The Effects of Extracorporeal Shock Wave Therapy on Spasticity in Chronic Stroke Patients

Hasuk Bae,Kyung Hwan Lee,Jung Min Lee 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.6

Objective To evaluate the immediate and short term effects of extracorporeal shock wave therapy (ESWT) on elbow flexor spasticity after stroke, to compare the treatment effects according to the ESWT applied site (muscle group and musculotendinous junction group) and to assess the factors affecting the treatment effect. Method A total of 32 stroke patients were enrolled, 23 of them were ESWT group and 9 were control group. ESWT was applied 1 session/week, total 3 sessions and 12 patients were applied at biceps muscle belly and 11 patients were applied at biceps musculotendinosus junction. Patients were evaluated using modified Ashworth scale (MAS), modified Tardieu scale (MTS), Korean-modified Barthel index (K-MBI) at baseline, immediately, 1 week and 4 weeks after ESWT. Results MAS and MTS were significantly improved immediately after ESWT, but were not significantly changed at 1 week, 4 weeks in ESWT group. The scores of K-MBI improved but were not different between ESWT group and control group. The treatment effect was greater in musculotendinous junction group than muscle belly group in MTS and MAS immediately after ESWT. We could not find out any significant factors affecting the effects of ESWT. Conclusion Spasticity after chronic stroke improved immediately after ESWT, but was not changed significantly at 1 week and 4 weeks after ESWT. Further studies about ESWT parameters for spasticity and factors affecting treatment effect are needed.

재활 훈련용 보행보조 로봇의 운동학적 특성

배하석(Hasuk Bae),김진오(Jin Oh Kim),전한용(Han Yong Chun),박광훈(Kwang Hun Park),이경환(Kyung Whan Lee) 대한기계학회 2011 대한기계학회 춘추학술대회 Vol.2011 No.5

보행보조 로봇의 운동학적 특성

배하석(Hasuk Bae),김진오(Jin Oh Kim),전한용(Han Yong Chun),박광훈(Kwang Hun Park),이경환(Kyung Whan Lee) 대한기계학회 2011 大韓機械學會論文集A Vol.35 No.5

보행 재활 훈련용 보행보조 로봇을 개발하고, 시제품의 운동학적 특성을 평가하였다. 이 보행보조로봇은 고관절(hip), 슬관절(knee), 족관절(ankle) 등으로 구성되며, 각 관절은 감속기가 포함된 모터에 의해 구동된다. 인체 보행 운동을 이론적으로 해석하여, 보행 운동 중 각 관절의 각도 변위를 계산하는 식을 구하였고, 계산된 각도 변위를 로봇 구동기에 입력하였다. 트레드밀(treadmill) 위에서의 실험을 통해 다양한 보행 속도(walking speed) 및 보폭(stride)에서 각 관절의 출력 각도 변위를 측정하고 입력 값과 비교하였다. 입력 각도 변위와 출력 각도 변위의 차이가 고관절에서는 5.22%, 슬관절에서는 2.97% 이내로 일치함을 확인하여, 설계대로 보행보조 로봇이 작동함을 입증하였다. We developed a walking-assistance robot for walking rehabilitation and assessed the kinematic characteristics of a prototype. The walking-assistance robot is composed of hip, knee, and ankle joints, and each joint is driven by a motor with a decelerator. The equations of angular displacement while walking were derived by theoretically analyzing human locomotion, and the calculated angular displacements were then applied to the robot controller. The output angular displacement of each joint was measured and compared with its input angular displacement in walking experiments on a treadmill at various walking speeds and strides. The differences between the input and output angular displacements are 5.22% for the hip and 2.97% for the knee joints, and it has been confirmed that the walking-assistance robot works well.

Association Between Length of Stay in the Intensive Care Unit and Sarcopenia Among Hemiplegic Stroke Patients

Aeri Jang,Chang Hoon Bae,Soo Jeong Han,Hasuk Bae 대한재활의학회 2021 Annals of Rehabilitation Medicine Vol.45 No.1

Objective To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients. Methods This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders. Results Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028). Conclusion The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.

Determining the Most Appropriate Assistive Walking Device Using the Inertial Measurement Unit-Based Gait Analysis System in Disabled Patients

Junhee Lee,Chang Hoon Bae,Aeri Jang,Seoyon Yang,Hasuk Bae 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.1

Objective To evaluate the gait pattern of patients with gait disturbances without consideration of defilades due to assistive devices. This study focuses on gait analysis using the inertial measurement unit (IMU) system, which can also be used to determine the most appropriate assistive device for patients with gait disturbances. Methods Records of 18 disabled patients who visited the Department of Rehabilitation from May 2018 to June 2018 were selected. Patients’ gait patterns were analyzed using the IMU system with different assistive devices to determine the most appropriate device depending on the patient’s condition. Evaluation was performed using two or more devices, and the appropriate device was selected by comparing the 14 parameters of gait evaluation. The device showing measurements nearer or the nearest to the normative value was selected for rehabilitation. Results The result of the gait evaluation in all 18 patients was analyzed using the IMU system. According to the records, the patients were evaluated using various assistive devices without consideration of defilades. Moreover, this gait analysis was effective in determining the most appropriate device for each patient. Increased gait cycle time and swing phase and decreased stance phase were observed in devices requiring significant assistance. Conclusion The IMU-based gait analysis system is beneficial in evaluating gait in clinical fields. Specifically, it is useful in evaluating patients with gait disturbances who require assistive devices. Furthermore, it allows the establishment of an evidence-based decision for the most appropriate assistive walking devices for patients with gait disturbances.

