뇌성마비 아동의 손기능분류시스템에 대한 아동치료사와 보호자의 측정자내 및 측정자간 신뢰도 분석

권해연(Hae Yeon Kwon),이재인(Jaein Lee) 대한인간공학회 2020 大韓人間工學會誌 Vol.39 No.6

Objective: To investigate the inter-rater and intra-rater reliability of the Korean version of the MACS by comparing the classification given by pediatric therapists and guardians of children with cerebral palsy. Background: Cerebral palsy can affect hand functions resulting in diminished mobility, muscle weakness, insufficient control in rapid coordinated movements, involuntary movements, spasticity, and poor postural control. The Manual Ability Classification System (MACS) has been widely used to describe children"s hands with cerebral palsy when handling objects in their daily activities. However, the reliability of this MACS has not been verified in Korean. Method: Data were collected from 45 children in the age range of 4~18 years old who were diagnosed with cerebral palsy by a medical specialist in rehabilitative medicine/neurosurgery. Total two pediatric therapists (physical therapist and occupational therapist) classified manual ability (MACS) through direct observation and information provided by guardians. Pediatric therapists and guardians used the Korean version of the MACS. Inter-rater and intra-rater reliability was analyzed using unweighted Kappa coefficient (k) and intra-class correlation coefficient (ICC). Results: The results of intra-rater agreement show almost perfect agreement almost perfect between both pediatric therapists classified the MACS of children with cerebral palsy in the initial assessment and after one month. The results of inter-rater agreement between the physical therapist and the occupational therapist that MACS has almost perfect [K=0.87 (95% CI: 0.81~0.92), ICC=0.93 (95% CI: 0.91~0.97)]. The results of inter-rater agreement between physical therapist and guardians were observed to be moderate [K=0.45 (95% CI: 0.34~0.57), ICC=0.76 (95% CI: 0.64~0.84)]. Conclusion: Therefore, The Korean version of the MACS has been shown to be a reliable measurement tool that can be used jointly by pediatric therapists with variable clinical careers and by guardians. Application: The application of the MACS in clinical practice can be an important focus to set treatment goals for disabled children including cerebral palsy in partnership with the guardians.

벽에 등을 기댄 쪼그려 앉는 동작에 따른 정상성인의 넙다리네갈래근 근활성도 비교

권해연(Kwon, Hae-Yeon),안소윤(Ahn, So-Youn) 한국체육과학회 2012 한국체육과학회지 Vol.21 No.5

The purpose of this study was to investigate the difference on quadriceps femoris activity performed wall squats during various dynamic tasks. Thirty one subjects, with no history of patellofemoral pain(PFOP), quadriceps injury, or other knee injury participated for this study. Muscle activation of the vastus medialis obliquus, rectus femoralis, vastus lateralis muscles were recorded while subjects performed 10 consecutive wall squats. Subjects performed the wall squats during four different four methods: (1) general wall squat, (2) back against fitness ball (3) weight in hands, (4) add in arms movement. Statistical analysis were accomplished by utilizing the one-way ANOVA(Bonferroni"s post hoc test) by SPSS 20.0 program. Significance level was set at p<.05. Muscle activations induced under the four different motions were compared and results showed that there was significant difference only in vastus medialis obliquus and rectus femoralis but there was no significant difference in vastus lateralis. The vastus medialis obliquus was significantly different back only against fitness ball at post-hoc test. The rectus femoris was significantly different back against fitness ball & add in arms movement at post-hoc test. Based on these results, we conclude that muscle activations are influenced by performing wall squats using various dynamic tasks in healthy adults.

과제지향적 훈련 프로그램이 경직성 양쪽마비 아동의 운동성, 균형 및 일상생활동작에 미치는 영향

권해연(Kwon, Hae-Yeon),안소윤(Ahn, So-Youn),김병조(Kim, Byung-Jo) 한국체육과학회 2014 한국체육과학회지 Vol.23 No.2

This purpose of this study was to contribute evidence towards the effectiveness of task-oriented training and neurodevelopmental treatment(NDT) on the mobility, balance and activities of daily living in children with cerebral palsy. We used a prospective quasi-group comparison design in ten children with spastic diplegia(3-7 years). The GMFCS level of these subject was Ⅱ, Ⅲ. The control group(n=4) received NDT and the experimental group(n=4) received the task-oriented training program during a period of 10weeks, with two 50-minute sessions per week. Participants in the experimental group received task-oriented training to improve locomotion ability, muscle strengthening and body coordination. There were significant differences of GMFM(Gross Motor Function Measures), GMPM(Gross Motor Performance Measure) in both groups. There was significant difference of PBS(Pediatric Balance Scales) in both groups. There was no significant difference of Wee-FIM(Functional Independence Measure for children) in both groups. The results of this study demonstrate that of task-oriented training for improve motor function, motor performance and functional balance in children with CP. The findings suggest that the application of a task-oriented training program is supported to positive movement experiences, exploration and global development. Further studies with a larger randomized sample and longer post-intervention follow-up are necessary to demonstrate the long-term effects of participant in task-oriented training programs in the cerebral palsy.

