| Abstract |1 ) PURPOSE: This study examined the effects of videoconferencing-based telerehabilitation exercise program on the gait, knee function, and quality of life of patients with knee osteoarthritis.METHODS: Forty-eight subjects, who were diagnosed with osteoarthritis of the knee by the radiologic findings, history, and a physical examination, were assigned randomly to a Control group, Experiment group I, and Experiment group Ⅱ. The control group did not perform any exercise program and were educated in understanding and managing the disease of knee osteoarthritis for only one hour.Experimental groups I and Ⅱ were provided with an exercise guidelines book for knee osteoarthritis, and the same exercise 본 논문은 김재윤(2018)의 박사 학위 논문의 요약본임. †Corresponding Author : Mo-Beom Jeong mobeom_j@dauml.net, https://orcid.org/0000-0003-2750-1078 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. programs were conducted by face-to-face visits and non-face-to-face using telerehabilitation for eight weeks, respectively. To verify the effectiveness of each exercise program, the gait speed, knee disability index, and health related quality of life were measured. All assessments were conducted twice before and after the intervention. RESULTS:The participants who underwent both face-toface and telerehabilitation exercise programs showed an improved gait speed, knee function, and health-related quality of life. In particular, there was no significant difference between the telerehabilitation exercise group and the direct face-to-face exercise group in improving the knee joint function and health related quality of life. CONCLUSION:A these findings the telerehabilitation exercise program for patients with knee osteoarthritis can alternate or supplement the face-to-face exercise program. Therefore, the telerehabilitation exercise program should be used not only as a substitute supplement program but also as an intervention for various diseases.
Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, MAS≥ 2) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p< 0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p< 0.05), significantly difference at 10 Hz between 30 Hz (p< 0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p< 0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p< 0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients. 서 론뇌졸중은 국내 사망 원인 3위를 차지하는 질환으로 과거에 비해 사 망률은 줄었으나 발병률은 증가하고 있는 추세이다. 뇌졸중 후 일반 적으로 40% 정도에서 기능적 손상이 남게 되고, 15-30%는 심각한 장 애를 얻게 된다. 1 이로 인한 스트레스, 2 운동능력의 제한, 신체의 장애 및 근력약화, 가동성 저하, 경직, 균형 능력의 문제를 동반하며 3,4 특정 근육의 약화, 운동협응 장애, 비정상적 시너지 운동을 일으킨다고 하 였다. 5 운동 조절과 움직임 개시 또한 근육 약화와 근력 저하로 인해 제한된다. 6 특히 만성 뇌졸중 환자의 경우 다양한 활동 제한으로 인해 불편함 을 호소한다. 7,8 다양한 활동 영역 중에서도 특히 보행 능력은 일상생 활을 영위하고 다양한 사회적 참여를 위해 필수적인 요소이나 달라 진 보행 능력의 저하로 인해 뇌졸중 환자들이 많은 불편함을 호소해 왔다. 9 보행 능력의 저하는 뇌졸중 발병 초기 단계부터 빈번하게 나타 나며 영향을 끼치는 다양한 원인 중 하나는 경직(spasticity)이다. 경직 은 일반적으로 속도에 비례하는 근육 신장 반사의 과흥분을 뜻하는 데 힘줄 반사 항진과 수동 움직임에 대한 저항 증가, 상위 운동 신경원 의 억제 제어 감소로 인한 근육 긴장 항진이 특징이다. 10 또 뇌졸중, 뇌 성마비, 다발성 경화증, 척수 손상 및 기타 중추신경계 병변 후 가장 흔히 발생하는 것으로 알려진 증상이기도 하다. 실제로 척수 또는 대 뇌 병변이 있는 많은 환자들이 경직성 운동 장애를 갖고 있다. 지속적 인 경직으로 관절 위치의 제한, 11 경직 근육과 관절 주변 결합 조직의 변화로 연부 조직이 짧아져 능동적, 수동적 관절 가동성, 하지의 수의 적 움직임, 보행 안정성, 일상생활 활동을 제한한다. 12 이러한 경직에 대한 주요 접근법은 보존적 치료와 외과적 개입이 있다. 물리치료 영This is an Open Access article distribute under the terms of the Creative Commons Attribution Non-commercial License (Http:// creativecommons.org/license/by-nc/4.0.) which permits unrestricted non-commercial use, distribution,and reproduction in any medium, provided the original work is properly cited.
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