• 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.

• Journal of Biomedical Engineering Research
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• v.31 no.5
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• pp.359-364
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• 2010

The purpose of the brain-computer (machine) interface (BCI or BMI) is to provide a method for people with damaged sensory and motor functions to use their brain to control artificial devices and restore lost ability via the devices. Functional electrical stimulation (FES) is a method of applying low level electrical currents to the body to restore or to improve motor function. The purpose of this study was to develop a SSVEP-based BCI rehabilitation training system with FES for spinal cord injured individuals. Six electrodes were attached on the subjects' scalp ($PO_Z$, $PO_3$, $PO_4$, $O_z$, $O_1$ and $O_2$) according to the extended international 10-20 system, and reference electrodes placed at A1 and A2. EEG signals were recorded at the sampling rate of 256Hz with 10-bit resolution using a BIOPAC system. Fast Fourier transform(FFT) based spectrum estimation method was applied to control the rehabilitation system. FES control signals were digitized and transferred from PC to the microcontroller using Bluetooth communication. This study showed that a rehabilitation training system based on BCI technique could make successfully muscle movements, inducing electrical stimulation of forearm muscles in healthy volunteers.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.45-55
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• 2020

Objective : The purpose of this study was to investigate the effects of visual perception on driving performance and the importance of visual training for improving driving performance in patients with stroke. Methods : The evaluations, using MVPT(Motor-free Visual Perception Test), TMT A&B(Trail Making Test A & B), UFOV(Useful Field Of View test), and a driving simulator, were carried out with patients in department of physical medicine and rehabilitation in a rehabilitation hospital from October 2014 to November 2014. Results : Driving performance was related to the ability of various visual perceptions of patients with stroke, and the highest correlation was found in the UFOV subtest 2, TMT B, and MVPT. The results of discriminant analysis indicated a sensitivity of 100.0%, specificity of 80.0%, and predicted the results of the driving simulator with 89.5% accuracy. Conclusion : This study found that visual-perception skills influence driving performance and suggested the importance of visual-perception skill training for driving.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.1-15
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• 2013

Objectives : In present study, we investigated the effects of ginsenoside Rg3 on early-stage inflammatory response in spinal cord compression of rodents. Methods : Spinal cord injury(SCI) was induced by a vascular clip method(30 g, 5 min) on the spinal cord of mice. Rg3 was treated orally at 1 hour prior to the SCI induction. Messenger ribonucleic acid(mRNA) expression of tumor necrosis factor-${\alpha}$(TNF-${\alpha}$), interleukin-1${\beta}$(IL-1${\beta}$), interleukin-6(IL-6) and cyclooxygenase-2(COX-2) was measured by the real-time polymerase chain reaction(RT-PCR). Microglia in the spinal cord tissue, neurophils and COX-2 in the peri-lesion and inducible nitric oxide synthase(iNOS) expression in the ventral horn of SCI induced rats were measured by immunohistochemical stain. Results : 1. Rg3 significantly reduced the mRNA expression of TNF-${\alpha}$, IL-1${\beta}$, and COX-2 in the spinal cord tissue compared with SCI group(p<0.05, p<0.01). 2. Rg3 significantly reduced the total number of activated microglia and proportion of phagocytic form in the total activated microglia compared with SCI group(p<0.05, p<0.01). 3. Rg3 significantly reduced myeloperoxidase(MPO) positive neurophil in the peri-lesion compared with SCI group(p<0.05). 4. Rg3 reduced the COX-2 expression in the tissue and motor neurons compared with SCI group. 5. Rg3 significantly reduced iNOS positive motor neurons in the ventral horn compared with SCI group(p<0.01). Conclusions : In conclusion, we demonstrated at first that treatment of ginsenoside Rg3 could reduce significantly the levels of inflammatory mediators in a spinal cord compression model of rodents. Therefore, these results suggested that ginsenoside Rg3 may be a useful antimiflamatory therapeutic candidate for SCI.

• 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.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.24-31
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• 2022

Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.788-797
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• 2018

Objective To investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Patients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment. Results For each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups. Conclusion Treatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Results of this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• The Journal of Korean Physical Therapy
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• v.25 no.3
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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.

• Physical Therapy Korea
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• v.21 no.4
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.