• Journal of Electrical Engineering and Technology
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• v.9 no.5
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• pp.1774-1779
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• 2014

It is known that muscle strength of human body can alter or deteriorate as aging. In this study, we present an inverse dynamics simulation to investigate the effect of muscle strength on performing the daily activities. A 3D musculoskeletal model developed in this study includes several segments of whole body, long and short muscles, ligaments and disc stiffness. Five daily activities such as standing, flexion, finger tip to floor, standing lift close and lifting flexed were simulated with varying the maximum muscle force capacities (MFC) of each muscle fascicles from 30 to $90N/cm^2$ with an increment of $30N/cm^2$. In the result, no solution can be obtained for finger tip to floor and lifting flexed with $30N/cm^2$. Even though the solution was available for standing lift close activity in case of $30N/cm^2$ capacity, many of muscle fascicles hit the upper bound of muscle strength which means that it is not physiologically possible to perform the acvities in reality. For lifing flexed, even the case of $60N/cm^2$ capaciy, represents the moderate healthy people, was not able to find the solutions, showing that 18 muscles among 258 muscle fascicles reached 100% of muscle capacity. The estimated results imply that people who have low muscle strength such as elders or rehabilitation patients were required higher muscle work to perform and maintain the same daily activities than healthy one.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.209-214
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• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• Physical Therapy Korea
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• v.10 no.3
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• pp.17-27
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• 2003

Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle $60^{\circ}$, FOV 220 mm, $64{\times}64$ matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.1
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• pp.79-89
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• 2003

Purpose: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music Movement program developed for the stroke patients. Subjects: 12 stroke survivors at "J" Public Health Center in Seoul. were participated in. The average age was 68 years old, the ratio of sex was almost 5.8:4.2, the duration of was almost over 1 year. Method: Music Movement program was conducted for 2 hours ${\times}$ 1day ${\times}$ 6 weeks. The contents of Music Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs, flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell, 1996), and ADL state(Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p<.05. Results: This program was effective to decrease the depression level of subjects(p<.05). The muscle strength, hand grip power, ROMs, life satisfaction, and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. Conclusion: Considering these results, the practical feasibility of Music Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.235-243
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• 2021

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

• The Journal of Korean Physical Therapy
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• v.9 no.1
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• pp.51-57
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• 1997

The purpose of this study was to determine the effect of two different forms of transcutaneous electrical nerve stimulation(TENS) and one of microcurrent high voltage pulsed galvanic current(HVPC) on sympathetic tone in healthy subjects. Fourty subjects received TENS(20) and PVPC(30) during short time(20min). Left finger tip skin temperatures were measured at four interval for each treatment : 1) before treatment, 2) after 10 minutes treatment, 3)after 20 minutes treatment, and 4) after 10 minutes rest. The results were as follows. 1) TENS treatment group increased skin temperature after treatment 20 minutes, but HVPC treatment increased akin temperature after 10 minutes and recovered normal skin temperature after 10 minutes treatment. It means that short time(20min) electrical stimulation decreased sympathetic activities. 2) Sympathetic activities of TENS stimulation were influenced by age, but HVPC were not. 3) During 10 minutes, both treatment increased sympathetic activities, but HVPC treatment reversed sympathetic activity more rapidly than TENS. 4) The changes of skin temperature means by sex, males in TENS treatment group were higher than females, but HVPC were reverted.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.202-222
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• 2003

Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

• Clinical Pain
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• v.20 no.1
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• pp.15-19
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• 2021

There are many wrist and hand diseases in which ultrasound can help in the diagnosis and treatment. Because many small structures are located, identifying anatomical locations and pathways is especially important. In De Quervain's syndrome, it is necessary to find tendon lesions located in the first compartment of the wrist. If injection therapy is required, administer the regimen accurately within the tendon sheath through ultrasound. In carpal tunnel syndrome, there are several methods to diagnose a disease by measuring cross-sectional area of the median nerve. Ultrasound has the advantage of administering injection therapy without damaging the nerve. Intersection syndrome can be diagnosed by observing swelling and hypoechoic appearances at the point where the tendons of the first compartment cross over the second compartment of the wrist. Ultrasound-guided injection is also safe and efficient. If there is a trigger finger lesion, the most representative findings is to observe a nodular hypoechoic thickening of the involved A1 pulley. When injection therapy is performed, it is effective to administer medication between pulley and flexor tendons as much as possible to reduce pressure on the attached structures.

• 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.