• 제목/요약/키워드: Function of upper limb

검색결과 177건 처리시간 0.024초

뇌졸중 후 환자의 일상생활활동 및 손 기능 개선에 대한 가상현실 훈련의 효과 : 예비 연구 (The Effects of Virtual Reality Training on Improving Hand Function and Activities of Daily Living in Patients Living Post-Stroke: A Pilot Study)

  • 문종훈;전민재
    • 디지털융복합연구
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    • 제17권11호
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    • pp.349-355
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    • 2019
  • 가상현실 훈련은 신체 기능을 개선하기 위한 중재로 제안되었다. 그러나 급성 뇌졸중 환자의 ADL 개선에 초점을 둔 가상현실 훈련의 효과는 명확하지 않다. 본 연구의 목적은 급성 뇌졸중 환자의 손 기능 및 일상생활활동(ADL)에 대한 가상 현실 훈련의 효과를 조사하는 것이다. 급성 뇌졸중 환자 16명이 본 연구에 포함되었다. 실험 군(VRA군)은 각 세션마다 ADL에 중점을 둔 30분의 가상현실 훈련을 받았으며, 통제군은 30분의 보편적인 가상현실 훈련을 받았다. 피험자의 손기능과 ADL을 조사하기 위해 JTHFT(Jebsen-Tylor Hand Function Test)와 K-MBI (Korean Modified Barthel Index)를 각각 사용했다. 두 그룹 모두 중재 후 마비측과 비마비측의 손기능 및 K-MBI 총점에서 유의미한 개선을 보였다. 실험군은 통제군보다 중재 후 K-MBI의 자가관리 영역에서 유의하게 큰 향상을 보였다. 이러한 결과는 급성 뇌졸중 환자에서 ADL에 중점을 둔 가상 현실 훈련이 기존의 가상 현실 훈련보다 자기관리에 더 나은 영향을 줄 수 있음을 시사한다.

Clinical Features and Long-Term Outcome in Adult Stroke Patient due to Moyamoya Disease : A Single Subject Study

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • 제25권3호
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    • pp.126-131
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    • 2013
  • This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

원자력발전소 특수경비원의 직무분석과 체력에 관한 연구 (A Study on Job Analysis and Physical Fitness of Special Security Guard in Nuclear Power Plant)

  • 정호원;김소라;채현수
    • 시큐리티연구
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    • 제56호
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    • pp.83-105
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    • 2018
  • 원자력발전소 특수경비원은 의도하지 않은 내외부의 위협으로부터 원자력발전소를 안전하게 운영 관리하는 인적방호의 역할을 담당하고 있다. 이러한 특수경비원의 체력관리는 인적방호수준의 향상 및 유지를 위한 가장 핵심적 요소 중 하나이다. 이에 본 연구는 특수 경비원의 직무분석을 통해 임무완수에 필요한 체력요인과 체력수준을 분석하였다. 그 결과 국내 원자력발전소 특수경비원은 크게 7개의 직무, 26개의 책무, 159개의 과업을 수행하고 있었으며, 임무완수를 위해서는 손, 상지, 하지, 코어의 근력 및 근지구력, 순발력, 민첩성, 심폐지구력이 필요하였다. 또한 책무수행에 필요한 체력요구 수준은 체포 및 호신술 수행하기, 비 군사적 방어 대책 수행하기, 반자동 소총으로 숙련도 입증하기, 보호장비 사용하기, 비상대책 대응과 방어전략 수행하기, 초소근무하기, 출입자 보안 검색하기, 물품수색하기, 출입 차량 통제하기, 화재대응하기, 테러대응요령 숙지하기, 보안 순찰하기, 응급처치하기, 3등급 방호구역 외부인 출입자 통제하기, 2등급 방호구역 및 핵심구역에 대한 내 외부인 출입자 통제하기, 차량 및 자재 이동 경호 기능 수행하기 순으로 높게 나타났다. 이러한 연구결과는 향후 특수경비원의 체력자격기준 및 훈련에 관한 지침마련에 필요한 기초자료를 제공하고, 나아가 원자력발전소 인적방호 강화에 기여할 것으로 기대된다.

슬링(Sling) 시스템을 이용한 경부 안정화 운동 (Cervical stabilization exercise using the Sling system)

  • 권재확;조미주;박민철;김선엽
    • 대한정형도수물리치료학회지
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    • 제8권2호
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    • pp.57-71
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    • 2002
  • Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

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Video Based Behavioral Analysis to Observe Attention during Mirror Therapy in Hemiplegic Patients : Preliminary Study

  • Kim, Jinmin;Song, Changho
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.212-216
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    • 2021
  • Objective: Mirror therapy is one of the promising methods suggested for the upper limb rehabilitation of stroke patients. While mirror therapy was presented to be effective in improving motor function of stroke patients, problems were raised as preceding studies had various methods in applying mirror therapy. Some studies even reported no effect in mirror therapy. Our supposition for the reason of such problems was a decrease of attention on the illusive image during mirror therapy of stroke patients, and we aimed to observe this. Design: A cross-sectional preliminary study. Methods: Three hemiplegic acute patients were recruited for the traditional mirror therapy. It lasted for 30 minutes, and 12 different tasks were asked to perform. All procedures were video-recorded, and Observer XT was used to analyse mirror-gazing time, gaze-distracted time, preparation time, frequency of mirror gazing, frequency of distraction, frequency of preparation for treatment. Results: Subjects spent an average of 4-5 minutes having instructions about the mirror therapy intervention (preparation duration), an average of 11 minutes watching the mirror during therapy (mirror-gazing duration), and the rest of 14-15 minutes looking around the environment (gaze-distracted duration). During the mirror therapy, the number of distracted moments (frequency of distraction) was eight times more than focusing on the mirror (frequency of mirror gazing). Conclusions: Once the patient looks at the mirror, it only lasts about 5 seconds on average. Thus, we confirmed that patients could not concentrate on the illusion during the session and therefore it may have affected the effectiveness of the therapy.

Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

  • Jeong, Ju-Young;Hwang, Tae-Sung;Song, Kun-Ho;Song, Joong-Hyun
    • 한국임상수의학회지
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    • 제39권5호
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    • pp.235-239
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    • 2022
  • A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

  • Imai, Takaki;Gotoh, Masafumi;Fukuda, Keiji;Ogino, Misa;Nakamura, Hidehiro;Ohzono, Hiroki;Shiba, Naoto;Okawa, Takahiro
    • Clinics in Shoulder and Elbow
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    • 제24권2호
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    • pp.80-87
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    • 2021
  • Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

치위생학과 스케일링 실습수업이 상지 근골격계에 미치는 영향 (Repercussions to the musculoskeletal system of the Upper Limb caused by scaling training exercise)

  • 노효련;유자혜;이민영
    • The Journal of Korean Physical Therapy
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    • 제20권3호
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    • pp.45-51
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    • 2008
  • Purpose: We evaluated the physical stress and pain to the musculoskeletal system of a dental practitioner when engaging in a dental scaling training exercise to prevent the development of musculoskeletal injuries. Methods: The 18 female (average age: 21$\pm$1 years) subjects were voluntarily picked from a group of juniors who have completed a one-and-a-half year training course that includes training exercises on the dentiform and on live subjects (other trainees). The test is done by measuring pain, activity, grip strength, and finger dexterity for each subject's hand and wrist. Before the test all subjects were confirmed to be right-handed and were informed of the study and its objective. Measuring was done before and after each subject performed dental scaling for one hour using the scaler and the curet. Results: Pain levels increased for both hand and shoulders, but hand pain was often greater than shoulder pain. Grip strength significantly declined in the right hand but not the left. For joint mobility, the flexion and the extension for the shoulder joint did not change; but the range of motion for both wrist joints significantly increased. For the dexterity test, both hands showed increased dexterity after the exercise. Conclusion: Dental scaling can affect the shoulders and wrists/hands. Therefore, a musculoskeletal injury prevention program for dental practitioners, which may include encouraging them to assume correct body posture when at work, must be sought. This study evaluated only the shoulders, wrists, and hands; but future studies should include areas such as the cervical area, the back, and the lower limbs.

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모션인식 디바이스를 이용한 수부재활치료 시스템 (Hand Rehabilitation System Using a Hand Motion Recognition Device)

  • 황제승;김민진;문미경
    • 한국컴퓨터정보학회논문지
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    • 제19권8호
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    • pp.129-137
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    • 2014
  • 수부와 상지 질환을 가지고 있는 환자가 질환 회복을 위해서 재활치료를 받게 된다. 재활치료는 신체 기능을 회복, 유지시키기 위해 환자의 활동에 대해 중재를 시행하고 물리적 자극을 이용하여 치료하는 것으로, 이는 반복하여 꾸준히 시행하는 것이 가장 중요하다. 본 논문에서는 손상 받은 수부의 기능을 향상시키고 회복시키기 위해 능동적인 활동으로 치료를 제공할 수 있는 수부재활 시스템의 개발 내용에 대해 기술한다. 이 시스템은 손의 움직임을 포착 추적하는데 특화된 디바이스인 립모션을 활용하여 환자 스스로 따라할 수 있는 6 가지 수부재활 운동 패턴을 제공한다. 이를 통해 환자가 일상생활에서 지속적으로 재활운동을 수행하도록 함으로써 치료의 성과를 향상시키도록 한다.

체성운동영역이 제거된 편마비 흰쥐에서 억제 유도치료가 기능향상과 BDNF 발현에 미치는 효과 (Effect of CIMT on the Functional Improvement and BDNF Expression in Hemiplegic Rats Whose Somatomotor Area was Removed)

  • 임창훈;황보각
    • 한국콘텐츠학회논문지
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    • 제8권9호
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    • pp.194-203
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    • 2008
  • 억제유도치료는 건측 상지의 운동을 제한하고 환측 상지의 운동을 유도함으로써 손상된 상지의 기능 및 사용을 향상시키는 치료이다. 본 연구의 목적은 동물모델을 이용하여 억제유도치료의 효과를 운동행동검사와 면역조직 화학법으로 검증하기 위함이다. 본 연구에서는 Sprague-Dawley계 흰쥐 수컷 실험군 40마리 대조군 40마리를 사용하였다. 실험동물은 마취 후 체성운동영역을 제거하여 억제유도치료를 적용한 실험군과 적용하지 않은 대조군으로 나누었다. 실험동물은 수술 후 1일, 3일, 7일, 14일째 10마리씩 나누어 자세 반사 검사, 막대 걷기 검사, 앞다리 배치 검사, 면역조직 화학반응을 실시하였다. 결과는 실험군의 운동행동 검사에서 모두 유의하게 높았고(p<.05), BDNF 발현은 시간이 지날수록 실험군의 발현량이 높게 나타났다. 이와 같은 결과는 중추신경계의 가소성을 검증 하는데 기여하리라 생각된다.