신경계 재활의 전통적 중재와 대안적 중재 방법에 대한 문헌 고찰

심재광,최호석 한국신경근육물리치료학회(구 한국신경근육재활학회) 2015 한국신경근육재활학회지 Vol.5 No.1

This paper is a review conducted to provide an overview of the history of the past and contemporary rehabilitation methods for patient with damaged central nerves. Neurorehabilitation is a complex medical process which an aim to facilitate a recovery from a nervous system injury, and to minimize and/or compensate for functional impairments arising from it. By focusing on all aspects of a person's wellbeing, neurorehabilitation offers a series of therapies from the psychological to occupational, teaching or re-training the patients on mobility skills, communication processes, and other aspects of that person's daily routine. Current viewpoint represents a paradigm shift in clinical intervention, and clinicians have differently considered the details of intervention for the nervous and musculoskeletal impairments. Such concepts require to see the overall history of physical therapy, we interpreted the hidden meaning in the history of physical therapy. The current and future physical therapists will be to look at the patients as a comprehensive perspective. Medical instruments have continuously been developed. However, it may not be competed by senior physical therapists working for a long time in rehabilitation field. It’s probably useless to find only a way to treat a variety of patients with neurological impairments, representing optimal effects of rehabilitation, because definite answer to the therapy does not exist and their symptoms should be handled case-by-case. Thus, we need to take the advantages of functional evaluation, and they will be integrated into intervention.

뇌졸중 환자의 재활기간에 따른 재활서비스 욕구 현황 및 치료사의 인식간의 비교

김창범 한국신경근육물리치료학회(구 한국신경근육재활학회) 2014 한국신경근육재활학회지 Vol.4 No.2

신경계 질환에 대한 COVID-19 범유행의 영향 : 신경재활을 위한 제언

이언주,오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2021 한국신경근육재활학회지 Vol.11 No.1

A coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Currently, the rapid spread of COVID-19 is one of the world’s most important health issues, having threatened the general health of people worldwide. Advanced age and comorbidities such as hypertension, diabetes, cardiovascular and respiratory disorders, and obesity are risk factors for the occurrence of critical illness and increased mortality. Although neurological symptoms and complications remain minor, they last a long time, resulting from the direct invasion of the virus into the central nervous system and systemic effects of the viral infection. For these reasons, patients with neurological impairment are more vulnerable to serious conditions caused by SARS-CoV-2 infection. However, for people with mild respiratory infections or those who are asymptomatic, it is not easy to find clear evidence of a relationship between COVID-19 and neurological disorders. Therefore, research and clinical practice should highlight the impact of the COVID-19 pandemic on neurological conditions in order to provide management guidelines and rehabilitation services in an effective way. To prevent the spread of COVID-19, social distancing has been imposed, restricting social activity and participation and facilitating individual isolation from societal groups, both of which had negative impacts on rehabilitation of neurologic disorders. It is important to develop efficient solutions for unwanted problems in the COVID pandemic. Tele-rehabilitation is considered to have some benefits in overcoming its detrimental effects. Accordingly, this study aimed to demonstrate the clinical course and pathogenesis of the SARS-CoV-2 infection, to summarize the impact of COVID-19 on neurologic disorders, and finally to provide suggestions for effective management.

신경계 질환에 대한 COVID-19 범유행의 영향 : 신경학적 증상과 합병증

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2021 한국신경근육재활학회지 Vol.11 No.1

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the most recently discovered a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 pandemic has changed the way that clinicians manage acute medical disorders worldwide. In addition, neurological manifestations of the COVID-19 had a negative effect on medical service of neurological diseases, which might be challenging to develop successful solutions for rehabilitation of patients with neurological impairments in clinical practice. This pandemic apparently threatened and threatening for achieving all functional goals in neurological rehabilitation due to lack of available care and compromised rehabilitation service globally. In general, neurotropic properties from SARS-CoV-2 lead to neurological symptoms and complications in direct and indirect way, including dysgeusia, hyposmia, myalgia, headache, and consciousness disorder. However, virus-related pathobiology has not been completely illustrated still However, as yet virus-related pathobiology has not been completely illustrated. On basis of emerging knowledge, creating multiple channels of rehabilitation interventions for neurological disorders helps to promote multidisciplinary collaboration and cooperation across clinicians. To accomplish this goal, it’s very important to demonstrate possible neurological effects from COVID-19. Accordingly, this study aimed to introduce neurological symptoms and complications caused by COVID-19, leading to upgrading the rehabilitation services to a satisfactory level.

