• Archives of Plastic Surgery
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• v.37 no.1
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• Journal of Magnetics
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• v.19 no.1
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• pp.28-31
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• 2014

The aim of the present study was to examine whether mirror therapy, in conjunction with repetitive transcranial magnetic stimulation (rTMS), can improve the upper extremity function of stroke patient. This study was conducted with 35 subjects, who were diagnosed as a hemiparesis by stroke. The Mirror plus rTMS group was of 12 members who undertook mirror therapy in conjunction with rTMS, the Mirror group was of 11 members who undertook mirror therapy, and the control group was of 12 members who undertook sham therapy. A motor cortex excitability was performed by motor evoked potential, and upper limb function was evaluated by Fugl-Meyer Assessment, and Box and Block Test. Significant difference was shown after the experiment, in comparison of the groups in terms of latency, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and control group, and between the Mirror group and control group, respectively. Significant difference was shown after the experiment in comparison of the groups in amplitude, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror plus rTMS group and control group. Significant difference was shown after the experiment, in comparison of the groups in FMA and BBT, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror group and control group. The study showed that mirror therapy in conjunction with rTMS is more effective to improve upper extremity function, than mirror therapy and sham therapy.

• Therapeutic Science for Rehabilitation
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• v.6 no.2
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• pp.37-45
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• 2017

Background: The presence of visuospatial impairment can make patients slow functional recovery and impede the rehabilitation process in TBI patients. Objective: The aim of this study is to investigate effects of prism adaptation treatment for functional outcomes in patients following traumatic brain injury. Methods: The subject received prism adaptation treatment for 2 weeks additionally during traditional rehabilitation for 4 weeks. The Patient has prism adaptation treatment while wearing wedge prisms that shift the external environment about $12^{\circ}$ leftward. The patient received 10 sessions, 15-20min each session. Outcome measures were visuospatial deficit(line bisection, latter cancellation), Visual and spatial perception(LOTCA-visual perception and spatial perception), motor function of upper extremity(FMA U/E; Fugl-Meyer motor assessment upper extremity, ARAT; Action research arm test), balance(BBS; Berg Balance Scale), mobility(FAC; Functional ambulation classification) and functional level(FIM; Functional independent measure). All Assessments took place on study entry and post-treatment assessments were performed at discharge from the hospital. Results: After prism adaptation, the visuospatial impairment scores improved as indicated in the line bisection(-15.2 to -6.02), latter cancellation(2 to 0) and LOTCA- spatial perception scores(7 to 9). The upper motor function improved as indicated in the scores of affected FMA U/E(21 to 40) and ARAT(4 to 22). Ambulation and balance improved as indicated in the BBS scores(25 to 38) and FAC scores(0 to 4). ADL function improved as indicated in the FIM total scores 54 to 70(motor 34 to 61, cognition 20 to 29). Conclusion: Prism adaptation did improve functional level such as motor functions and ADL abilities in TBI patient. Further research is recommended.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.7
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• pp.3023-3029
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• 2012

The purpose of this study was to investigate the effect of the home-based virtual reality (VR) on upper extremity motor function in hemiparetic stroke patients. Two matched subjects with left hemiplegia were volunteered to participate in this study. One subject received the home-based VR whereas the other subject recovered a modified home-based constraint-induced movement therapy (CIMT). Both interventions were given for 4 hours x 5 times a week for 4 weeks. Outcome measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Wolf Motor Function Test (WMFT). The VR-trained subject showed considerable improvement in all the tested motor functions when compared with the home-based CIMT. Specifically, the FMA measure demonstrated that the VR subject showed 17% enhancement whereas the CIMT subject showed 5% increase. Similarly, Amount of Use (AOU) and Quality of Movement (QOM) of the MAL scores of the VR subject showed 40% and 20% increase whereas the CIMT subject showed 0% and 20% increase, respectively. The WMFT scores of the VR subject and CIMT subject showed 20% increase. Our home-based VR was effective in upper extremity motor recovery of chronic hemiparetic patients even when compared with the well-established CIMT approach in stroke victims.

• PNF and Movement
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• v.9 no.4
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• pp.1-11
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• 2011

Purpose : This study is to identify the effect of a thera-band exercise program on the physical function of elderly women. Methods : The subjects included 54 elderly women who participated in the program at J Senior Welfare Center in Jeollabuk-do. They were divided into two groups, 30 elderly women of control group and 24 of experimental group. A thera-band exercise program was conducted to both groups for total eight weeks-three times a week with a 50-minute period. After/before the experiment, the following seven categories were estimated for each subject: cardiopulmonary endurance, lower extremity power, upper extremity power, muscle endurance, flexibility, equilibrium, and agility. Results : There was a significant increase on the physical function of all the subjects in the experimental group and the control one after the experiment. Furthermore, the experimental group showed more meaningful improvement than the control one. Conclusion : On the basis of these findings, the thera-band exercise program contributes the enhancement of physical function of elderly women. Thus, more various physical exercise program should be developed for healthy aging.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.257-266
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• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.3
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• pp.515-524
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• 2017

The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.21-36
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• 2013

Objective : The purpose of this study was to look at a systematic review on the effects of robot-assisted therapy on stroke rehabilitation in upper limbs. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from June 2012 to September 2012, using EMBASE, MEDLINE, etc. 12 studies(randomized controlled trials) were included in the analyses. Results : Selected 12 studies were Pedro score 2 or more. The primary outcome measure tools including tools for upper extremity function and activities daily of living were used. Through various intervention, Robot-assisted therapy maximizes the effectiveness of intervention. The effects of upper extremity function and functional ability(ADL) by robot-assisted therapy showed significant effect, but no difference exists between the robot-assisted therapy and conventional therapy groups in terms of upper extremity function and functional ability. Conclusions : Robot-assisted therapy has been widely used clinically for stroke patients to maximize the effect had been applied to various interventions. Robot-assisted therapy depending on the methods of intervention showed that the effect of difference. In the future study, the use of robot-assisted therapy applied to a variety of interventions is needed on occupational therapy.

• PNF and Movement
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• v.15 no.3
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• pp.237-246
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• 2017

Purpose: The purpose of this study was to investigate the effects of forward-and-backward shift trunk exercise using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern in a closed kinematic chain exercise on the upper limb function and activity of daily living (ADL) in a stroke patient. Methods: One subject participated in this study. The study used a reversal A-B-A' design, where A and A' were the baseline period (no intervention), and B was the intervention period. The intervention was a forward-and-backward trunk shift exercise, using a PNF diagonal pattern on both a stand-on-hand position and a quadruped position of closed kinematic chain exercises, for 20 min per day for 2 weeks. The range of motion (ROM) of the shoulder joint was measured and a Fugl-Meyer assessment of upper extremity (FMA-UE) and a functional independence measure (FIM) were performed to measure upper limb function and activity of daily living (ADL). Results: ROMs of shoulder joint (flexion, extension, abduction, and external rotation) increased in the intervention phase. The FMA-UE score increased (from 28 to 36) in the intervention phase. The FIM score increased (from 20 to 25) in the intervention phase. These increases were maintained after intervention (Baseline II). Conclusion: These results suggest that forward-and-backward shift trunk exercises using a PNF diagonal pattern in a closed kinematic chain exercise have a positive effect on stroke patients' upper limb function and ADL ability.

• Journal of Korea Entertainment Industry Association
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• v.14 no.6
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• pp.269-277
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• 2020

The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.