유방암 절제술 후 상지 림프부종과 견갑골 기능이상의 상관관계

하해정(Ha, Hae-Jung),안소윤(Ahn, So-Youn),권해연(Kwon, Hae-Yeon) 한국체육과학회 2013 한국체육과학회지 Vol.22 No.2

The purpose of this study was to investigate the most effective and comprehensible method for the assessment of lymphedema and scapular dyskinesis in breast cancer-related lymphedema (BCRL). 20 volunteers with diagnosed BCRL were involved in the study. all assessment of the patient’s edema sides (ES) and non-edema sides (NES) were evaluated. the assessment tools for lymphedema are; the circumference of the upper limb for the volume. scapular dyskinesis was used resting scapular position (RSP) and range of motion (ROM). RSP are; 1) scapular index, 2) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance, 3) standing PM distance, 4) PM index (PMI). ROM are; 1) shoulder flexion, 2) shoulder extesion. the paired t-test was used to compare ES and NES. pearson correlation analysis was used to confer a relationship between the volume of arm, RSP, and ROM. The result of this study indicated that; 1) the volume of arm statistically significant (p<.05), 2) all the variable between the ES and NES for scapular dyskinesis were statistically significant (p<.05), 3) the standing PM distance showed the strongest relationship in the correlation analysis between RSP and ROM (p<.05, r=.87). Therefore, it can be concluded that there is a relationship between the standing PM distance and ROM and it is suggested that an assessment tool using the standing PM distance to evaluate scapular dyskinesis in BCRL would be clinically effective.

국내 자생 철쭉나무 집단에 있어서의 I-SSR 변이체 분포양상

홍용표 ( Hong Yong Pyo ),권해연 ( Kwon Hae Yeon ),김용률 ( Kim Yong Lyul ),김찬수 ( Kim Chan Su ),한상돈 ( Han Sang Don ) 한국산림과학회 2003 한국산림과학회지 Vol.92 No.5

Distribution pattern and level of genetic diversity in 6 populations of an endemic shrub in Korea, smile rosebay (Rhododendron schlippenbachii), were monitored by analyzing a molecular genetic marker, inter-simple sequence repeats (I-SSR). From the results of PCR with 5 I-SSR primers, a total of 61 I-SSR, variants were observed in 120 smile rosebay trees. All the analyzed individuats could be distinguished by pooling all the observed I-SSR markers. Moderate level of genetic diversity within populations was observed, ranged from 0.360 (Gwangneung) to 0.456 (Mt. Gaya) with the mean of 0.395. From the results of AMOVA at 2 hierarchical levels, 88.38% of I-SSR variants was allocated among individuals within populations, which resulted in moderately high degree of population differentiation in this species (Φ_(ST)=0.116). From the results of AMOVA at 3 hierarchical levels, moderate degree of genetic differentiation was observed among geographic regions (Φ_(CT)=0.05O) and among populations within groups (Φ(CT_=0.076). This observation suggested that genetic differentiation among geographic groups might be partially responsible for the observed moderately high degree of population differentiation at 2 hierarchical levels (Φ_(ST)=0.116). Reconstruction of genetic relationships among 6 population by UPGMA, revealed 2 geographic groups (Mts. Dykyu, Gaya, and Sobaek; Mt. Seorak and Gwangneune) and a most distantly related population of Mt. Taebaek to both groups. Overall patterns of genetic relationships among populations were relatively well coincided with geographic affinity among populations. Observed results in this study could provide molecular genetic information on future supplementing of any shortage in genetic diversity in the natural populatins of smile rosebay.

