• Title/Summary/Keyword: Functional movement Rehabilitation

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Development of EMG-Triggered Functional Electrical Stimulation Device for Upper Extremity Bilateral Movement Training in Stroke Patients: Feasibility and Pilot study

  • Song, Changho;Seo, Dong-kwon
    • Physical Therapy Rehabilitation Science
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    • v.10 no.3
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    • pp.374-378
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    • 2021
  • Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

The Cortical Activation by Functional Electrical Stimulation, Active and Passive Movement (능동 및 수동 운동과 기능적 전기자극에 의한 대뇌 피질의 활성화)

  • Kwon, Yong-Hyun;Jang, Sung-Ho;Han, Bong-Soo;Choi, Jin-Ho;Lee, Mi-Young;Chang, Jong-Sung
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.73-80
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    • 2005
  • We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.

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Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

  • Cho, Ki Hun;Song, Won-Kyung
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.93-98
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

Multidisciplinary Treatment Approach in a Secondary Cleft Lip and Palate Patient for Functional Occlusal Rehabilitation (성인 구순구개열 환자에서 Multidisciplinary 치료로 기능성 교합을 형성한 증례)

  • Lee, Jina Linton
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.29-38
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    • 2012
  • A 20 year-old cleft lip and palate patient came for occlusal rehabilitation, but the constricted maxilla and early loss of posterior teeth called for an unusual treatment modalities. Distraction osteogenesis in the edentulous areas followed by artificial bone graft, dental implant along with orthodontic tooth movement were planed. Multidisciplinary treatment enabled both esthetic and functional oral rehabilitation of this patient.

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Correlations of the Stroke Rehabilitation Assessment of Movement, Berg Balance Scale, and Modified Barthel Index in Patients With Acute Stroke (급성기 뇌졸중 환자에서 Stroke Rehabilitation Assessment of Movement와 Berg Balance Scale, Modified Barthel Index와의 상관관계)

  • Chung, Yu-Hoe;Song, Eun-Ji;Lee, Kang-Noh;Ahn, Jun-Su;Seong, Jun-Hyuk;Song, Mun-Seong
    • Physical Therapy Korea
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    • v.18 no.2
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    • pp.52-59
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    • 2011
  • The purpose of this study was to examine the relationship of the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), and the Modified Barthel Index (MBI) in the acute stroke care setting. Twenty patients with their first stroke were evaluated using STREAM, BBS, and MBI initially and at 4 weeks. The data was analyzed using the independent t-test, paired t-test, and the Pearson product moment correlation analysis. The scores on the STREAM were strongly associated with the scores on both the BBS and MBI (with Pearson correlation coefficients ranging from .88 to .95), and there was significant improvement between the initial scores and those obtained four weeks later for STREAM, BBS, and MBI (p=.001, p=.001, p<.001). The results suggest that STREAM may be able to reflect functional recovery and to assess voluntary movement in patients who have suffered an acute stroke.

The Effects of Motor Control with Active Movement and Passive Movement (능동운동과 수동운동이 운동조절에 미치는 영향)

  • Bae Sung-Soo;Kim Cheul-Yong;HwangBo Gak;Chung Hyun-Ae;Choi Jae-Won
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.13-21
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    • 1999
  • Active movement is able to actively contract his muscles and move a segment either with or without assistance. This movement maintain physiologic elasticity and contractility of the participating muscles, provide sensory feedback from the contracting muscles and stimulus for bone integrity as well as increase circulation and prevent thrombus formation, in addition to develop coordination and moor skills for functional activities. Passive movement is the motion to the external force; gravity, machine, another individuals. Active movement is more activated rather than passived on the central nervous system. Therefore, we think that active movement is more effected facilitating through specific inhibitory mobilization of muscle.

