• The Journal of Korean Physical Therapy
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• v.18 no.4
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• pp.1-9
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• 2006

Recently, several investigations revealed that after unilateral brain damage, movement abnormalities were exposed on the ipsilateral side as well as the upper extremity contralateral to the damaged hemisphere. Even the motor abilities had significantly recovered from ipsilateral motor deficits on not only simple sensoriomotor function, also clinical assessments since subacute stage, although could not completely returned. Such motor deficits were detected in a diversity of motor tasks depending on the interhemispheric specialization, further in clinical evaluation and a daily of activities. In the clinical features, muscular weakness, sensory loss and impaired manual dexterity were observed. In a laboratory experiment, there were increasing evidences that the kinematic processing deficits was founded in various-specific motor tasks, which ranged from simple basic element to complex tasks, such as tapping task, step-tracking, goal directional aiming task, and iso(and non-)directional interlimb coordination. In the point of view, the manifest understanding in related to ipsilateral deficits provide the clinicians with an important information for scientific management about brain injured patient's prognosis and therapeutic guidelines.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.1
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• pp.193-200
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• 2011

This study is intended to examine the tDCS and Montoya stair task(MST) on sensorimotor recovery and glial scar expression in MCAo induced stroke model of rat. To achieve this goal, this study selected 80 SD rats of 8 weeks. The experiment groups were divided them into four groups, and assigned 20 rats to each group. Group I was a experimental control group; GroupII was a tDCS application group after MCAo; Group III was a MST application group after MCAo; Group IV was a tDCS and MST application group after MCAo. In each group, neurological function test measurement, motor behavior test, montoya stair task test, immunohistochemistric finding of GFAP expression finding were analyzed. In motor behavior test, the outcome of group I was significantly difference than the other group, especially from 14days. In montoya stair task test, the outcome of group I was significantly lower than the other group especially, group II were significantly different on 14days and group IV was most significantly difference than the other group. In immunohistochemistric finding, group II, III, IV were decrease GFAP expression on depend on time stream. These results throughout the MCAo due to focal ischemic brain injury rat model four weeks tDCS and MST was applied, when the neurobehavioural, upper extremity function and ability, histopathologic data suggest that sensorimotor function recovery and a positive influence on glial scar decrease and confirmed that.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.1-15
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• 1996

From Fabuary 1982 to May 1995, 396 patients had undergone reconstructive surgery of the upper and lower limb with microsurgical technique at department of orthopaedic surgery, Yonsei University of Medicine. The results were as follows; 1. Average age at the time of operation was 23.4years(2-64 years), and there were 277 male and 119 female patients. 2. Among 324 patients of soft tissue flap(87 inguinal flap, 132 scapular flap, 38 latissimus dorsi flap, 11 latissimus dorsi and scapular combind flap, 6 gracilis flap, 12 deltoid flap, 3 tensor facia lata flap, 11 dorsalis pedis flap, 6 lateral thigh flap, 12 wrap around flap, 1 lateral arm flap, 5 musculocutaneous flap), 274 cases(85.5%) were succeed. 3. Among 37 patients of vascularized bone graft(18 fibular bone graft, 11 iliac bone graft, 7 toe to finger transplantation,1 vascular pedicle rib graft), 30 cases(80.1%) were succeed. 4. In 26 cases of segmental resection and rotationplasty at lower extremity, 23 cases were succeed. 5. In 7 cases of Tikhoff-Linberg procedure and in 2 case of segmental resection and replantation, all case was succeed. Overall success rate of microscopic reconstructive surgery was 85.6%. In conclusion, microsurgical technigue is valuable for reconstruction of tissue defect or function loss of the limb.

• Korean Journal of Applied Biomechanics
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• v.16 no.2
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• pp.37-44
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• 2006

The purposes of this study were to analyze and compare EMG activities of the pectoralis major, biceps brachii, triceps brachii, and brachioradialis muscles during biceps curls using a VRT device and an elastic tubing. Fifteen male college students were recruited as subjects and they performed 10-RM and 20-RM biceps curls. For each load and device condition, the mean and peak normalized EMG levels during different phases of a biceps curl were computed. For each load and phase, paired t-test (p.05) was used to find the significant difference between two devices. ANOVA with repeated measures was also used to find the significant difference among phases in terms of EMG values for each muscle. For each load and device condition, the peak and mean EMG levels during different phases of a biceps curl were computed The significant differences between devices were found in biceps brachii for EA, MD, LD phases, and triceps brachii muscles for all phases, respectively. However, no differences were found among phases for any muscle. This indicated that elastic band could have a similar characteristics of VRT. High antagonistic muscle activity as a function of injury prevention which found particularly in VRT device may suggest that elastic tubing can be a safer training device than VRT. This also imply that elastic tubing could be very effective as a home exercise tool for rehabilitation patients and elderly people.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.95-108
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• 2021

Objective : This study aimed to develop prototypes of "smart stacking cones" by combining ICT to evaluate and train the upper extremity function and dual task performance in patients with central nervous system impairment, and to identify the complementary point to the completion of the device through a usability test. Methods : This prototype comprised of a hardware and software system that enabled the evaluation and training of patients and the management of data obtained from patients' performance. Specific measurement variables were established so that patient performance could be measured correctly. Based on the measurement variables, a the prototype included a 'single task evaluation modes', 'dual task evaluation mode', 'single task training mode', and 'dual task training modes'. Additionally, a usability test was conducted to assess clinical applicability and overall satisfaction for the prototype. Results : The results of the usability test were generally found to be appropriate. The 'content adequacy' in the usability test was the area with the highest level of adequacy and the lowest level of inadequacy. Additionally, overall 'satisfaction' in the usability test was the area with the highest appropriate and inappropriate levels. Hence, the overall satisfaction results were unstable. Conclusion : Future studies should be conducted to identify the clinical effectiveness of the device by applying an upgraded smart stacking cone to an actual patient group.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.21-26
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• 2009

