운동조절이론과 중추신경계 손상환자를 위한 치료 접근법의 재검토

김종만,신헌석 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.1

Physical therapists should understand motor control models and apply various models to evaluation and treatment of neurologically impaired patients, Thus, this paper reviews motor control models and applications in clinical settings. Assumptions and limitations of reflex models, hierarchical models, and systems models are presented. This paper also delineates goals and dissatisfaction of neurologic rehabilitation approaches for neurologically impaired patients. Muscle reeducation approach, neurotherapeutic facilitation approach, and contemporary task-oriented approach are explained.

하퇴 의지 사용자의 족저압 분포 특성에 관한 연구

김장환,신헌석 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.3

The purpose of this study was to compare the static pressure, dynamic pressure, dynamic pressure-time integral, relative impulse, and contact time between the sound lower limb and amputated lower limb in trans-tibial amputee subjects using Parotec system. Seventeen trans-tibial amputee subjects wearing endoskeletal trans-tibial prosthesis voluntarily participated in this study. The results were as follows: 1) In static standing condition, there were significantly higher static pressure in sound lower limb insole sensor of 10, 14, 15, 18, 19, 23, and 24 and in amputated lower limb insole sensor of 9, 12, and 16 (p<.05). 2) In dynamic gait condition, there were significantly higher dynamic pressure in sound lower limb insole sensor of 2, 18, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, 14, 15, and 16 (p<.05), 3) In dynamic gait condition, there were significantly higher pressure-time integral in sound lower limb insole sensor of 2, 4, 18, 19, 20, 21, 23, and 24 and in amputated lower limb insole sensor of 5, 11, 12, and 15 (p<.05). 4) In dynamic gait condition, there were significantly higher relative impulse in sound lower limb insole sensor of 18, 19, 20, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, and 15 (p<.05). 5) In dynamic gait condition, there was significantly higher percentage of contact time in push off phase of sound lower limb and in support phase of amputated lower limb (p<.05). These results suggest that trans-tibial amputee subjects had characteristics of shortened push off phase due to unutilized forefoot and of lengthened support Phase with higher pressure in the midfoot.

유지-이완기법과 냉치료가 지연성 근육통에 미치는 효과

김종만,박장성,김원호,신헌석,김연중 한국전문물리치료학회 2000 한국전문물리치료학회지 Vol.7 No.1

Despite research to treat delayed onse muscle soreness(DOMS), no effective treatment has been reported. The purpose of this study is to investigate the effect of a hold-relax technique and cryotherapy on DOMS. Thirty-three subjects were randomly assigned to one of three treatment groups: control, hold-relax technique, or hold-relax technique and cryotherapy. DOMS was induced in the non-dominant biceps muscle through repeated eccentric contractions. Resting elbow joint position, flexion and extension(universal goniometer), pain(Visual Analogue Scale; VAS), and WBC count(blood analysis) were measured one hour before DOMS was induced and 24, 48, and 72 hours after DOMS was induced. The data were analyzed by repeated measure of two-way ANOVA. The results of this study were summarized as follows: 1) While analysis showed no significant differences between groups in relation to resting elbow joint position, there were significant differences over time, especially at 24, 48 hours after DOMS was induced compared with resting elbow joint position before DOMS was induced. 2) While analysis showed no significant differences between groups in relation to range of flexion, there were significant differences between rage of flexion before DOMS was induced and range of flexion 72 hours after DOMS was induced. 2) There were no significant differences between groups or over time in relation to range of extension. 4) While analysis showed no significant differences between groups in relation to VAS, there were significant differences over time in different hours. 5) There were no significant differences between groups or over time in relation to WBC count. 6) There were no interactions between groups or over time in all variables. This results suggested that hold-relax technique and cryotherapy were not effective to reduce DOMS.

Effects of Lumbar Stabilization on the Trunk and Lower Limb Muscle Activity and Velocity of the Center of Pressure During Single Leg Standing

Heon-seock Cynn 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.4

The aim of this study was to investigate the effects of lumbar stabilization on both trunk and lower limb muscle activity and center of pressure (COP) in single leg standing. Surface electromyography (EMG) was used to collect muscle activity data, the mean velocity of COP was measured using a force plate, and a pressure biofeedback unit was used for lumbar stabilization training. The findings of this study are summarized as follows: l) The EMG activity of the erector spinae decreased significantly and the activity of the rectus abdominis, internal oblique, external oblique, gluteus maximus, and gluteus medius increased significantly with lumbar stabilization single leg standing. 2) No differences in activity in the tibialis ante-rior, medial gastrocnemius, rectus femoris, and medial hamstrings were found with single leg standing. 3) The mean velocity of COP in the antero-posterior and medio-lateral directions in the lumbar stabilization single leg standing decreased significantly compared with the preferred single leg standing. The findings of this study therefore indicate that lumbar stabilization can facilitate the co-activation of deep stabilization and global muscles that improve postural control capability during single leg standing.

