운동조절이론과 중추신경계 손상환자를 위한 치료 접근법의 재검토

김종만,신헌석 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.1

Physical therapists should understand motor control models and apply various models to evaluation and treatment of neurologically impaired patients, Thus, this paper reviews motor control models and applications in clinical settings. Assumptions and limitations of reflex models, hierarchical models, and systems models are presented. This paper also delineates goals and dissatisfaction of neurologic rehabilitation approaches for neurologically impaired patients. Muscle reeducation approach, neurotherapeutic facilitation approach, and contemporary task-oriented approach are explained.

하퇴 의지 사용자의 족저압 분포 특성에 관한 연구

김장환,신헌석 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.3

The purpose of this study was to compare the static pressure, dynamic pressure, dynamic pressure-time integral, relative impulse, and contact time between the sound lower limb and amputated lower limb in trans-tibial amputee subjects using Parotec system. Seventeen trans-tibial amputee subjects wearing endoskeletal trans-tibial prosthesis voluntarily participated in this study. The results were as follows: 1) In static standing condition, there were significantly higher static pressure in sound lower limb insole sensor of 10, 14, 15, 18, 19, 23, and 24 and in amputated lower limb insole sensor of 9, 12, and 16 (p<.05). 2) In dynamic gait condition, there were significantly higher dynamic pressure in sound lower limb insole sensor of 2, 18, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, 14, 15, and 16 (p<.05), 3) In dynamic gait condition, there were significantly higher pressure-time integral in sound lower limb insole sensor of 2, 4, 18, 19, 20, 21, 23, and 24 and in amputated lower limb insole sensor of 5, 11, 12, and 15 (p<.05). 4) In dynamic gait condition, there were significantly higher relative impulse in sound lower limb insole sensor of 18, 19, 20, 22, 23, and 24 and in amputated lower limb insole sensor of 5, 9, 10, 11, 12, and 15 (p<.05). 5) In dynamic gait condition, there was significantly higher percentage of contact time in push off phase of sound lower limb and in support phase of amputated lower limb (p<.05). These results suggest that trans-tibial amputee subjects had characteristics of shortened push off phase due to unutilized forefoot and of lengthened support Phase with higher pressure in the midfoot.

유지-이완기법과 냉치료가 지연성 근육통에 미치는 효과

김종만,박장성,김원호,신헌석,김연중 한국전문물리치료학회 2000 한국전문물리치료학회지 Vol.7 No.1

Despite research to treat delayed onse muscle soreness(DOMS), no effective treatment has been reported. The purpose of this study is to investigate the effect of a hold-relax technique and cryotherapy on DOMS. Thirty-three subjects were randomly assigned to one of three treatment groups: control, hold-relax technique, or hold-relax technique and cryotherapy. DOMS was induced in the non-dominant biceps muscle through repeated eccentric contractions. Resting elbow joint position, flexion and extension(universal goniometer), pain(Visual Analogue Scale; VAS), and WBC count(blood analysis) were measured one hour before DOMS was induced and 24, 48, and 72 hours after DOMS was induced. The data were analyzed by repeated measure of two-way ANOVA. The results of this study were summarized as follows: 1) While analysis showed no significant differences between groups in relation to resting elbow joint position, there were significant differences over time, especially at 24, 48 hours after DOMS was induced compared with resting elbow joint position before DOMS was induced. 2) While analysis showed no significant differences between groups in relation to range of flexion, there were significant differences between rage of flexion before DOMS was induced and range of flexion 72 hours after DOMS was induced. 2) There were no significant differences between groups or over time in relation to range of extension. 4) While analysis showed no significant differences between groups in relation to VAS, there were significant differences over time in different hours. 5) There were no significant differences between groups or over time in relation to WBC count. 6) There were no interactions between groups or over time in all variables. This results suggested that hold-relax technique and cryotherapy were not effective to reduce DOMS.

