• Title/Summary/Keyword: 상지 재활

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Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke (국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석)

  • Yoo, Eun-Young;Park, Ji-Hyuk;Kwon, Jae-Sung;Cho, Sang-Yoon;Lee, Bo-Mi;Kim, Yeong-Jo;Kim, Jae-Nam;Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.79-88
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    • 2018
  • Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.

A Case Study on the Clinical Application of Lee Silverman Voice Treatment-BIG (LSVT-BIG) Program for Occupational Performance and Motor Functions of Stroke Patients (뇌졸중 환자의 작업수행과 운동기능을 위한 Lee Silverman Voice Treatment-BIG(LSVT-BIG) 프로그램의 임상적용에 대한 사례연구)

  • Jeong, Sun-A;Hong, Deok-Gi
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.63-75
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    • 2020
  • Objective : The purpose of this study was to examine the changes in work performance and motor function of stroke patients in the Lee Silverman Voice Treatment-BIG (LSVT-BIG) program and to confirm its clinical applicability. Methods : Two stroke patients underwent the LSVT-BIG program for a total of 16 sessions (60 minutes per session and, four days a week for four weeks). To assess any changes between before and after the intervention, the Canadian Occupational Performance Measurement (COPM), Berg Balance Scale (BBS), Timed Up and Go (TUG), Functional Reaching Test (FRT), Manual Function Test (MFT) were used. Differences in scores between before and after the intervention were analyzed. Results : The performance and satisfaction of occupational performance increased after the intervention in both subjects. The performance time of the TUG decreased to 0.91, 8.42 seconds for each subject, increasing the walking speed. In FRT distance change, the subject increased in both the affected side and unaffected side. The BBS score increased by 3 points in one subject and by 6 points in the other, indicating improved balance. In addition, in the MFT score, subject A showed an improvement of 1 point on the unaffected side, and subject B showed an improvement of 1 point on the unaffected side and 3 points on the affected side. Conclusion : We confirmed the applicability of the LSVT-BIG program as a new intervention technique for stroke patients. Future, complementary research on the effects of the LSVT-BIG program on stroke patients will be needed.

Double Threshold Method for EMG-based Human-Computer Interface (근전도 기반 휴먼-컴퓨터 인터페이스를 위한 이중 문턱치 기법)

  • Lee Myungjoon;Moon Inhyuk;Mun Museong
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.471-478
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    • 2004
  • Electromyogram (EMC) signal generated by voluntary contraction of muscles is often used in a rehabilitation devices such as an upper limb prosthesis because of its distinct output characteristics compared to other bio-signals. This paper proposes an EMG-based human-computer interface (HCI) for the control of the above-elbow prosthesis or the wheelchair. To control such rehabilitation devices, user generates four commands by combining voluntary contraction of two different muscles such as levator scapulae muscles and flexor-extensor carpi ulnaris muscles. The muscle contraction is detected by comparing the mean absolute value of the EMG signal with a preset threshold value. However. since the time difference in muscle firing can occur when the patient tries simultaneous co-contraction of two muscles, it is difficult to determine whether the patient's intention is co-contraction. Hence, the use of the comparison method using a single threshold value is not feasible for recognizing such co-contraction motion. Here, we propose a novel method using double threshold values composed of a primary threshold and an auxiliary threshold. Using the double threshold method, the co-contraction state is easily detected, and diverse interface commands can be used for the EMG-based HCI. The experimental results with real-time EMG processing showed that the double threshold method is feasible for the EMG-based HCI to control the myoelectric prosthetic hand and the powered wheelchair.