Correlation of Forearm Circumference; With Hand Grip Strength

신헌석,Cynn, Heon-Seock Korean Physical Therapy Science 2001 대한물리치료과학회지 Vol.8 No.2

이 연구의 목적은 전완 원주와 악력과의 상관관계를 알아보는 것이다. 오른손잡이 여성 30명이 이 연구에 참여하였으며, 연구의 대상자의 평균 연령은 31.0세였다. 전완 원주는 척골의 주두와 경상돌기의 1/2 지점과 근위 3/4 지점에서 줄자를 이용하여 측정하였다. 악력은 미국 수부 치료사 협회의 기준에 의하여 Jarmar dynamometer를 사용하여 측정하였다. 통계학적 분석은 피어슨 상관 관계 계수를 이용하여 상관관계를 조사하였다. 전완 두 지점에서 측정된 원주와 악력간에는 낮은 상관관계를 나타내었다(r=.02. p=.921; r=.02, p=.928). 연구 대상자 30명 중 정기적으로 상체 운동을 하는 18명의 연구 대상자들의 전완 두 지점에서도 낮은 상관 관계를 나타내었다(r=.16, p=.521: r=.18, p=.468). 본 연구의 결과는 선행된 다른 연구 결과와는 상이하게 높은 상관관계를 나타내지 않았다. 그 이유로는 본 연구에서 악력에 영향을 주는 여러 가지 요소들(신체 유형, 운동 습관. 직업 피하 지방성분, 유전적 요소 등)의 측정이 고려되지 않았고. 연구 대상자의 수(n=30)가 적었다는 점을 들 수 있다.

The Reliability of Thickness Measurement of the Deep Fiber of the Lumbar Multifidus Using Ultrasonography

Doh-heon Jung,Su-jung Kim,Chung-hwi Yi,Heon-seock Cynn,Houng-sik Choi 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.4

The reliability of the thickness measurement of the lumbar multifidus (LM) using real-time ultrasonography (US) was determined in only the superficial fiber of the lumbar multifidus (SM). However, previous studies have not examined the reliability of the deep fiber of the LM (DM). The purpose of this study was to determine the intrarater and the interrater reliability of the thickness measurements of DM using US. Eleven healthy males participated in the study. The thickness of the DM was measured with an US in the prone position. Reliability was examined using intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and the Bland and Altman plot. ICC(3,1) was used to calculate the interarater reliability of the thickness measurement of DM using the values from both the first and second test sessions. Additionally, ICC(3,1) was used to calculate the intrarater reliability of the measurements over two days using the measurements obtained in test session 1 and test session 2. The results of this study were as follows: 1) the ICC(3,1) value for interarater reliability was .94 in the first test session, and .93 in the second test session. 2) the ICC(3,1) values for intrarater reliability of the measurements over two days was .90 in both the first examiner and the second examiner The intrarater reliability and interrater reliability of the DM measurements, obtained via the US protocol used in this research was excellent. Therefore, we conclude that the thickness measurement of the DM obtaioned from the US protocol used in this research would be useful for clinician assessment of the thickness of the DM

Correlations Between Maximal Isometric Strength and the Cross-Sectional Area of Lumbrical Muscles in the Hand

Doh-heon Jung,Won-hwee Lee,Su-jung Kim,Heon-seock Cynn 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.4

