• Title/Summary/Keyword: Function of upper limb

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The Effects of mCIMT using PNF on the Upper Extremity Function and Activities of Daily Living in Patients with Subacute Stroke (고유수용성촉진법을 이용한 수정된 강제유도 운동치료가 아급성 뇌졸중 환자의 상지 기능과 일상생활수행능력에 미치는 영향)

  • Bang, Dae-Hyouk;Song, Myung-Soo;Cho, Hyuk-Shin
    • PNF and Movement
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    • v.16 no.3
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    • pp.451-460
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    • 2018
  • Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

The Effects of Occupational Therapy Intervention Using Fully Immersive Virtual Reality Device on Upper Extremity Function of Patients With Chronic Stoke: Case Study (완전 몰입형 가상현실 기기를 이용한 작업치료 중재가 만성 뇌졸중 환자의 상지기능에 미치는 영향: 사례연구)

  • Han, Soul;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.7 no.2
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    • pp.17-27
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    • 2018
  • Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.

Effects of Manual Lymphatic Drainage and High Frequency Diathermy on Pain, Volume, Function of Upper Extremity and Quality of Life in Breast Cancer Patients with Axillary Web Syndrome : a Study of Five Case Reports (겨드랑이막증후군을 가진 유방암 환자들의 도수림프배출법과 고주파 투열치료가 통증, 부피, 기능 및 삶의 질에 미치는 효과 : 사례군 연구)

  • Ahn, Soo-Yeon;Shin, Won-Seob
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.4
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    • pp.19-28
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    • 2021
  • Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius (원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술)

  • Song, Seok-Whan;Lee, Yoon-Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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Comparative study of Acupuncture, Bee Venom Acupuncture and Bee Venom Herbal Acupuncture on the treatment of Post-stroke Hemiplegic Shoulder Pain (견관절 동통을 호소하는 중풍편마비 환자에 대한 체침, 봉독침 및 봉약침 치료효능의 비교연구)

  • Eom, Jae-Yong;Won, Seung-Hwan;Kwon, Ki-Rok;Lee, Hyang-Sook
    • Journal of Pharmacopuncture
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    • v.9 no.1
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    • pp.139-154
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    • 2006
  • Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.

Effects of Honeybee Venom Acupuncture Therapy on the Poststroke Hemiplegic Shoulder Pain (중풍(中風) 편마비환자(偏痲痺患者)의 견관절(肩關節) 동통(疼痛)에 대(對)한 봉독약침료법(蜂毒藥鍼療法)의 효과(效果))

  • Yin, Chang-Shik;Nam, Sang-Soo;Kim, Yong-Suk;Lee, Jae-Dong;Kim, Chang-Hwan;Koh, Hyung-Kyun
    • Journal of Pharmacopuncture
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    • v.3 no.2
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    • pp.213-232
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    • 2000
  • Hemiplegic shoulder pain(HSP) is one of the most frequent and difficult problems affecting poststroke hemiplegic patients. Honeybee venom acupuncture therapy(BVAT) is known for its pain relieving effects in arthralgia. To evaluate the effectiveness of BVAT on HSP, 24 patients were sequential1y allocated into BVA T treatment group and control group and monitored for 4 weeks at time interval of initial(T0), 1 week(T1), 2 weeks(T2) and 4 weeks(T4). In treatment group, 1:10000 honeybee venom solution 0.2㎖ was injected into acupoint(s) following Deqi three times a week. Kyonu(LI15) was used in the first week. Thereafter Kyonu(LI15) and Nosu(SI10) were used. Visual analogue scale of pain severity showed significant decrease in treatment group compared to control group at T2 and T4 evaluation. Painless passive range of motion of shoulder external rotation showed significant increase in treatment group compared to control group at T4 evaluation. Fugl-Meyer Motor Assessment of upper limb motor function and Modified Ashworth scale of the spasticity of upper limb showed no difference between two groups. BVAT showed as an effective therapy in HSP and further extensive clinical studies are expected.

IT based EMG biofeedback training on the effects of upper extremity function in chronic stroke patients (IT 기반 근전도 바이오피드백 훈련이 만성 뇌졸중 환자의 상지기능에 미치는 효과)

  • Kim, Ju-Hong;Oh, Myung-Hwa
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.1
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    • pp.41-50
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    • 2014
  • The subjects of this study were 30 hemiplegia patients whose disease duration was over 6 months, and they were divided at random into a control group (n=15) receiving traditional rehabilitation therapy and an experimental group (n=15) receiving both traditional rehabilitation therapy and training using IT based EMG biofeedback. The program was applied for a total of 4 weeks. In order to examine the subjects' functional recovery, we measured their upper limb function using FMA and MFT, and activities of daily living using FIM before and after the training. Comparison between experimental groups in the study of upper extremity function improved after training in all tests was higher compared to the control group significantly (p<.05), but activities of daily living were not significantly different in. The results of this study were as follows. we concluded that stroke patients receving intensive IT based EMG biofeedback showed upper extremity functional recovery.

Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1312-1326
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    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

Functional Electric Stimulation-assisted Biofeedback Therapy System for Chronic Hemiplegic Upper Extremity Function

  • Kim, Yeung Ki;Song, Jun Chan;Choi, Jae Won;Kim, Jang Hwan;Hwang, Yoon Tae
    • 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.

The Effect of Action Observation Training on Upper Motor Function in Stroke Patients : A Multiple Bbaseline Design (동작관찰훈련이 뇌졸중 환자의 상지운동기능에 미치는 영향 : 다중기초선연구)

  • Yun, Tae-Won;Park, Hye-Ryoung;Kim, Tae-Yoon;Lee, Moon-Kyu
    • PNF and Movement
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    • v.12 no.2
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    • pp.123-132
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    • 2014
  • Purpose: The discovery of mirror neuron system may positively affect functional recovery; therefore, rehabilitation is needed that is practical for use in clinical settings. The purpose of this study was to examine the effect of action observation training on upper motor function in people who had suffered strokes. Methods: Three elderly patients with stroke, aged to years, were recruited from a stroke rehabilitation center. A nonconcurrent, multiple baseline subject approach was taken, with an A-B-A treatment single-subject experimental design, and the experiment was conducted for 3 weeks. The action observation training was repeated 5 times in 5 days during the intervention period. The arm function, including WMFT, BBT, and grip and pinch strength, was evaluated in each subject 5 times during the baseline period, the intervention period, and the baseline regression period. Results: The results of the evaluation for each subject were presented as mean values and video graphs. The WMFT scores of 2 subjects were improved during the intervention period in comparison with the baseline period, and this improvement was maintained even during the regression baseline period. The BBT and the grip and pinch strength were not improved. Conclusion: Based on these results, we suggest that the action observation training for 5 sessions was effective in improving upper limb function of stroke patients but was not effective in improving hand dexterity or grip and pinch strength.