• 제목/요약/키워드: FMA

검색결과 153건 처리시간 0.026초

밸런스 핸들 장치를 이용한 상지 운동 기능의 근전도 신호 분석 (EMG Signal Analysis of Upper Extremity Motor Function using Balance-handle Device)

  • 이충근;송기호;안재용;신성욱;정성택
    • 재활복지공학회논문지
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    • 제10권4호
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    • pp.295-303
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    • 2016
  • 편마비 환자의 상지 운동 기능 재활 치료에 대한 지속적인 관심과 훈련의 정량적인 평가를 위한 다양한 장치가 요구되고 있다. 이러한 문제를 해결하기 위해서 본 논문에서는 거치대와 핸들, 밸런스 볼을 결합한 밸런스 핸들 장치를 개발하였다. 피험자 7명을 대상으로, 개발된 상지 훈련 장치를 기울일 때 주요 상지 근육에 대한 근전도 신호의 변화를 측정하여 재활 훈련 장치로 사용이 가능한지에 대한 유효성을 검토하였다. 밸런스 핸들 장치를 앞뒤로 기울였을 때의 상지 신전 굴곡 운동 동작과 좌우 기울임을 이용한 상지 운동 동작에서 근 수축과 이완이 기준이 되는 주동근과 길항근에서 근 활성화 신호를 분석하였다. 실험결과, Fugl-Meyer Assessment(FMA)의 신전 굴곡 운동 평가 항목에서 편마비 환자의 상지 운동 기능 평가에 이용되는 이두근, 삼두근, 삼각근에서 근 활성화 경향을 보였다. 이러한 결과를 바탕으로 개발된 장치를 활용하여 편마비 환자의 상지 재활 훈련에 도움이 될 수 있다고 볼 수 있다.

가상현실을 이용한 조기 로봇보조 보행 훈련이 뇌졸중 환자에 미치는 영향 (Effect of early robot-assisted training using virtual reality program in patient with stroke)

  • 이동순;이경화;강태우;조성태
    • The Journal of Korean Physical Therapy
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    • 제25권4호
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    • pp.195-203
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    • 2013
  • Purpose: The purpose of this study was to determine the effect of early Robot-assisted training on gait ability, function and ADL in patients with stroke. Methods: 26 patients with stroke were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 13 patients in each group. All subjects received a routine physical therapy. The robot-assisted training was for 30 min in the case of the EG subjects. The assessment tools of this study involved the gait ability, balance ability, function and ADL. The measurements were recorded before the intervention and after the intervention. Results: EG subjects and CG subjects, the variables measured after the intervention significantly differed from gait ability, balance ability, function and ADL without the FMA (p<0.05). The FMA was only effective experimental group after intervention. Also, there were significant differences in gait ability, balance ability, function and ADL without the FMA at post-test between the 2 groups (p<0.05). Conclusion: The findings indicate that early robot-assisted training exerts a positive effect on gait ability, balance ability, function and ADL in patients with stroke. This result indicates the possibility of application of the early Robot-assisted training to the management for stroke patients. Further studies are required to generalize the result for this study.

Effects of Intensive Neuro Rehabilitation Intervention on the Motor Function Recovery and Balance in Stroke Patients

  • Lee, Je-Hyeok;Choi, Jong-Duk
    • 대한물리의학회지
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    • 제11권4호
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    • pp.41-47
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    • 2016
  • PURPOSE: The purpose of this study was to investigate the effects of differences in exercise time arrangement on the functional recovery of the lower limbs and balance of stroke patients. METHODS: The subjects of this study were 100 patients who were hospitalized in two hospitals located in Gyeonggi-do. Before the experiment, 60 of these patients who met the inclusion criteria and did not meet the exclusion criteria were randomly divided into an experimental group (n = 30), whose exercise time was concentrated, and a control group (n = 30), whose exercise time was diffuse. The two groups underwent six weeks of physical and occupational therapy four times a day for five days a week. One session of therapy took 30 minutes, including three sets of physical therapy and one set of occupational therapy. The rest time between the sessions was different for each group. The experimental group had five minutes of rest between each therapy session, and the control group had two hours of rest time between each session. The Fugl-Meyer assessment (FMA), an assessment of each patient's limit of stability (LOS), and a timed up and go test (TUG) were used as test tools. RESULTS: Both groups showed statistically significant increases in their FMA results, LOS measurements, and TUG results. The FMA results of the experimental group were significantly higher than those of the control group. CONCLUSION: Thus, concentrated exercise time was more effective than diffuse exercise time for the recovery of motor function.