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Effects of the Movement Strategies on Functional Forward Reach in Standing (운동전략이 기립자세의 기능적 전방 팔뻗기에 미치는 영향)

  • Park, Je-Sang;Kwon, Oh-Yun;Choi, Houng-Sik;Kim, Tack-Hoon
    • Physical Therapy Korea
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    • v.7 no.1
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    • pp.46-54
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    • 2000
  • The purpose of this study is to determine whether movement strategies affect functional forward reach distance in a standing position. Forty-seven healthy subjects were selected for this study: 23 men and 24 women, with an average age of 22.3. Functional forward reach distances were measured as hip strategy and squat strategy (included knee and ankle movement strategy) in a standing position, respectively. The mean values of functional forward reach distance in hip strategy, squat strategy were 33.57 cm, 29.48 cm, respectively. There was significantly difference in functional forward reach distance between hip strategy and squat strategy(p<.001). There was no difference of functional forward reach distance between male and female in hip strategy, but there was significant difference in other strategy(p<.05). These results suggest that movement strategies should be considered during functional forward reach test in standing. Further study is required to determine whether movement strategies affect functional reach distance in elderly and disabled groups.

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Modified constraint-Induced Movement Therapy (CIMT) for the Elderly With Parkinson's Disease: A Preliminary Study (파킨슨병 노인을 위한 수정된 강제-유도운동치료: 사전연구)

  • Hwang, Su-Jin;Hong, Young-Ju;Yoo, In-Gyu;Jeon, Hye-Seon
    • Physical Therapy Korea
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    • v.16 no.1
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    • pp.70-78
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    • 2009
  • This study was designed to examine a 3-week modified constraint-induced movement therapy (CIMT) to the less-affected arm of patients with Parkinson's disease (PD) would improve function of the more-affected arm in PD. The subjects were 6 institutional older adults with PD and clients of the social welfare facilities. The subjects (2 men, 4 women) ranged in age from 66 to 90 years (mean age 77.2 yrs). Three clinical tests were used to determine the improvement of functional activity between before and after modified CIMT. The tests included Unified Parkinson's Disease Rating Scale (UPDRS). Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). There were significantly differences after the modified CIMT for time performance in WMFT and pinch in ARAT (p<.05), No significant difference was noted after the modified CIMT for UPDRS and functional ability scale in WMFT. Therefore, the modified CIMT might improve time performance and is available to therapeutic program helping them improve functional ability for upper extremity in Parkinson's disease.

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The Study of Myofascial Meridian Clinical Application for Functional Exercise and Manual Therapy (기능적인 움직임 치료를 위한 경근(經筋)의 임상활용에 대한 연구(I))

  • Lim, Hyung-Ho;Song, Yun-Kyung
    • The Journal of Korea CHUNA Manual Medicine
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    • v.3 no.1
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    • pp.65-83
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    • 2002
  • We are made a comparison between 12 meridian tendino-musculature and myofascial/locomotor anatomy in which the bodywide connections among the muscles within the fascial net. We consider that these unique 'whole systems' view is of vital importance to understanding the role of fascial in normal movement and postural distortion and to application of manual and movement therapy.

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Using ICF model Rehabilitation Management Case Report on Patients with Cerebellum Disorder (ICF 모델을 적용한 소뇌손상환자의 재활관리 사례보고)

  • Kong, Sun-Woong;Kim, Ji-Sun;Bae, Si-Jeol;Hwang, Ki-Kyeong
    • PNF and Movement
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    • v.11 no.1
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    • pp.79-88
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    • 2013
  • Purpose : Currently, ICF to describe the functions and disability in the world has been used as a universal language. ICF tools based on ICF, the rehabilitation management of clients have been developed to be efficient. This study was designed to describe clinical decision for functional goal of clients to used ICF tools. Methods : In the following the utilization of all developed ICF tools will be described within a case example of a 53-year-old women, suffering from cerebellum disorder. As problems in the subject's functional activities was difficulties in changes sitting postures, standing postures and maintaining standing postures. Activity limitation was determined change sitting, standing posture as a goal through discussion with the patient. Results : After setting the identified problems as the purpose of intervention through the assessment, we find out the outcomes using the ICF evaluation display. Consequently, with functional activities limitation that discovered from assessment(categorical profile, assessment sheet), sitting postures to standing postures and maintaining standing postures were improved. Conclusion : This study was showed ICF tools based on Rehab-cycle for the patient's functional goals clinical practice. The future study, the ICF in clinical practical tools for effective use will require more attempt.