• 재활치료과학
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• 제6권2호
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• pp.37-45
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• 2017

Background: The presence of visuospatial impairment can make patients slow functional recovery and impede the rehabilitation process in TBI patients. Objective: The aim of this study is to investigate effects of prism adaptation treatment for functional outcomes in patients following traumatic brain injury. Methods: The subject received prism adaptation treatment for 2 weeks additionally during traditional rehabilitation for 4 weeks. The Patient has prism adaptation treatment while wearing wedge prisms that shift the external environment about $12^{\circ}$ leftward. The patient received 10 sessions, 15-20min each session. Outcome measures were visuospatial deficit(line bisection, latter cancellation), Visual and spatial perception(LOTCA-visual perception and spatial perception), motor function of upper extremity(FMA U/E; Fugl-Meyer motor assessment upper extremity, ARAT; Action research arm test), balance(BBS; Berg Balance Scale), mobility(FAC; Functional ambulation classification) and functional level(FIM; Functional independent measure). All Assessments took place on study entry and post-treatment assessments were performed at discharge from the hospital. Results: After prism adaptation, the visuospatial impairment scores improved as indicated in the line bisection(-15.2 to -6.02), latter cancellation(2 to 0) and LOTCA- spatial perception scores(7 to 9). The upper motor function improved as indicated in the scores of affected FMA U/E(21 to 40) and ARAT(4 to 22). Ambulation and balance improved as indicated in the BBS scores(25 to 38) and FAC scores(0 to 4). ADL function improved as indicated in the FIM total scores 54 to 70(motor 34 to 61, cognition 20 to 29). Conclusion: Prism adaptation did improve functional level such as motor functions and ADL abilities in TBI patient. Further research is recommended.

• 한국운동역학회지
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• 제25권4호
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• pp.453-463
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• 2015

Objective : The purpose of this study was to investigate the effects of the Probody Massage Program on the physical characteristics, gross motor function and ROM (Range Of Motion) of children with cerebral palsy. Method : The subjects of this study were two children who have been diagnosed with first grade cerebral palsy that utilized T development support center located in B Metropolitan city for 8 weeks, twice a week, to carry out the Probody Massage Program for 30 minutes. Physiological reactions (height, weight, BMI, blood pressure (an index of inflammation), pulse rate) and large operating functions (sitting, crawling and the joints' range of motion as an angle of the shoulders' upper limb articulation) were measured pretest, after 4 weeks, and after 8 weeks. Results : The Probody Massage Program showed positive changes in physical characteristics (blood pressure, sitting, and crawling), gross motor function (upper limb shoulder movement), joint range of motion, height, body weight, metabolic activation and blood circulation of children with cerebral palsy. Conclusion : We believe making a practical impact on the growth and development, functional recovery of daily life, and improvement of quality of life of children with cerebral palsy by utilizing Probody Massage Program improves blood pressure (an index of inflammation), pulse, sitting, crawling, and the joints' range of motion as an angle of the shoulder joints' upper limb movement of children with cerebral palsy.

• The Journal of Korean Physical Therapy
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• 제18권3호
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• pp.59-70
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• 2006

Purpose: This study is intended to examine the aquatic exercise on the improvement of muscle atrophy and motor function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: We used 60 Sprague-Dawely rats which were divided into 4 groups; the subjects were divided into group of 5 rats. Group I was a group of high dose aquatic exercise after inducing ischemic stroke; Group II was a group of low dose aquatic exercise after inducing ischemic stroke; Group III was a control group, Group IV was a sham group without ischemic stroke. Results: Muscle weight of gastrocnemius muscle was significantly difference in Group II compared to Group III on 8 weeks(p<0.05). For the changes in relative muscle weight of gastrocnemius muscle, there was significant increase in Group II compared to Group III on 8 weeks(p<0.05). For neurologic exercise behavior test, Group II generally had the highest score, compared to other groups. The results of behavior test that Group II improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group III. Conclusion: Based on these results, aquatic exercise may improve muscle atrophy and contribute to the improvement of motor function.

• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.130-135
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• 2006

Objective : After ischemic stroke, partial recovery of function frequently occurs and may depend on the plasticity of axonal connections. Here, we examine whether blockade of the Nogo/NogoReceptor[NgR] pathway might enhance axonal sprouting and thereby recovery after focal brain infarction. Methods : Adult male Sprague Dawley rats weighing $250{\sim}350g$ were used. Left middle cerebral artery occlusion[MCAO] was induced with a intraluminal filament. An osmotic mini pump [Alzet 2ML4, Alza Scientific Products, Palo Alto, CA] for the infusion of NgR-Ecto[310]-Fc to block Nogo/NgR pathway was implanted 1 week after cerebral ischemia. Prior to induction of ischemia, all animals received training in the staircase and rotarod test. Two weeks after biotin dextran amine injection, animals were perfused transcardially with PBS, followed by 4% paraformadehyde/PBS solution. Brain and cervical spinal cord were dissected. Eight coronal sections spaced at 1mm intervals throughout the forebrain of each animal with cresyl violet acetate for determination of infarction size. Images of each section were digitized and the infarct area per section was measured with image analysis software. Results : Histological examination at 11 weeks post-MCAO demonstrates reproducible stroke lesions and no significant difference in the size of the stroke between the NgR[310]Ecto-Fc protein treated group and the control group. Behavioral recovery is significantly better and more rapid in the NgR-Ecto[310]-Fe treated group. Blockade of NgR enhances axonal sprouting from the uninjured cerebral cortex and improves the return of motor task performance. Conclusion : Pharmacological interruption of NgR allows a greater degree of axonal plasticity in response this is associated with improved functional recovery of complicated motor tasks.

• 한방재활의학과학회지
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• 제19권2호
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• pp.27-49
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• 2009

Objectives : The purpose of this study was to investigate the effects of Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang) and Cervi Cornu Parvum pharmaco-acupuncture in Spinal Cord Injury(SCI)-induced rats. Methods : The subjects were divided into 5 groups ; Normal, Control no treatment after SCI, Experimental I taken with Yanghyuljanggeungunbo-tang (Yangxuezhuangjinjianbu-tang) 500 mg/kg $0.5m{\ell}$ daily after inducing SCI. Experimental II taken with Cervi Cornu Parvum pharmaco-acupuncture at Taegye(KI3) and $Yangnungch{\acute{o}}n$(GB34) after inducing SCI and Experimental III taken with Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang) 500 mg/kg $0.5m{\ell}$ and Cervi Cornu Parvum pharmaco-acupuncture at KI3 and GB34 to SCI-induced rats. After each operation, the present author observed the motor behavior recovery and nerve regeneration by analysis of the motor behavior tests, EMG, hematological(AST, ALT, WBC), histological and immunological changes. Rats were tested at modified Tarlov test at the 1st, 2nd, 3rd, 4th day, and Motor behavior test at 1st, 3rd, 7th, 14th, 21st day. Results : Results are as follows. 1. All the experimental groups were improved compared with control group in the motor behavior tests including Tarlov test, Basso-Beattle-Bresnahan locomotor rating scale, modified inclined plane test, open field test, grid walk test and narrow beam test. Especially Experimental III was improved significantly among other groups. 2. In EMG test, H wave appeared weak only in Experimental III. And M wave was increased significantly in Experimental III. 3. All the experimental groups were significantly decreased compared with control group in serum AST, serum ALT and serum WBC tests. 4. significantly decreased in Tumor Necrosis Factor-${\alpha}$ test compared with the first day of SCI. 5. Muscle contraction and denaturation of all the experimental groups were inhibited in histological observations of gastrocnemius muscle. Especially, those of experimental III was more effective. 6. NGF and BDNF of spinal cord gray matter in all the experimental groups were increased compared with control group. Especially, those of experimental III was more effective. Conclusions : As above, it can be suggested that Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang) and Cervi Cornu Parvum pharmaco-acupuncture may improve motor behavior, EMG, hematological, histological and immunological findings in Spinal Cord Injury(SCI)-induced rats. Especially, effects will be somewhat better in combination of these two treatments.

