• 대한골관절종양학회지
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• 제1권2호
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• pp.154-163
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• 1995

1986년 3월부터 1993년 12월까지 연세대학교 의과대학 정형외과학 교실에서 상지에 발생한 악성 및 침윤성 양성 골종양에 대하여 사지구제술을 시행하여 다음과 같은 결과를 얻었다. 1. 총 13명의 상지에 발생한 악성 및 침윤성 양성골종양 환자에 대해 사지 구제술을 시술 하였다. 2. 사지 구제 술의 내용은 8 례가 Tikhoff -Linberg 수술, 2 례가 분절절제 및 재접합술, 2 례가 종양삽입물 치환술 그리고 1 례가 분절절제술 및 유리혈관부착 생비골이식술이었다. 3. 13 례중 3 례가 골육종, 4 례가 연골육종, 3 례가 거대세포종, 1 례가 병적 골절을 동반한 유잉육종, 1 례가 연골아세포종, 1 례가 전완부 건 및 근육과 원위요골 및 척골을 동시에 침범한 평활근 육종이었다. 4. 추시기간은 술수 1년에서부터 7년 5개월로 평균 4년 5개월이었다. 5. 총 13명의 환자 중 1 례의 상완골에 발생한 병적 골절을 동반한 유잉 육종의 환자에서 국소재발 및 다발성 골전이가 나타나 수술 후 4년 4개월만에 사망하였고 나머지 12 례의 환자는 국소재발이나 원격전이의 소견은 없었다. 6. 상지에 발생한 악성 및 침윤성 양성 골종양의 치료로 여러방법의 사지구제술은 병의 치료 면이나 기능적인 면에서 만족스런 결과를 가져왔다.

• 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.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.143-148
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• 2016

Objective: This study aimed to quantify one of the useful upper extremity movements to evaluate motor control abilities between the groups of people with mild and moderate arm impairments performing a door handling task. Design: Cross-sectional study. Methods: Twenty-one healthy participants and twenty-one persons with chronic stroke (9 mild stroke and 12 moderate stroke) were recruited for this study. Stroke participants were divided into 2 groups based on Fugle-Meyer Assessment scores of 58-65 (mild arm) and 38-57 (moderate arm). All they performed door handling task including the pronation and supination phases 3 times. We measured some movement factors which were reaction time, movement time, hand of peak velocity, hand of movement units to perform door handling task using the three-dimensional motion analysis. Results: The majority of kinematic variables showed significant differences among study groups (p<0.05). The reaction time, total and phase of movement time, hand of peak velocity, the number of movement units discriminated between healthy participants and persons with moderate upper limb stroke (p<0.05). In addition, reaction time, total and phase of movement time, the number of movement units discriminated between those with moderate and mild upper limbs of stroke patients (p<0.05). Conclusions: Three-dimensional kinematic motion analysis in this study was a useful tool for assessing the upper extremity function in different subgroups of people with stroke during the door handling task. These kinematic variables may help clinicians understand the arm movements in door handling task and consist of discriminative therapeutic interventions for stroke patients on upper extremity rehabilitation.

• The Korean Journal of Pain
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• 제8권1호
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• pp.55-59
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• 1995

Stellate ganglion block (SGB) is applicated frequently to increase the blood flow and to reduce the pain in head, neck and upper extremity. The effects of SGB are able to be estimated by clinical signs and symptoms of Horner's syndrome, skin warmth, anhydrosis, etc. The effects are also estimated by sympathetic function and the blood flow. Blood flow velocities and pulsatility indices of common carotid,d axillary, brachial and radial artery were measured by Doppler flowmeter after SGB with 1% lidocaine at C6 level. Blood velocities of all arteries were increased and pulsatility indices of all arteries were decreased. This results suggest that SGB increase the blood flow of head and upper extremity and Doppler flowmeter is a good indicator of the effects of SGB.

• The Journal of Korean Physical Therapy
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• 제23권2호
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• pp.7-15
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• 2011

Purpose: We investigated the relationship between the muscle activity and kinematic variables of the upper extremity during a push-up task on stable and unstable surfaces. Methods: We recruited 15 healthy subjects. Subjects completed the push-up task on stable and unstable surfaces. Surface electromyograms were recorded from the serratus anterior, upper trapezius, latissimus dorsi, infraspinatus to monitor changes in muscle activity. Markers for kinematic changes of elbow flexion, shoulder extension, shoulder retraction and scapular adduction were attached at C7, the T7 spinous process, both acromions, the scapula superior and inferior angle, the humerus lateral epicondyle, and the ulnar styloid process. Correlation coefficients between muscle activity and kinematic variables were analyzed by SPSS for Windows, version 15.0. Results: On the unstable surface, elbow flexion and shoulder extension increased with increasing muscle activity of serratus anterior, upper trapezius and infraspinatus. On the stable surface, shoulder retraction decreased with increasing muscle activity of serratus anterior and infraspinatus. Scapular adduction decreased with all types of increasing muscle activity, regardless of the support surface. Conclusion: Correlations between muscle activity and kinematic variables were observed on stable and unstable surfaces during a push-up task, while correlations between right and left variables were not clear. These finding suggest that it may be used to develop a rehabilitation program which could be effective in improving shoulder function in patients with shoulder problems.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.142-148
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• 2016

