• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.1-9
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• 2018

PURPOSE: This study investigated the neurophysiological and behavioral adaptation during one or both hands movement in chronic stroke patients. METHODS: The study included sixteen hemiplegic stroke patients. Neurophysiological data (brain activation and muscle activation) were examined by electroencephalography (EEG) and electromyography (EMG), and behavioral adaptation was examined by wrist extension angle during wrist extension with one hand or both hands. Outcome variables of one hand or both hands were; mu rhythm of the EEG, EMG amplitude of wrist extensor and flexor muscles, and wrist angle of Myomotion 3D motion analysis. RESULTS: Our results revealed that wrist extension angle was significant increased during both hands movement compared to one hand movement (p<.05). Furthermore, in affected sensorimotor area, there was significant increase in the brain activation during both hands movement compared to one hand movement (p<.05). However, there was no significant different between one hand and both hands movement in muscle activation (p>.05). CONCLUSION: According to the findings of this experiment, bilateral arm movement improved brain activity on affected sensorimotor area and wrist extension angle. Therefore, we suggest that bilateral arm movement would positive effect on stroke rehabilitation in terms of increase in brain activation on affected motor area and wrist extension during bilateral arm movement.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.65-72
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• 2011

Purpose: The intention of this study was to investigate the effects of modified constraint-induced movement therapy (mCIMT) with bilateral arm training (BAT) on the motor performance and daily activity performance of individuals with chronic hemiparetic stroke. Methods: Sixteen subjects one year after stroke participated in this study with a control group; the pretest-posttest method was used. The subjects were randomly allocated into two groups: combination of bilateral arm training and modified constraint-induced movement therapy (n=8), and modified constraint-induced movement therapy (n=8). The mCIMT group received therapy for 90 minutes in 3 sessions per week over a period of 4 weeks. The patients receiving a combination of mCIMT and BAT were treated for the same period and frequency. The results were evaluated using the Fugl-Meyer Assessment, Action Research Arm Test (ARAT), and Motor Activity Log-Amount of Use, and Quality of Movement (MAL-AOU, QOM) assessment tools. Results: The Fugl-Meyer Assessment showed that hand and wrist performance improved significantly more in the mCIMT group than in the Combination group (p<0.05). Result from the ARAT assessment showed greater scores for gross movement in the combined group than in the mCIMT group (p<0.05). The MAL-AOU showed that there was greater improvement in the combined group than in the mCIMT group (p<0.05). Conclusion: The forced use of the more affected side can be important for the enhancement of upper extremity performance for chronic hemiparetic stroke patients during their daily activities.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2140-2146
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• 2020

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.374-378
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• 2021

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

• PNF and Movement
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• v.17 no.3
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• pp.421-429
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• 2019

Purpose: This study evaluated the relationship between pelvic pressure and irradiation of the proprioceptive neuromuscular facilitation (PNF) upper arm pattern exercises with an elastic band while in a sitting position. Methods: Fourteen subjects with asymptomatic pelvic pressure participated in this study. Pelvic pressure was measured using a Gaitview® system while sitting and performing PNF bilateral upper arm patterns. Resistance strength was provided by the blue elastic band. The statistical significance of the results was evaluated using a repeated one-way ANOVA and the independent t-test. The Bonferroni method was used for the post-hoc test. Results: The results revealed a significant change in the pelvic pressure when performing the PNF arm pattern. The average resistance pressure on the pelvis, with the elastic band, significantly increased after the initial sitting position (F=3.91, 3.92; p<0.05). No significant pelvic pressure changes were noted for each PNF upper arm pattern (p>0.05). Conclusion: The results of this study showed a positive relationship between pelvic pressure and the irradiation of PNF upper arm pattern exercises with resistance in the sitting position.

• Journal of Trauma and Injury
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• v.27 no.3
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• pp.79-83
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• 2014

The brachial plexus is a network of nerves that provides movement and feeling to the shoulder, arm and hand. The majority of acute brachial plexus injuries occur when the plexus is stretched violently or torn. This happens as result of the shoulder being pressed down forcefully while the head is pushed up and away from that shoulder. Such injuries frequently result from automobile or motor-cycle accidents or from falls and usually affect one side. Nerve injuries vary in severity from a mild stretching of the nerve to a tearing of the nerve root away from the spinal cord. We experienced a 50-year-old woman with weakness in both upper extremities after an attempted hanging. A consecutive workup revealed bilateral brachial plexus injuries. Six months after the incident, she had fully recovered. This is a very rare case of bilateral brachial plexus injuries after an attempted hanging.

• Research in Vestibular Science
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• v.17 no.4
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• pp.134-141
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• 2018

Objectives: We aimed to study the role of vestibular input on spatial memory performance in mice that had undergone bilateral surgical labyrinthectomy, semicircular canal (SCC) occlusion and 4G hypergravity exposure. Methods: Twelve to 16 weeks old ICR mice (n=30) were used for the experiment. The experimental group divided into 3 groups. One group had undergone bilateral chemical labyrinthectomy, and the other group had performed SCC occlusion surgery, and the last group was exposed to 4G hypergravity for 2 weeks. The movement of mice was recorded using camera in Y maze which had 3 radial arms (35 cm long, 7 cm high, 10 cm wide). We counted the number of visiting arms and analyzed the information of arm selection using program we developed before and after procedure. Results: The bilateral labyrinthectomy group which semicircular canal and otolithic function was impaired showed low behavioral performance and spacial memory. The semicircular canal occlusion with $CO_2$ laser group which only semicircular canal function was impaired showed no difference in performance activity and spatial memory. However the hypergravity exposure group in which only otolithic function impaired showed spatial memory function was affected but the behavioral performance was spared. The impairment of spatial memory recovered after a few days after exposure in hypergravity group. Conclusions: This spatial memory function was affected by bilateral vestibular loss. Space-related information processing seems to be determined by otolithic organ information rather than semicircular canals. Due to otolithic function impairment, spatial learning was impaired after exposure to gravity changes in animals and this impaired performance was compensated after normal gravity exposure.

