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한국전문물리치료학회지
26권3호(2019년 09월) 수록논문
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KCI등재

1날개 어깨뼈 대상자들에게 어깨 내밈 운동시 벌림 각도와 외부 무게에 따른 앞톱니근, 큰가슴근, 위 등세모근의 활성도 및 비율에 미치는 영향

저자 : 야담바담허럴 ( Yadam Badamkhorl ) , 김태호 ( Tae-ho Kim ) , 박한규 ( Han-kyu Park )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 1-10 (10 pages)

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Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction.
Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position.
Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0˚, 30˚, 60˚, and 90˚. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA.
Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p< .05). The angle of abduction at 0˚, 30˚ and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p >.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30˚, 60˚ and 90˚ (p<.05). For UT/SA, significant difference was only observed at 90˚ (p<.05).
Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0˚ and 30˚ at shoulder protraction in supine position.

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2진동을 동반한 슬링 운동이 어깨 손상 환자의 관절가동범위, 근력, 통증, 기능장애 수준에 미치는 영향

저자 : 지창연 ( Chang-yeon Chi ) , 김선엽 ( Suhn-yeop Kim )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 11-22 (12 pages)

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Background: Sling exercises are frequently used for the rehabilitation process of patients with shoulder joint injuries, but research on the significant frequency intensity and appropriate treatment duration for sling exercises with local vibration stimulation is lacking.
Objects: The aim of this study was to investigate the effects of sling exercise with vibration on shoulder range of motion (ROM), muscle strength, pain, and dysfunction in patients with a medical diagnosis of shoulder joint injury.
Methods: Twenty-two patients were randomly assigned to the experiment and control groups. Six sling exercises with and without 50 ㎐ vibrations were applied in the experiment and control groups, respectively. Each exercise consisted of 3 sets of 5 repetitions performed for 6 weeks. The assessment tools used included shoulder joint range of motion, muscle strength, pain level, and shoulder pain and disability index for functional disability. We conducted re-evaluations before and 3 and 6 weeks after intervention. The changes in the measurement variables were analyzed and compared between the two groups.
Results: The ROM of the external rotation of the shoulder joint had a significant interaction between the group and the measurement point (F=3.652, p<.05). In both groups, we found a significant increase in external rotation angle between the measurement points (p<.05). The flexor strength of the shoulder joint significant interaction between the group and the measurement point (F=4.247, p<.05). Both the experiment (p<.01) and control groups (p<.05) showed a significant increase in shoulder flexor strength at the measurement points. After 6 weeks of the interventions, both the groups showed significantly improved VAS (p<.01), SPADI (p<.01), and orthopedic tests (p<.01). However, there was no significant difference between the group and the measurement point in terms of the clinical outcomes observed.
Conclusion: The sling exercise with local vibration of 50 ㎐ affected the external rotation of the shoulder range of motion and improved shoulder flexor strength in the patients with shoulder injuries. Therefore, we propose the use of the sling exercise intervention with vibration in the exercise rehabilitation of patients with shoulder joint injuries.

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3목말밑 관절의 중립자세와 무릎관절 자세가 수동적인 발등굽힘 가동범위에 미치는 영향

저자 : 정도영 ( Do-young Jung )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 23-31 (9 pages)

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Background: Measurement of passive ankle dorsiflexion range of motion (ADROM) is often part of a physical therapy assessment.
Objects: The objective of this study was to identify the effects of subtalar joint neutral position (SJNP) on passive ADROM according to knee position in young adults.
Methods: We recruited 14 young adult participants for this study. Two examiners used a universal goniometer to measure passive ADROM with and without SJNP. Dorsiflexion force was applied to the forefoot until maximum resistance was reached in two knee positions (extension and 90˚ flexion) in the prone position. Subtalar joint position was also recorded at maximum ADROM. Passive ADROM was measured three times at different knee and subtalar joint positions, in random order. Two-way repeated-measures analysis of variance was used to compare the effects of subtalar joint and knee position on passive ADROM.
Results: Passive ADROM was significantly lower with than without SJNP during both knee extension (mean difference: 7.4˚) and 90˚ flexion (mean difference: 16.9˚) (p<.01). Passive ADROM was significantly higher during 90˚ knee flexion than during knee extension both with (mean difference: 5.8˚) and without SJNP (mean difference: 15.2˚) (p<.01). The valgus position of the subtalar joint was significantly lower with than without SJNP during both knee extension (mean difference: 3.3˚) and 90˚ flexion (mean difference: 4.3˚) (p<.01).
Conclusion: Our results indicate that the gastrocnemius may limit ankle dorsiflexion more than the soleus does. Greater dorsiflexion at the subtalar and midtarsal joints was observed during passive ADROM measurement without than that with SJNP; therefore, SJNP should be maintained for accurate measurement of ADROM.