Effects of Lumbar Stabilization on the Trunk and Lower Limb Muscle Activity and Velocity of the Center of Pressure During Single Leg Standing

Heon-seock Cynn 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.4

The aim of this study was to investigate the effects of lumbar stabilization on both trunk and lower limb muscle activity and center of pressure (COP) in single leg standing. Surface electromyography (EMG) was used to collect muscle activity data, the mean velocity of COP was measured using a force plate, and a pressure biofeedback unit was used for lumbar stabilization training. The findings of this study are summarized as follows: l) The EMG activity of the erector spinae decreased significantly and the activity of the rectus abdominis, internal oblique, external oblique, gluteus maximus, and gluteus medius increased significantly with lumbar stabilization single leg standing. 2) No differences in activity in the tibialis ante-rior, medial gastrocnemius, rectus femoris, and medial hamstrings were found with single leg standing. 3) The mean velocity of COP in the antero-posterior and medio-lateral directions in the lumbar stabilization single leg standing decreased significantly compared with the preferred single leg standing. The findings of this study therefore indicate that lumbar stabilization can facilitate the co-activation of deep stabilization and global muscles that improve postural control capability during single leg standing.

Correlation of Forearm Circumference; With Hand Grip Strength

신헌석,Cynn, Heon-Seock Korean Physical Therapy Science 2001 대한물리치료과학회지 Vol.8 No.2

이 연구의 목적은 전완 원주와 악력과의 상관관계를 알아보는 것이다. 오른손잡이 여성 30명이 이 연구에 참여하였으며, 연구의 대상자의 평균 연령은 31.0세였다. 전완 원주는 척골의 주두와 경상돌기의 1/2 지점과 근위 3/4 지점에서 줄자를 이용하여 측정하였다. 악력은 미국 수부 치료사 협회의 기준에 의하여 Jarmar dynamometer를 사용하여 측정하였다. 통계학적 분석은 피어슨 상관 관계 계수를 이용하여 상관관계를 조사하였다. 전완 두 지점에서 측정된 원주와 악력간에는 낮은 상관관계를 나타내었다(r=.02. p=.921; r=.02, p=.928). 연구 대상자 30명 중 정기적으로 상체 운동을 하는 18명의 연구 대상자들의 전완 두 지점에서도 낮은 상관 관계를 나타내었다(r=.16, p=.521: r=.18, p=.468). 본 연구의 결과는 선행된 다른 연구 결과와는 상이하게 높은 상관관계를 나타내지 않았다. 그 이유로는 본 연구에서 악력에 영향을 주는 여러 가지 요소들(신체 유형, 운동 습관. 직업 피하 지방성분, 유전적 요소 등)의 측정이 고려되지 않았고. 연구 대상자의 수(n=30)가 적었다는 점을 들 수 있다.

The Reliability of Thickness Measurement of the Deep Fiber of the Lumbar Multifidus Using Ultrasonography

Doh-heon Jung,Su-jung Kim,Chung-hwi Yi,Heon-seock Cynn,Houng-sik Choi 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.4

The reliability of the thickness measurement of the lumbar multifidus (LM) using real-time ultrasonography (US) was determined in only the superficial fiber of the lumbar multifidus (SM). However, previous studies have not examined the reliability of the deep fiber of the LM (DM). The purpose of this study was to determine the intrarater and the interrater reliability of the thickness measurements of DM using US. Eleven healthy males participated in the study. The thickness of the DM was measured with an US in the prone position. Reliability was examined using intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and the Bland and Altman plot. ICC(3,1) was used to calculate the interarater reliability of the thickness measurement of DM using the values from both the first and second test sessions. Additionally, ICC(3,1) was used to calculate the intrarater reliability of the measurements over two days using the measurements obtained in test session 1 and test session 2. The results of this study were as follows: 1) the ICC(3,1) value for interarater reliability was .94 in the first test session, and .93 in the second test session. 2) the ICC(3,1) values for intrarater reliability of the measurements over two days was .90 in both the first examiner and the second examiner The intrarater reliability and interrater reliability of the DM measurements, obtained via the US protocol used in this research was excellent. Therefore, we conclude that the thickness measurement of the DM obtaioned from the US protocol used in this research would be useful for clinician assessment of the thickness of the DM

Correlations Between Maximal Isometric Strength and the Cross-Sectional Area of Lumbrical Muscles in the Hand

Doh-heon Jung,Won-hwee Lee,Su-jung Kim,Heon-seock Cynn 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.4