• Fashion & Textile Research Journal
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• v.12 no.5
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• pp.633-641
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• 2010

The purpose of this study is to evaluate a new flight suit in bilateral ways; subjectively and objectively in the improvements of comfort and mobility. Seven healthy males at the age of twenties volunteered in this wearing test. They were over 177 cm in height and 92-95 cm in chest circumference, which satisfies the M95 Special' size described in the Korean Military Specifications and Standards. The subjective satisfaction was evaluated according to the criteria of ease of donning and doffing, fitness of wear, mobility, space between cloth and body, convenience in using restroom. Subjective satisfaction evaluation says that the best improvement of movement are neck circumference, chest breadth, armscye circumference, waist back length, crotch length, crotch height and body rise. According to the evaluation, improvements of mobility were conspicuous especially in parts of body like neck, breast, waist, back, and arms. When evaluating objective satisfaction, we measured a angle difference in a prescribed standard-grid on a photograph that picked up while the subject performed each motion in front of 10 cm-interval grid. As a result, the motion that had angle difference above 5 degrees were arm stretching and standing on single leg holding at forward or at his side. Bending necks and waist, crouching also had angle difference of over 5 degrees. The improvements are discussed from the viewpoint that the increased ease in parts of armscye circumference and crotch in new flight suit pattern.

• International Journal of Advanced Culture Technology
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• v.7 no.1
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• pp.231-236
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• 2019

Background/Objectives: This paper proposes a dual mode feedback-controlled cycling system for children with spastic cerebral palsy to rehabilitate upper extremities. Repetitive upper limb exercise in this therapy aims to both reduce and analyze the abnormal torque patterns of arm movements in three- dimensional space. Methods/Statistical analysis: We designed an exercycle robot which consists of a BLDC motor, a torque sensor, a bevel gear and bearings. Mechanical structures are customized for children of age between 7~13 years old and induces reaching and pulling task in a symmetric circulation. The shafts and external frames were designed and printed using 3D printer. While the child performs active/passive exercise, angular position, angular velocity, and relative torque of the pedal shaft are measured and displayed in real time. Findings: Experiment was designed to observe the features of a cerebral palsy child's exercise. Two children with bilateral spastic cerebral palsy participated in the experiment and conducted an active exercise at normal speed for 3 sets, 15 seconds for each. As the pedal reached 90 degrees and 270 degrees, the subject showed minimum torque, in which the child showed difficulty in the pulling task of the cycle. The passive exercise assisted the child to maintain a relatively constant torque while visually observing the movement patterns. Using two types of exercise enabled the child to overcome the abnormal torque measured in the active data by performing the passive exercise. Thus, this system has advantage not only in allowing the child to perform the difficult task, which may contribute in improving the muscle strength and endurance and reducing the spasticity but also provide customizable system according to the child's motion characteristic. Improvements/Applications: Further study is needed to observe how passive exercise influences the movement characteristics of an active motion and how customized experiment settings can optimize the effect of pediatric rehabilitation for spastic cerebral palsy.

• The Korean journal of sports medicine
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• v.36 no.4
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• pp.197-206
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• 2018

Purpose: This study analyzed the muscle activity changes induced by motions of reaching forward and chest expansion that were examined from the bilateral muscles with rectus abdominis, external oblique, multifidus, and longissimus thoracic using Pilates cadillac instrument. Methods: Nine young adult women, who have no musculoskeletal disorder and any of chronic diseases, were participated. Surface electromyography system was used for recording of all signals produced by muscles, and then normalized as percentage of maximum voluntary isometric contraction (%MVIC). The paired t-test and repeated measures of analysis of variance was performed. Results: Reaching-forward motion showed a higher muscle activity from non-dominant external oblique muscle than that of the chest-expansion motion. During both reaching-forward motion and chest-expansion motion, MVIC values collected from dominant side of external oblique muscle were shown a significantly lower than the values obtained from non-dominant side (p<0.05). Conversely, %MVIC values in external oblique muscle collected from dominant side showed a significantly higher than the values obtained from non-dominant side of the same oblique muscle (p<0.05). Reaching-forward motion was caused a higher %MVIC on non-dominant external oblique muscle than that of the chest-expansion motion (p<0.05). Regardless of dominant or non-dominant sides, external oblique muscle was shown the highest activation rate of all the other muscles during reaching forward action, and longissimus thoracic muscle was shown the highest activation rate of all the other muscles during chest expansion action. Conclusion: Reaching-forward motion is suitable for activating an external oblique muscle, and chest-expansion motion is an effective enough in activating of longissimus thoracic muscle.