The lumbrical muscles contribute to the intrinsic plus position, that is simultaneous metacarpophalangeal (MCP) flexion and interphalangeal (IP) extension. The strength of the lumbrical muscles is necessary for normal hand function. However, there is no objective and efficient method of strength measurement for the lumbrical muscles. In addition, previous studies have not investigated the measurement of the cross-sectional area (CSA) of the lumbrical muscles using ultrasonography (US) and the relationship between lumbrical muscle strength in the intrinsic plus position and the CSA. Therefore, the purpose of this study was to identify the measurement method of the CSA of the lumbrical muscles using US and to examine the relationship between maximal isometric strength and the CSA of lumbrical muscles. Nine healthy males participated in this study. Maximal isometric strength of the second, third, and fourth lumbrical muscles was assessed using a tensiometer in the intrinsic plus position which isolated MCP flexion and IP extension. The CSA of the lumbrical muscles was measured with an US. The US probe was applied on the palmar aspect of the metacarpal head with a transverse view of the hand in resting position. There was no significant difference between maximal isometric strength of the lumbrical muscles, but the fourth lumbrical muscle was stronger than the others. The CSA of the lumbrical muscles was significantly different and the fourth lumbrical muscle was significantly larger than the second lumbrical muscle. There was moderate to good correlation between maximal isometric strength and the CSA of the lumbrical muscles. Therefore, we conclude that maximal isometric strength of the lumbrical muscles was positively correlated to the CSA of the lumbrical muscle in each finger, while the measurement of the CSA of the lumbrical muscles, using US protocol in this study, was useful for measuring the CSA of the lumbrical muscles.

Understanding and Exercise of Gluteus Medius Weakness: A Systematic Review

Seung-min Baik,Heon-seock Cynn,Seok-hyun Kim 한국전문물리치료학회 2021 한국전문물리치료학회지 Vol.28 No.1

A weak or dysfunctional gluteus medius (Gmed) is related to several pathologies, and individuals with hip abductor weakness have Gmed weakness. This study aimed to systematically review the literature associated with the anatomy and function of the Gmed, and the prevalence, pathology, and exercise of Gmed weakness. Papers published between 2010 and 2020 were retrieved from MEDLINE, Google Academic Search, and Research Information Sharing Service. The database search used the following terms: (glut* OR medius OR hip abduct*) AND weak*. The Gmed plays an important role in several functional activities as a primary hip abductor by providing pelvic stabilization and controlling hip adduction and internal rotation. Weakness of the Gmed is associated with many disorders including balance deficit, gait and running disorders, femoroacetabular impingement, snapping hip, gluteal tendinopathy, patellofemoral pain syndrome, osteoarthritis, iliotibial band syndrome, anterior cruciate ligament injury, ankle joint injuries, low back pain, stroke, and nocturia. Overuse of the tensor fasciae latae (TFL) as a hip abductor due to Gmed weakness can also cause several pathologies such as pain in the lower back and hip and degenerative hip joint pathology, which are associated with dominant TFL. Similarly, lateral instability and impaired movements such as lumbar spine lateral flexion or lateral tilt of the pelvis can occur due to compensatory activation of the quadratus lumborum for a weakened Gmed while exercising. Therefore, the related activation of synergistic muscles or compensatory movement should be considered when prescribing Gmed strengthening exercises.

Relationships Between Rounded Shoulder Posture and Biceps Brachii Muscle Length, Elbow Joint Angle, Pectoralis Muscle Length, Humeral Head Anterior Translation, and Glenohumeral Range of Motion

Sil-ah Choi,Heon-seock Cynn,Ji-hyun Lee,Da-eun Kim,A-reum Shin 한국전문물리치료학회 2017 한국전문물리치료학회지 Vol.24 No.2

Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ≥2.5 cm from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson’s correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.

Effects of Five-month Training of Playing Harmonica on Pulmonary Function in Patients With Neuromuscular Disease: A Pilot Study

Bit-na-rae Kim,Heon-seock Cynn 한국전문물리치료학회 2018 한국전문물리치료학회지 Vol.25 No.3

Background: Progressive muscle weakness is aggravated not only in the skeletal muscles but also in the respiratory muscles in many patients with neuromuscular diseases (NMD). Inspiratory muscle training (IMT) has been reported as therapy for pulmonary rehabilitation to improve respiratory strength, endurance, exercise capacity, and quality of life, and to reduce dyspnea. Objects: The purpose of this study was to determine the effect of playing harmonica for 5 months on pulmonary function by assessing the force vital capacity (FVC), peak cough flow (PCF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV) in patients with NMD. Methods: Six subjects with NMD participated in this study. The subjects played harmonica once a week for 2 hours at a harmonica academy and twice a week for 1 hour at home. Thus, training was performed thrice a week for 23 weeks. The examiner assessed pulmonary function by measuring FVC in the sitting and supine positions and PCF, MIP, MEP, and MVV in the sitting position at the beginning of training and once a month for 5 months. Results: Both sitting and supine FVC significantly increased after playing harmonica (p=.042), as did MIP (p=.043) and MEP (p=.042). Conclusion: Playing harmonica can be used as an effective method to improve pulmonary function in patients with NMD.