재활의학과 치료 부도율 관리

하현근 한국의료QA학회 2007 가을학술대회 Vol.2007 No.3

The reliability of dual rehabilitative ultrasound imaging measurements for muscle co-activation

한주희,하현근,이황재,임승엽,이완희 물리치료재활과학회 2017 Physical therapy rehabilitation science Vol.6 No.3

Objective: The aim of this study was to determine the intra-rater and inter-rater reliability of the dual rehabilitative ultrasound imaging (D-RUSI) when simultaneously measuring muscle thickness changes at rest and during co-contraction of the biceps brachii (BB) and triceps brachii (TB). Design: Cross-sectional study. Methods: This study included 36 healthy participants (23 men, 13 women). The participants sat on a chair in a comfortable position with a cushion placed under their elbow to maintain a 90-degree elbow flexion angle. The muscle thickness of the biceps brachii and triceps brachii was measured twice using the D-RUSI by two examiners during resting and co-contraction states. One week later, the same procedure was performed once again. Results: The intra-class correlation coefficients (ICCs) for intra-rater reliability ranged from 0.887 to 0.989 and the confidence interval was within an acceptable range of 0.778 to 0.994. The standard error of measurement (SEM) values ranged from 0.303 to 0.866 and the minimal detectable change (MDC) values ranged from 0.84 to 2.40. The ICCs for inter-rater reliability ranged from 0.758 to 0.925. The SEM values ranged from 0.702 to 1.486 and the MDC values ranged from 1.95 to 4.12. Conclusions: The use of the D-RUSI of the BB muscle had a very good intra-rater reliability and very good inter-rater reliability at the resting state, and a, good inter-rater reliability at the co-activation state. ICC values showed very good intra-reliability and inter-reliability for the TB muscle. the D-RUSI is a useful tool for simultaneously measuring the thickness of two muscles when the BB is an agonist and the TB is an antagonist during co-activation of the upper arm.

물리치료 기술 개발 방향 정립을 위한 세부 연구 분야 우선순위 도출

김형근,하현근,배영현,Kim, Hyeong Geun,Ha, Hyun Geun,Bae, Young-Hyeon 대한물리치료과학회 2022 대한물리치료과학회지 Vol.29 No.1

Background: The purpose of this study was to suggest agenda priorities for research and development with physical therapy technology. Design: Cross-sectional study. Methods: A survey was consecutively done to 62 experts working in physical therapy research areas to investigate the priority of the categories. Paired T-tests and Importance-Performance Analysis using SPSS 21.0 package were conducted to find the differences between importance and satisfaction of the categories and the order of priority. Results: In results, it was developed that the research and development with physical therapy technology were divided with 18 categories. And the importance were significantly higher than satisfaction in 18 categories. Specifically, categories about assistive technology and robot rehabilitation were found to be on the high importance and lower performance quadrant. Conclusion: In sum, this study was meaningful in finding usage categories of research and development with physical therapy technology and investigating Importance-Performance differences for deriving research and development with physical therapy technology.

만성 뇌졸중 환자에서 운동 기능 회복에 대한 로봇-보조 보행치료의 효과

정경훈,하현근,신희준,온석훈,성덕현,이강우,김연희 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.3

Objective: To investigate the effects of robot-assisted gait therapy on locomotor recovery in hemiparetic patients after stroke.Method: Twenty five stroke patients were randomly divided into 2 groups. Robotic training group received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks, while control group received conventional gait training with same duration and frequency as robotic group. Outcome was measured using Motricity index, Fugl-Meyer assessment (FMA), function ambulation category, modified motor assessment scale, 10-meter gait speed, isometric torque, Ashworth scale, gait analysis, body tissue composition, and Beck's depression inventory (BDI).Results: Robotic training group showed significant improvement in motor functions measured by Motricity Index, FMA, 10-meter gait speed, isometric torque of hip compared with the baseline and with those of control group. Ashworth scale of hip, BDI, and muscle mass showed significantly greater improvement in robotic training group than control group. In gait analysis, stride length of unaffected leg demonstrated significant improvement in robotic training group (p<0.05).Conclusion: The robot-assisted gait therapy with body weight-support is considered to facilitate locomotor recovery of the hemiparetic stroke patient.

