하지마비 환자에서 수근관증후군의 초음파적 소견

주민철,양충용,김태진,송재은,박순아,조해중,길은영,신용일 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.2

Objective: To assess the diagnostic value of ultrasonography for the median nerve, the state of life style activities and the pain degree of upper extremities in paraplegics with carpal tunnel syndrome (CTS). Method: Eighteen wheelchair ambulators with spinal cord injury who had neurological level below T2 were studied. Patients with peripheral or central neuropathies were excluded. Patients were assigned to either the electrodiagnostic CTS (group CTS, 7) or electrodiagnostically negative (group non- CTS, 11), and healthy volunteers (15) were classified as control group. The cross sectional area of the median nerve (MN-CSA) at carpal pisiform level was ultrasonographically measured. The degree of painful restriction to execute ADL by hands (TR-ADL), the pain grade (visual analog scale, VAS) of upper extremities and revised version of Korean spinal cord independence measure (KSCIM-R) for functional level were measured and analyzed. Results: Nine hands (14.3%) of 7 patients out of 34 hands had CTS in electrodiagnostic study. There were significant difference among groups in TR-ADL hours (CTS group; 5.0 vs non-CTS group; 10.2, p<0.05), VAS (4.1 vs 2.0, respectively, p<0.05), and no statistical difference in KSCIM-R (68.4 vs 52.1, p>0.05), MN-CSA (12.3 mm2 vs 7.9 mm2 vs control group; 8.0 mm2, p<0.05). Using the ROC curve, the cut-off value of MN-CSA produced 8.5 mm2 providing a diagnostic sensitivity of 77.8% and specificity of 59.6%. Conclusion: The ultrasonographic measurement of the median nerve may be a useful non-invasive screening test for the diagnosis of CTS in paraplegic patients with wrist pain.

회전보행 훈련이 초기 뇌졸중 환자의 균형 자신감, 낙상 효능에 미치는 영향: 무작위 대조 예비 연구

주민철,정경만,정일승,Joo, Min-Cheol,Jung, Kyeoung-Man,Jeong, Il-Seung 한국의료질향상학회 2020 한국의료질향상학회지 Vol.26 No.1

Purpose: This study aimed to determine the effect of curved walking training on balance confidence and fall efficacy in early stroke patients. Methods: The study included 16 early stroke patients who were randomly allocated to a curved walking training group (experimental group, N=8) and a straight walking training group (control group, N=8). Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using the Activities-specific Balance Confidence (ABC) Scale, Fall Efficacy Scale (FES), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Results: After 3 weeks of training, both groups showed significantly improved ABC, FES, BBS, and TUG (p<.05 in both groups). However, the ABC, FES, BBS, and TUG scores in the experimental group were significantly better than those in the control group (p<.05). Conclusion: These findings indicate that curved walking training may be effective at improving balance confidence and decreasing fall risk in early stroke patients. Therefore, curved walking training can be used as a recommended walking method in early stroke patients.

Changes in the Muscarinic Receptors on the Colonic Smooth Muscles of Rats with Spinal Cord Injury

주민철,김용성,최을식,오정택,Hyun Joon Park,이문영 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.5

Objective To investigate changes in (1) the colonic response to acetylcholine (Ach), (2) the muscarinic (M)receptors in the colon, and (3) the levels of colonic contraction-related proteins after a spinal cord injury (SCI). Method We divided 16 Sprague-Dawley rats into 2 groups: the control group and the SCI group. A spinal cord transection was performed surgically at the T10 vertebral level. After 1 week, the entire colon was divided into 2segments, the proximal and distal colon. Each segment was mounted in a longitudinal or circular muscle direction in a 10-ml organ bath. We determined the intergroup differences as percentage changes in contractility after Ach treatment alone, Ach treatment with M2 receptor antagonist (AQ-RA741) pretreatment, and Ach treatment with M3 receptor antagonist (4-DAMP) pretreatment. Western blot analyses were performed to determine the expression level of RhoA, and heat shock protein 27 (HSP27). Results Compared to the control rats, the SCI rats showed an increased response to Ach along both the directions in the proximal colon (p<0.05). Compared to the control group, in the SCI group, the Ach response was signifi cantly diff erent in the proximal segment under AQ-RA741 pretreatment (p<0.05) and in the distal segment under 4-DAMP pretreatment (p<0.05). Findings of the western blot analyses showed a signifi cant decrease in the level of protein gene product 9.5 in the proximal and distal colon and a signifi cant increase in the level of RhoA and HSP27 in the proximal colon of the SCI rats. Conclusion Our results suggest that changes in colonic contractility after SCI are partly attributable to changes in the M receptor subtypes.

측방보행 훈련이 급성기 뇌졸중 환자의 균형 자신감, 낙상 효능감, 낙상 위험도에 미치는 영향: 무작위 대조 예비 연구

주민철,정경만,Joo, Min-Cheol,Jung, Kyeoung-Man 한국의료질향상학회 2021 한국의료질향상학회지 Vol.27 No.1

Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.

