• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.96-103
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• 2005

The motor recovery mechanism of a 21-year-old male monoparetic patient with cerebral palsy, who had complained of a mild weakness on his right hand since infancy, was examined using functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). The patient showed mild motor impairment on the right hand. MRI located the main lesion on the left precentral knob of the brain. fMRI was performed on this patient as well as 8 control subjects using the Blood Oxygen Level Dependent technique at 1.5 T with a standard head coil. The motor activation task consisted of finger flexionextension exercises at 1 Hz cycles. TMS was carried out using a round coil. The anterior portion of the coil was applied tangentially to the scalp at a 1.0 cm separation. Magnetic stimulation was carried out with the maximal output. The Motor Evoked Potentials (MEPs) from both Abductor Pollicis Brevis muscles (APB) were obtained simultaneously. fMRI revealed that the unaffected (right) primary sensori-motor cortex (SM1), which was centered on precentral knob, was activated by the hand movements of the control subjects as well as by the unaffected (left) hand movements of the patient. However, the affected(right) hand movements of the patient activated the medial portion of the injured precentral knob of the left SM1. The optimal scalp site for the affected (right) APB was located at 1 cm medial to that of the unaffected (left) APB. When the optimal scalp site was stimulated, the MEP characteristics from the affected (right) APB showed a delayed latency, lower amplitude, and a distorted figure compared with that of the unaffected (left) APB. Therefore, the motor function of the affected (right) hand was shown to be reorganized in the medial portion of the injured precentral knob.

• The Journal of Korean Physical Therapy
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• v.1 no.1
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• pp.27-45
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• 1989

This study aims at helping cerebrally palsied children to overcome and minimize their sufferings, inducing them to perform ordinary activities of daily living for themselves by coducting ADL Tests which are fundamental activities in daily life and presenting treatment plan for their overall rehabilitation and basic data for achieving the training objective. For that purpose, 173 cerebrally palsied children were selected and given ADL performance Tests from Dec. 1987 to Oct. 1988 and the following results were obtained. 1. Correlation coefficients for each ADL category indicated significant statistical value at .01 level. 2. Correlation coefficient between school-year variable and ADL category variable was significant at .01 level. 3. Correlation between age variable and ADL variable category proved significant at .01 level as well. 4. Correlation coefficients between each category in terms of functional state of extremities were significant at .01 level. 5. The difference in ADL achievements between each category by school year were as follows ; 1) In the category of meeting nature's tall, the age span of more than 4 school years showed statistical significance. 2) In the category of putting off and on clothing, the age span of 3 school years indicated statistical significance. 3) In taking meals statistical significance was found in the age span of 4 school years. 4) In finger movements the age span of more the 4 school years indicated statistical significance. 5) In walking activities statistical significance was noticed in the age span of 2 or 3 school years. Besides, in category by school year, and exceptional case was noticed that the 6th graders were lower than the 5th graders in self-reliance rate. 6. the difference in ADL achievements by type of palsy, children of triplegia were the lowest, while those of monoplegia were the highest. 7. The difference in ADL achievements by kind of palsy, patients of athetosis showed lower rate of self-reliance than those of spasticity, and particularly the latter showed a high rate of self-reliance in taking meals$(83.5\%)$. The former were relatively low in self-reliance and lowerst in meeting nature's call $(59.8\%)$.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.445-452
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• 2015

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers a low-intensity direct current to the cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to examine the changes in various sensory functions after tDCS. A single-center, single-blinded, randomized trial was conducted to determine the effect of a single session (August 4 to August 29) of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies (NCS) were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1mA for 15 minutes under two different conditions, with 25 subjects in each group. The conditions were as follows: tDCS on the dorsolateral prefrontal cortex (DLPFC) and sham tDCS on DLPFC. The parameters of the CPT was recorded with a Neurometer$^{(R)}$ at frequencies of 2000, 250 and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure the CPT values of the DLPFC in the anodal tDCS group, the values increased significantly in all of 250 and 5 Hz. All CPT values decreased for the sham tDCS. These results showed that DLPFC anodal tDCS can modulate the sensory perception and pain thresholds in healthy adult volunteers. This study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.21-32
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• 2018