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4즉각적인 뒤넙다리근 편심성 운동과 정적 스트레칭이 몸통 전방 굽힘에 미치는 영향

저자 : 김태은 ( Tae-eun Kim ) , 최보람 ( Bo-ram Choi )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 32-41 (10 pages)

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Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending.
Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings.
Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures
Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending.
Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

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5등뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향

저자 : 이화정 ( Hwa-jeong Lee ) , 김선엽 ( Suhn-yeop Kim )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 42-56 (15 pages)

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Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients.
Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain.
Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks.
Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group.
Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

KCI등재

6게임 기반의 자세수직 훈련이 급성 뇌졸중 환자의 밀기행동, 자세조절, 그리고 일상생활동작에 미치는 영향: 사전연구

저자 : 안창만 ( Chang-man An ) , 노정석 ( Jung-suk Roh ) , 김택훈 ( Tack-hoon Kim ) , 최흥식 ( Houng-sik Choi ) , 최규환 ( Kyu-hwan Choi ) , 김경모 ( Gyoung-mo Kim )

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 57-66 (10 pages)

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Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke.
Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients.
Methods: Fourteen participants with acute stroke (< 2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score >2) were randomly divided into the GPVT group (n1=7) and conventional postural vertical training (CPVT) group (n2=7). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured preand post-intervention.
Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively).
Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

KCI등재

7Effects of Transcutaneous Electrical Stimulation on Physiological Symptoms and Psychological Satisfaction in Women With Stress Urinary Incontinence: A Preliminary Study

저자 : Ji-hyun Kim , Oh-yun Kwon , Hye-seon Jeon , Ui-jae Hwang , Kyeong-tae Gwak , Hyeo-bin Yoon , Eun-young Park

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 67-75 (9 pages)

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Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed.
Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention.
Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires.
Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05).
Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

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8Reliability of Lateral Deviation Measurement in the Hyoid Bone With Center Point and Lateral Motion Tests

저자 : Hye-jin Min , Tae-lim Yoon

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 76-83 (8 pages)

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Background: The hyoid bone is the only non-jointed structure among the skeletal tissues of the head and neck region, and its movement and posture depend on the attached muscle, ligament, and fascia. The location of the hyoid bone is important for airway maintenance, vocalization, chewing, swallowing, breathing, and head and scapular position. In general, the location of the hyoid bone is measured using radiographs and 3D computed tomography, and no studies have reported on clinical measurement methods.
Objects: This study was performed to suggest clinical measurement methods for lateral deviation of the hyoid bone and to evaluate their reliability.
Methods: In this study, 24 healthy volunteers (12 males, 12 females) in Cheongju-si participated. Two examiners performed the center point test and lateral motion test twice each to measure the lateral displacement of the hyoid bone. The reliability of the center point test was analyzed using intra-class correlation coefficients (ICC), and the reliability of the lateral motion test was analyzed using Cohen's kappa coefficient.
Results: The intra-rater reliability of the center point test was good, and the inter-rater reliability was moderate. The intra- and inter-rater reliability of the lateral motion test showed substantial reliability.
Conclusion: Based on these results, the center point test and the lateral motion test can be used as an alternative methods of the measurement of lateral deviation of the hyoid bone for people who have musculoskeletal disorders of the head, neck, and scapula.

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9Ankle Evertor Strength of Healthy Subjects in Different Ankle and Toe Positions

저자 : Sun-hee Ahn , Hyun-a Kim , Jun-hee Kim , Kyung-tae Kwak , Oh-yun Kwon

발행기관 : 한국전문물리치료학회 간행물 : 한국전문물리치료학회지 26권 3호 발행 연도 : 2019 페이지 : pp. 84-90 (7 pages)

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Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle.
Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects.
Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF).
Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01).
Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

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Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles.
Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion.
Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with 90˚ knee flexion, without hip external rotation (b) with 90˚ knee flexion, with hip external rotation (c) with 135˚ knee flexion, without hip external rotation (d) with 135˚ knee flexion, with hip external rotation.
Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). While HAM muscle activity was significantly less in 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). ES muscle activity was significantly less in the 135˚ knee flexion position than in the 90˚ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively).
Conclusion: For patients performing the bridge exercise, positioning the knee in 135° of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

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1연안해역에서 석유오염물질의 세균학적 분해에 관한 연구

(2006)홍길동 외 1명심리학41회 피인용

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부산가톨릭대학교 연세대학교 을지대학교 한국교통대학교 한국외국어대학교
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