Purpose: The aim of this pilot study was to determine the effect of soft tissue technique (STT) in Axillary Web Syndrome (AWS) following sentinel Lymph Node Biopsy in breast cancer patients by examining the upper extremity function, range of motion, and pain. Methods: Nineteen patients with breast cancer-related AWS were evaluated. STT was performed on the symptom area for treatment of AWS symptoms. We evaluated AWS symptoms and pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, glenohumeral joint (GHJ) flexion and abduction range of motion (ROM) with or without elbow extension. Results: Visual analyses of the data suggest a modest effect of STT in improving GHJ flexion, abduction ROM with or without elbow extension, DASH for upper extremity function, and Pain. The statistically significant improvement in baseline observed for pain, DASH, and ROM data made it impossible to assess the effects of STT on those outcomes. There were no adverse events. Conclusions: STT may be an effective and safe treatment option for AWS patients recovering from breast cancer treatment; however, further research is needed.

• Physical Therapy Rehabilitation Science
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• 제2권1호
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• pp.1-6
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• 2013

Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.

• 한국산학기술학회논문지
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• 제12권7호
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• pp.3109-3116
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• 2011

본 연구는 뇌병변으로 상지경직이 관찰되는 환자를 대상으로 자극방식에 따른 진동자극이 경직에 미치는 영향에 대하여 알아보고자 하였다. 뇌병변으로 인해 상지경직이 있는 21명의 환자가 연구에 참여하였고, 실험군 I: 길항근(상완삼두근)자극, 실험군II: 주동근(상완이두근)자극, 실험군III: 동시(상완삼두근 및 상완이두근)자극에 각 7명씩을 배정하여 진동자극을 실시하였다. 척수운동신경원 흥분성을 알아보기 위해 Neuro-EMG_Micro를 이용한 F파를 자극전, 자극 직후, 자극 10분 후, 자극 20분 후에 측정하였고, 임상적 평가로는 MAS(Modified Ashworth Scale)와 MFT(Manual Function Test)를 자극 전, 자극 20분 후에 평가하였다. 본 연구의 결과, MAS는 세군 모두 유의한 감소를 나타냈고, F파 진폭 및 F/M비에서는 세군 모두에서 자극 직후에서부터 유의한 감소를 나타냈으며, 실험군III에서 시간 경과상 변화량이 가장 크게 나타났다. MFT에서는 실험군II와 III에서 유의한 증가를 나타냈으며 특히, 실험군III에서 기능적 변화량이 가장 크게 나타났다. 이러한 결과는 경직근에 대한 진동자극시 경직 주동근이나 길항근에 대한 단일 자극 방식보다는 동시자극 방식이 척수운동신경원의 흥분성 감소 및 상지 운동 기능 향상에 더 효과적임을 확인할 수 있었다.

• 국제물리치료학회지
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• 제10권1호
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• pp.1734-1738
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• 2019

Background: Stroke patients usually have arm weakness, which affects trunks and arms. Objective: To investigate the effects of paretic side and non-paretic side arm training on trunk control and upper limb functions. Design: Randomized Controlled Trial (single blind). Methods: Twenty patients with stroke in hospital were enrolled in the study. Twenty subjects were randomly assigned to paretic side arm training group (PATG, n = 10) or non-paretic side arm training group (NATG, n = 10). Trunk impairment scale (TIS) was used for trunk control, and box and block test (BBT) was used for upper limb function. Training was conducted for 4 weeks. Results: PATG showed significant difference in TIS (static balance, dynamic balance, coordination, total score) and BBT. NATG showed significant differences in static balance, and dynamic balance and total score except for coordination and BBT. PATG also showed a more significant difference in BBT and coordination and total score than NATG. Conclusions: The arm training performed on the paretic side are more effective than those performed on the non-paretic side in improving both upper limb function and trunk control in stroke patients.

• 지역사회간호학회지
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• 제17권4호
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• pp.482-491
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• 2006

Purpose: Hemiplegia patients who were attacked by a stroke suffer from hemiplegic disabilities as well as motor disabilities. For them, rehabilitation cure is being carried out broadly. However, it is not enough for them to use the upper extremity than the lower extremity. For the use of the upper extremity, we examined the effect of constraint-induced movement therapy developed in this research on patients who experienced a stroke following hemiplegia. Method: For this study we selected 36 stroke patients who were registered at the community health center through accidental sampling, and assigned 21 of them to the experimental group, and 15 to the control group. The experimental group had constraint-induced movement therapy for 5 days and 7 hours a day from 9 to o'clock in the morning 9 to 4 o'clock in the afternoon 4 including warmup exercise and main exercise in the rehabilitation room, whereas the control group were restricted. Result: As a result of constraint-induced movement therapy, affected side elbow joint flexion range, side shoulder joint extension range and side shoulder joint of the flexion range of motions increased obviously in the experimental group compared to those in the control group. Conclusion: The result above clearly shows that constraint-induced movement therapy is an effective intervention for the rehabilitation of hemiplegia patients in increasing affected side elbow joint of the flexion range of motion, the shoulder joint extension, and the increase of flexion range of motion.