Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지

Effects of Upper Extremity Exercise Training Using Biefeedback and Constraint-induced Movement on the Upper Extremity Function of Hemiplegic Patients

바이오피드백과 건측 억제유도 운동을 이용한 상지운동훈련이 편마비 환자의 상지기능에 미치는 효과

  • Published : 2003.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients. Method: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the VIE motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality). Result: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. Conclusion: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

Keywords

References

  1. Basmajian, J. V., Gowland, C. A., Finlayson, A. J., Hall, A. L., Swanson, L. R., Stratford, P. W., Trotter, J. E., and Brandstater, M. E. (1987). Stroke treatment: Comparison of integrated behavioral physical therapy vs traditional physical therapy programs. Arch Phys Med Rehabil, 68, 267-272
  2. Blanchard, E. B., & Epstein (1990). Feedback treatments of essential hypertension, Biofeedback Self-Regulation, 15, 209-227
  3. Burnside, I. G., Tobias, H. S., & Bursill, D. (1982). Electromyographic feedback in the remobilization of stroke patients: A controlled trial. Arch Phys Med Rehabil, 63, 217-222
  4. Dromerick, A., Edwards, D., & Hahn, M. (2000). Does the application of constrain-induced movement therapy during acute rehabilitation reduce arm impairment after ischemic stroke? Stroke, 31(12), 2984
  5. Feys, H. M., De Weerdt, W. J., Selz, B. E., Cok Steck, G. A., Spichiger, R., Vereeck, L. E., Putman, K. D., Hoydonck, G. A. (1998). Effect of Therapeutic Intervention for the Hemiplegic Upper Limb in the Acute Phase After Stroke. Stoke, 29, 785-792
  6. Hesse, S., Bertelt, C., Jahnke, M., Schaffrin, A., Malezic, M. & Mauritz, K. (1994). Treadmill training with partial body weight support compared with physiotherapy in nonambulatory hemiplegic stroke patients. Stroke, 26, 976-981
  7. Kang, J. (2002). Effects of constraint-induced movement using self-efficacy on the upper extremity function of hemiplegic patients. Unpublished doctoral thesis. Seoul National University
  8. Kim, C., Lee, J., & Bai, S. (2001). The Comparison Effect of Passive Isokinetic Exercise and Electrical Stimulation on Elbow Spasticity for Chronic Cerebral Apoplexy Patients. Journal of Korean Society of Sport and Leisure Studies, 15, 301-308
  9. Kim, K. S. (2000). The Effect of Progressive Muscle Relaxation using Biofeedback on Stress Response and Natural Killer Cell in first Clinical Practice of Nursing Students, J Korean Acad Fund Nurs, 7(1), 109-121
  10. Kim, K. S. (2001). A Correlational Study on Activities of Daily Living, Self-efficacy, Stroke Specific Quality of Life and Need for Self-help Management Programs for Patients with Hemiplegia at Home. J Korean Acad Fund Nurs, 8(1), 81-94
  11. Kim, K., Lee, S., Choi, M. & Lee, M. (1999). The Effect on Menstrual Pain of Relaxation Therapy using Biofeedback . The Seoul Journal of Nursing, 13(1), 7-22
  12. Kim, K., Lee, S., Choi, M., Lee. M., & Kim, E. (2001). Effects of Biofeedback Exercise Training in Hemiplegic Patients after Stroke. J Korean Acad Nurs, 31(5), 432-442
  13. Kopp B., Kunkel A., Muehlnickel W., Villringer K., Taub E., & Flor H. (1999). Plasticity in the motor system related to therapy-induced improvement of movement after stroke. Neuroreport, 10, 807-10
  14. Kunkel A., Kopp B., & Muller G. (1999). Constraint-Induced Movement Therapy: a powerful new technique to induce motor recovery in chronic stroke Arch Phy Med Rehabil, 80, 624-8
  15. Lee, E., Lim, N. & Park, H. (1998). 간호.의료연구와 통계 분석. Soo Moon Sa Co. Seoul
  16. Lee, S., Kim, K. & Park, S. (1999). A Study on the Effect of Self-Management and Relaxation Training through Biofeedback on Influencing the Stress Response and Immune Functions, J Korean Acad Nurs, 29(4), 855-869
  17. Liepert J., Miltner, W., Bauder H., Sommer M., Dettmers, C., Taub, E. & Weiller, C. (1998). Motor cortex plasticity during constraint-Induced movement therapy in chronic stroke patients. Neuroscience Letter, 250(1), 5-8
  18. Miltner W., Bauder H., Sommer M., Dettmers C., & Taub E.(1999). Effects of constraint-induced movement therapy on chronic stroke patients: a replication. Stroke, 30, 586-92
  19. Nudo, R. J., Wise, B. M., SiFuentes, F., & Milliken, G. W. (1996). Neural substrates for the effects of rehabilitative training on motor recovery following ischemic infarct. Science, 272, 1791-1794 https://doi.org/10.1126/science.272.5269.1791
  20. Page, S., & Sisto, S. (2002). Constraint-induced therapy: ready for prime time? Featured article of www.Rehab'Irials.org, May 6
  21. Page, S., Sisto, S., Levine, P., Johnston, M. & Hughes, M. (2001). Modified constraint induced therapy: a randomized feasibility and efficacy study. J Rehabil Res Dev, 38(5), 585-590
  22. Rho, Y., Kim, N. & Kim, H. (1990). The Effects on EMG Level by EMG Biofeedback with Progressive Muscle Relaxation Training on Tension Headache. J Korean Acad Nurs, 20(2), 195-213
  23. Rho, Y., & Kim, H. (1993). The effect of thermal biofeedback and progressive muscle relaxation training in reducing blood pressure, plasma cortisol and aldostrone level of patients with essential hypertension. J Korean Acad Adult Nurs, 2, 157-163
  24. Runck, B. (1980). Biofeedback : Issues in treatment and assessment, national institute of mental health, Department of Health and Human Service, Washington, D.C. Publication No.(ADM) 80-1032
  25. Schleenbaker, R. E., & Mainous, A. G. 3rd. (1993). Electromyographic biofeedback for neuromuscular reeducation in the hemiplegic stroke patient: a meta-analysis. Arch Phy Med Rehabil, 74(12), 1301-4
  26. Suh, Y. (1999). Effects of Rehabilitation Program on Functional Recovery in Stroke Patients. J Korean Acad Adult Nurs, 29(3), 665-678
  27. Taub, E., Miller, N. E., Novack, T. A. (1993). Technique to improve chronic motor deficit after stroke. Arch Phy Med Rehabil, 74, 347-354
  28. Taub, E., & Wolf, S. L. (1997). Constraint-Induced (CI) Movement techniques to facilitate upper extremity use in stroke patients. Top Stroke Rehabil, 3, 38-61
  29. Taub, E., Crago, J. E., & Uswatte, G. (1998) Constraint-Induced movement therapy: a new approach to treatment in physical rehabilitation. Rehabil Psychol, 43, 152-70 https://doi.org/10.1037/0090-5550.43.2.152
  30. van der Lee, J. H., Wagenaar, R. C., Lankhorst, G. J., Vogelaar, T. W., Deville, W. L., & Bouter, L. M. (1999). Forced use of the upper extemity in chronic stroke patients: results from a single -blind randomized clinical trial. Stroke, 30(11), 2269-2375
  31. Wolf, S. L., Binder-Macleod, S. A. (1983). Electromyographic biofeedback applications to hemiplegic patient: Changes in lower extremity neuromuscular and functional status. Physical Therapy, 63(9), 1393-1413