerative knee OA patients complained the pain going up or down stairs, stiffness after getting up in the morning. immediately. 2. They also had significant difficulty ascending or decending stairs, getting in or out of car, rising from sitting, doing chores. 3. There was the high correlation among pain, stiffness, physical function. Conclusions : It may provide information to assess the ADL of knee OA patients and the exercise, outcome for their independent life effectly.

GAITRite 시스템 분석을 통한 젊은층과 노년층의 보행특성 비교

황보각,정학영,배성수,Hwang-bo, Gak,Jeong, Hak-young,Bae, Sung-soo 대한고유수용성신경근촉진법학회 2003 PNF and Movement Vol.1 No.1

Objectives : The purpose of this study was to describe and compare the temporo-spatial gait characteristics of healthy young people with those of healthy elderly people. Methods: The data were collected by 40 volunteers. 20 subjects were between 20 and 31 years of age, and 20 subjects were between 65 and 84 years of age. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : The system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance score. Differences in gait characteristics between the two groups were examined using a correlated t-test(p<.05). Significant differences were observed between the groups for step length, step/extremity ratio and velocity. Young people demonstrated a significantly larger velocity, step length and step/extremity ratio than the elderly people. Conclusions: These results indicate that the GAITRite system can be useful in detecting footfall patterns and selected time and distance measurements of young and older persons. Additionaly, differences in walking velocity, step length and step/extremity ratio between old and young people may have influenced the gait characteristics measured.

Starting Current Application for Magnetic Stimulation

Sun-Seob Choi,Gak Hwang Bo,Whi-Young Kim 한국자기학회 2011 Journal of Magnetics Vol.16 No.1

A power supply for magnetic-stimulation devices was designed via a control algorithm that involved a start current application based on a resonant converter. In this study, a new power supply for magnetic-stimulation devices was designed by controlling the pulse repetition frequency and pulse width. The power density could e controlled using the start-current-compensation and ZCS (zero-current switching) resonant converter. The results revealed a high-repetition-frequency, high-power magnetic-stimulation device. It was found that the stimulation coil current pulse width and that pulse repetition frequency could be controlled within the range of 200-450 μS and 200-900 pps, respectively. The magnetic-stimulation device in this study consisted of a stimulation coil device and a power supply system. The maximum power of the stimulation coil from one discharge was 130 W, which was increased to 260 W using an additional reciprocating discharge. The output voltage was kept stable in a sinusoidal waveform regardless of the load fluctuations by forming voltage and current control using a deadbeat controller without increasing the current rating at the starting time. This paper describes this magnetic-stimulation device to which the start current was applied.

단하지보조기(AFO) 착용이 편마비 환자의 균형과 보행에 미치는 효과에 관한 고찰

신지원,김은정,황보각 대구대학교 특수교육재활과학연구소 2010 再活科學硏究 Vol.28 No.1

이 연구의 목적은 단하지보조기(ankle foot orthosis:AFO) 착용이 편마비 환자의 균형과 보행에 미치는 효과를 알아보는데 있다. 편마비 환자의 단하지보조기와 관련된 균형, 보행에 관한 연구들을 평가하여 단하지보조기(AFO)의 착용에 따른 균형과 보행에 관한 9개의 연구결과를 확인하였다. 균형은 5개 중 4개의 연구에서 유의하게 향상됨을 알 수 있었고, 보행능력은 7개 중 6개의 연구에서 일부분 유의하게 향상된다는 결과를 알 수 있었다. 따라서, 단하지보조기(AFO) 착용이 편마비 환자의 균형향상에 도움을 줄 수 있고, 보행능력에 일부분 도움이 됨에 따라 보행능력을 개선한다는 근거로 작용할 수 있다. The purpose of this study looked at the differences in balance and gait among the hemiplegic patients wearing an AFO. This study found out that there are nine research results related to balance and gait of hemiplegic patients with AFOs. Four out of five studies recognized an significant increase in balance and six out of seven identified an evident improvement on gait ability. In conclusion, this study agreed that AFOs may help hemiplegic patients to increase stability and correct gait.