• PNF and Movement
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• 제12권2호
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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.

• 생명과학회지
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• 제19권10호
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• pp.1489-1494
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• 2009

본 연구는 척수 앞뿔의 세포손상을 준 흰쥐를 대상으로 수영운동과 미노싸이클린의 치료적 중재를 통해 운동기능과 신경계의 회복을 알아보고 운동에 의한 척수손상의 신경학적 회복기전을 밝히는 것의 목적이 있다. 본 연구의 진행은 Sprague-Dawley계 흰쥐 28마리의 허리뼈 1-2번 사이에 6-OHDA로 척수손상을 일으킨 다음 3일 후에 치료를 시작하였다. 수영은 주 5회 15분간 운동을 실시하고 미노싸이클린은 척수손상을 유발한 후 12시간마다 복강내 주입하였다. 척수손상을 유발한 후 치료를 시작하기 전에 운동기능의 평가를 시행하며 2주 동안 4번의 검사가 이루어졌으며, Bcl-2 발현에 관한 측정은 2주간 치료 후 검사하였다. BBB 척도에서 대조군에 비해 실험군에서 7일에 차이가 있었으며, 14일에는 II, III군에 비해 실험군 Ⅳ군에서 증가하였다. Bcl-2의 면역학적 소견에서 실험군 모두 대조군에 비해 척수 앞뿔에서 Bcl-2의 발현이 증가되었으며, 실험군 Ⅳ에서 가장 많은 Bcl-2의 발현이 관찰되었다. 척수손상 후 미노싸이클린과 수영은 행동학적, 면역학적 소견을 긍정적으로 개선시키는 것으로 나타났으며, 수영과 미노싸이클린을 함께 실시한 경우 세포사멸의 감소와 운동기능의 회복에 효과가 있음을 알 수 있었다.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.777-787
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• 2018

Objective To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with task-specific training on paretic hand function following subacute stroke. Methods Sixteen participants were randomly selected and grouped into two: the experimental group (real LF-rTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour task-specific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training. Results Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks. Conclusion The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.

• 한국전문물리치료학회지
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• 제18권2호
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• pp.27-34
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• 2011

The aim of this study was to determine the effect of action-observation training on arm function in people with stroke. Fourteen chronic stroke patients participated in action-observation training. Initially, they were asked to watch video that illustrated arm actions used in daily activities; this was followed by repetitive practice of the observed actions for 3 times a week for 3 weeks. Each training session lasted 30 min. All subject participated 12 training session on 9 consecutive training days. For the evaluation of the clinical status of standard functional scales, Wolf motor function test was carried out at before and after the training and at 2 weeks after the training. Friedman test and Wilcoxon signed rank test was used to analyze the results of the clinical test. There was a significant improvement in the upper arm functions after the 3-week action-observation training, as compared to that before training. The improvement was sustained even at two weeks after the training. This result suggest that action observation training has a positive additional impact on recovery of stroke-induced motor dysfunctions through the action observation-action execution matching system, which includes in the mirror neuron system.

• 대한치료과학회지
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• 제10권2호
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• pp.21-30
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• 2018

Objective: The purpose of this study was to investigate questions and instructions for internal feedback effects on functional recovery and task performance while chronic stroke patients practised task-specific training. Method: Twenty-four chronic stroke patients were randomly divided into two groups; when patients performed same tasks, one was treated using questions and the other using instructions for internal feedback Both lasted 30 minutes, 5 times a week for 8 weeks. Outcome measures included Erasmus MC Modifications to the Nottingham Sensory Assessment (EmNSA), Measurement Properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), Chedoke Arm and Hand Activity Inventory (CAHAI), Korean version of Modified Barthel Index (K-MBI). Results: There were no significant differences between the two groups in EmNSA and K-MBI(p>.05). But, in MESUPES and CAHAI, there was significant difference between the two groups(p<.05). Conclusion: In this study, questions for internal feedback during task-specific training are more effective in improving upper extremity motor function and task performance than instructions for internal feedback.