앞쪽 머리자세에서 자가신장 운동과 유지–이완기법에 따른 근피로도 회복의 비교

송민영(Song, Min-Young),권해연(Kwon, Hae-Yeon) 한국체육과학회 2012 한국체육과학회지 Vol.21 No.5

This purpose of this study was to identify that the effect of Self-stretching exercise and Hold-relax techniques on recoveries of muscle fatigue in upper trapezius and splenius capitis using a smart phone in forward head posture. The subjects were consisted of thirty participations and they were divided into three groups equally at random; control group, self-stretching group and hold-relax group. The muscle fatigue measured by tracing the median frequency decrement from power spectrum analyses of EMG signals. This data were analyzed using repeated measured two-way ANOVA & one-way ANOVA(Bonferroni"s post hoc test) by SPSS 20.0 for windows program. Muscle fatigue of upper trapezius and splenius capitus were significantly different all intervention techniques(control group, self-stretching group, hold-relax group) at the resting, tasking and post intervention(p<.05). The upper trapezius and splenius capitus was no significant difference control group between intervention techniques but there was significant difference of self-stretching group and hold-relax group on recoveries of muscle fatigue(p<.05). Consequently, this study suggest that upper trapezius and splenius capitis was effective for hold-relax better than control group and self-stretching on recoveries of muscle fatigue.

다감각스토리텔링 기반의 활동중심중재가 뇌성마비 아동의 사회적 상호작용에 미치는 영향

이은정 ( Eun-jung Lee ),권해연 ( Hae-yeon Kwon ) 한국감성과학회 2021 감성과학 Vol.24 No.4

본 연구의 목적은 뇌성마비 아동에게 다감각스토리텔링에 기반한 활동중심중재를 적용하고 사회적 상호작용에 미치는 영향에 대해 알아보는 것이다. 유사실험연구로 단일눈가림, 두 집단 사전-사후검사로 설계하였고, 경직형 뇌성마비로 진단받고, 대동작기능분류체계(GMFCS) Ⅰ~Ⅲ단계에 속하는 7~8세 아동 24명을 대상으로 하였다. 실험군과 대조군에 12명씩 무작위 배정하고 아동과 보호자는 집단이 어디에 속하는지 알 수 없도록 하였다. 집단별 프로그램은 회기당 60분, 주 2회, 8주간, 총 16회기 동안 진행되었고, 실험군은 다감각스토리텔링에 기반한 활동중심중재를 하였고, 대조군은 구조화된 신체활동을 실시하였다. 아동의 중재 전과 후에 사회적 상호작용의 변화정도를 확인하기 위해 또래관계기술척도를 사용하여 측정하였다. 수집된 자료는 SPSS 25.0 for windows (IBM Corp, USA) 프로그램을 이용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 또래관계기술의 집단 내 변화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)으로 확인하고, 두 집단 간 변화량 차이의 비교는 맨휘트니검정(Mann-Whitney U test)으로 분석하였다. 연구결과 또래관계기술의 집단 내 변화에서 또래관계기술의 전체 값과 하위평가의 협동과 공감영역에서 실험군과 대조군 모두 유의한 차이가 있었고, 주도성 영역에서는 실험군은 유의한 차이를 나타냈으나 대조군은 유의한 차이가 없었다. 두 집단 간 변화량 차이에서 또래관계기술의 하위평가의 주도성영역과 전체 값에서 유의한 차이를 나타냈고, 협동과 공감 영역에서는 유의한 차이가 없었다. 본 연구에서는 뇌성마비 아동을 대상으로 다감각스토리텔링에 기반한 활동중심중재를 적용하여 또래관계기술에 유의한 향상을 확인하였다. 다감각스토리텔링에 기반한 활동중심중재는 뇌성마비 아동의 사회적 상호작용에 효과적인 중재방법으로 제안할 수 있다. This study aimed to verify how a multisensory storytelling-based activity-based intervention affects social interaction in children with cerebral palsy. As a quasi-experimental investigation, this study used a single-blind, two-group pre-post test design. This study comprised 24 children aged 7 to 8 y who had been diagnosed with spastic cerebral palsy and were classified as having GMFCS stages I to III. Twelve children were randomly assigned to experimental and control groups, with neither the children nor their guardians knowing which group they were placed in. The group program comprised 16 sessions of 60 min each, twice a week for eight weeks. The experimental group engaged in an activity-centered intervention centered on multisensory storytelling, whereas the control group engaged in structured physical activity. The activities were assessed using the peer relations skills scale to determine the extent to which social interaction had changed prior to and during the child’s intervention. The SPSS 25.0 for Windows (IBM Corp, USA) application was used to analyze the data, and the significance level (α) for statistical verification was set to 0.05. Furthermore, the Wilcoxon Signed-Rank and Mann-Whitney U tests were used to assess the differences in social interaction between the experimental and control groups. Significant differences were observed in the total of the peer relationship skill scale and cooperation and empathy areas of the subtest in the intragroup change of the peer relationship skill scale between the experimental and control groups. However, the experimental group demonstrated a significant difference in the initiative area, whereas the control group demonstrated no significant difference. A significant difference was observed in the amount of change between the two groups in the initiative area and total of the subtest of peer relationship skills but no significant difference in the collaboration and empathy areas. We gave a multisensory storytelling-based activity-based intervention based on multisensory storytelling to children with cerebral palsy and saw a significant improvement in peer relationship skills. It may be proposed as an effective intervention strategy for children with cerebral palsy who struggle with social contact.