The Effect of Treadmill Walking With Using a Smartphone in Various Head Positions on Static Balance and Gait Parameters

Min-Young Oh,Hyun-Sun Sin,A-Reum Yun,Tae-lim Yoon 한국신경근육물리치료학회(구 한국신경근육재활학회) 2017 한국신경근육재활학회지 Vol.7 No.2

Purpose: The purpose of this study is an investigation of the changes in static balance and gait parameters after treadmill walking with using a smartphone in various head positions. Methods: The subjects of this study were 20 healthy college students (7 male, 13 female). Subject walked in treadmill at the speed of 2km/h for 3 minutes without using smartphone and with both hands using smartphone in straight ahead and down head. During the task, static balance and gait parameters were collected. A one-way repeated analysis of variance with the level of a significant level of .05 was used. And Bonferroni correction (α=.05/3=.0017) executed to evaluate the significance of between-exercise pairwise comparisons. Results: Our result presented that center of gravity way velocity sway velocity and total sway distance with the eyes closed on the unstable sponge surface, ware significantly greater in walking without using a smartphone condition than head straight ahead. There were no significant differences in gait parameter. Conclusion: Walking with straight ahead would enhance the equilibrium information and cause a positive effect on static balance only

이중과제훈련이 치매 환자의 인지 기능 및 신체수행 능력에 미치는 영향 : 단일 사례 연구

박현주,임성현,이형준,오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2019 한국신경근육재활학회지 Vol.9 No.1

The purpose of this study is to examine the effects of the dual task training on cognitive function and performance in dementia. This study used a single-subject multiple baseline design. Three patients with dementia participated in this study. Measurement sessions of subject 1, 2, and 3 were 4 times, 7 times, and 9 times in the baseline phase, and 15 times, 12 times, and 10 times in the intervention phase, respectively. Outcome measures included mini-mental state examination (MMSE), grip strength, 10-m walk test (10MWT), timed up and go test (TUG), 6-min walk test (6MWT), Berg balance scale (BBS), and modified Barthel index (MBI). For all subjects, cognitive function, grip strength, balance and walking functions, and activities of daily living was remarkably increased after the intervention. This results support that the dual-task training may be helpful to improve cognitive function and physical performance for patients with dementia. Further studies need to warrant our findings.

뇌졸중 환자들의 균형 능력 평가를 위한 임상적 검사 : 문헌 고찰

오덕원 한국신경근육물리치료학회(구 한국신경근육재활학회) 2018 한국신경근육재활학회지 Vol.8 No.1

Balance is one of essential components to improve functional level after stroke, which is complicated motor skill depending on multi sensory-motor process and interaction between environmental factor and functional condition. After stroke, neurological impairments lead to the decrease in functional level and produce compensatory strategy in order to ensure an independence in daily activities. Because of such variety in this aspect, precise evaluation should be performed to identify the problems of each patients in motor, sensory, and cognition as well as functional implications, which is helpful to establish individualized program in stroke rehabilitation. Tools to evaluate balance function should be adequately valid, and selected by reflecting personal characteristics of patients with stroke. Therefore, many evaluation tools have been developed to demonstrate balance function. Laboratory tests are difficult to be commonly used in clinical setting, benefits are to offer quantitative data on balance reaction and performance. Also, clinical tests provide valuable data to understand postural impairment and function disability of patients with stroke. Accordingly, this study aimed to describe balance mechanisms and strategies as well as evaluation methods of balance function in stroke. Focus was to demonstrate clinical tests to readily use in clinical setting.

