Rehabilitation Strategies in Lifestyle Intervention for Improving the Physical Function of the Knee

Jongmin Lim,Bumchul Yoon 대한스포츠물리치료학회 2018 정형스포츠물리치료학회지 Vol.14 No.2

Purpose: Lifestyle intervention (LSI) provides basic recommendations that improve the quality of life and health of patients with minor disabilities. The LSI intervention strategies are associated with active living, healthy weight, healthy eating, and emotional stability. These intervention strategies can change an unhealthy lifestyle to a healthy lifestyle and provide important health care information. Main issue: This study focused on a new LSI-based knee rehabilitation protocol and proved the effect of exercise prescription on the knee. The clinical significance of this study demonstrated that continuous rehabilitation, effective rehabilitation, and recurrence prevention can be achieved by prescribing the appropriate exercise for patients after discharge. Therefore, practical lifestyle medicine knowledge and information are provided by the home-based rehabilitation self-exercise program with the new LSI-based knee rehabilitation protocol. Conclusions: The LSI-based protocol can improve and maintain health conditions and knee function. With the aim of improving self-care abilities, this program is expected to make significant contributions recurrence prevention, reduced mortality, and improved quality of life, physical function, and fitness.

Effects of Transcranial Direct Current Stimulation Over Primary Motor Cortex on the Onset Time of Upper Extremity Muscles’ Activities for Forward Reaching Performance : A Preliminary Study

JaeHyuk Lee,BumChul Yoon 대한스포츠물리치료학회 2019 정형스포츠물리치료학회지 Vol.15 No.1

Purpose: This study aimed to investigate the effect of transcranial direct current stimulation (tDCS) on the onset of upper extremity muscle activities during forward reaching performance. Methods: Fifteen healthy men (age, 24.2±1.55y) participated in this randomized double-blind crossover study. Each participant received both a sham and 2-mA stimulation over M1 bilaterally for 20 min, with a minimum washout period of 4 days. Muscle activation was evaluated for all the participants during the task of reaching out for a marked target as fast as possible, using electromyography (EMG) before and immediately after tDCS application. Results: For the within arm-length reaching performance in the 2-mA stimulation session, the muscle activities of the anterior deltoid (AD), posterior deltoid (PD), biceps brachii (BB), and inferior spinatus (IS) were decreased significantly during, immediately after, and 20 min after the tDCS period compared with the baseline values (p for all values <0.05). The pectoralis major (Pec) muscle showed a significant decrease only in the 20-min period after tDCS compared with the baseline values (p=0.001). For the beyond arm-length reaching performance, the 2-mA application on the AD, PD, BB, and IS showed significant decreases in onset time in all the periods after tDCS as compared with the baseline (p for all values <0.05). The onset of the triceps brachii muscle activity significantly decreased immediately and 20 min after the tDCS periods. For the Pec muscle, the onset time of muscle activation significantly changed only in the 20 min after the tDCS period compared with the baseline values. Conclusion: The present study demonstrated that bilateral tDCS over M1 facilitates muscle activation rapidly during the reaching performance, regardless of the reaching target distance.

The Onset Time of Neck and Shoulder Muscles Activation During Shoulder Elevation in Older and Young Adults

TaeYeong Kim,Minhee Kim,BumChul Yoon 대한스포츠물리치료학회 2017 정형스포츠물리치료학회지 Vol.13 No.1

This study examined differences in the time to onset of neck and shoulder muscle activation during arm elevation in older and younger adults. Eleven older and 10 younger adults were recruited. Data from neck and shoulder muscles were recorded as a subject elevated one arm. The mean time to onset of muscle activation was compared using an independent t-test. Older adults demonstrated significantly later onset of contraction of the ipsilateral sternocleidomastoid during shoulder flexion (p = 0.046), as well as significantly later contraction of the middle deltoid (p = 0.005), posterior deltoid (p = 0.027), contralateral splenius capitis (p = 0.008), upper trapezius (p = 0.020), middle trapezius (p = 0.012), lower trapezius (p = 0.012), and infraspinatus (p = 0.001) during shoulder abduction. These findings indicate that older adults use different neuromuscular strategies than younger adults during arm elevation. These changes could result from age-related decline in the neuromuscular system. The findings could be used to identify contributors to neck and shoulder discomfort or dysfunctionin older adults.

