속도변화 보행 훈련이 만성 뇌졸중 환자의 심폐기능에 미치는 영향

서동열(Dong-Yel Seo),양용필(Yong-Pil Yang) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.5

본 연구는 보행 훈련시 심박수의 변화에 따라 보행속도를 조절하여 뇌졸중 환자의 심폐기능의 변화를 알아보고자 하였다. 대상자는 만성 뇌졸중 환자 20명을 무작위로 실험군과 대조군으로 분류하여 연구를 진행하였다. 실험군은 심박수 측정기를 착용한 상태로 트레드밀에서 심박수의 변화에 따라 보행속도를 증가 또는 감소시키면서 보행훈련을 실시하였고, 대조군은 대상자의 주관적인 속도에 의해 보행훈련을 실시하였다. 보행훈련 사이에 10분 간격으로 1분씩 휴식시간을 부여했으며 주 3회씩 총 6주간 중재를 실시하였다. 대상자들의 중재이후의 변화를 살펴보기 위하여 폐활량(VC), 호기예비용적(ERV), 흡기예비용적(IRV) 노력성 폐활량(FVC), 1초간 노력성 호기량(FEV1), 최대 호기 속도(PEF)를 측정하여 심폐기능의 변화를 확인하였다. 연구결과 폐활량, 흡기예비용적, 호기예비용적에서 집단과 시기사이에서 상호작용을 나타내었으며 주효과인 집단 및 시기 간 유의한 차이도 나타났다(p<.05), 1초간 노력성 호기량, 노력성 폐활량, 최대 호기속도에서는 그룹과 시기사이에서 상호작용이 나타나지 않았다. 주 효과에서는 집단 간 유의한 차이를 보이지 않았으나(p>.05) 시기 간에는 유의한 차이를 보였다(p<.05). 연구결과 보행과정에서 심박수의 변화에 따라 속도를 변화시켜 훈련을 시행할 경우 심폐기능의 유의한 향상을 보인 것으로 보아 보행 훈련시 속도변화를 통해 훈련을 할 경우 심폐기능의 유의한 변화를 이끌어 낼 수 있을 것으로 판단된다. This study examined the changes in the cardiopulmonary functions of stroke patients by adjusting the s heart rate during walking training. This study was conducted on 20 chronic stroke patients. The experimental group conducted walking training by varying the walking speed according to the change in heart rate on the treadmill. In contrast, the control group conducted walking training by the subjective speed of the subject. The walking training was conducted for 32 minutes, three times a week, for a total of six weeks. The changes after the intervention of the subjects were determined by measuring the VC, ERV, IRV, FVC, FEV1, and PEF. The study revealed interactions between the groups and timing in the VC, ERV, and IRV(p<.05). There were no interactions between the groups and timing in FEV1, FVC, and PEF. The main effects showed no significant differences between the groups (p>.05) but showed significant differences between periods (p<.05). These results suggest that the cardiopulmonary function was improved significantly when the training was conducted by changing the pace of the heart rate in the walking process, leading to significant changes in the cardiopulmonary function.

머리전방자세가 턱관절의 최대 개구량과 관자근 및 깨물근의 근활성도와 비대칭률에 미치는 영향

양용필(Yong-Pil Yang),서동열(Dong-yel Seo) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.3