젊은 여성에서 신발 뒤굽 높이가 신체 동요 시 다리 근육의 근 활성도와 개시시간에 미치는 영향

강철진,홍형경,최연지,홍예은 한국신경근육물리치료학회(구 한국신경근육재활학회) 2018 한국신경근육재활학회지 Vol.8 No.1

This study aimed to identify the influence of high-heeled shoes on activation patterns (muscle activity and onset time) of leg muscles during body perturbation in healthy young females. Thirty-one healthy females in their 20s were recruited for this study. Subjects underwent two experimental conditions: (1) barefoot, and (2) wearing high-heeled shoes with a 7-cm heel height. And then forward and backward body perturbation impacts were randomly applied in each condition while subjects stand on perturbation board. Electromyographic measurements were performed on gastrocnemius (GCM), hamstring (HAM), and erector spinae (ES) for the forward perturbation, and tibialis anterior (TA), quadriceps (QAUAD), and rectus abdominis (RA) for the backward perturbation. During the forward perturbation, there were found for significant differences in the onset time among GCM, HAM, and ES for both conditions (p<0.05), suggesting differences between GCM and HAM and between GCM and ES for the barefoot condition, and between GCM and HAM for the high-heeled shoes condition. Muscle activities showed significant differences in both conditions (p<0.05), indicating differences between GCM and HAM and between GCM and ES for both conditions. Furthermore, during the backward perturbation, the onset time of muscle activity was significantly different among TA, QUAD, and RA in the barefoot condition (p<0.05), suggesting a difference between TA and QUAD. Muscle activities appeared to be significantly different between the muscles for both conditions (p<0.05), indicating differences between TA and QUAD and between QUAD and TA for the both condition.These findings indicate that wearing high-heeled shoes leads to changes for recruitment pattern of leg muscles, indicating alterations of ankle strategy to maintain balance during body perturbation.

시각적 되먹임을 이용한 3D-자세조절 트레드밀 보행훈련이 뇌졸중 환자의 보행 및 균형 능력에 미치는 효과 : 증례연구

박현주,오덕원,김용정,김지선 한국신경근육물리치료학회(구 한국신경근육재활학회) 2016 한국신경근육재활학회지 Vol.6 No.2

This study aimed to identify the effects of a 4-week of treadmill training focusing on postural alignment corrected on a three-dimensional plane using visual feedback in individuals with post-stroke hemiparesis. Two patients with chronic stroke participated in the study. Treadmill training taken under postural alignment corrected on a three-dimensional plane using visual feedback was performed for 1 hour, three times per week for a period of 4 weeks (a total of 12 sessions) using the Functional Training System (FTS®). Timed up to go test (TUG), stair up test, Figure-of walk test (F8WT), and Rivermead mobility index (RMI) measured three times; pre-test, post-test, and 4-week follow-ups. TUG, stair up test, F8WT, and RMI scores improved after intervention in the results. Furthermore, stair up test, F8WT, and RMI scores were favorably maintained at the 4-week follow-ups. These findings suggest that the treadmill walking training focusing on 3-dimensional postural correction using visual feedback may be a beneficial methods for improving the walking and balance ability in patients with chronic stroke.

고빈도 반복적 경두개자기자극이 뇌졸중 환자의 우울증과 운동기능에 미치는 영향

강태우,김태윤 한국신경근육물리치료학회(구 한국신경근육재활학회) 2018 한국신경근육재활학회지 Vol.8 No.1

This study aimed to identify the effect of a high frequency repetitive transcranial magnetic stimulation (rTMS) on the depression and motor function in patients with stroke. Thirty subjects with post-stroke hemiparesis volunteered to participate in this study. All subjects underwent the high frequency rTMS for averaging 20 minutes daily for 4 weeks (total of 20 sessions). Assessment tools were made with Beck depression index (BDI) and Fugl-Meyer assessment (FMA) before and after the 4-week training period. BDI and FMA showed significant improvement after high frequency rTMS (p<0.05). This study demonstrates that a high frequency rTMS may be favorable for enhancing depression and motor function of patients with stroke. This study provides valuable information for future studies in this field. Further studies with wider range of subjects and longer experiment span are required to strengthen the results of this study.