EMR을 통한 Communication 강화활동

김연희,하현근,박선욱,김양구,이경식,전희정,남미숙,임용섭 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

뇌졸중환자에서 로봇보조 보행치료 후 뇌가소성 - 증례보고 -

유지성,박창현,하현근,신희준,허정필,김연희 대한뇌신경재활학회 2008 뇌신경재활 Vol.1 No.1

In this case study, we investigated the effects of robot-assisted gait training on the plasticity of motor system in a stroke patient using functional MRI. A patient who suffered from the left hemiparesis following the right MCA infarction performed gait training with a robot-assisted gait orthosis. Before and after gait training, motor performances were assessed and functional MRIs were acquired with motor activation task of affected lower limb. After gait training with a robot-assisted orthosis, the patient's motor performances were improved and cortical activities were changed. Activation in the ipsilesional primary sensorimotor cortex was increased and cortical reorganization was induced in a way that nearby regions were recruited for the movement of affected lower limb. The results of this study showed that gait training with a robot-assisted orthosis induced cortical reorganization of the motor network that resulted in enhancement of motor performance of the lower limb.

재활 초음파 영상을 이용한 젊은 성인의 하지 근 구조 비교: 서울과 하노이 하지 근 단면적비교 연구

이황재,김민규,하현근,이완희,Lee, Hwang-Jae,Kim, Min-Kyu,Ha, Hyun-Geun,Lee, Wan-Hee 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.5

Purpose: The aim of the current study was to compare the muscle architecture of lower extremity using rehabilitative ultrasound imaging (RUSI) in young adults in Seoul and Hanoi. Methods: The study design was a comparative study of muscle cross-sectional area of lower extremity. Sixty healthy young subjects (Seoul group: 30, Hanoi group: 30) participated in this study. Real-time B-mode RUSI with a 7.5MHz linear transducer was used for measurement of cross-sectional area, pennation angle, and muscle thickness of the rectus femoris, tibialis anterior, and medial gastrocnemius muscles. Independent t-test was used for statistical analysis. Results: Significant difference in cross sectional area of rectus femoris was observed between Korean young adults and Hanoi young adults (p<0.01). Muscle thickness and pennation angle of tibialis anterior in Korean young adults were greater than in Hanoi young adults (p<0.01). In addition, the muscle thickness and pennation angle of the medial part of gastrocnemius muscle were greater in Korean young adults than in Hanoi young adults (p<0.01). In addition, in the results for gender, men had larger muscle architectures than women in both groups (p<0.01). Conclusion: This study, using RUSI, showed significant difference in muscle architectures of lower extremity in a diverse group of young adults RUSI.

EMR적용 후 재활치료 의뢰 환자의 24시간 내 치료 start시간관리

김연희,김양구,황지혜,박광홍,하현근,남미숙,이경식,전희정,박현희,채순엽,안현주 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