정상인과 편마비 환자의 주관절 등척성 운동시 우력양상과 심혈관계에 미치는 영향

신형수,황보각,임원식,김중선,Shin, Hyung-Soo,Hwang-Bo, Gak,Lim, Weon-Sik,Kim, Chung-Sun 대한물리치료학회 2001 대한물리치료학회지 Vol.13 No.3

The isometric torque of the elbow flexor and extensor muscles were measured for 6 seconds at a joint angle of 90$^{\circ}$ , in 10 normal subjects (control group) and 10 hemiplegic subjects(patient group), using the Cybex NORMTM System. The peak torque, the time to peak torque were measured for each exercise. In addition, heart rate and blood pressure were recorded simultaneously at rest and immediately following exercise completion at 1 and 3m mutes. Statistical analysis was performed using SPSS 8.0 for Windows software and mean and standard deviations were calculated. The results are as follows. 1) In the patient involved group. the isometric values for flexors and extensors were significantly lower than in the normal nondominant group(p<.05). 2) The extensor to flexor strength ratio in the isometric mode was 121.0% in the patient involved group compared with 78.7%in the normal nondominant group, a significant difference(p<.05). 3) The mean increment ratio was increased 19.0% for systolic blood pressure and 25.2% for disatolic blood pressure in the patient group. 4) The mean increment ratio was increased 36.0% heart rate in the patient group.

승마치료가 조산아로 태어난 경직형 뇌성마비 아동의 체간근 활성도에 미치는 영향

조성현,오병환,황보각 대구대학교 특수교육재활과학연구소 2012 특수교육재활과학연구 Vol.51 No.1

The purpose of this study was to discern how participation for 8 weeks hippotherapy program can affect the activities of trunk muscle in preterm born children with spastic cerebral palsy. To investigate the variation between groups and verify the variation between the groups of befere and after hippotherapy program, one-way ANOVA, Tukey post-hoc test and paired t-test were conducted. There was significant difference between groups after the program in the area of left rectus abdominis, left and right erector spinae, and left and right glueus maximus. As for the variation of the movement on trunk muscle activity between groups accoring to the time of horseback riding exercise program, there was a significant difference in the horseback riding group, in the area of left and right rectus abdominis, right external oblique, left and right erector spinae, and left and right gluteus maximus. Also, there was a statistically significant difference, in the horseback riding machine goup, in the area of left and right rectus abdominis, left and right erector spinae, and left and right gluteus maximus. Hippotherapy (horseback riding, horseback riding machine) proved to be effective in improving the activities of trunk muscle for preterm born children with spastic cerebral palsy. 본 연구의 목적은 조산아로 태어난 경직형 뇌성마비 아동들에게 8주간의 승마치료 프로그램(승마운동, 승마기구운동)이 체간근의 활성도에 미치는 영향을 알아보는 것이다. 연구 대상자는 경직형 뇌성마비 아동 30명으로 승마운동군, 승마기구군, 대조군으로 무작위 구분하여 실시하였다. 그룹 간 측정 시기의 변화율을 알아보기 위해 one-way ANOVA과 Tukey검정을 실시하였으며, 시간의 경과에 따른 그룹 내 승마치료 프로그램 전ㆍ후 검정을 위해 대응표본 t-검정을 실시하였다. 승마치료 프로그램 후 그룹 간 비교 결과 좌 배곧은근, 좌ㆍ우 척추세움근, 좌ㆍ우 큰 볼기근에서 통계학적으로 유의한 차이가 있었다. 승마치료 프로그램의 시간에 따른 체간근 활성도의 그룹 내 변화에서 승마운동군은 좌ㆍ우 배곧은근, 우 바깥 배빗근, 좌ㆍ우 척추세움근, 좌ㆍ우 볼기근에서 통계학적으로 유의한 차이가 있었고, 승마기구군은 좌ㆍ우 배곧은근, 좌ㆍ우 척추세움근, 좌ㆍ우 큰 볼기근에서 통계학적으로 유의한 차이가 있었다. 이와 같은 결과는 뇌성마비 아동에게 있어서 승마치료가 체간근 활성도의 향 상에 효과적이라는 것을 알 수 있었다. 본 연구는 승마치료가 경직형 뇌성마비 아동의 치료효과를 더욱 높아질 수 있다는 것을 의미하며, 다른 형태의 뇌성마비에 대한 연구들도 지속적으로 진행되어야 할 것이다.

노인의 계단과 경사로 오르기 동안 하지의 운동학적 분석

한진태 ( Jin Tae Han ),황보각 ( Bo Gak Hwang ) 한국운동역학회 2009 한국운동역학회지 Vol.19 No.3