수정된 강제 유도 운동치료와 결합된 이중 반구 경두개 직류 자극이 만성 뇌졸중의 팔 기능에 미치는 영향 : 단일 맹검 무작위 통제 시험 (Impact of Dual-Hemisphere Transcranial Direct Current Stimulation Combined with Modified Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Single Blinded Randomized Controlled Trial)

  • 김선호
    • 대한통합의학회지
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    • 제8권2호
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    • pp.11-20
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    • 2020
  • Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

Association between one-leg standing ability and postural control in persons with chronic stroke

  • Choi, Bora;Hwang, Sujin;Kim, Eunjeong
    • Physical Therapy Rehabilitation Science
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    • 제9권3호
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    • pp.165-170
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    • 2020
  • Objective: To investigate the association between one-leg standing ability and postural control for chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Forty individuals who had a first diagnosis of stroke with hemiparesis before six months and over had participated in this study. To analyze the relationship between one-leg standing ability and postural control in the participants, six clinical measurement tools were used for assessment, including the Timed-Up-and-Go (TUG) test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Fugl-Meyer Assessment (FMA), 5 times sit-to-stand (5TSTS) and one-leg standing (OLS). Results: After analyzation, the OLS scores in the more-affected side showed significant positive correlations with BBS scores (r=0.469, p<0.01), DGI scores (r=0.459, p<0.01).and FMA scores (r=0.425, p<0.01). The OLS scores in the more-affected side showed significant negative correlations with TUG score (r=-0.351, p<0.05). The OLS score in the less-affected side showed significant positive correlations with BBS scores (r=0.485, p<0.01), DGI scores (r=0.488, p<0.01) and FMA score (r=0.352, p<0.05). The OLS scores in the less-affected side showed significant negative correlation with TUG scores (r=-0.392, p<0.05) and 5TSTS (r= -0.430, p<0.01). The OLS scores in the more-affected side showed significant positive correlations with the OLS scores in less-affected side (r=0.712, p<0.01). Conclusions: The results of the study suggest that the OLS time may be moderately correlated with static and dynamic postural stabilities and motor recovery following stroke. This study also suggests that the OLS test is as a simple clinical tool for predicting postural control performance for individuals with chronic hemiparetic stroke.

점진적 관찰감소 동작 관찰훈련이 만성기 뇌졸중 환자의 상지 기능과 일상생활 활동에 미치는 영향 : 예비 연구 (The Effect of Gradually Observation-Reduction Action Observation Training on Upper Extremity Function and Activities of Daily Living in Patients with Chronic stroke: a Pilot Study)

  • 한민;박주형
    • 융합정보논문지
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    • 제10권8호
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    • pp.229-238
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    • 2020
  • 본 연구는 점진적 관찰감소 동작 관찰훈련이 만성기 뇌졸중 환자의 상지 기능과 일상생활 활동에 미치는 영향을 알아보고자 실시하였다. 만성기 뇌졸중 환자를 대상으로 점진적 관찰감소 동작 관찰훈련을 하는 실험군 4명과 기존의 동작 관찰 훈련을 받는 3명의 대조군으로 구분하여, 주 6회, 회당 30분씩, 총 2주간 실시하였다. 상지 기능 평가는 상자와 나무토막 검사(BBT)와 푸글 마이어 상지 운동기능평가 (FMA)를, 일상생활 활동 수행능력 평가는 한글판 수정바델지수(K-MBI)와 운동 활동 지표 (MAL)를 사용하였다. 그룹 별 중재 전·후 차이의 비교 결과와 두 그룹 간의 비교 결과는 BBT, FMA, K-MBI, MAL에서 통계적으로 유의한 차이를 보이진 않았으나, 실험군이 대조군에 비해 평균 점수 측면에서 더 큰 차이가 나타났다. 결과적으로 점진적 관찰감소 동작 관찰훈련은 기존의 동작관찰훈련 보다 더욱 긍정적인 영향을 끼칠 수 있음을 확인할 수 있었다.

Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

  • Cho, Ki Hun;Song, Won-Kyung
    • Physical Therapy Rehabilitation Science
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    • 제8권2호
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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.

뇌졸중 환자에 대한 상지기능 평가도구의 검사자간 신뢰도 (Interrater Reliability of Upper Extremity Function Assessment on Stroke)

  • 황성수;김푸름;원지인;유선주;윤준병;이근우;이왕재
    • PNF and Movement
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    • 제10권1호
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    • pp.1-7
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    • 2012
  • Purpose : To verify the interrater reliability of upper extremity function assessment among three tools(Wolf motor function test, Motor assessment scale, Fugl-meyer assessment scale). Methods : The subjects of this study 40 (20 was physical therapists and 20 was physical therapy students). For the test one patients with chronic hemiparesis after stroke participated in the study. The Wolf Motor Function Test consists of 16 functional tasks. The motor assessment scale consists of 3 functional tasks. The fugl-meyer assessment scale consists of 8 functional tasks. All test sessions were videotaped and scored by 40 subjects. Analysis : The data was analysis by SPSS PC 14.0 with Cronbach alpha Coefficients, intraclass Correlation Coefficients Kendall tau-b value. Results : WMFT was highly scored in Cronbach's value, Cronbach's ${\alpha}=0.819$ that means high interrater reliability among assessment. WMFT was highly scored all items in p-value except one item, that means high p-value between therapists and students. WMFT was highly scored in Intrarater correlation coefficient (ICC) = 0.79, that means high interrater reliability of each examination item. WMFT was low index of coincidence from all items, MAS was low index of coincidence from a tim and FMA was low index of coincidence from 4 items. Conclusion : The interrater reliability of WMFT were compared with MAS, FMA and highly verified. WMFT can be more useful tool among upper extremity function assessment.

뇌졸중 환자의 비손상측 대뇌겉질 운동영역에 적용한 반복 경두개 자기자극의 빈도가 팔 기능에 미치는 영향 (Effects of Differences Frequency of Repeated Transcranial Magnetic Stimulation Applied to the Less Affected Contralesional Corticomotor Area on Upper Extremity Function in Patients with Stroke)

  • 김하나;정상미
    • 대한통합의학회지
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    • 제11권4호
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    • pp.281-289
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    • 2023
  • Purpose : In this study, we aimed to determine how frequencies different of repetitive transcranial magnetic stimulation applied to the less affected contalesional corticomotor area affect upper extremity motor function in patients with acute stroke within 3 months of onset. By doing so, we aimed to propose a new method of rTMS intervention based on the degree of damage and recovery status of the patient, rather than the generalized rTMS intervention that has been used uniformly. Methods : The rTMS intervention was applied on the contralesional side of the cerebral hemisphere damage. 15 subjects in the HF-rTMS group, 12 subjects in the LF-rTMS group, and 14 subjects in the SF-rTMS group were randomized to receive the rTMS intervention in each group for a total of 10 sessions on five consecutive weekdays for two weeks, and underwent FMA-U to determine changes in upper extremity function following the intervention in each group. FMA-U was performed within 24 hours before and after the rTMS intervention. Results : When the FMA-U was performed to determine the pre- and post-intervention changes in upper extremity motor function within the groups, no statistically significant differences were found in the SF-rTMS group before and after the intervention, but significant statistical differences were found in the HF-rTMS group (p=.006) and the LF-rTMS group (p=.020), with greater significance in the HF-rTMS group than the LF-rTMS group. Conclusion : This study confirmed that compensatory action by activating the less affected contralesional corticomotor area based on the bimodal balance-recovery model can support upper extremity recovery patients with acute stroke within 3 months of onset, depending on the degree of damage level and recovery status. Therefore, the results of the contralesional HF-rTMS application in this study may provide a basis for proposing a new rTMS intervention for upper extremity recovery in stroke patients.

