엄지발가락벌림을 강조한 PNF 다리패턴 시 엄지발가락벌림근을 활성화시킬 수 있는 가장 효과적인 방법은?

김용훈,박두진,Kim, Yong-Hun,Park, Du-Jin 대한고유수용성신경근촉진법학회 2020 PNF and Movement Vol.18 No.1

Purpose: This study aimed to determine the most effective way to facilitate the abductor hallucis muscle during PNF leg pattern-emphasized hallux abduction. Methods: The study recruited 18 healthy adults. All participants agreed voluntarily to take part in the study following an explanations of its purpose and procedures. They randomly performed the PNF leg pattern-emphasized hallux abduction variations in a hook-lying or sitting position. Activation of the abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and tibialis anterior (TA) muscles, and the ratio of AbH/AdH, were measured during PNF exercises using electromyography. One-way repeated ANOVA was used to compare the activation of foot intrinsic and extrinsic muscles during the four PNF exercises. Results: PNF leg pattern-emphasized hallux abduction using normal timing was significantly higher in TA compared to PNF leg pattern-emphasized hallux abduction using timing for emphasis, regardless of the starting position. The PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position was significantly higher in AbH than in other exercises. Although there was no statistically significant difference in the ratio of AbH/AdH, it was higher in the hook-lying position. Conclusion: PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position can be recommended as a method to optimize the activation of AbH and the ratio of AbH/AdH.

스마트폰 시청 시 몸통 교정기 착용에 따른 목, 허리 굽힘-이완 비율, 관절가동범위, 압통, 착용감 변화

박진성,박두진,Park, Jin-Seong,Park, Du-Jin 대한고유수용성신경근촉진법학회 2021 PNF and Movement Vol.19 No.3

Purpose: This study was conducted to investigate changes in the cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort following the wearing of a trunk brace during smartphone watching. Methods: To calculate the number of subjects for this study, an analysis with G^*Power was performed at a statistical power of 0.8, an effect size of 0.5, and a significance level of 0.05, based on the results of a preliminary experiment on five subjects. In total, 27 adult men and women were recruited who had been informed of the study's purpose and process and had agreed to participate. All subjects watched content on a smartphone for 20 minutes in the same posture and conditions while wearing and not wearing a trunk brace, and then their cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort were measured. Results: Compared to the non-wearing of a trunk brace, the wearing of a trunk brace resulted in a statistically significant smaller decline in cervical extension and right-side cervical rotation (p<0.05). When the subjects wore a trunk brace, their right- and left-side cervical and right-side lumbar pressure pain statistically significantly improved when compared to not wearing a trunk brace (p<0.05). They also perceived a significantly lowered level of comfort 20 minutes after wearing a trunk brace compared to immediately after wearing it (p<0.05). Conclusion: The trunk brace was effective in reducing declines in right-side cervical rotation and the occurrence of left- and right-side cervical and right-side lumbar pressure pain. The findings indicate the need to improve the perceived comfort of trunk braces.

복부 할로잉 운동의 이해와 임상적 적용 : 문헌적 고찰

이현옥,박두진,Lee, Hyun-Ok,Park, Du-Jin 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.2

Purpose : To provide the understanding of abdominal hollowing exercise, this study reviewed literatures related with TrA and AHE. Methods : We reviewed the prior studies related with TrA and AHE. Results : Crook lying is easier to facilitate isolated contraction of TrA from EO than the others. The contraction of the TrA is shown to be the highest muscle activity in prone lying. Additionally, wall support standing(or standing) is shown a higher contraction of entire abdominal muscle than the others. However, learning and teaching correct AHE have innate difficulties in four positions. Conclusion : We have to consider that Rehabilitative Ultrasonic Imaging(RUSI) can facilitate accurate AHE. In the country, physical therapists will be necessary more training and efforts to use ultrasound because very few use ultrasound in clinical field. It will be necessary to study the effects of RUSI feedback and examine effects of exercises in combination with AHE.

네발기기 자세에서 PNF 후방흔듬 운동 시 견갑골 안정근의 근활성도

이현옥,박두진,Lee, Hyun-Ok,Park, Du-Jin 대한고유수용성신경근촉진법학회 2012 PNF and Movement Vol.10 No.3

Purpose : The purpose of this study was to examine activities of the scapular stabilizers during push-up plus and PNF backward rocking exercises. Methods : 9 subjects performed randomly push-up plus and PNF backward rocking exercises in four point kneeling. The activities of 4 scapular stabilizing muscles were compared between push-up plus and PNF backward rocking exercises. Results : PNF backward rocking exercise showed significantly higher lower trapezius and lower serratus anterior activations compared to push-up plus exercise. Push-up plus exercise showed significantly higher middle serratus anterior activation than PNF backward rocking exercise. Conclusion : PNF backward rocking exercise facilitates the lower trapezius and serratus anterior activations compared to push-up plus exercise.

호흡방법에 따른 전방머리자세의 목근육 활성도 변화

배원식,이현옥,박두진,Bae, Won-Sik,Lee, Hyun-Ok,Park, Du-Jin 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.2

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.