The lumbrical muscles contribute to the intrinsic plus position, that is simultaneous metacarpophalangeal (MCP) flexion and interphalangeal (IP) extension. The strength of the lumbrical muscles is necessary for normal hand function. However, there is no objective and efficient method of strength measurement for the lumbrical muscles. In addition, previous studies have not investigated the measurement of the cross-sectional area (CSA) of the lumbrical muscles using ultrasonography (US) and the relationship between lumbrical muscle strength in the intrinsic plus position and the CSA. Therefore, the purpose of this study was to identify the measurement method of the CSA of the lumbrical muscles using US and to examine the relationship between maximal isometric strength and the CSA of lumbrical muscles. Nine healthy males participated in this study. Maximal isometric strength of the second, third, and fourth lumbrical muscles was assessed using a tensiometer in the intrinsic plus position which isolated MCP flexion and IP extension. The CSA of the lumbrical muscles was measured with an US. The US probe was applied on the palmar aspect of the metacarpal head with a transverse view of the hand in resting position. There was no significant difference between maximal isometric strength of the lumbrical muscles, but the fourth lumbrical muscle was stronger than the others. The CSA of the lumbrical muscles was significantly different and the fourth lumbrical muscle was significantly larger than the second lumbrical muscle. There was moderate to good correlation between maximal isometric strength and the CSA of the lumbrical muscles. Therefore, we conclude that maximal isometric strength of the lumbrical muscles was positively correlated to the CSA of the lumbrical muscle in each finger, while the measurement of the CSA of the lumbrical muscles, using US protocol in this study, was useful for measuring the CSA of the lumbrical muscles.

Relationship Between Electromyographic Activity of the Abductor Hallucis and the Pressure of a Pinch Gauge During Short Foot Exercise

Kyung-mi Park,Heon-seock Cynn,Houng-sik Choi 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.4

The aims of this study were to investigate the correlation between the electromyographic (EMG) activity of the abductor hallucis (AbdH) and the amount of pressure measured by a pinch gauge (PG), and to compare the EMG activity of AbdH and the pressure measured by the PG during short foot (SF) exercise in subjects with pes planus and in subjects with a neutral foot alignment. Fourteen subjects were recruited for this study (pes planus group=7; neutral foot alignment group=7). A surface EMG was used to collect AbdH activity, and a PG was positioned under the first metatarsophalangeal joint to measure the pressure produced by the first metatarsal head during the SF exercise. The AbdH activity and the pressure measured by the PG showed a positive good correlation (r=.80, p<.05). The EMG activity of the AbdH and the pressure measured by the PG were significantly lower for subjects with pes planus than for subjects with a neutral foot alignment (p<.05). Based on these findings, the PG can be recommended as an effective instrument for evaluating the performance of the AbdH. It may also be beneficial for monitoring how well the SF exercise is performed, and for providing visual feedback to patients with pes planus during SF exercise in a clinical setting.

Functional Outcome After Complete Spinal Cord Injury With Left Below Elbow Amputation, Medial Nerve Palsy at Right Hand : 증례연구 A Case Report

Kim, Tack-hoon,Cynn, Heon-seock,Lee, Jae-ho 한국전문물리치료학회 1999 한국전문물리치료학회지 Vol.6 No.4

Comparison of Knee Push-up Plus Exercise Versus Knee Push-up Plus Exercise with Isometric Shoulder Extension on Scapular Muscle Activities in Subjects with Rounded Shoulder Posture

Chi-hun Lee,Heon-seock Cynn,A-reum Shin,Seung-min Baik,Woochol Joseph Choi,Ji-hyun Lee 한국신경근육물리치료학회(구 한국신경근육재활학회) 2023 한국신경근육재활학회지 Vol.13 No.3

Excessive activity of the upper trapezius (UT) muscle contributes to a rounded shoulder posture (RSP) through abnormal rotation of the scapula that weakens the lower trapezius (LT) and serratus anterior (SA) muscles. This study compared the effects of knee push-up plus (KPP) exercise and KPP with isometric shoulder extension (KPPISE) exercise on the activities of LT, SA, and UT, and lower trapezius/upper trapezius (LT/UT) and serratus anterior/upper trapezius (SA/UT) activity ratios in subjects with RSP. Twenty subjects with RSP performed KPP and KPPISE. Electromyography was used to examine the muscle activity and a caliper, to measure the RSP. The paired t-test was used to compare the effect of KPP and KPPISE exercises on LT, SA, and UT activities, as well as LT/UT and SA/UT activity ratios in subjects with RSP. The LT and SA muscle activities significantly increased during KPPISE exercises than during KPP exercise (p=.004, p=.001; respectively). In contrast, the UT muscle activity significantly decreased during KPPISE exercise than after KPP exercise (p=.001). The LT/UT and SA/UT activity ratios increased significantly during KPPISE exercise than during KPP exercise (both p=.001). The KPPISE exercise may be an effective way to increase the LT and SA activity while reducing UT activity in subjects with the RSP.