전기자극이 척수손상 대장의 pCaldesmon 발현에 미치는 영향

주민철,한용재,김태진,유수진,김용성,이문영 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.2

Objective: To find out whether electrical stimulation affects intracellular signaling mechanisms that link the biochemical and mechanical events of smooth muscle contraction. Method: A total of 31 adult Sprague-Dawley female rats were divided into 3 groups: control group, spinal cord injury (SCI) only group, and spinal cord injury with electrical stimulation (SCI+ES) group. Complete spinal cord transection was performed surgically at T10 cord level. The electrode for electrical stimulation was implanted into sacral spinal cord region (S2-4). Electrical stimulation was applied 4 hours per day from the day of operation. Results: In SCI+ES group, the weights of fecal pellet were significantly higher from the 3rd day of post-operation to the 6th day than the SCI only group. The numbers of pERK 1/2 immunoreactive cells significantly increased in all colon segments of the SCI+ES group but had decreased in the SCI only group. Western blot showed the stronger bands of phosphorylated ERK1/2 in all colon segments and also phosphorylated caldesmon in mid or distal colon segments in the SCI+ES group. Conclusion: These results suggest that electrical stimulation to sacral plexus region activate phosphorylation of ERK1/2 and caldesmon which leads to improvement of bowel function by promotion of secretion or motility in the colon. Objective: To find out whether electrical stimulation affects intracellular signaling mechanisms that link the biochemical and mechanical events of smooth muscle contraction. Method: A total of 31 adult Sprague-Dawley female rats were divided into 3 groups: control group, spinal cord injury (SCI) only group, and spinal cord injury with electrical stimulation (SCI+ES) group. Complete spinal cord transection was performed surgically at T10 cord level. The electrode for electrical stimulation was implanted into sacral spinal cord region (S2-4). Electrical stimulation was applied 4 hours per day from the day of operation. Results: In SCI+ES group, the weights of fecal pellet were significantly higher from the 3rd day of post-operation to the 6th day than the SCI only group. The numbers of pERK 1/2 immunoreactive cells significantly increased in all colon segments of the SCI+ES group but had decreased in the SCI only group. Western blot showed the stronger bands of phosphorylated ERK1/2 in all colon segments and also phosphorylated caldesmon in mid or distal colon segments in the SCI+ES group. Conclusion: These results suggest that electrical stimulation to sacral plexus region activate phosphorylation of ERK1/2 and caldesmon which leads to improvement of bowel function by promotion of secretion or motility in the colon.

아급성기 뇌졸중 환자에서의 상지 재활 로봇 치료의 효과

주민철,박효인,노세응,김지희,김현준,장철환 대한뇌신경재활학회 2014 뇌신경재활 Vol.7 No.2

Objective: To investigate the effects of robot-assisted arm training on motor and functional recovery of upper limb in patients with subacute stroke. Method: Thirty one subacute stroke patients were randomly divided into 2 groups. Robot-assisted arm training group received robot-assisted therapy using ArmeoⓇSpring (Hocoma Inc., Zurich, Switzerland) for thirty minutes per day and five times every week during four weeks while control group received conventional arm training with same duration and frequency as robotic group. Outcome measures were used manual muscle test (MMT) for motor strength, Fugl-Meyer assessment (FMA), Manual function test (MFT) for arm function, Korean-modified Barthel index (K-MBI) for activities of daily living, Korean-mini mental state examination (K-MMSE) and Computerized Neuro-Cognitive Function test software-40 (CNT-40) for cognitive function. All recruited patients underwent these evaluations before and after four weeks robot-assisted arm training. Results: Robot-assisted training on upper limb after subacute stroke showed improvement on motor strength, arm function, and activities of daily living. But change values in terms of MMT, FMA, MFT, K-MBI exhibited a no statistically significant difference compared with conventional group (p>0.05). Conclusion: In patients with upper limb deficits after subacute stroke, Robot-assisted arm training was considered to facilitate motor and functional recovery of upper limb. But robot-assisted arm training did not significantly improve motor and arm function at 4 weeks compared with conventional arm training group. Further research is required about the comparison of conventional rehabilitation therapy group and the questions about the duration, severity of stroke.

상완신경총 신경절전 손상의 전기진단검사와 자기공명영상의 유용성

주민철,강문규,양충용,신용일 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.6

Objective: This study aims at evaluating the usefulness of the electrodiagnostic study (EDx) and the magnetic resonance imaging (MRI), which are performed before surgical operation of brachial plexus injury. Method: We reviewed 57 cases of brachial plexopathy diagnosed with surgical findings. EDx and MRI were performed to the patients before surgery. Based upon intraoperative findings, we evaluated the occurrence of preganglionic root injury and subsequently each injured spinal root level. Results: EDx and MRI for preganglionic root injuries showed 92.1% and 78.9% of diagnostic sensitivity and 63.2% and 42.9% of diagnostic specificity, respectively. The followings were about each injured spinal root level. EDx showed that the sensitivities of C5, C6, C7, C8, T1 were 91.4%, 91.4%, 92.6%, 96%, 95.8%, and their specificities were 59.1%, 59.1%, 56.7%, 68.8%, 66.7%. MRI showed that the sensitivities were 47.4%, 57.9%, 58.3%, 75%, 66.7%, and their specificities were 57.1%, 71.4%, 78.6%, 85.7%, 85.7%. Conclusion: As for preganglionic brachial plexopathy, EDx was more useful than MRI to diagnose preganglionic root injury and determine the level of injured spinal root.

