베이징 올림픽 대한민국 선수단의 물리치료 이용 실태

안승헌 ( Seung Heon An ),이제훈 ( Je Hoon Lee ) 대한물리의학회 2010 대한물리의학회지 Vol.5 No.3

Purpose:To provide information and data about the physical therapy service for planning future Olympic and other mass gatherings. Methods:To document the injuries sustained during the 2008 Beijing Olympic Games in a sample of patients visiting the physical therapy department of the Korean Olympic Committee. Athletes visited the physical therapy department in 2008 Beijing Olympic Korean delegation from 1 August through 22August. Results:The sex ratio of athletes who visited physical therapy room was male 27.5%, female 72.5% and that number of case sports were higher Handball (26.2%), hockey (15.8%), archery (10.4%). The most prevalent injury of body parts was shoulder (15.1%), followed by the lumbar (14.2%), and the cervical spine (10.5%). Treatment modality had manual therapy (891), electrical therapy (584), ultrasound (461) and the number of taping were handball (47.8%), hocky (23.8%), judo (8.2%). Ankle (31.4%) was the most body parts of taping Conclusion:Physical therapy in sport as a professional sports event to get their players to injury prevention and treatment. These results can be of help to optimize the strategies to prevent injuries and to treatment the injured athletes

뇌졸중 환자의 균형과 기능 수행 및 보행 검사를 위한 평가도구의 비교: BBS, TUG, Fugl-Meyer, MAS-G, C,MGS, MBI

안승헌 ( Seung Heon An ),박창식 ( Chang Sik Park ),이현주 ( Hyun Ju Lee ) 한국전문물리치료학회 2007 한국전문물리치료학회지 Vol.14 No.3

만성 뇌졸중 환자의 자세 조절과 일상생활동작, 근긴장도, 그리고 기능증진과의 관계

안승헌 ( Seung Heon An ),서영종 ( Young Jong Seo ),박창식 ( Chang Sik Park ) 한국전문물리치료학회 2007 한국전문물리치료학회지 Vol.14 No.1

뇌졸중 환자의 체간 조절 수준이 균형과 보행 및 기능적 수행 능력에 미치는 영향

안승헌(Seung-heon An),정이정(Yi-jung Chung),박세연(Sei-yeon Park) 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.2

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BBS), gait ability (10 m walk test), functional performance ability (Timed Up and Go Test; TUG) and the mobility part of the Mdified Barthel index(MBI), Fugl Meyer-Upper/Lower Extremity (FM-U.L/E). The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p

뇌졸중 환자들을 위한 한국어판 Modified Rivermead Mobility Index의 측정자간 신뢰도와 동시 타당도

안승헌 ( An Seung-heon ),이규창 ( Lee Gyu-chang ),이경봉 ( Lee Kyeong-bong ),이동건 ( Lee Dong-geon ),송선해 ( Song Sun-hae ),표승현 ( Pyo Seung-hyeon ) 대구대학교 특수교육재활과학연구소 2016 특수교육재활과학연구 Vol.55 No.4

