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한윤교,한기훈 仁荷大學校 스포츠科學硏究所 1999 論文集 Vol.11 No.-
The purpose of this study was to collect basic data in the gait pattern of the spastic diplegia children for rehabilitation program, and to examine the differences in the gait pattern against normal children group. Three-dimentional motion analysis technique was employed to compare the gait pattern of five children with diplegic cerebral palsy against a group of 10 normal children of the same age. The following conculsions were drawn from the results: Spastic diplegia revealed asymmetrical gait pattern in which the step length of the stride which was a result of the effort to minimize the loading on the leg by shortening the swing phase of the leg. C.P spastic diplegia scored lower phase ratios, lesser cadence and walking velocity with lower gait stability and function. More anterior tilting of the pelvis was observed throughout the gait cycle. C.P. children showed more hip and knee flexion during the stance phase. The main problem in C.P children originated from the insufficient dorsiflexion of the foot during the swing phase. Therefore, C.P children showed difficulty with foot clearance in the swing phase. Usually, this compensated for by using excessive hip adduction and external rotation in conjunction with trunk elevation flexion and as well as increased vertical displacement of the center of mass. C.P spastic diplegia revealed foot flat and forefoot initial contact pattern. The findings were as follows: 1. The walking velocity and stride length decreased in the spastic diplegia group. 2. The proportion ratios of the stance phase tended to increase with spastic diplegia. 3. The range of the hip joint motion with C.P increased while knee flexion angle during the swing phase increased. 4. The plantar flexion angle of the ankle also increased through the gait cycle. 5. Hip adduction and external rotation with C.P increased through the gait cycle.
발달장애 아동을 대상으로 한 대동작 운동기능 평가와 베일리 영유아 발달검사-Ⅱ의 상관관계 연구
김지선,김태현,고대영,강연경,한윤교 대한작업치료학회 2005 대한작업치료학회지 Vol.13 No.1
목적 : 뇌성마비가 아닌 발달장애로 진단된 아동을 대상으로 GMFM과 BSID-Ⅱ 평가를 각각 실시한 후 GMFM이 BSID-Ⅱ의 하위 항목들과 상관관계가 있는지 알아봄으로써 발달장애 아동의 평가도구로써 활용가능성을 검증하고자 한다. 연구방법 : 연구의 대상은 인하대학부속병원 재활의학과에서 뇌성마비 이외의 발달장애로 진단받은 만 3세 이하의 아동 26명을 대상으로 GMFM과 BSID-Ⅱ를 평가하였다. 대상자들의 특성에 따라 조산의 유무, 출생시 체중, 역연령에 따라 구분한 후 각 집단간 차이 및 두 평가도구의 상관관계를 알아보았다. 결과 : 발달장애 아동 26명 중 조산의 유무와 출생시 체중에 따라 각 집단간 GMFM, BSID-Ⅱ 정신척도, BSID-Ⅱ 운동척도의 점수를 비교한 결과 유의한 차이가 없었으며, 교정연령에 따른 집단에서만 유의한 차이가 있었다(p<0.05). 또한 집단간 GMFM과 BSID-Ⅱ 정신척도는 조산아(r=0.68), 만숙아(r=0.67), 저체중아(r=0.63), 평균체중아(r=0.72)에서 모두 상관관계가 있었으며, GMFM과 BSID-Ⅱ 운동척도도 조산아(r=0.57), 만숙아(r=0.89), 저체중아(r=0.65), 평균체중아(r=0.90)에서 모두 상관관계가 있었다. 전체 아동의 GMFM과 BSID-Ⅱ 정신척도의 상관계수는 0.71, GMFM과 BSID-Ⅱ 운동척도의 상관계수는 0.84로 관계가 있었으며, 교정연령 상 하위집단에서 0.56-0.85로 상관관계가 있었다. 결론 : 본 연구의 결과를 볼 때 발달장애 아동의 GMFM과 BSID-Ⅱ의 평가 결과는 모두 뚜렷한 상관관계를 나타내었으며, 발달장애 아동의 운동기능을 평가하는데 있어 GMFM의 적용가능성을 보여주는 기초 자료가 될 것으로 사료된다. Objective : We compared the Gross Motor Function Measure(GMFM) and the Bayley Scale of Infant Development-second edition(BSID-Ⅱ) to investigate the applicability of GMFM in evaluating infants with developmental disabilities except cerebral palsy. Methods : Subjects were 26 infants with a mean corrected age of 16.26(SD=8.17). Subjects divided into subgroups by gestational age, birth weight, corrected age. The GMFM and BSID-Ⅱ were administered to the total infants. Statistical analysis was done by Mann-Whitney U test and Spearman’s correlation, using SPSS-PC(version 10.0). Results : There were not statistically significant for the comparison of the GMFM percentage scores with the BSID-Ⅱ raw scores in subgroups expect corrected age group. The correlation coefficients of GMFM scores and BSID-Ⅱ mental scale were ranged between 0.63 and 0.72, those of GMFM scores and BSID-Ⅱ motor scale were ranged between 0.57 and 0.90 in subgroups. The average correlation coefficients of GMFM scores and BSID-Ⅱ mental scale were 0.71, those of GMFM scores and BSID-Ⅱ motor scale were 0.84 in total subjects. Conclusion : The findings suggest that the GMFM and BSID-Ⅱ are valuable in evaluating infants with developmental delays. Implications for selection and use of either measures are discussed.
특수체육 : 경직성 양측 뇌성마비아들의 좌우 하지 근육활동과 보행형태 비교 분석
한기훈(HanKi-Hoon),한윤교(HanYoun-Kyo) 한국체육학회 2003 한국체육학회지 Vol.42 No.6
In order to gather information on the lower extremity muscle activity and gait pattern of children with spastic-diplegia cerebral palsy, an electromyographic and kinematic analysis was performed. Three children with diplegic cerebral palsy were selected for the experiment. VICOM 370 kinematic data collection system and Ariel EMG system were used for the study. Kinematic data comparison was made with previous study of 10 children without disabilities using three-dimensional motion analysis technique. Left-right kinematic data comparison was also made. Muscle activities of tibialis anterior, gastrocnemius, rectus femoris and medial hamstring for both legs were measured for comparison among children with cerebral palsy. The following conclusions were drawn from the kienematic data analysis and lower extremity muscle activity comparison.1) Children with spastic-diplegia cerebral palsy revealed an asymmetrical left-right stance and swing phase in the gait pattern.2) CSDCP showed shorter single support to keep the stability during walking.3) Knee flexion for CSDCP during stance phase occurred much earlier than that of normal group.4) CSDCP hardly dorsiflexed their ankle joint through the gait cycle.5) Joint movement of CCSDCP was quite different from right to left under similar low extremity muscle activity pattern.