급성 뇌졸중 환자의 중증도 수준에 따른 노인 배우자의 우울 및 부담감 분석을 위한 미국 국립보건원 뇌졸중척도의 유용성과 관련성

배영현,강승탁,이종훈,장원혁,김양구,김연희,하현근 한국장애인재활협회 2013 재활복지 Vol.17 No.3

본 연구는 급성 뇌졸중 환자를 돌보는 노인 배우자가 가장 의미 있는 돌봄의 제공자임을 인식하고 불안의 발생이 높은 뇌졸중 초기 단계에서 노인 배우자가 인지하는 우울 및 부담감을 분석하기 위한 다양한 증상을 체계적으로 평가하는 미국 국립보건원 뇌졸중척도의 유용성을 확인하고 관련성을 알아보고자 하였다. 급성 뇌졸중 환자를 돌보는 노인 배우자 50명에게 일반적 특성, 우울과 부담감에 대한 자기 기입식 설문지를 이용하여 조사하였다. 연구결과, 노인 배우자의 우울 및 부담감은 급성 뇌졸중 환자의 중증도 수준에 따라 유의하게 차이를 보였다. 그리고 급성 뇌졸중 환자의 중증도가 증가할수록 노인 배우자의 우울 및 부담감이 증가하는 양의 상관관계를 보였고 노인 배우자의 우울 및 부담감 간에도 양의 상관관계를 보였다. 또한 노인 배우자의 우울 및 부담감에 가장 영향을 주는 예측 변수로는 환자의 증증도였다. 따라서 급성 뇌졸중 환자를 돌보는 노인 배우자는 환자를 돌보는 과정에서 환자의 중증도 수준에 따른 우울 및 부담감을 다르게 경험하게 되고 서로 간의 관련성이 있는 것으로 보이고 뇌졸중 척도가 평가하는 것이 유용할 것으로 보인다. 그러므로 급성 뇌졸중 환자에게 뇌졸중 척도로 중증도 수준을 평가하고 그에 따른 노인 배우자의 특성을 이해하여 초기부터 노인 배우자의 부담감과 우울을 관리 할 필요가 있을 것으로 보인다. The purpose of this study was to examine the relationship and usefulness for the analysis of the severity of stroke patients and depression and caregiver burden of elderly spouses in early stage of stroke. Self-reported questionnaires were given to 50 elderly spouses of stroke patients. Variables examined included the stroke patient's severity measured by NIH stroke scale(NIHSS), elderly spouse's depression and caregiver burden, financial status, recognition level of disease, hospital costs, etc. Elderly spouse's depression and caregiver burden differed significantly according to the severity stroke patients(p <0.05). Severity of stroke patients showed a positive correlation with elderly spouse's depression and caregiver burden(p <0.01). These results demonstrated that elderly spouses of stroke patients are suffered from proportionally increasing caregiver burden and depression depending on the severity of stroke. Therefore, rehabilitation team need to manage the caregiver burden and depression of elderly spouses of stroke patients according to severity of patients.

아급성 뇌졸중 환자에서 Space Balance 3D와 Tinetti Mobility Test를 이용한 균형 능력 평가의 신뢰도 및 동시타당도 연구

최지민(Ji-Min Choi),이종훈(Jong-Hoon Lee),하현근(Hyun-Geun Ha),김양구(Yang-Gu Kim),김연희(Yun-Hee Kim),배영현(Young-Hyeon Bae) 한국콘텐츠학회 2012 한국콘텐츠학회논문지 Vol.12 No.8

본 연구는 아급성 뇌졸중 환자를 대상으로 컴퓨터화된 시각적 되먹임 균형 훈련 및 평가 장비인 space balance 3D와 기능적 검사인 tinetti mobility test (TMT)의 신뢰도 및 버그균형척도와의 동시타당도를 분석하기 위해 실시하였다. 아급성 뇌졸중 환자 총 23명을 대상으로 하였고 대상자에게 space balance 3D, TMT, 버그균형척도를 이용해 균형 능력 평가를 실시하였다. 검사-재검사간 신뢰도에서 space balance 3D의 정적균형과 동적균형은 중등도의 신뢰도를 보인반면, TMT의 세가지 점수와 버그균형척도는 높은 신뢰도를 보였다. 동시타당도에서 TMT의 세가지 점수, 버그균형척도, space balance 3D의 정적균형간에 각각 중등도의 유의한 (p<.01) 양의 상관관계를 보였다. TMT의 세가지 점수와 버그균형척도는 space balance 3D의 동적균형의 후좌측, 전좌측 방향과는 각각 유의한 (p<.05) 낮은 양의 상관관계를 보였지만 나머지 방향과는 유의한 상관관계를 보이지 않았다. 따라서 space balance 3D와 TMT의 균형 능력 평가는 아급성 뇌졸중 환자의 균형 능력을 평가하는데 유용하게 쓰일 수 있을 것으로 보이나 space balance 3D의 동적균형 평가는 한계점이 있었다. The purpose of this study was to determine the test-retest reliability and the concurrent validity between tinetti mobility test (TMT), berg balance scale (BBS) and space balance 3D which is one of the computerized measurement and visual feedback balance assessment system in subacute stroke patients. Twenty three ambulatory acute stroke subjects were measured the TMT, BBS and space balance 3D. The test-retest reliability(intra-class correlation coefficient: ICC) indicated that the static and dynamic balance in space balance 3D considered moderate reliability and TMT, BBS were good reliability. In case of concurrent validity, there were moderate validity (p<.01) between static balance test with space balance 3D and each TMT, BBS. But there were only poor validity (p<.05) between center to forward-left, center to backward-left phase in dynamic balance test with space balance 3D and each TMT, BBS. These findings suggest that in subacute stroke patients the test-retest reliability and concurrent validity using the space balance 3D and TMT were valuable in balance test but there was limitation to evaluate dynamic balance test.