• 대한물리의학회지
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• 제16권4호
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• pp.103-116
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• 2021

PURPOSE: This study examined the effects on the upper extremity function, muscle strength, and hand function of a task-oriented training approach using a percussion instrument for patients with chronic stroke. METHODS: Twenty-four chronic stroke patients accompanied with upper extremity hemiplegia were selected for research and were classified randomly into 12 experimental groups and 12 control groups. The experimental group performed a task-oriented approach, and the control group performed upper extremity occupational therapy. Stroke upper extremity test, Jebsen-Taylor Hand Function test, upper extremity muscle strength test, and hand muscle strength test were measured before and after training in the evaluation process. RESULTS: In the upper extremity test and Jebsen-Taylor test, there were no significant differences between the groups. In the upper extremity muscle strength test, there were significant differences in shoulder flexion, internal rotation, and elbow flexion in the experimental group. In the hand muscle strength test, there were significant differences in the grip, tip Pinch, lateral Pinch, and 3-jaw chuck in the experimental group and significant differences in only grip, tip pinch, and lateral pinch in the control group. In addition, there were significant differences in the lateral pinch compared to the amount of change. CONCLUSION: Task-oriented approach using percussion instruments for upper extremity rehabilitation in stroke patients is effective in the upper extremity function and strength, hand function, and strength.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.325-331
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• 2015

Purpose: This study attempts to understand the effect of stabilization exercise of biofeedback scapular on muscle activity and functional evaluation of the upper extremity in stroke patients. Methods: Patients were divided into two groups; a biofeedback scapular stabilization exercise group comprised of 8 patients and a task-oriented training group including another 8 patients, and 30-minute exercise was performed 5 times a week for 8 weeks. Electromyogram was used to measure muscular activity of lower trapezius, deltoid middle, and serratus anterior. Fugl-Meyer Assessment and Manual Function Test were used to evaluate functions of the muscles mentioned. Results: Significant difference was observed in the comparison group before and after exercise in muscular activity of lower trapezius, deltoid middle, and serratus anterior, Fugl-Meyer Assessment, and Manual Function Test. Conclusion: Therefore, we could see that biofeedback scapular stabilization exercise is more effective than task-oriented training in facilitating muscle activation and functional capacity of upper limb.

• 한국융합학회논문지
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• 제11권9호
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• pp.31-37
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• 2020

본 연구는 뇌졸중 환자에게 과제 지향적 훈련과 진동 자극을 결합한 중재에 경두개 직류 전류 자극을 융합했을 때 상지 기능의 회복에 미치는 영향을 알아보고자 하였다. 총 20명을 대상으로 총 4주간, 주 5회, 30분씩 실시했으며, 경 두개 직류 전류 자극을 융합한 과제 지향적 훈련과 진동자극의 결합 중재의 실험군과 과제 지향적 훈련과 진동자극의 결합 중재의 대조군으로 나누었다. 측정은 손의 기민성과 상지기능의 회복을 측정하였다. 실험군과 대조군은 손의 기민성과 잡기, 쥐기, 큰 동작 움직임에서 유의한 개선을 보였으며(p<.05), 실험군은 손의 기민성과 잡기, 쥐기 동작에서 대조군 보다 유의한 개선을 보였다(p<.05). 중재 전후 효과 크기는 모든 평가 항목에서 작은 효과이상을 보였다. 본 연구 결과를 근거로 하여 임상 환경에서 보다 효과적이고 효율적인 재활 치료를 할 수 있을 것으로 사료된다.

• 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.

• 대한통합의학회지
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• 제8권1호
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• pp.87-99
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• 2020

Purpose : This study aims to investigate the effect of somatosensory stimulation on the upper limb sensory and function and self-esteem of stroke patients. Methods : This study period was march 4 to april 4 (5 weeks). The subject were 20 stroke patients with somatosensory impairment in B hospital, seongnam, gyeonggi province. They were devided into two group-experimental and control-with 10 members each. The members of the experimental group underwent somatosensory stimulation, whereas the members of the control group underwent an occupation-based intervention for 5 weeks. Thirty-minute therapy was provided 3 times per week for 5 weeks. Before and after the intervention, both groups were evaluated via light touch, static two-point discrimination, stereognosis, Fugl-Meyer assessment (FMA), and self-esteem scale Results : In this study, light touch was not significant in both groups. Static two-point discrimination was significant among the experimental group member's index fingers. Among the control group members, it was significant in the ring finger. The comparison between the two groups was significant in the index finger. The stereognosis results were significant in the experimental group but not in the control group. The comparison between the groups after the intervention was not significant. FMA was significant in the shoulder/ elbow/ forearm (SEF), hand and coordination among the experimental group. Among the control group, it was significant in the SEF and hand. The comparison between the groups was significant in the SEF, hand and coordination. The self-esteem scale results were significant among both groups, and the comparison between the group's score was likewise significant. Conclusion : In conclusion, somatosensory stimulation therapy increases the static two-point discrimination, stereognosis, upper extremity function, and self-esteem of patients with stroke. Therefore, while somatosensory stimulation therapy is not the best therapy, it is one of the best occupational therapies for stroke patients.