본 연구는 머리전방자세가 증가함에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도, 근육의 비대칭률에 미치는 영향을 알아보고자 진행하였다. 연구 참가자들의 머리척추각을 측정하여, 연구의 선정요구를 충족시키는 머리척추각이 50° 이상인 대상자 50명(23.10±2.73세)을 선정하였다. 머리전방자세를 증가시키기 위해 머리척추각을 0%, 10%, 20%를 감소시켜 Control Ⅰ, Control Ⅱ, Control Ⅲ으로 설정하였다. 각 조건에 따른 턱관절의 최대 개구량, 관자근과 깨물근의 근활성도와 비대칭률의 변화를 측정하였다. 연구 결과, 머리척추각의 감소에 따라 최대 개구량은 유의하게 감소하였다(p<.001). 조건 변화에 따른 근활성도 변화를 측정한 결과, 오른쪽 관자근과 깨물근 및 왼쪽 관자근의 근활성도는 감소하였으며(p<.001), 왼쪽 깨물근의 근활성도도 감소하였다(p<.01). 조건 변화에 따른 근육의 좌우 비대칭률을 측정한 결과 좌우 관자근의 비대칭률, 좌우 관자근과 깨물근을 더한 근육의 비대칭률은 증가하였다(p<.01). 본 연구결과는 턱관절 부위에 대한 치료 전략과 종합적 진단을 세우고, 턱관절 장애 치료를 위해 사용된 도수치료와 치료적 운동의 이론적 근거를 제시하는 데 도움이 될 것으로 사료된다. This study examined the effects of the forward head posture on the maximum mouth opening of the jaw joint and the muscle activity and asymmetry of the temporalis and masseter. The craniovertebral angle was measured in 50 subjects (23.10±2.73 years) who met the selection requirements of the study. The maximum mouth opening, muscle activity, and muscle asymmetry were measured by reducing 0%, 10%, and 20%. As the craniovertebral angle decreased, the maximum mouth opening decreased (p<.001), the muscle activity of the right and left temporalis decreased (p<.001), and the muscle activity of the left temporalis also decreased. (p<.01). The asymmetry rate of the added muscles of the left and right temporalis, left and right temporalis, and masseter increased according to the change in condition (p<.01). The results of this study are expected to help establish a treatment strategy and comprehensive diagnosis for the temporomandibular joint and present a theoretical basis of manual therapy and therapeutic exercises used for the treatment of TMD.

COVID-19로 인한 마스크 착용이 보행 속도에 따라 심혈관계 기능에 미치는 영향

남기원 ( Ki-Won Nam ),서동열 ( Dong-Yel Seo ) 대한물리의학회 2022 대한물리의학회지 Vol.17 No.4

PURPOSE: To find out how wearing a mask due to COVID-19 affects cardiovascular function as the pace of walking changes. METHODS: Forty-nine college students (27 men, 22 women) were subjected to treadmill exercises without masks (Group Ⅰ) and wearing masks (Group Ⅱ). The body temperature, heart rate, oxygen saturation, and blood pressure were measured to determine the changes in cardiovascular function. These parameters were measured at rest (Control Ⅰ), low-intensity (Control Ⅱ), medium-intensity (Control Ⅲ), and high-intensity (Control Ⅳ) before and after exercise. RESULTS: Significant differences in heart rate were observed between Control Ⅲ and Control Ⅳ, and a significant difference in oxygen saturation was noted in Control Ⅳ. Significant differences in the exercise intensity change in Group Ⅱ were as follows: Body temperature was Control Ⅳ compared to Control Ⅰ and Control Ⅱ, heart rate was Control Ⅲ and Control Ⅳ compared to Control Ⅰ and Control Ⅱ, and Control Ⅳ compared to Control Ⅲ. The heart rate was Control Ⅲ and Control Ⅳ compared to Control Ⅰ and Control Ⅱ, Control Ⅳ for Control Ⅲ, oxygen saturation was Control Ⅳ compared to Control Ⅰ, blood pressure was Control Ⅱ and Control Ⅲ and Control Ⅳ compared to Control Ⅰ, and Control Ⅳ compared to Control Ⅱ. CONCLUSION: Exercising when wearing a mask affects the cardiovascular system. Therapists should consider the patient's condition when setting the exercise intensity. In particular, therapists should be more careful when setting the exercise intensity of patients with cardiovascular disease.

전정자극 훈련이 만성 뇌졸중 환자의 균형에 미치는 영향

남기원(Ki-Won Nam),오채은(Chae-Eun Oh),서동열(Dong-Yel Seo) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.12