10대 하악과두흡수 환자의 임상적 평가 및 악안면 골격형태에 대한 연구 (Clinical Assessment and Cephalometric Characteristics of Patients with Condylar Resorption in Teenagers)

  • 전용현;허윤경;정재광;채종문;최재갑
    • Journal of Oral Medicine and Pain
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    • 제35권1호
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    • pp.61-73
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    • 2010
  • 2006년 한 해 동안 경북대학교 구강내과에 내원한 하악과두의 형태적 변이가 관찰된 10대 과두흡수 환자를 대상으로 임상검사와 악안면 골격형태를 분석하여 다음과 같은 결론을 얻었다. 1. 임상적 평가 1) 10대 과두흡수 환자는 59명으로 여자는 47명, 남자는 12명으로 여자에서 월등히 많이 유발되었다. 환자의 연령분포는 12세가 2명, 14세가 9명, 15세가 4명, 16세가 8명, 17세가 12명, 18세가 12명, 그리고 19세가 12명으로 나타났다. 2) 과두의 편평화나 침식, 과두형태의 변형이 초래된 Grade II를 많이 나타냈다. 3) Class I 교합자가 27명으로 가장 많았고, 개교합이 동반된 경우는 20명, 평균 overjet은 3.58mm, overbite는 0.97mm를 보였다. 4) 과두흡수 부위의 통증을 호소한 경우는 41명, 통증을 호소하지 않은 경우가 18명이었다. 5) 이갈이 습관을 26명, 이악물기 습관은 24명이 보고하였다. 6) 환자의 치료기간은 1개월 미만이 23명, 보조요법으로 치료한 경우가 28명이었다. 2. 악안면 골격 형태 평가 1) 16세 여자환자에서 SNA, SNB는 유의한 작은 값을 나타냈고 articular angle은 유의한 큰 값을 보였다. 2) 17세 여자환자에서 SN, SAr, TPFH와 ramus height가 유의한 작은 값을, SN-GoMe, FMA 그리고 articular angle은 유의한 큰 값을 나타냈다. 3) 18세 이상 여자 환자에서는 SN, SNB, TPFH, ramus height은 유의한 작은 값을, ANB, FMA, SN-GoMe, LAFH, articular angle, gonial angle은 유의성 있는 큰 값을 보였다. 4) 18세 이상 남자 환자에서는 SN, TPFH, ramus height은 유의한 작은 값을 FMA, SN-GoMe, LAFH, articular angle, gonial angle은 유의성 있는 큰 값을 보였다. 5) mandibular body length는 10대 과두흡수 환자에서 정상인과 차이가 없었다. 10대 과두흡수의 특징은 임상적으로 통증호소는 심하지 않으나 골소실이 빠르게 일어나서 이환측 과두에서 후방지지의 갑작스런 상실이 초래되는 특발성 과두흡수의 형태를 많이 나타내며 개교합 발생 비율도 높았다. 근골격계 성장이 완료되지 않은 10대에 특히 수직적 악안면 골격형태로 인한 부하의 집중과 이상기능활동에 의해 하악과두에 과도한 부하가 가해지면 과두흡수가 더욱 쉽게 일어날 수 있으며, 결국 악골의 성장을 저해하고 안모에 악영향을 미칠 수 있을 것으로 생각한다.