토끼의 경골골절 후 치유 촉진을 위한 전기자극 치료의 효과

이재학(JaeHac Lee),윤범철(BumChul Yoon) 고려대학교 보건과학연구소 2007 보건과학논집 Vol.33 No.1

  Electrotherapy is one of the most important modality of Physical Therapy. Many therapists have been using electrotherapy to treat musculoskeletal diseases. Since 1950"s, researchers have been experimenting about effects of electrical stimulation to facilitate the healing of fractured bones. Taking into account that MES also increases blood flow in the muscle tissue and that blood flow has a close relationship to the fracture healing, it is likely that the use of MES may result in an improvement in the healing of fractured bones. We performed studies, to confirm the effects of electrical stimulation which is applied to rabbit"s fractured tibial bone. The object of the present study was to evaluate the effect of electrical stimulation on fracture healing, using rabbits model. 10 rabbits(3.9~4.5 ㎏) were used and divided into two groups, one group was treated by electrical stimulation and the other group was not given any treatment.<BR>  All rabbits received unilateral, transvers, mid-tibial, 3㎜ gapped osteotomics that were stabilized with double bar external fixator and splinter. Electrical stimulation was applied 1 hour per day for 2 weeks. We used the needle electrodes to stimulate the muscles selectively. Used electrical stimulator was Free Q. We employed X-ray to confirm the callus formation and used CT to verify bone mineral density at cross section of fractured areas of the bone. Fracture healing was not significantly increased in the experimental group on the radiological studies(p> .05). respectively, higher in the study group compared to the control group.<BR>  This result of the present study demonstrated that use of MES can enhance callus development and mineralization, with the consequent improvement of the healing bone.

건강보험정책심의위원회의 이익집단 간 대립이 물리치료 수가에 미치는 영향

김유신,윤범철,Kim, Yushin,Yoon, Bumchul 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.2

Purpose: The aim of this study was to demonstrate that non-participation of physical therapists on the political decision-making committee results in invasion of their interests. Methods: To demonstrate the effects, we analyzed the change of medical insurance score decided by the Health Insurance Policy Deliberation Committee between 2001 and 2012 years, focusing on medical examination as the interest of the participation group and physical therapy cost as interest of the non-participation group. Results: Total medical insurance cost increased by 23.72%, on average. Medical examination cost increased by 23.90% and 37.66% in medical examination for new and established patients, respectively. However, physical therapy cost was reduced by 5.01%. The medical examination cost for physical therapy without medical checkup increased by 2.62%. Conclusion: This study shows that the physical therapy cost, related on the interest of the non-participative group in the Health Insurance Policy Deliberation Committee, rather decreased while the total medical insurance cost increased.These findings demonstrate the invasion of the non-participative group on the Health Insurance Policy Deliberation Committee. Thus, aggressive participation in political decision-making committee is necessary in order to protect and increase rights and interests of Korean physical therapists.

The Effect of Multi-channel FES Stimulation Gait Training based on Muscle Synergy Analysis on Gait Performance in Stroke Patients : A Case Study

TaeHyun Lim,JungHwan Lim,BumChul Yoon 대한스포츠물리치료학회 2019 정형스포츠물리치료학회지 Vol.15 No.2

Purpose: Foot drop is a common symptom in disorders of the central nervous system (CNS : Central Nervous System), such as stroke. The combination of functional electrical stimulation (FES : Functional Electronical Stimulation) and gait rehabilitation is an effective intervention for stroke gait rehabilitation. Therefore, the aim of this study was to determine the effectiveness of FES training based on the muscle synergy pattern of stroke patients during gait. Methods: The intervention was tested on two chronic stroke patients. They underwent a 6-week intervention consisting of 30 min sessions of FES-supported gait three times per week. Muscle synergies were extracted from electromyography (EMG : electromyography) signals using a non-negative matrix factorization algorithm (NMF : Non-negative Matrix Factorization). Results: The optimal number of synergies has been defined as the minimum number needed to obtain variability accounted for (VAF) ⩾90%. Before treatment, both patients presented only three merged muscle synergies during gait, resembling two different gait abnormalities. After the 6-week intervention, the number of extracted synergies became four and they increased their gait speed with the physiological muscle synergies. The 10m walking test (10MWT : 10Meter Walking Test) used in the first and last days of intervention increased from 16.11 to 14.56 m/s, and from 19.76 to 15.37m/s for Subject 1 and Subject 2, respectively. Conclusion: Multi-channel FES walking intervention based on synergy analysis influenced the number of muscle synergies during the gait of stroke patients. This intervention has an effective effect on improving the gait performance of stroke patients.

The Effects of Mobile-app-based McKenzie Exercises on the Improvement of Neck Pain, Functional Disability, Exercise Adherence, Fear-avoidance Belief and Quality of Life in Intensive Computer Users

JaeHyuk Lee,Maria Celeste Flores Gimenez,BumChul Yoon 대한스포츠물리치료학회 2017 정형스포츠물리치료학회지 Vol.13 No.1

Prolonged sitting is a high-risk factor for chronic neck pain. McKenzie exercises are commonly used in clinics. Mobile app-based care is increasingly popular, and providesaccess to health information. This study examined the effect of mobile app-based McKenzie exercise on pain intensity, functional disability, exercise adherence, fear avoidance, and quality of life. Twenty graduate students participated in the study to completion. Neck exercise was performed as directed by the mobile app in the workplace environment for at least 10 min/day, 3 days/week for 8 weeks. The Visual Analog Scale (VAS) score for pain intensity, the Neck Disability Index (NDI) for functional disability, the level of exercise adherence, the Fear-Avoidance Belief Questionnaire (FABQ), and the 36-Item Short-Form Health Survey (SF-36) for the quality of life were used to evaluate outcomes. After an 8-week intervention, the VAS (p < .001) and NDI(p < .001) scores were significantly improved with app-based neck exercise. The work-related subscale (p = 0.023) in the FABQ and physical component summary (p < .001) of the SF-36 showed significant improvement in psychological and physical health. The exercise adherence rate was 87.5 %. In conclusion, this study showed that app-based neck exercise can reduce pain intensity and functional disability.