Effects of Lymphovenous Anastomosis Surgery Using Ultrasonography in Lymphedema From a Pressure Perspective

Jayoung Lee,Soojin Kim,Kyongje Woo,Hasuk Bae 대한재활의학회 2022 Annals of Rehabilitation Medicine Vol.46 No.4

Objective To analyze the effects of lymphovenous anastomosis (LVA) surgery after 1 year using the elastic index (EI) and volume.Methods This study was a retrospective study of 41 patients, with lymphedema, who underwent LVA surgery between July 2018 and June 2020. Limb circumference, used to determine the volume of the limb with lymphedema, and EI, which reflects tissue stiffness and measured using ultrasonography were measured for each patient before and 1 year after LVA surgery. To examine the effect of LVA, differences in the preoperative and 1-year postoperative volumes and EIs were analyzed using the Wilcoxon signed-rank test.Results The mean volume and EI of the dominant site in upper-extremity lymphedema were 2,309.4 cm3 and 1.4, respectively, preoperatively and 2,237.1 cm3 and 0.9, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year after surgery was -16.6 cm3 (p=0.22) and -0.5 (p<0.001). The mean volume and EI of dominant site in lower-extremity lymphedema were 6,137.0 cm3 and 1.2, respectively, preoperatively, and 5,832.6 cm3 and 1.1, respectively, at 1 year postoperatively. The mean volume and EI difference of the dominant site 1 year postoperatively were -320.9 cm3 (p=0.04) and -0.2 (p=0.09), respectively.Conclusion LVA surgery is more effective in reducing pressure than in reducing volume, which may be helpful in preventing the progression of lymphedema.

유한요소법을 이용한 인두의 기능이상에 대한 생체역학적 모델

김성민,김성재,배하석 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-

Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement) into the esophagus and functioning as airway passages, In this study, structural changes of pharyngeal dysfunction is analyzed by biomechanical model using CT and FEM(finite element method). Loading condition assumed that equal pressure loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model, the pharyngeal dysfunctions classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke, which is a change of material property is caused by muscular tissue stiffness, deformation of cross sectional area of the pharynx is analyzed increasing the stiffness 25%, 50%, 75% in each case on the basis of stress-strain relationship. Based on three - dimensional reconstruction of pharyngeal structure using limited - factor - techniques and the optimization procedure by means of inverse dynamic approach, the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

AI(Aritificial Intelligence) Determination of Functional Ambulatory Category of Stroke Patients

Jeong-Hyun Kim,Seong-Ho Jang,Hye Jung Park,Jae-Young Han,Hasuk Bae,Seok Kang,Sang Yoon Lee,Hyundo Kim,Shi-Uk Lee 한국재활복지공학회 2021 한국재활복지공학회 학술대회논문집 Vol.2021 No.11

요양시설의 기능회복훈련 서비스 제공기준과 적정성 연구: 혼합연구방법의 적용

최귀윤(Gui Yun Choi),이혜경(Hye Kyung Lee),정덕유(Dukyoo Jung),배하석(Hasuk Bae),양서연(Seoyon Yang),최종녀(Jongnyeo Choi) 한국노인간호학회 2024 노인간호학회지 Vol.26 No.3

Purpose: This study was conducted to confirm the provision standards and appropriateness of functional recovery training services performed on residents in long-term care facilities. Methods: Twenty-eight service providers working in four long-term care facilities applied the functional recovery training services to 63 older residents for 15 days, integrating them with their existing daily tasks. The contents recorded by the service providers on checklists were analyzed, and the experiences of applying functional recovery training services by the service providers were examined through focus group interviews. Results: Training for activities of daily living, excluding bathing, five items such as dressing and undressing are performed 2 to 4 times per day. The duration for one session is approximately 16 minutes for meals, around 10 minutes for bathing, and about 5 to 7 minutes for the remaining activities. Movement and walking training, covering five items like standing, occurs 2 to 3 times per day, with session durations ranging from 3 to 10 minutes. Physical activity training is conducted 1 to 2 times per day, with each session lasting about 5 to 7 minutes. Cognitive activity training is performed 1 to 2 times per day, with each session lasting approximately 4 to 7 minutes. Conclusion: For functional recovery training to be established in long-term care facilities, it is crucial to share an accurate understanding of the concept of training. Prior to the provision of training services, appropriate personnel such as nurses need to comprehensively assess the individuals and plan the training accordingly.