본 연구의 목적은 뇌졸중 환자의 Modified Rivermead Mobility Index(MRMI)의 측정자간신뢰도와 동시 타당도를 알아보는 것이다. 본 연구에서는 뇌졸중 환자 42명을 대상으로 하였다. MRMI의 측정자간 신뢰도(Inter-rater reliability)를 알아보기 위해 대상자들은 MRMI를 이용한 검사에 2회 참여하였다. 또한, MRMI의 동시 타당도를 알아보기 위하여 수정된 기능적 보행 지수(Modified Functional Ambulation Category, MFAC), 수정된 5m 보행 속도 검사, 일어나 걸어가기 검사(Timed Up & Go test, TUG), 버그 균형 척도(Berg Balance Scale, BBS), 수정된 바델 지수(Modified Barthel Index, MBI), 그리고 퓨글 마이어 평가(Fugl Meyer Assessment, FMA)에 참여하였다. MRMI의 측정자간 일치율은 급간내 상관계수(Intraclass correlation coefficient; ICC), 내적일치도(Cronbach`s α), 가중치 카파 계수(Weighted Kappa coefficient)를 이용하였고, MRMI의 개별 항목과 총점 간의 관계는 스피어만 상관 계수(Spearman Correlation Coefficient)를 이용하였다. 또한 MRMI의 표준오차 측정(Standard Error Measurement, SEM)과 최소 감지 변화(Minimal Detectable Change, MDC)를 구하였다. MRMI의 동시 타당도는 MFAC, 수정된 5m 보행 속도 검사, TUG, BBS, MBI, FMA와의 관계를 알아보았다. 본 연구의 결과, MRMI의 측정자간 일치율은 가중치 카파계수 .64∼.84, MRMI 개별항목과 총점 간의 상관계수는 r=.89∼.96, MRMI의 Cronbach`s α 계수는 .97, 개별 항목을 삭제한 경우에도 평균 .96∼.97로 높은 수준으로 나타났다. 또한, MRMI 총점의 ICC는 .97(.94∼.98), SEM은 1.32점, MDC는 3.66점으로 매우 신뢰할 만 수준으로 나타났다. MRMI의 동시 타당도에서 MFAC(r=.64), 수정된 5m 보행 속도 검사(r=.73), TUG(r=-.76), BBS(r=.83),MBI(r=.83), FMA(r=.56∼.59) 등과 높은 상관관계가 있었다. 게다가, 대상자들의 이동성은 실제 3.6점 이상 변화될 수 있는 것으로 확인되었다. 본 연구를 통해 MRMI는 높은 측정자간신뢰도와 동시 타당도가 있는 것으로 확인되었고, 만성 뇌졸중 환자의 이동성을 평가하는데 있어 유용하게 사용될 수 있을 것으로 사료된다. The purpose of this study was to investigate the inter-rater reliability and concurrent validity of the Modified Rivermead Mobility Index(MRMI) for stroke survivors. 42 stroke patients were participated in the study. The MRMI was administered in 2 testing sessions. Inter-rater reliability (Intraclass Correlation Coefficient; ICC), Internal consistency, and Weighted Kappa coefficient were used to examine the level of agreement between raters. For scale the item-total correlation and alpha if each item was deleted were calculated. Also we used to the Absolute reliability indices, including the Bland and Altman method, the standard error of measurement(SEM), and the Minimal Detectable Change(MDC). The concurrent validity was examined by correlating results to Modified Functional Ambulation Category(MFAC), 5m Walking Test(5mWT), Timed Up & Go test(TUG), Berg Balance Scale(BBS), Modified Barthel Index(MBI), Fugl Meyer Assessment(FMA). The mRMI meets the following requirements; 1) Inter-rater exact agreement for separate items was between Weighted Kappa=.64-.84. 2) The item-to-total correlations were all significant, ranging from r=.89∼.96(p < .01). MRMI showed good internal consistency(Cronbach`s α=.97). Individual items also possessed high internal consistency .96∼.97. Inter-rater reliability was excellent for ICC2,1=.97(.94~.98) for mRMI summary score and excellent SEM and MDC were 1.32, 3.66 respectively. 3) The mRMI were demonstrated high concurrent validity with the FAC(r = .84), the 5m WT(r = .73), TUG(r = -.76), BBS(r = .83), MBI(r = .83), and FMA(r = .56 ~ .59 p < .01). In addition, there needs to be a difference of more than 3.6 points(MDC score) in the overall score to detect true change in the subjects level of mobility. The MRMI makes it feasible to measure changes in mobility in routine clinical practice with high inter-rater reliability and concurrent validity.

노인의 기능 수행 평가 도구의 적용과 비교

안승헌(Seung-heon An),이형수(Hyoung-Soo Lee),조병모(Byeong-Mo Cho),강필(Pil Kang),신영일(Young-Il Shin) 한국코칭능력개발원 2007 코칭능력개발지 Vol.9 No.3

만성 뇌졸중 환자들의 체간 조절이 상지 기능에 미치는 영향

안승헌 ( An Seung-heon ),박창식 ( Park Chang-sik ) 대구대학교 특수교육재활과학연구소 2019 특수교육재활과학연구 Vol.58 No.2

