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넙다리뒤근육에 대한 스트레칭이 근육의 뻣뻣함에 미치는 즉각적 효과
김중휘,김태호,Kim, Joong-Hwi,Kim, Tae-Ho 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.1
Purpose: Stretching exercises are commonly used in conjunction with sports and rehabilitation. Weassessed the immediate effects of stretching on passive stiffness of the hamstring muscles and knee range of motion (ROM) using three stretching techniques. Methods: A total of 45 participants were recruited. Isokinetic equipment was used to measure the passive stiffness of hamstring muscles and an inclinometer was used to measure active and passive ROM of the knee joint pre and post stretching. Stiffness was then calculated based on the incline of the torque-angle relationship. The test conditions for Group I were $3{\times}30$ seconds of static stretches using the hamstring muscle, Group II were $3{\times}30$ seconds of static stretches using the hamstring muscle with ankle dorsiflexion, and Group IIII had $3{\times}30$ seconds of active stretching. Results: Group II had significantly higher excursion of active ROM and Group IIIhad significantly higher excursion of passive muscle stiffness. All of the groups had significantly higher active and passive ROM and significantly lower muscle stiffness after stretching. The participants showed no change in hamstring muscle stiffness on the following day. Conclusion: Stretching has significant acute effects on ROM and muscle stiffness and canbe used in warm-up protocols for reducing muscle stiffness before a variety of exercise programs.
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플라스틱 단하지 보조기와 신발 착용이 편마비 환자의 정적 선자세 균형에 미치는 영향
김중휘,김중선,Kim, Joong-Hwi,Kim, Chung-Sun 대한물리치료학회 2001 대한물리치료학회지 Vol.13 No.2
In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.
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김중휘,김중선,Kim Joong-Hwi,Kim Chung-Sun 대한물리치료학회 2002 대한물리치료학회지 Vol.14 No.4
In the last years, it has become possible to regain some locomotor activity in patients with incomplete spinal cord injury (SCI) through intense training on a treadmill. The ideas behind this approach owe much to insights derived from animal studies. Many studies showed that cats with complete spinal cord transection(spinalized animals) can recover locomotor function. These observations were at the basis of the concept of the central pattern generator located at spinal level. The neural system responsible for the locomotor restoration in both cats and humans is thought to be located at spinal level and is referred to as the central pattern generator(CPG). The evidence for such a spinal CPG in human is emphasis on some recent developments which support the view that there is a human spinal CPG for locomotion. An important element in afferent inputs for both spinal injured cats and humans is the provision of adequate sensory input related locomotor, which can possibly activate and/or regulate the spinal locomotor circuitry This review article deals with the afferent control of the central pattern generator. Furthermore, the application of adequate afferent inputs related locomotor for stroke patients will be able to facilitate locomotion ability, which is automatic, cyclic, rhythmic. These insights can possibly contribute to a better therapeutic approach for the rehabilitation of gait in patients with stroke.
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근육긴장도와 이에 영향을 미치는 체성감각계에 관한 고찰
김중휘,권용현,박정미,김중선,Kim Joong-Hwi,Kwon Yong-Hyun,Park Jung-Mi,Kim Chung-Sun 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.2
Muscle tone is the force with which a muscle resists being lengthened. Muscle tone is often tested clinically by passively extending and flexing a relaxed patient's limbs and feeling the resistance offered by the muscle. Both nonneural and neural mechanism contribute to muscle tone. Muscle tone is the mechanisms that contribute to the generation of tone in individual muscles when a person is in a relaxed state. This background level of activity changes in a certain antigravity posture muscle when we stand upright, thus counteracting the force of gravity. This increased level of activity in antigravity muscles is known as postural tone. The evidence from experiments showing that lesions of the dorsal(sensory) roots of the spinal cord reduced muscle(postural) tone is influenced by inputs from the somatosensory system. Patients with neurological damage have several state of muscle(postural) tone, which display from flaccidity to rigidity. This review article deal with muscle tone and somatosensory system acting on this. The understanding about this contribute to a better therapeutic approach for the rehabilitation of patients to have an abnormal muscle(postural) tone due to neurological damage.
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뇌졸중 환자의 보행 대칭성과 기능적 균형 및 보행과의 상관관계 연구
김중휘,Kim, Joong-Hwi 대한물리치료학회 2014 대한물리치료학회지 Vol.26 No.1
Purpose: The aim of the present study was to understand the relationship between gait symmetry and functional balance, walking performance in stroke patients and to makes recommendation regarding the most suitable measure for standardization of expression of spatiotemporal gait symmetry. Methods: 45 subjects with stroke (31 men, 14 women, $57.3{\pm}10.3$ years old) participated in this study. Gait symmetry was calculated by equations of symmetry ratio (SR) and symmetry criterion (SC) for stance time, swing time, single leg support time (SLST), step length, and stride length. Spatiotemporal parameters were measured respectively by walkway system ($GAITRite^{TM}$ system). Limit of stability (LOS) by using forceplate (Balance Performance Monitor) during voluntary weight displacement and Berg Balance Scale (BBS) were measured as functional balance and Timed Up and Go test (TUG) and Functional Ambulation Category (FAC) were assessed as functional walking. Results: SR in stance time and swing time was correlation with BBS, TUG and FAC (p<0.05). SR in SLST only with BBS (p<0.01), SR in step length only with FAC (p<0.05). SC in stance time was correlation with BBS and TUG (p<0.05). SC in swing time and SLST with BBS, TUG and FAC (p<0.01), SC in step length with TUG and FAC (p<0.01), SC in stride length with BBS and FAC (p<0.01). Conclusion: Gait symmetry in spatiotemporal gait parameters provides meaningful information about functional balance and walking performance in stroke subjects. Our analysis may support the recommendations of the symmetry criterion as equation for standardization of gait symmetry.
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