• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.93-98
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• 2019

Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.25-36
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• 2021

Background: This study aimed to investigate the effect of modified constraint-induced movement therapy (mCIMT) and resistive exercise using elastic band with pressure belt on improving upper extremity function in stroke patients. Methods: Sixteen patients with stroke were randomly assigned to a control group that received mCIMT and resistive exercise using elastic band (n=8) and an experimental group that received mCIMT and resistive exercise using elastic band with pressure belt (n=8). Over the course of four weeks, mCIMT were conducted 60 minute three times per week and resistive exercise using elastic band (with pressure belt) were conducted twice daily, three times per week. The function of the upper extremities were evaluated before, after 2 weeks and 4 weeks using the grip strength test (GST), the box and block test (BBT), and motor activity log (MAL). Results: The values for the GST, the BBT, and MAL increased in both groups as the treatment period progressed. The values for the GST (p<.01), the BBT (p<.001), and MAL (p<.001) were significantly higher in the experimental group than in the control group at 4 weeks after initiating the treatment. Conclusion: We found that mCIMT and wearing a pressure belt during resistive exercise was very useful in improving the function of the upper extremities in patients with stroke.

• Physical Therapy Korea
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• v.30 no.2
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• pp.128-135
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• 2023

Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4-10 years; Gross Motor Function Classification System levels II-IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.

• Therapeutic Science for Rehabilitation
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• v.9 no.4
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• pp.7-20
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• 2020

Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2018.05a
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• pp.205-206
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• 2018

Recently, interest in unmanned vehicles, autonomous vehicles and connected cars has increased, and autonomous driving capability is also increasing. Depending on the autonomous driving ability, the maximum number of steps is divided into 6 steps. The higher the step, the less the involvement of the person in the running, and the person does not need to be involved at the highest stage. Today's autonomous vehicles have been developed in stages 4 to 5, but solutions are not clearly defined in case of an accident, so only the test run is possible. Such an accident occurring during traveling is almost inevitable, and it is judged who has made a mistake in case of an accident, which increases the punishment for the accident. Although a black box is used to clarify such a part, it is easy to delete a photographed image, and it is difficult to solve an accident such as a hit-and-run. In this paper, we design a driving record system using black chain to solve such an accident.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.53-62
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• 2023

Purpose : This study evaluated the effects of transcranial direct current stimulation and a virtual reality program on the depression, hand functions, cognitive function, and activities of daily living of patients with mild cognitive impairment by dividing 20 patients with mild cognitive impairment and depression. The 20 patients were divided into a treatment group (transcranial direct current stimulation + a virtual reality program) and a control group (placebo transcranial direct current stimulation + a placebo virtual reality program). Methods : This study allocated ten subjects to the treatment group and ten subjects to the control group. The treatment was given five times per week for six weeks (30 sessions), and each session was 30 minutes. This study screened depression by using SGDS-K, a short geriatric depression scale, to examine depression before and after treatment intervention. This study also used the box and block test, NCSE, and FIM to evaluate hand functions, cognitive function, and activities of daily living, respectively. Results : The results showed that depression significantly decreased, hand functions significantly increased, cognitive function significantly improved, and activities of daily living significantly increased after intervention in the treatment and control groups. The magnitude of changes in depression, hand functions, cognitive function, and activities of daily living was significantly different between the two groups after intervention (p>.05). Conclusion : The results showed that the application of transcranial direct current stimulation and a virtual reality program could improve cognitive function, hand functions, and activities of daily living by decreasing depression. Therefore, it can be concluded that the simultaneous application of transcranial direct current stimulation and a virtual reality program is an intervention method, which can be applied for decreasing depression, enhancing hand functions, improving cognitive function, and increasing activities of daily living in patients with mild cognitive impairment.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.59-78
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• 2018

Objective : The purpose of this study was to investigate the effect of robot-assisted therapy on upper extremity function. Methods : This study used a single-subject experimental A-B-A' design. Three Parkinson's disease patients took part. Each subject received a robot-assisted therapy intervention (45 min/session, 5 sessions/week for 4 weeks). Upper extremity movement was evaluated with the Reo Assessment tool in Reogo. The Jebsen-Taylor hand motor function test, Fugle-Mayer Assessment score, Box and Block Test, and Nine-hole pegboard test were assessed pre- and post-intervention. Results : After intervention, all subjects underwent 3D motion analysis of reaching function. There was overall improvement in resistance, smoothness, direction accuracy, path efficiency, initiation time, and time to moving target with robot-assisted therapy. Robot-assisted therapy may have a positive effect on upper extremity movement in Parkinson's disease. Conclusion : Robot-assisted therapy is considered an alternative in clinical occupational therapy to improve upper extremity function in Parkinson's disease.

• The Journal of Korean society of community based occupational therapy
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• v.3 no.1
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• pp.55-66
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• 2013

Objective : The purpose of present study was to determine effects of task oriented action observation training on dexterity of upper limb function after stroke. Training was progressed to imitation and intensive training after observation to required action in ADL. Method : 15 stroke patients were selected and one group pretest-posttest design was applied. Targets observed performance actions of task orientated task through a video and limitated action repeatedly, Training was performed 3 times a week and 20~30 minutes for each round for 3 weeks. Manual function test and 10-second test and Box and block test were performed for a dexterity of upper extremity motor function, Modified Barthel index and Motor activity log were performed for ADL. Result : After the training, a dexterity of affected upper extremity motor function of the target showed significant difference between before and after intervention, ADL showed significant improvement between before and after intervention. Conclusion : Task orientated Action observation lead a positive effect of recovering a dexterity of upper extremity motor function and ADL. Therefore, this study suggest a action observation training as one strategy of an intervention type of th e occupational therapy.

• Therapeutic Science for Rehabilitation
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• v.7 no.2
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• pp.17-27
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• 2018

Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.