본 연구는 만성 뇌졸중 환자들의 체간 조절이 상지 기능에 어떠한 영향을 미치는지 알아 보고자 하였다. 87명의 만성 뇌졸중 환자를 대상으로 체간 조절 평가는 체간 조절 검사(Trunk Control Test, TCT), 뇌졸중 자세 평가 척도-체간 조절(Postural Assessment Scale for Stroke-Trunk Control, PASS-TC), 수정된 체간 장애 척도(modified Trunk Impairment Scale, mTIS)를 상지 기능 평가는 Wolf 운동 기능 검사(Wolf Motor Function Test, WMFT), 퓨글 마이어 상지 검사(Fugl Meyer Assessment-Upper/Extremity, FM-U/E)를 이용하였다. 체간 조절이 상지 기능 수행에 미치는 요인 분석과 상지 기능 구분( FM-U/E: 만점 66점, 51∼65점: 경미한 장애/ FM-U/E=0∼50점: 중증 또는 경증 장애)을 위한 체간 조절 평가의 변별력은 수용자 작업 특성곡선을 이용하여 선별 기준값과 우도비를 구하였다. 연구 결과 체간조절이 상지 기능에 미치는 요인 분석에서 mTIS-동적 항목(체간 외측 굴곡)과 협응(체간 회전)이 (설명력 37%) WMFT에 영향을 주었고, mTIS-동적 항목(42%)이 FM-U/E에 영향을 주는 것으로 나타났다. 상지 기능 수행 예측을 위한 최적의 선별 기준값은 mTIS-협응 >2.5점, mTIS-총점은 >7.5점이었다. mTIS-총점이 상지 기능 수행(FM-U/E: 51∼65점)을 예측할 수 있는 변수로 mTIS 총점이 >7.5점인 경우 ≤7.5점인 환자들에 비해 0.161배 높은 것으로 나타났다. 뇌졸중 환자들은 여전히 체간 조절 결핍과 상지 기능에 장애가 보인다. 따라서 체간 조절은 상지 기능 회복과 유의한 관련이 있으므로 체간 조절의 외측 굴곡과 회전 훈련은 강조되어야 한다. The purpose of this study is to investigate the effect of trunk control on upper extremity function in stroke patients. The evaluation of trunk control in 87 stroke patients was conducted using trunk control test(TCT), postural assessment scale for stroke-trunk control(PASS-TC), modified trunk impairment scale(mTIS), and the evaluation of upper extremity function was conducted using Wolf Motor Function Test(WMFT) and Fugl-Meyer Upper Extremity(FM-U/E). This study calculated the selection criteria value and the likelihood ratio using the receiver operating characteristic(ROC) curve, to analyze the factors by which trunk control affects the performance of upper extremity function and identify the discriminant power of trunk control evaluation for upper extremity functional classification [FM-U/E (66 points in full scale) = 51-65 points (minor disability) / FM-U/E = 0-50 points (severe or mild disability)]. According to the result of analyzing the factors by which trunk control affects upper extremity function, it turned out that mTIS-dynamic items (lateral trunk bending) and coordination (trunk rotation) affected the WMFT (explanatory power of 37%) and that mTIS-dynamic items (42%) affected FM-U/E. The optimal selection criteria value for the prediction of upper extremity functional performance were mTIS - coordination > 2.5 points and mTIS - total score > 7.5 points. t turned out that the patients with mTIS total score > 7.5 points was 0.161 times higher than the patients with ≤7.5 points in mTIS - total score, which is a predictor of upper extremity functional performance (FM-U/E: 51-65 points). Stroke patients are still deficient in trunk control and they have an impaired upper extremity function. In conclusion, trunk control is significantly associated with upper extremity function recovery, and thus, lateral trunk bending and rotation training should be emphasized.

한국판 기능적 동작 검사의 신뢰도와 타당도

안승헌,이제훈,An, Seung-Heon,Lee, Je-Hoon 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.5

Purpose: The purpose of this study was to determine the reliability and validity of the Functional Movement Screen (FMS) for assessing Korean athletes. Methods: A total of 48 patients (37 males and 11 females) participated in this study. Data were acquired after translation of the FMS from English to Korean and cross-cultural adaptation of the this questionnaire. To determine inter-rater reliability, the relationship between the FMS scores obtained by two raters was evaluated using the Kappa coefficient, which was in total agreement with the Intra-Correlation Coefficient (ICC3,1). Concurrent validity was examined by correlating the FMS scores with the Oswestry disability index (ODI) scores and Visual analogue scale (VAS) scores. Results: The raters demonstrated excellent agreement on 7 (above 90%) of the 17 test (72.9 to 97.9%) components. Substantial agreement was seen in 11 of the 17 tests. Two components of the In-line lunge and rotatory stability tests demonstrated moderate agreement. It showed good inter-rater reliability: the Kappa coefficients ranged from 0.42 to 0.97. ICC3,1=0.42~0.99 and 0.93 (total FMS score). Cronbach's alpha for FMS was 0.80. It was not correlated with ODI or VAS. Conclusion: The Korean version of the FMS is a reliable instrument for measuring movement patterns of Korean athletes and for making decisions related to interventions for performance enhancement.