Deficits in motor abilities for multi-finger force control in hemiparetic stroke survivors

Kim, Yushin,Kim, Woo-Sub,Koh, Kyung,Yoon, BumChul,Damiano, Diane L.,Shim, Jae Kun Springer-Verlag 2016 Experimental brain research Vol.234 No.8

<P>The ability to control redundant motor effectors is one of hallmarks in human motor control, and the topic has been studied extensively over several decades since the initial inquiries proposed by Nicholi Bernstein. However, our understanding of the influence of stroke on the control of redundant motor systems is very limited. This study aimed to investigate the effect of stroke-related constraints on multi-finger force control abilities in a visuomotor task. Impaired (IH) and less-impaired hands (LH) of 19 hemiparetic stroke survivors and 19 age-matched control subjects were examined. Each hand repeatedly produced isometric forces to match a target force of 5 N shown on a computer screen using all four fingers. The hierarchical variability decomposition (HVD) model was used to separate force-matching errors (motor performance) into task-relevant measures (accuracy, steadiness, and reproducibility). Task-irrelevant sources of variability in individual finger force profiles within and between trials (flexibility and multiformity) were also quantified. The IH in the stroke survivors showed deficits in motor performance attributed mainly to lower accuracy and reproducibility as compared to control hands (p < 0.05). The LH in stroke survivors showed lower reproducibility and both hands in stroke also had higher multiformity than the control hands (p < 0.05). The findings from our HVD model suggest that accuracy, reproducibility, and multiformity were mainly impaired during force-matching task in the stroke survivors. The specific motor deficits identified through the HVD model with the new conceptual framework may be considered as critical factors for scientific investigation on stroke and evidence-based rehabilitation of this population.</P>

엎드려 누운 자세에서 고관절 각도변화에 따른 슬괵근의 등장성 근력평가

이재학(JaeHak Lee),함용운(YoungWoon Ham),윤범철(BumChul Yoon) 고려대학교 보건과학연구소 2005 보건과학논집 Vol.31 No.1

Since isotonic exercise equipment can give an evaluation of muscle strength with great accuracy and objectivity, it is widely used as the one of the important methods for evaluation of muscle performance. The purpose of this study were to measure concentric and eccentric muscle strength of the Hamstring muscles as the change of hip angle in dominant. Concentric and eccentric muscle strength was assessed by monitoring peak power, average peak power, average power, peak velocity, average peak velocity, peak force, average peak fore, and total work for the Hamstring muscles using the EN-TreeM isotonic dynamometer. For this thirty healthy males performed knee motion at 74.89% of their 1 RM with 45° and 0° flexion fo their hip angle. The results were as follow : 1. The peak power, average peak power, peak force and average peak force of concentric contraction at 0° of the hip joint angle were greater than those at 45° of the hip joint angle. 2. The peak power, average peak power, peak force and average peak force of eccentric contraction at 45° of the hip joint angle were greater than those at 0° of the hip joint angle. 3. The average power and total work of concentric and eccentric contraction at 45° of the hip joint angle were greater than those at 0° of the hip joint angle.

정상 성인 남녀의 선 자세에서 비예측적 지지면 이동 시체간 안정성과 균형능력 비교

김민희,김유신,윤범철,Kim, Minhee,Kim, Yushin,Yoon, BumChul 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.2

Purpose: The aim of this study was to clarify the gender difference during standing balance in accordance with recruitment of abdominal muscles against sudden support surface translation. Methods: Twenty healthy males (n = 10, $26.50{\pm}3.54$ years, $170.60{\pm}6.30cm$, $72.80{\pm}5.69kg$) and females (n = 10, $24.40{\pm}2.63$ years, $163.00{\pm}4.97cm$, $52.10{\pm}4.41kg$) participated in the study. Each subject performed standing balance task on a platform, which moved in the anterior and posterior direction, with a total of 18 trials in three abdominal conditions (resting, hollowing, and bracing). We analyzed angular displacement of thoracic and lumbar spine and linear displacement of center of mass for evaluatione of spinal stability and standing balance, respectively. Results: Angular displacement of thoracic and lumbar spine and linear displacement of center of mass did not differ significantly between female and male in all conditions. Conclusion: Our results indicate that the ability to maintain spinal stability and standing balance were similar between male and female regardless of the abdominal contractile conditions and the direction of support surface translation.