본 연구의 목적은 만성 뇌졸중 환자를 대상으로 전정자극훈련 프로그램이 정적 균형 및 동적 균형에 미치는 영향을 알아보는 것이다. 본 연구는 2014년 7월 15일부터 9월 6일까지 진행하였으며, 대상자는 뇌졸중 진단을 받은 환자 20명이 본 연구에 참여하였고, Group Ⅰ(일반운동치료, n=10)과 Group Ⅱ(전정자극훈련, n=10)로 나누었다. 두 군 모두 주 3회, 회당 40분씩 6주간 치료적 중재를 실시하였다. 균형 능력은 Good Balance System을 이용하여 정적 균형 및 동적 균형을 측정하였으며, 중재 전과 후를 비교하였다. 연구 결과, 전정자극 훈련군에서는 눈감고 선자세의 좌우 및 전후 균형, 눈뜨고 선자세의 좌우 및 전후 균형, 이동시간, 이동거리에서 통계학적으로 유의한 차이를 보였고, 일반운동 치료군에서는 눈뜨고 선자세의 좌우 균형을 제외한 모든 항목에서 통계학적으로 유의한 차이는 보이지 않았다. 결론적으로, 본 연구에서 전정자극 훈련은 만성 뇌졸중 환자의 정적 균형 능력과 동 적균형 능력 향상에 긍정적인 영향을 미쳤으며, 이러한 뇌졸중 환자의 균형 능력 향상을 위한 치료프로그램에 다양한 방법으로 활용될 수 있을 것이다. This study examined the effects of vestibular stimulation training on the static and dynamic balance of patients with chronic stroke. This study was conducted from July 15th to September 6, 2014 and 20 subjects diagnosed with stroke participated in this study. The subjects were divided randomly into Group Ⅰ(general therapeutic exercise, n=10) and Group Ⅱ(vestibular stimulation training, n=10). Both groups were trained for 40 minutes, 3 times a week, for 6weeks. The balance ability, static balance and dynamic balance, were evaluated using a Good Balance System and compared before-and-after intervention. In the vestibular training group, there were statistically significant differences in the left-right and anterior-posterior balance with the eyes closed and standing posture, in the left-right and anterior-posterior balance with the eyes open and standing posture, and moving time and distance. In the general therapeutic exercise group, there was no significant difference except in the left-right balance with the eyes open and standing posture. In conclusion, vestibular stimulation training had positive effects on the static and dynamic balance of chronic stroke patients, and this training can be effective in a treatment program to improve the balance ability of stroke patients.

궁둥신경 가동술이 여성노인의 뻗은다리올림 검사와 보행능력에 미치는 영향

남기원 ( Ki-won Nam ),고재청 ( Jae-chung Go ),서동열 ( Dong-yel Seo ) 대한물리의학회 2017 대한물리의학회지 Vol.12 No.4

PURPOSE: The purpose of this study was to examine the effects of sciatic nerve mobilization techniques on straight leg raising (SLR) and walking ability in elderly women aged over 65. METHODS: Seventy women aged over 65 were examined using SLR test and forty women were selected as subjects. They were divided into Group Ⅰ (under 70° of SLR test of both legs, n=20) and Group Ⅱ (over 70° of SLR test of both legs, n=20). Nerve mobilization was applied to both groups (three times a week for 4 weeks). SLR angle was measured using digital goniometer and walking ability was measured by step length, stride length, velocity, double support, using GAITRite System. After 4 weeks, paired t-test was used to compare the changes of SLR test and walking ability within GroupⅠ and Group Ⅱ. RESULTS: In Group I, SLR test, step length, stride length and gait velocity were significantly increased but double support was significantly difference. In Group II, SLR test, step length and stride length were significantly increased but gait velocity was not significantly increased and double support was significantly decreased. CONCLUSION: This study showed that sciatic nerve mobilization techniques had positive effects on the SLR angle and walking ability in elderly women.

만성 목통증에 대한 자가신장과 위등뼈 관절가동술이 머리척추각 및 자율신경계 기능에 미치는 효과

남기원 ( Ki-won Nam ),김세훈 ( Se-hun Kim ),서동열 ( Dong-yel Seo ) 대한물리의학회 2018 대한물리의학회지 Vol.13 No.2

PURPOSE: This study aimed to examine the effects of self-stretching (SS) and joint mobilization (JM) on pain, craniovertebral angle (CVA), autonomic system function in chronic cervical pain patient with forward head posture (FHP). METHODS: A total of 30 male college students were selected as study subjects, and were divided into Group Ⅰ (general physical therapy; GPT, n=10), Group Ⅱ (GPT+SS, n=10), Group Ⅲ (GPT+JM, n=10). All groups were evaluated three times a week for 4 weeks. Pain was measured by visual analogue scale (VAS), CVA was measured using digital goniometer and autonomic system function (heart rate; HR, skin conductivity; SC, LF norm, HF norm, LF/HF ratio) was measured by Biofeedback ProComp Infiniti. After 4 weeks, paired t-test was used to compare the changes within the group and one way ANOVA was used to compare those between the groups. RESULTS: In Group I, VAS was significantly decreased. In Group II and Ⅲ was a significantly change in all items. In comparison between Group I and II was a difference in all items except HR. In comparison between Group I and Ⅲ was a difference in all items. In comparison between Group II and Ⅲ was a difference in VAS, LF norm and LF/HF ratio. CONCLUSION: This study showed that SS and JM can effectively reduce pain and normalize the autonomic system function.