으쓱 운동과 PNF어깨뼈패턴 시 어깨뼈 안정근의 근활성도

김민정,정수민,박성권,박두진,Kim, Min-Jeong,Jeong, Su-Min,Park, Seong-Kwon,Park, Du-Jin 대한고유수용성신경근촉진법학회 2016 PNF and Movement Vol.14 No.2

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey's multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

동적 신경근 안정화 접근법과 결합한 PNF 중재 프로그램이 소뇌 위축 환자의 균형에 미치는 영향 -사례보고-

나은진,문상현,김은경,박두진,Na, Eun-Jin,Moon, Sang-Hyun,Kim, Eun-Kyung,Park, Du-Jin 대한고유수용성신경근촉진법학회 2016 PNF and Movement Vol.14 No.3

Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

복부 할로잉 운동에서 실시간 초음파 영상 피드백의 사용 효과

권남희 ( Nam Hee Kwon ),이현옥 ( Hyun Ok Lee ),박두진 ( Du Jin Park ) 대한물리의학회 2011 대한물리의학회지 Vol.6 No.3

Purpose:This study examined the feedback effect of real-time ultrasound imaging on the thickness of transversus abdominis(TrA), internal abdominal oblique(IO) and external abdominal oblique(EO) during abdominal hollowing exercise(AHE) in crook lying. Methods:We performed this study on 30 healthy men who voluntarily consented to participate in this study after listening to its purpose and method. All subject were divided into an experimental group(n=15) with using the real-time ultrasound imaging feedback(RUIF) and a control group(n=15) without the RUIF The thickness changes between rest and AHE were compared between the two groups in crook lying. Results:The difference in TrA and EO thickness changes between the groups were significant in crook lying (p<0.05). Conclusion:The group with using real-time ultrasound imaging feedback showed a higher increase in the thickness of TrA than the other group without real-time ultrasound imaging feedback. And the thickness of EO in the group with using real-time ultrasound imaging feedback decreased than the other group without real-time ultrasound imaging feedback. If the muscle thickness can be regarded as an indicator of muscle activity, RUIF will be helpful for inducing the independent activity of TrA by reducing the activities of abdominal muscles such as EO.

말기암 환자의 통증 치료에 있어 서방형 모르핀과 경피형 펜타닐의 비교 연구

권재영,백승완,신상욱,김해규,김인세,박두진 대한통증학회 2000 The Korean Journal of Pain Vol.13 No.1

Background: For terminal cancer pain management, controlled-release oral morphine (morphine sulfate tablet, MST) is a simple and convenient regimen. Recently, fentanyl transdermal therapeutic system (F-TIS, transdermal fentanyl) has been developed and became one of the alternative ways of providing adequate pain relief. This open prospective study was designed to compare the analgesic efficacy and safety of MST and transdermal fentanyl in the management of terminal cancer pain. Methods: In this open comparative and randomized study, 64 terminal cancer patients received one treatment for 15 days, controlled-release oral morphine (MST group) or fentanyl transdermal therapeutic system (F-TTS group). Daily diaries about the vital sign, visual analogue scale (VAS) for pain, opioids requirement, co-anagesics, adjuvant drugs and adverse effects were completed with 24 patients in MST group, 18 patients in F-TTS group. Results: The majority of patients in both treatment groups were late-stage cancer and their distribution was not different in both groups. Daily opioids requirement was 126.4 mg in MST uced in F-TTS group (P$lt;0.05). The incidence of nausea, vomiting and constipation was lower in F-TTS group (P$lt;0.05). Patients satisfaction was similar, but F-TTS patient group favored continous use of same treatment compared with MST group after the study was finished. Conclusions: Transdermal fentanyl seems to be safe and similar analgesic effect to controlled-release oral morphine for the control of the terminal cancer patients. However, transdermal fentanyl provides a simpler and more convenient especially in respect to constipation, nausea & vomiting. To determine the exact analgesic effect, cost-effectiveness and complications, controlled trials should be followed.

백서의 중대뇌동맥 폐쇄에 의한 허혈성 뇌손상 모델에서 Dexamethasone과 MK-801이 뇌부종 형성에 미치는 영향

권재영,백승완,신상욱,김해규,김인세,박두진 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.2

Background: This study was conducted to determine the effects of dexamethasone and MK-801 on the formation of brain edema resulting from a focal ischemic injury by middle cerebral artery occlusion in rats. Methods : Fifteen Sprague-Dawley rats (220 280 g) were freely allowed to drink and eat until just before surgery. Anesthesia was induced with 4% isoflurane in oxygen and then maintained with 2% isoflurane in oxygen. Ischemic injury was induced by an intraluminal suture with a blunted tip inserted into the internal carotid artery and occlusion of the middle cerebral artery. All rats were divided randomly into three groups. In group I (n = 5), normal saline 1 ml was injected intravenously 10 minutes before MCA occlusion. In group II (n = 5), dexamethasone 3 mg/kg was administered 10 minutes before injury. In group III (n = 5), a N-methyl-D-aspartate receptor antagonist, MK-801 1 mg/kg was injected 30 minutes before injury. Rectal temperatures were monitored during the experiment. After 60 minutes of MCA occlusion, the intraluminal sutures were removed and all the rats were returned to their cages. Their brain were quickly removed and the cerebral hemispheres were sepaerated into ischemic cores and penumbra zones after 1 hour of reperfusion. The separated cerebral hemispheres were dried 7 days at 60oC dry oven. The cerebral water content was assessed by the dry-weight method. Results: In the dexamethasone group, there were no significant changes in cerebral edema formation in both ischemic core and the penumbra. In the MK-801 group, there were significant reductions in the brain edema formation in the penumbra (P< 0.05), but not in the core. Conclusions : Dexamethasone has no effect on ischemic brain edema; however, MK-801 is effective in the ischemic penumbra zone by reducing of edema formation. (Korean J Anesthesiol 1999; 37: 327∼333)