Purpose: The aim of this study was to examine the dose-related effect of extracorporeal shock wave therapy (ESWT) for lateral epicondylitis. Materials and methods: Thirty patients with refractory lateral epicondylitis despite conservative treatment for 6 months were enrolled in this study. The patients were divided randomly into a low- and high-energy group. All patients were treated 3 times with ESWT with an interval of 1 week in a double blinded manner. The mean energy level in the low- and high-energy group was $0.12 mJ/mm^2$ and $0.24 mJ/mm^2$, respectively. The upper extremity functional scales and Mayo elbow scores were measured prospectively at the baseline, 1, 3 and 6 months after ESWT. Results: Significant clinical improvement was observed in both groups after ESWT. The high-energy group showed better pain improvement at 6 months after ESWT (p=0.019). The effect of ESWT was dominant between 1 and 6 months after ESWT than within 1 month. Conclusion: ESWT for lateral epicondylitis demonstrated showed good results regardless of the energy dose. However, a high-energy level was more effective in pain improvement after 6 months of treatment.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.83-92
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• 1998

Fractures of the clavicles are extremely common, accounting for 5 to 10% of all injuries in the adult skeletal trauma. Despite this, nonunions and symptomatic malunions after clavicular fracture are uncommon. When these complications occur, however, they may be associated with 11 pattern of disability that includes not only pain but also impairment of upper extremity function. The purpose of this study was to clarify the outcome of clavicular fractures treated by conservatively, and emphasize treatment and factors that possibly predispose a clavicular fracture to poor function or nonunion. We evaluated 9] consecutive fractures of the middle-third of the clavicle in adults which had been treated conservatively. There were 59 males and 33 females ranging in age from 17 to 80 years (average 36.8 years). Nine of the 91 fractures (10%) had developed nonunion, and 4 fractures (4.4%) reported unsatisfactory results. No patients had significant impairment of range of motion or strength as a result of the injury. We found that initial shortening at the fracture of≥20mm(6 cases) had a highly significantly association with nonunion(P<0.0001). Final shortening of 20mm or more (4 cases) was associated with an unsatisfactory result, but not with nonunion(P<0.0001). Our results have led us to recommend the open reduction and internal fixation of severely displaced fractures of the middle third of the clavicle in adults patients.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.26-31
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• 2006

Purpose : To evaluate the effect of global scaling analysis on brain activation for sensory and motor functional MR imaging study. Materials and methods : Four normal subjects without abnormal neurological history were included. Arm extension-flexion movement was used for motor function and 1KHz pure tone stimulation was used for auditory function. Functional magnetic resonance imaging was performed at 3T MRI (GE, Milwaukee, USA) using BOLD-EPI technique and SPM2 was employed for data analysis. On data analysis, the brain activation images were obtained with and without global scaling by fixing other parameters such as motion correction and realignment. Results : The difference in brain activation between no scaling and global scaling was not large in case of right upper extremity movement (p<0.000001). For auditory test, brain activation with global scaling showed larger activation than that of without global scaling (p<0.05). Conclusion : A caution must be taken into account when analyzing functional imaging data with global scaling especially for functional study of small local BOLD signal change.

• Therapeutic Science for Rehabilitation
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• v.1 no.1
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• pp.57-70
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• 2012

Objective : This study was to evaluate the effects of a Neurofeedback(NFB) and Computer Assisted Cognitive Rehabilitation(CACR) training to improve on cognition and affected arm function in stroke subjects. Methods : Participants were randomly allocated to three groups: NFB(n=14), CACR(n=14) and control(n=16). All groups received occupational therapy and physical therapy for 5 session 30 minutes per week during 6 weeks. Also NFB and CACR group practiced additional NeuroComp training and RehaCom training for 30 sessions 30 minutes during 6 weeks. Results were evaluated by cognition, affected arm function. Results : There were significantly increased by CACR training that outcomes of MMSE-K(p<.05). And there weren't significantly difference by NFB and CACR training that outcomes of the affected arm function. And a difference between three groups wasn't found. Conclusion : The NFB and CACR training improves cognitive function. These results suggest that NFB and CACR training is feasible and suitable for individuals with stroke.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.25-29
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• 2001

Objective : Intracranial metastasis is responsible for nearly 50% of mortalities of systemic cancers. Although its frequency is increasing and there is little doubt that improving the quality and expectancy of life is the final goal, the mode of treatment is still disputed. The authors report the postoperative motor function after surgery in patients with metastatic tumors around the motor cortex. Materials and Methods : We studied 24 patients with metastatic tumors around the central sulcus during the last 22 months. Motor function was assessed pre- and post-operatively as well as its response to corticosteroids. MRI, neuronavigation system and intraoperative ultrasonography were used for tumor localization and functional MRI and cortical stimulator were used to define the motor cortex. Results : Single metastasis was found in 13 cases(54%) and 11 cases(44%) had multiple foci. Thirteen cases were located in precentral, 7 in postcentral, and 4 in superior or middle-frontal lobe. The most common primary focus was the lung(16 cases). There was no difference in postoperative motor function improvement between the steroid responsive group and non-responsive group(92% versus 90%). Ninty-two percent of the patients showed significant improvement of motor function and lived independently but there was worsening in the upper extremity in one and in another no improvement. Whole brain radiation of 3000cGy was given in all cases and 4 patients died of recurrence in primary or intracranial focus during mean follow-up periods of 14 monthes. Conclusion : Surgery may provide substantial improvement of the motor function and quality of life of the patients with metastatic tumors around the motor cortex.