• 한국엔터테인먼트산업학회논문지
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• 제14권3호
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• pp.431-442
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• 2020

본 연구는 테라테인먼트 스위스 볼 운동이 겨드랑 신경 손상 환자의 상지기능, 통증, 일상생활활동에 미치는 효과를 알아보고자 하였다. 연구기간 및 대상은 2019년 11월 5일부터 2020년 2월 25일까지 G광역시에 거주하는 23세 여성 1명으로, 개별사례실험 연구 중 A-B-A' 설계를 사용하였다. 본 연구는 겨드랑신경 손상 환자에게 다양한 방향과 점진적 무게의 운동 형태로 반복 훈련을 제공하였다. 이는 어깨의 구조의 안정성, 가동성을 높이고, 사용가능한 어깨 기능을 강화시켜 통증을 완화에 효과적이었고 다양한 환경 안에서 활동에 따른 자세 변화의 적응력과 대응능력을 발휘하게 하여, 최대한의 독립적 생활의 수행이 가능하도록 하였다. 따라서 본 연구의 테라테인먼트 스위스 볼 운동은 겨드랑신경 손상 환자의 상지기능, 통증 및 장애, 일상생활활동에 긍정적 영향을 미쳤기에 중재방법으로의 가능성을 확인할 수 있었다. 이는 다양한 환자치료에 전문성을 요구하는 작업치료사의 치료적 접근법으로 발휘할 수 있도록 지속적인 조사와 반복연구를 통해 효과를 검증하고 발전 방안을 모색할 필요가 있다.

• 대한감각통합치료학회지
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• 제16권2호
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• pp.64-74
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• 2018

목적 : 뇌성마비 아동의 상지기능을 향상시키기 위해 국내에서 사용되고 있는 중재방법의 종류와 그 효과를 체계적 고찰방법을 사용하여 국내에서 사용되는 치료경향을 제시하고자 한다. 연구방법 : 연구 대상은 2008년 이후로 국내학회지에 게재된 연구를 대상으로 하였다. 누리미디어(DBpia), 스콜라(Scholar), 한국사회과학데이터(KSDC), 학술연구정보서비스(RISS), 그리고 한국학술정보(KISS)의 데이터베이스를 사용하여 '뇌성마비', '상지 기능', '손 기능'의 검색어를 사용하였다. 총 12개의 연구로 근거의 질적 수준, 방법론적 질적 수준으로 분석한 후 대상자(Patient), 중재(Intervention), 대조(Comparison), 결과(Outcome)의 PICO로 제시하였다. 결과 : 분석에 포함된 연구에서 근거기반 실행의 질적 수준은 수준 IV와 수준 V가 가장 많았고, 방법론적 질적 수준은 '우수'의 연구가 가장 많았다. 대상자는 편마비 아동을 대상으로 한 연구가 가장 많았고, 실험설계는 단일대상연구 및 사례연구가 높았다. 중재의 종류는 강제유도운동치료가 가장 많았고, 평가는 젭슨테일러 손기능 검사 빈도가 높았다. 총 11개의 연구에서 뇌성마비 아동의 상지기능에서 유의한 향상 또는 긍정적인 효과가 나타났다. 결론 : 국내에서 뇌성마비 아동의 상지기능을 향상시키기위해 다양한 중재방법이 시행되어 왔다. 앞으로 마비 유형별에 따른 중재방법에 대한 연구와 근거의 질적수준이 높은 연구가 지속적으로 이루어져야 할 것이다.

• 대한물리의학회지
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• 제16권1호
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• pp.63-71
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• 2021

PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

• 대한한의학회지
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• 제42권4호
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• pp.75-101
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• 2021

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• 한국정밀공학회지
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• 제26권7호
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• pp.134-141
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• 2009

Recently, many researchers have tried to develop wearable robots for various fields such as medical and military purposes. We have been studying robotic exoskeletons to assist the motion of persons who have problems with their muscle function in daily activities and rehabilitation. The upper-limb motions (shoulder, elbow and wrist motion) are especially important for such persons to perform daily activities. Generally for shoulder motion 300F is needed to describe its motion(extension/flexion, abduction/adduction, internal/external rotation) but we have used a redundant actuator thus making a 4 DOF system. In this paper, we proposed the mechanism design of the exoskeleton which consists of 4-DOF for shoulder and 1-DOF for elbow robotic exoskeleton to assist upper-limb motion. Then we compared the new mechanism design and prototype mechanism design. Here we also analyze the proposed system kinematically to find out and to avoid the singular point. This research will ensure that the proposed wearable robot system make human's motion more powerfully and more easily.