자발적 움직임 활동 심리운동이 지적장애 아동의 신체 운동성과 사회적 능력에 미치는 영향

이은정 ( Eun-jung Lee ),권해연 ( Hae-yeon Kwon ) 대한통합의학회 2021 대한통합의학회지 Vol.9 No.4

Purpose : The purpose of this study has been performed to find the effect of psychomotorik program with voluntary movement activity on the development of social competence and physical exercise ability improvement in children with intellectual disability. Methods : This study was conducted with a similar group comparison study design to examine applicative effects of voluntary movement group psychomotor activities on body locomotion skills and social competence of intellectually disabled children. This study included 12 children with intellectual disability aged between 7 and 10 years. Experimental group was performed 50 minutes psychomotorik program for once a week during 12 weeks. Physical Exercise ability (TGMD-2) and changes in social competence were measured before and after the intervention program. Results : There were positive changes in social competence and physical exercise ability in the experimental and control groups before and after the intervention program. Only the experimental group showed significant difference in the pre and post measurement. There was a significant difference between the two groups before and after the intervention. Conclusion : Psychomotorik program with voluntary movement activity has a positive effect on the improvement of activity on the development of social competence and physical exercise ability improvement in children with intellectual disability. Accordingly, voluntary movement psychomotor activities programs can be utilized as a useful intervention method to improve the body locomotion skills of intellectually disabled children in the clinical and educational fields in the future.

충해관리용 유기농업자재 주성분의 분류 체계 설정

권덕호(Deok Ho Kwon),곽가연(Ga-Yeon Kwack),원설묵(Seol Muk Won),김미현(Mi Hyeon Kim),최효준(Hyo Jun Choi),안율균(Yul Kyun Ahn),홍규현(Kue Hyen Hong),권해연(Hae-Yun Kwon),박윤미(Yunmi Park) 한국농약과학회 2021 농약과학회지 Vol.25 No.4

시트의 각도 및 높이가 앉고 서기 시 하지 및 몸통의 근활성도에 미치는 영향

김병조 ( Byeong Jo Kim ),이수경 ( Su Kyoung Lee ),이정훈 ( Jung Hoon Lee ),권해연 ( Hae Yeon Kwon ) 대한물리의학회 2015 대한물리의학회지 Vol.10 No.4

PURPOSE: This study investigated the effects of lower limb and trunk muscles activation on seat angle and height during sit to stand and stand to sit. METHODS: Subjects were instructed to sit and stand on different angles and heights; 0˚(43cm), 5˚(48cm), 10˚(51cm) and 15˚(58cm). Measurements were conducted from sit to stand and stand to sit for external oblique, transversus abdominis, rectus femoris, vastus medialis, vastus lateralis, tibialis anterior and gastrocnemius muscle activation by surface EMG. The muscle activation was measured three times for five seconds in each posture, and the %RVC value was calculated after the exclusion of one second before and after this measurement. This calculation standardized the data from each participant so it could be comparatively analyzed. RESULTS: The external oblique, tibialis anterior, and erector spinae muscles showed significant difference in 10˚(51cm), 15˚(58cm) and 0˚(43cm), rectus femoris, in 15˚(58cm) and 0˚(43cm)(p <.05) during sit to stand. The external oblique, tibialis anterior, and rectus femoris muscles showed significant difference in 0˚(43cm) and 15˚(58cm), erector spinae and vastus medialis muscles showed significant difference in 10˚(51cm), 15˚(58cm) and 0˚(43cm)(P<.05) during stand to sit. CONCLUSION: The present study findings indicate that the toilet seat angle and height could affect muscle activities of the lower limb and trunk.