휠체어 이동 및 조작 훈련을 통한 모의 대피훈련 향상 활동의 효과

주민철,정유진,채수민,조성태,Joo, Min-Cheol,Jung, Yu-Jin,Chae, Su-Min,Cho, Sung-Tae 한국의료질향상학회 2020 한국의료질향상학회지 Vol.26 No.2

Purpose: The purpose of this study was to determine the effect of simulation evacuation training improvement activity through wheelchair skill training. Methods: The study included 40 patients with early stroke who were randomly allocated to a wheelchair skill training group (Experimental group, n=20) and a general exercise group (Control group, n=20). Both groups performed the exercise 3 times a week for 3 weeks. Outcomes were assessed using Wheelchair Skills Test Skills Performance (WSTSP), Wheelchair Skills Test Skills Safety (WSTSS) and Wheelchair Propulsion Velocity (WPV). Results: After 3 weeks of training, both groups showed significantly improved WSTSP, WSTSS and WPV (p<.01 in both groups). However, the WSTSP, WSTSS and WPV in the experimental group were very significantly better than in the control group (p<.01). Conclusion: These findings indicate that wheelchair skill training may be effective at improving wheelchair skill ability and wheelchair propulsion velocity in stroke patients who cannot walk independently. Therefore, short-term wheelchair skill training could be useful for patient safety in simulated evacuation situations.

향상된 정규 근사법의 간략화된 표현을 이용한 MCR-DS/CDMA 시스템의 성능 분석

주민철,김귀훈,김형명 한국통신학회 2000 韓國通信學會論文誌 Vol.25 No.8

본 논문에서는 요구되는 서비스와 비트율에 따라서 칩률반송 주파수 처리 이득 그리고 전송 전력을 다르게 할당하는 비동기 multiple-chip-rate(MCR)-DS/CDMA 시스템의 성능을 분석하였다 향상된 정규 근사법의 간략화된 표현(SEIGA)은 성능 분석 중 비트 오율을 간단하게 하면서도 정확히 얻을 수 있는 방법으로 알려져 있는데 본 논문에서는 이방법을 MCR 시스템의 분석에 적용하여 그 결과를 얻도록 하였다 기존의 방법에서 사용하는 직접적으로 사용하기 때문에 계수사이의 직접전인 관계를 알 수 있다 제안된 과정을 이용하여 얻은 MCR-DS/CDMA 시스템의 성능 분석 결과를 모의 실험을 통하여 보여 주었다. In this paper, we investigate the performance of asynchronous multiple-chip-rate (MCR)-DS/CDMA systems, where singles are transmitted at different chip rates, processing gains, and transmitted powers according to the required services and their own bit rates. A simplified expression for the improved Gaussian approximation (SEIGA), which is hewn for as a very accurate and simple tool for the performance evaluation, is applied to MCR systems, The correlations between chip waveforms and integrations are utilized instead of correlations between chip sequences which are used in conventional method [6] [7][8], and since this approach makes use of the system model parameter directly, we obtain more direct relationship among system parameters. Simulation results show that the performance of MCR-DS/CDMA systems can be evaluated more accurately by using the proposed procedure than by using the GA.

관절 테이핑과 근육 테이핑이 만성 뇌졸중 환자의 동적 균형과 보행에 미치는 영향

주민철,이양진,황준현,김성렬,Joo, Mincheol,Lee, Yangjin,Hwang, Junhyun,Kim, Seongryeol 대한통합의학회 2019 대한통합의학회지 Vol.7 No.2

Purpose : Elastic taping is a therapeutic method, used for treatment of various musculoskeletal and neuromuscular deficits. However, there is limited evidence, of the effects of ankle elastic taping in neurologic patients. The purpose of this study, was to investigate the effect of elastic taping on gait, in the affected ankle area of chronic stroke patients. Methods : Subjects were randomized to receive 30 chronic stroke patients, who were 6 months old from the date of onset according to screening criteria. Group I showed ankle joint taping, and Group II had ankle muscle taping. Dynamic balance and temporal and spatial gait, were measured before taping application, and after 30 minutes of taping application. Results : Dynamic balance was measured using the Time up & Go test (TUG). There was statistically significant difference, between Group I and Group II (p<.05). There was no statistically significant difference, between Group I and Group II. Temporal and spatial gait were measured using GaitRite. In Group I, there was significant difference, before and after taping (p<.05). In Group II, there was no significant difference, before and after taping (p>.05). There was significant difference in Group I, between Group I and Group II (p<.05). Conclusion : Results suggest that intervention using elastic taping, may have a positive effect, on rehabilitation diversity and function in stroke patients. Based on this, it can be used for rehabilitation of stroke patients. Various studies on the application method, and effect of the application site as well as application time, should be continued with stroke patients.