Objectives This study was designed to investigate the effects of wet cupping on Wisu (BL12) in non-acute low back pain patients. Methods We recruited 30 participants for this study. Fifteen patients were randomly assigned to the Wisu (BL21) treatment group (WT group) and 15 were assigned to the non-acupoint treatment group (NT group). Both groups were treated with the pricking-cupping bloodletting method three times. Values at baseline and follow-up were analyzed by Wilcoxon signed rank test and the differences between the two groups were determined by Wilcoxon rank sum test. p-values less than 0.05 were considered significant. The primary outcome was the visual analogue scale (VAS), and secondary outcomes were the Oswestry disability index (ODI), Rolland-Morris disability questionnaire (RMDQ), Euroqol-5 dimension questionnaire (EQ-5D) and finger-to-ground distance (FTGD). These outcomes were measured on the day of first treatment before the procedure and on follow-up 7 days after the last treatment. Results Significant changes were identified in the VAS for pain and ODI in each group after wet cupping treatment on Wisu (p<0.05). However, no significant changes were found between groups. Meanwhile, RMDQ and EQ-5D were significantly decreased only in the NT group (p<0.05) without any differences between groups. FTGD was decreased in both groups, but not significantly. Conclusions Wet cupping with both Wisu treatment and non-acupoint had significant effects on non-acute low back pain, although there were no differences between the two groups. A large-scale study is needed to identify the effect of wet cupping on Wisu.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.157-182
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• 2004

The purpose of this study was to evaluate effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients. The subjects were consisted of sixty patients who had non specific chronic low back pain(32 females. 28 males; mean aged 37.3) from 19 to 65 years of age(mean age : 37.3). All subjects randomly assigned to the lumbar stabilizing exercise group, the modalities treatment group, the manual treatment group. Lumbar stabilizing exercise group received manual treatment with lumbar stabilizing exercise for 30minutes, modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 20minutes and US or MWD used deep thermal therapy for 15minutes, manual treatment group received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. The results of this study were summarized as follows : 1. The MR-MDQ of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 2. The VAS of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 3. The RST of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 4. The F-T-FT of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 5. The results of analyzed effects of MR-MDQ, RST, F-T-FT were significantly reduced (p<.05), but VAS wasn't significantly reduced(p>.05) between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment. 6. The results of LSD post-hoc to find difference between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment that MR-MDQ was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and VAS wasn't significantly reduced all treatment group(p>.05), and RST was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and F-T-FT was significantly reduced stabilizing exercise group than modalities treatment group and manual treatment group (p<.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.1
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• pp.77-89
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• 2008

The purpose of this study was to evaluate internal conical abutment sinking and fitness according to the loading condition. In this study, Alloden implant fixture and two abutment(conventional, FDI) systems were used. Each abutment was applied 1 time of finger force, 3 times of malleting force, 5 times of 20kg and extra several times to the fixture until the amount of abutment singking showed no change. Then, the length of abutment to fixture which was binding lightly with no pressure state was measured by Vernier caliper. After loading application, the length was remeasured and the amount of sinking was calculated. The implant was buried in unsaturated polyester (Epovia, Cray Valley Inc. Korea) for making a comparison between the change of length and fitness of abutment-fixture connection part. Then All samples were cross-sectioned with high speed precision cut-off(accutom-5, Struers, Denmark). Finally, The result were observed and analyzed using FE-SEM (field emission scanning electron microscopy).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.55-68
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• 2007

Object: to evaluate the effects of two different treatments-joint mobilization and therapeutic exercise on difference for length of lower limbs. Method: The subjects were participated twenty six who has difference for length of lower limbs more 10mm. All subjects randomly assigned to Joint mobilization group(n=13) and therapeutic exercise group. Joint mobilization group received joint mobilization for 2 minutes, Therapeutic exercise group received for 15 minutes per day and 3 times a week during 4 week period. Tape measure method was used to measure the difference for length of lower limbs. Biodex was used to measure the muscle power of lower limbs(Knee flexion, extension). Finger to floor test was used to measure the mobility of spinal column. All measurement of each subjects were measured at pre-experiment, after 2weeks and post-experiment. Result: The result of this study were summarized as follows : 1. Both treatment decreased difference for length of lower limbs while joint mobilization more decreased difference for length of lower limbs than therapeutic exercise. 2. Both treatment increased mobility of spinal column while joint mobilization more increased mobility of spinal column than therapeutic exercise. 3. Joint mobilization increased muscle power while therapeutic exercise decreased muscle power. Conclusion: in a group-wise comparison joint mobilization is more effective than therapeutic exercise.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.291-299
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• 2012

Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.295-345
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• 2003

This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.481-491
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• 2012

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL's. And we also found relationship among somatosensory, hand function, and ADL performance.