The History of CO2 Laser Acupuncture and Moxibustion (CO2 레이저 침구 치료의 역사)

  • Jang, Insoo;Yang, Changsop;Sun, Seungho;Jeong, Minjeong;Han, Changho;Hwang, Eui-Hyoung;Seo, Hyungsik
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.36-43
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    • 2019
  • Objectives : Carbon dioxide ($CO_2$) laser, a high power laser has been used for pain management, dermatology, and surgery and laser acupuncture and moxibustion as well, since it had been oscillated in 1964 at Bell Telephone Laboratories in the US. The purpose of this study is to investigate the history of $CO_2$ laser acupuncture through reviewing studies published in early stage of laser medicine. Methods : To investigate the early history of $CO_2$ laser acupuncture, studies were searched in the electronic databases, including PubMed, ScienceDirect, CNKI, Wanfang, J-STAGE, CiNii, KTNP, and OASIS, since 1964. Articles in English, Chinese, Japanese and Korean were included, and there were no limitations in literature types such as reviews, essays, clinical trials, animal experiments and veterinary research. Results : We found that the first $CO_2$ laser application to acupoints was done by a research team in Shanghai in 1976. They used $CO_2$ laser for acupuncture treatment and it was also the first laser acupuncture treatment in China. Since the first case report of $CO_2$ laser for leukopenia, it has been applied to various diseases in China, Korea, Japan and other western countries. It has been widely applied in the fields of dentistry and veterinary medicine, as well as clinical applications. Conclusions : Not only $CO_2$ laser can be used as laser acupuncture by stimulating the acupoints and meridians, but also can produce moxibustion effect by using heat stimulus. Therefore, it is expected that it will be used in various clinical fields in the future.

The Effect of Teratainment Task Oriented Activity on the Hemiplegia Weight Shifting of Stroke Patients (테라테인먼트 과제 지향적 활동이 뇌졸중 환자의 마비측 체중이동 능력에 미치는 영향)

  • Jung, Sang-Mi;Choi, Won-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.3
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    • pp.455-462
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    • 2020
  • The purpose of this study was to investigate the effect of hemiplegia on weight shift when mediating task-oriented activities in stroke patients. To this end, from September to December 2019, 33 patients with stroke were randomly assigned and divided into 17 experimental groups and 16 control groups. The experimental group provided task-oriented activities, and the control group general occupational therapy was conducted 3 times a week, 35 minutes per session for a total of 4 weeks. The weight shift of the left and right body was evaluated by the MTD balance system, and an initial evaluation before intervention and a re-evaluation was performed after 4 weeks of intervention. The result were as follows: 1) When evaluating the pre- and post-intervention within the group, the weight shift to the hemiplegia side showed an improvement in the weight shift to the hemiplegia side in both the experimental group(p<.001), and control groups(p<.001, p<.05). 2) In the pre- and post-intervention evaluation between groups, the experimental group showed a statistically significant improvement in weight shift to the control group(p<.01, p<.05). Through future supplementary studies, it is thought that task-oriented activities in the treatment of stroke patients could be usefully applied to promote weight transfer to the paralysis side.

Domestic Occupational Therapist Awareness Survey for the Need to Apply Artificial Intelligence Measurement Technology for Clinical Observation Evaluation Based on Sensory Integration (감각통합에 기초한 임상 관찰 평가의 AI 측정 기술 적용 필요성을 위한 국내 작업치료사 인식 조사)

  • Cho, Sun-Young;Jung, Young-Jin;Kim, Jung-Ran
    • Therapeutic Science for Rehabilitation
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    • v.12 no.1
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    • pp.23-35
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    • 2023
  • Objective : This study is to examine the practical use of clinical observational evaluation of sensory integration therapy and the difficulty and importance of measuring results for each sub-item, and through this, to confirm the usefulness of the application of Artificial Intelligence measurement technology in clinical observational measurement and the need for application. Methods : The questionnaire consisted of the actual use of the sensory integration evaluation tool, the difficulty of measurement for each detailed item of clinical observation, the usefulness of AI measurement technology, the importance of evaluation for each detailed item, and the need for developing AI measurement technology. Results : The detailed items that were difficult to measure during clinical observation were the Finger-to-Nose Test and Postural control (71.0%), followed by Eye movement and Protective Extension Test (67.7%). 83.9% of the study subjects answered that it would be useful to apply AI measurement technology when observing images. Postural control (on the ball) (90.3%) was the highest item that answered that AI measurement technology was needed, followed by Eye movement (83.9%), and Prone Extension and Protective Extension Test (77.4%). Conclusion : The results confirmed the desire of therapists that clinical observation is an important evaluation tool in the field of child occupational therapy in Korea.

Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1312-1326
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    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

Development Of Virtual Reality System For The Training And Assessment Of Proprioception During Upper-limb Reaching Task: A Pilot Study (상지재활 훈련동안 자기수용감각의 훈련 및 평가를 위한 가상현실 시스템 개발: 예비연구)

  • Cho, Sang-Woo;Ku, Jeong-Hun;Han, Ki-Wan;Lee, Hyeong-Rae;Park, Jin-Sick;Lee, Won-Ho;Shin, Young-Seok;Kim, Hong-Joon;Kang, Youn-Joo;Kim, In-Young;Kim, Sun-I.
    • 한국HCI학회:학술대회논문집
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    • 2008.02a
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    • pp.749-753
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    • 2008
  • Proprioception defined it as the ability to detect, the spatial position or movement of joints using balance, power of the muscle, agility in the internal parts of the body. In existing study for improvement of proprioception, reaching task training provided a feedback; the assessment was not provided a feedback. But, this has problem that it can not guide a proprioception from situation with visual feedback. Virtual reality technique can solve the problem of way providing feedback during training. In this study, we developed proprioception training program using virtual reality and pilot study is performed. VR task were composed three modes. In mode 1, real-time movement of the body was provided using visual feedback. In mode 2, body position was provided using visual feedback when participant have specific response. And in mode 3, body position was not provided. VR task is performed five sessions at each mode and one session performed one by one a three target. In the result of this study, the moving time toward the target from mode 3 was smaller than the moving time toward the target from mode 1 (p= 0.001). The correlation was statistically significant between mode 2 and mode 3 while be offering visual feedback position of mode 2 1session. But, the correlation was not statistically significant between mode 2 and mode 3 after be offered visual feedback position of mode2 1session (p = 0.012). Training environment of mode 1 shows which training used visual feedback than proprioception. Mode2 can execute training of proprioception because first session acquires visual feedback by proprioception. The next study will be verification of the system for training or assessment by clinical experiment.

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Norm-referenced criteria for strength of the elbow joint for the korean high school baseball players using the isokinetic equipment: (Focusing on seoul and gyeonggi-do) (등속성 장비를 이용하여 한국고교야구선수 주관절 근력 평가기준치 설정: (서울 및 경기도 중심으로))

  • Kim, Su-Hyun;Lee, Jin-Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.442-447
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    • 2017
  • The purpose of this study was to establish norm-referenced criteria for the isokinetic strength of the elbow joint in Korean high school baseball players. Two hundred and one high school baseball players participated in this study, none of whom had any medical problem with their upper limbs. The elbow flexion/extension test was conducted four times at a speed of $60^{\circ}/sec$. The HUMAC NORM (CSMI, USA) system was used to obtain the values of the peak torque and peak torque per body weight. The results were presented as norm-referenced criterion valuesusing the 5-point scale of Cajori which consists of five stages (6.06%, 24.17%, 38.30%, 24.17%, and 6.06%). In the results of this study, the peak torques of the elbow (flexor and extensor?) at an angular velocity of $60^{\circ}/sec$ were $37.88{\pm}8.14Nm$ and $44.59{\pm}11.79Nm$, and the peak torque per body weight of the elbow (flexor and extensor?) were $50.06{\pm}8.66Nm$ and $58.28{\pm}12.84Nm$, respectively. The reference values of the peak torque and peak torque per body weight of the elbow flexor and extensor were setat an angular velocity of $60^{\circ}/sec$. On the basis of the results analyzed in this study, the following conclusions were drawn. There is a lack of proper studies on the elbow joint strength, even though the most common injury in baseball players occurs in the elbow joint. Therefore, we need to establish a standard muscle strength in order to prevent elbow joint injuries and improve their performance. The criteria for the peak torque and peak torque per body weight established here in will provide useful information for high school baseball players, baseball coaches, athletic trainers and sports injury rehabilitation specialists in injury recovery and return to rehabilitation, which can beutilized as objective clinical assessment data.

Lower Extremity Edema in Terminal Cancer Patients (말기 암 환자에서의 하지 부종)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Ji-Chan;Hong, Sug-Hui;Choi, Gang-Heun;Cho, Hong-Joo;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.152-155
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    • 2005
  • Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

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