• 제목/요약/키워드: Motor Rehabilitation

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요추부 최소침습적 시술 후 길랑-바레 증후군: 증례보고 (Guillain-Barre Syndrome after Minimally Invasive Lumbar Procedure: A Case Report)

  • 이봉연;윤서라;류수라;최유리
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.159-163
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    • 2018
  • Guillain-Barre syndrome (GBS) after trauma and general orthopedic surgery is rare. A 74-year-old woman showed ascending paralysis symmetrically, dysarthria, dysphagia and areflexia on 14 days after minimally invasive endoscopic thermoannuloplasty on L4-5 level. Brain and lumbar magnetic resonance imaging demonstrate no abnormal findings. The electrodiagnostic study showed prolonged distal motor, sensory latencies and F-wave latencies and reduced amplitude of compound muscle action potential in nerves of upper and lower extremities. In the cerebrospinal fluid (CSF) examination, total protein and IgG were increased. We diagnosed Guillain-Barre Syndrome based on clinical features, electrodiagnostic study and CSF examination and the patient improved symptoms after immunoglobulin injection and rehabilitation. Because the occurrence of GBS after minimally invasive procedure has not been reported, we report a case of GBS after minimally invasive procedure with literature review.

Pediatric tetrasomy 18p presenting as a spastic cerebral palsy: A case report

  • Lim, Ikhyun;Park, Sang Hee;Suh, Mi Ri;Kwak, Hyunseok;Park, Wookyung;Shim, Sung Han;Kim, MinYoung
    • Journal of Genetic Medicine
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    • 제18권2호
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    • pp.105-109
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    • 2021
  • Tetrasomy 18p is a genetic syndrome caused by an isochromosome consisting of two copies of the short arm of chromosome 18. Clinically, pediatric cases of tetrasomy 18p manifest with global developmental delay, similar to most cases of chromosomal abnormality. In addition, it causes various symptoms including abnormal muscle tone. We report a case of an infant with global developmental delay and remarkable spasticity, the typical phenotype of bilateral spastic cerebral palsy. However, she had a subtle anomaly in her face, and brain magnetic resonance imaging (MRI) findings were inconsistent with her strong upper motor neuron signs. Upon genetic testing, she was determined to have an 18p isochromosome, confirming de novo non-mosaic tetrasomy 18p. Cerebral palsy is a neurological disorder that includes developmental delay caused by a non-progressive lesion in the developing brain. During diagnostic workup in patients with cerebral palsy, genetic testing should be considered when there are minor physical anomalies or equivocal MRI findings.

감각통합치료가 뇌성마비 아동의 대근육 운동발달 및 호흡기능에 미치는 영향 (Effect of Sensory Integration Therapy on Gross Motor Development and respiratory Function of Cerebral Palsy Children)

  • 권혜정
    • 대한물리치료과학회지
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    • 제8권1호
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    • pp.799-811
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    • 2001
  • The purpose of this study was to examine the effects of sensory integration therapy (SIT) on gross motor development and respiratory function of cerebral palsy children. The design of this study was one-group pre-and post-test design. Subjects of the study were arbitrarily chosen based on predetermined selection criteria among the cerebral palsy children who were treated as out-patients at one rehabilitation hospital in Kyunggi-do. The study was conducted between early April and late July in 2000. Twelve children were in the experimental group. A five-step SIT program was devised from a combination of SIT programs suggested by Ayres(1985) and Fink(1989), and an author-designed SIT program for cerebral palsy children. The experimental group was subjected to 20 to 30 minutes of SIT per session, two sessions a week for ten-week period. Collected data were statistically analyzed by SPSS PC for Wilcoxon signed rank test, and paired t-test. The results were as follows: 1. In gross motor development, post-experimental gross motor scores were higher compared to pre-experimental scores with statistical significance. 2. In respiratory function, post-experimental forced capacity vital scores were higher compared to pre-experimental scores with statistical significance. In conclusion, SIT was found to be effective in gross motor development and respiratory function. But, for the more effectiveness of SIT on gross motor development and respiratory function, further studies employing longer-time experiments are recommended.

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이중운동과제 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 효과 (The Effects of Two Motor Dual Task Training on Balance and Gait in Patients with Chronic Stroke)

  • 조기훈;이완희
    • The Journal of Korean Physical Therapy
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    • 제22권4호
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    • pp.7-14
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    • 2010
  • Purpose: The goal of this study was to investigate the effect of balance and gait ability through two motor dual task training in chronic stroke subjects. Methods: A group of twenty-five subjects who were six months post stroke participated in this study, where they were designated into pretest-posttest control The subjects were randomly allocated into two groups: experimental (n=13) and control (n=12). Both groups received physical therapy for 5 session 30 minutes per week during 6 weeks. Experimental group practiced additional two motor dual task training programs for thirty minutes a day, three days a week during six weeks. Evaluation of results was obtained through analyzing static balance, dynamic balance and gait function. Results: There was significant improvement among the group that practiced the additional two motor dual task training in that the postural sway area with open eye and close eye on the foam surface, the dynamic balance (p<0.05), and the gait function (p<0.05). Conclusion: Two motor dual task training improved static balance on the foam, dynamic balance, gait function. These results suggest that two motor dual task training is a feasible and suitable treatment for individuals with chronic stroke.