집단 운동치료가 노인의 인지기능과 일상생활동작 및 균형 수행능력에 미치는 영향

안승헌 ( Seung Heon An ),이현주 ( Hyun Ju Lee ),임원식 ( Weon Sik Lim ),이형수 ( Hyoung Soo Lee ) 한국전문물리치료학회 2006 한국전문물리치료학회지 Vol.13 No.2

보행에 제한이 있는 뇌졸중 환자들의 한국어 번안 기능적 앉기 검사의 신뢰도와 타당도

안승헌 ( An Seung-heon ),이병권 ( Lee Byoung-kwon ) 대구대학교 특수교육재활과학연구소 2016 특수교육재활과학연구 Vol.55 No.3

국내에서 뇌졸중 환자들의 앉기 균형 평가에 관한 표준화된 평가 도구는 거의 없다. 본 연구의 목적은 기능적 앉기 검사(Function In Sitting Test, FIST)를 한글로 번안하여 보행에 제한이 있는 뇌졸중 환자들의 앉기 균형 평가의 신뢰도와 타당도를 검증하고자 하였다. 피 실험자 43명을 대상으로 FIST 개별 항목과 총점의 측정자간 신뢰도(Inter-rater reliability)는 가중치 카파 계수(Weighted kappa coefficient)와 급간 내 상관계수(Intra class coefficient, ICC_2,1)를 이용하였다. FIST 개별 항목과 총점간의 관련성은 스피어만 상관 계수(Spearman correlation coefficient)를 이용하였고, 문항 내적 일치도는 크론바 알파 계수(Cronbach`s α coefficient)로 구하였다. 또한 절대적 신뢰도 지수인 FIST의 표준 측정 오차(Standard error measurement, SEM)와 최소 감지 변화(Minimal detectable change, MDC)를 구하였다. FIST의 동시 타당도는 체간 조절 검사(Trunk Control Test, TCT), 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke, PASS), 수정된 델지수(Modified Barthel Index, MBI)를 이용하여 스피어만 상관 계수를 구하였다. 본 연구 결과 FIST 1∼14번 개별 항목의 가중치 카파 계수는 .80∼.96, FIST 총점의 ICC=.99(.98∼.99)이었다. FIST 개별 항목과 총점간의 관련성은 r=.82∼.93이었고, FIST의 문항 내적 일치도는 .97로 높은 수준이었다. FIST의 SEM은 0.95점(평균 점수 29.95점의 10%미만), MDC는 2.63점으로(FIST평가 최고 점수인44점의 20%미만)신뢰할만하였다. FIST의 동시 타당도는 TCT(r=.85), PASS(r=.82), MBI(r=.81)와는 매우 높은 상관관계가 있었다. FIST 평가는 보행에 제한이 있는 뇌졸중 환자들의 앉기 균형을 평가 하는데 매우 적합한 것으로 확인되었다. 따라서 FIST는 임상에서 앉기 균형 평가에서 시작하여 서기자세 균형과 보행에 필요한 동적 균형 능력을 평가하는데 보조적인 평가 방법이 될 수 있을 것이다. In Korea, there is no standardized assessment tool for sitting balance assessment of stroke patients. The purpose of this study was to adopt FIST into Korean in order to verify the reliability and validity of a sitting balance assessment of stroke patients who had limited walking abilities. The study was held with 43 subjects who were measured using the FIST individual item score and Inter-rater reliability with the Weight Kappa Coefficient and Intra Class Coefficient (ICC2,1). The relevance between the individual items of FIST and total scores was calculated through Cronbach`s a coefficient. In addition, absolute reliability indexes including the Standard Error Measurement(SEM) of FIST and Minimal Detectable Change(MDC) were measured. Concurrent Validity of the FIST Trunk Control Test(TCT), Postural Assessment Scale(PAS) for Stroke, Modified Barthel Index(MBI) were measured in relation to the Spearman correlation coefficient. According to this study, the Weighted Kappa coefficient of the FIST individual items 1-14 was 0.80 to 0.96 times, and the FIST total score was ICC=.99 (.98~.99). The relevance of the FIST score and individual items was r=.82~.93 which showed high relevant levels between the two items. The Crohn`s alpha coefficient of FIST bar was high at 0.97. The SEM of FIST was 0.95 points and was less than 10%(average 29.95score). The MDC was fairly reliable by only being 2.63 points, less than 20%(FIST highest rating 44score). The concurrent validity of FIST has been confirmed to have a very high correlation with the TCT(r=.85), PASS(r=.82) and MBI(r=.81). The FIST assessment has been found to be very suitable for a sitting balance evaluation of stroke patients with limited walking. Therefore, FIST could be useful as a secondary evaluation method in assessing functions ranging from sitting balance to standing balance and evaluating the dynamic balance skills needed for clinical postural and gait.