뇌성마비의 기능성평가도구에 대한 고찰 - GMFCS, GMFM 과 PEDI 중심으로 - (A Study of Functional Assesment in Children With Cerebral Palsy)

  • 유선애;김보경
    • 동의신경정신과학회지
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    • 제21권1호
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    • pp.13-42
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    • 2010
  • Objectives: This study is to investigate the method for assesment of cerebral palsy(CP), especislly focusing on function assesment Methods: We searched the recent date of the publication and paper in Cerebral Palsy Results: Measuring the function of children with cerebral palsy is mobility, self-care and social ability. Early adequate evaluation of motor development and prognosis of degree of long-term motor disability is very important not only for parents, but also for correct management of goal oriented rehabilitation treatment and for planning of preventive measures. 1. Gross Motor Function Classification System(GMFCS) is valuable to prognostication about gross motor progress in children with CP, using longitudinal observation. 2. Gross Motor Function Measure(GMFM) is the instrument most commonly used to measure gross motor function in children with cerebral palsy(CP). 3. Pediatric Evaluation of Disability Inventory(PEDI) is one of the most commonly used assessments for children with a disability. Conclusions: The functional Assesment of children with CP are used GMFCS, GMFM and PEDI.

Effects of Goal-Oriented Functional Tasks on Gross Motor Function and Activities of Daily Living in Children with Cerebral Palsy -A Single Case Study-

  • Lee, Eun-Jung;Kwon, Hae-Yeon
    • PNF and Movement
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    • 제18권2호
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    • pp.159-172
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    • 2020
  • Purpose: The study sought to determine whether goal achievement, performance, satisfaction, activities of daily living, and gross motor function in children with spastic cerebral palsy are positive affected by goal-oriented functional task training. Methods: In a single case study, two 7-year-old girls diagnosed with spastic cerebral palsy were given functional task training based on individualized goals for 24 60-minute sessions over a period of 6 months. The individualized goals reflected the needs of both children and parents. The Canadian occupational performance measure (COPM) and the goal attainment scale (GAS) were used to measure goal performance and satisfaction before and after intervention. Independence of activities of daily living before and after intervention were assessed using the functional independence measure for children (Wee-FIM). And change of gross motor function were assessed using gross motor function measure (GMFM). Results: Clinically significant changes were observed in COPM and GAS, as well as positive changes in independence of gross motor function and activities of daily living. Conclusion: The findings indicate that goal-oriented functional task training addresses the needs of children with spastic cerebral palsy, which increases treatment satisfaction and has a positive effect on independent activities and participation in daily life.

Effect of Motor Imagery Training on Somatosensory Evoked Potentials and Upper Limb Function in Stroke Patients

  • Choi, Jongbae;Yang, Jongeun
    • 국제물리치료학회지
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    • 제11권1호
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    • pp.2005-2011
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    • 2020
  • Background: Motor imagery is the mental representation of an action without overt movement or muscle activation. However, few previous studies have demonstrated motor imagery training effects as an objective assessment tool in patients with early stroke. Objective: To investigate the effect of motor imagery training on Somatosensory Evoked Potentials (SSEP) and upper limb function of stroke patients. Design: A quasi-experimental study. Methods: Twenty-four patients with stroke were enrolled in this study. All subjects were assigned to the experimental or control group. All participants received traditional occupational therapy for 30 minutes, 5 times a week. The experimental group performed an additional task of motor imagery training (MIT) 20 minutes per day, 5 days a week, for 4 weeks. Both groups were assessed using the SSEP amplitude, Fugl-Meyer assessment of upper extremity (FMA UE) and Wolf motor function test. Results: After the intervention, the experimental group showed significant improvement in SSEP amplitude and FMA UE than did the control group. Conclusion: These findings suggest that the MIT effectively improve the SSEP and upper limb function of stroke patients.

신장 자극이 근 수축 촉진에 미치는 영향에 관한 고찰 (Review of Effect of the Stretch Stimulus on Muscle Contraction Facilitation)

  • 김미현;배성수;최재원
    • PNF and Movement
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    • 제1권1호
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    • pp.19-25
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    • 2003
  • Objectives: The purpose of this article is to summarize the effect of stretch stimulus on muscle contraction facilitation. Methods : Some studies of the stretch reflex. ${\gamma}-motor$ system, and the effect of stretch stimulus on muscle activation were reviewed. Results : To facilitate muscle contraction, before the movement is started, the prime mover is in stretched position. The patient must be instructed to occur voluntary muscle contraction after quick stretching. It elicits the functional stretch reflex to produce a more powerful and functional contraction. The intensity of muscle contraction depends on two ways. One is firing rate of ${\alpha}-motor$ neuron by sensory information from the periphery induced in stretched position and stretch reflex. The other is excitation level of the cortical motor area and the corresponding motor neurons. Conclusions: To activate central nervous system and to increase firing rate of ${\alpha}-motor$ neuron. the therapist should apply quick stretch for the patient with stretched position and the patient should make voluntary muscle contraction.

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Relationship between Ipsilateral Motor Deficits on the Less-Affected Side and Motor Function Stage on the Affected Side

  • Son, Sung Min;Nam, Seok Hyun;Kang, Kyung Woo;Kim, Dae Hyun
    • The Journal of Korean Physical Therapy
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    • 제30권6호
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    • pp.234-238
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    • 2018
  • Purpose: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. Methods: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. Results: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. Conclusion: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

경두개 자기자극과 확산텐서 신경섬유로 검사를 통한 대뇌 병변의 국소화: 증례보고 (Localization of Bilateral Hemisphere Lesion Using Combined Transcranial Magnetic Stimulation and Diffusion Tensor Imaging: Report of Two Cases)

  • 이형남;오영빈;김기욱;원유희;고명환;서정환;박성희
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.106-111
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    • 2018
  • Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.