Kim, G.H.;Ryu, M.H.;Shin, Y.I.;Kim, H.I.;Kim, N.G.;Yang, Y.S.
Journal of Biomedical Engineering Research
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v.28
no.1
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pp.153-161
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2007
Stroke is the second most significant disease leading to death in Korea. The conventional therapeutic approach is mainly based on physical training, however, it usually provides the limited degree of recovery of the normal brain function. The electric stimulation therapy is a novel and candidate approach with high potential for stroke recovery. The feasibility was validated by preliminary rat experiments in which the motor function was recovered up to 80% of the normal performance level. It is thought to improve the neural plasticity of the nerve tissues around the diseased area in the stroked brain. However, there are not so much research achievements in the electric stimulation for stroke recovery as for the Parkinson's disease or Epilepsy. This study aims at the developments of a wireless variable pulse generator using ZigBee communication for future implantation into human brain. ZigBee is widely used in wireless personal area network (WPAN) and home network applications due to its low power consumption and simplicity. The developed wireless pulse generator controlled by ZigBee can generate various electric stimulations without any distortion. The electric stimulation includes monophasic and biphasic pulse with the variation of shape parameters, which can affect the level of recovery. The developed system can be used for the telerehabilitation of stroke patient by remote control of brain stimulation via ZigBee and internet. Furthermore, the ZigBee connection used in this study provides the potential neural signal transmission method for the Brain-Machine Interface (BMI).
Objective: The purpose of this study was to develop and evaluate smart secondary controls using iPad for the drivers with physical disabilities in the driving simulator. Background: The physically disabled drivers face problems in the operation of secondary control devices that accept a control input from a driver for the purpose of operating the subsystems of a motor vehicle. Many of conventional secondary controls consist of small knobs or switches that physically disabled drivers have difficulties in grasping, pulling or twisting. Therefore, their use while driving might increase distraction and workload because of longer operation time. Method: We examined the operation time of conventional and smart secondary controls, such as hazard warning, turn signal, window, windshield wiper, headlights, automatic transmission and horn. The hardware of smart secondary control system was composed of iPad, wireless router, digital input/output module and relay switch. We used the STISim Drive3 software for driving test, customized Labview and Xcode programs for interface control of smart secondary system. Nine subjects were involved in the study for measuring operation time of secondary controls. Results: When the driver was in the stationary condition, the average operation time of smart secondary devices decreased 32.5% in the normal subjects (p <0.01), 47.4% in the subjects with left hemiplegic disabilities (p <0.01) and 38.8% in the subjects with right hemiplegic disabilities (p <0.01) compared with conventional secondary devices. When the driver was driving for the test in the simulator, the average operation time of smart secondary devices decreased 36.1% in the normal subjects (p <0.01), 41.7% in the subjects with left hemiplegic disabilities (p <0.01) and 34.1% in the subjects with right hemiplegic disabilities (p <0.01) compared with conventional secondary devices. Conclusion: The smart secondary devices using iPad for people with hemiplegic disabilities showed significant reduction of operation time compared with conventional secondary controls. Application: This study can be used to design secondary controls for adaptive vehicles and to improve the quality of life of the people with disabilities.
Kim, Keum-Soon;Choe, Myung-Ae;Hah, Yang-Sook;Yi, Myung-Sun;Kim, Bog-Ja;Kim, Sung-Reul;Kim, Kyung-Hee;Kwon, So-Hi;Hwang, Young-Ran
The Korean Journal of Rehabilitation Nursing
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v.10
no.2
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pp.90-98
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2007
ression and quality of life of family caregivers of patients with Parkinson's disease(PD). Methods: A cross-sectional descriptive study was conducted in one neurology outpatient clinic in Seoul, Korea from March to June, 2006. Sixty eight family caregivers of PD patients were participated to the study, using CES-D and SF-36. Results: Mean scores of depression were $16.18{\pm}8.39$ (range: 0-48) and it was a little lower than caregiver's who took care of Dementia patients and were higher than primary caregivers of the patients with Stroke. Time for caregiving, perceived severity, duration of PD were significantly related with depression respectively. Higher ADL scores which mean greater motor disabilities were related to higher caregiver depression. Lower income and greater medical expenditure were closely related with the depression of family caregivers respectively. The mean scores of total QOL were $435.5{\pm}96.5$ and the mean scores of PF, SF, RE and MH were lower than general population. Time for caregiving, depression, patients' ADL scores were significantly associated with QOL respectively. People who were older and had lower educational background showed lower QOL scores respectively. Conclusion: Healthcare professionals should pay more attention to emotional aspects of caregivers who take care of PD patients, and develop comprehensive management strategies both for patients and their caregivers.
Purpose: This study examined the effects of action observational training to improve the gait function for patients with stroke. Methods: The participants were divided into two groups: right hemiplegia group (n=12) and left hemiplegia group (n=12). All groups received conventional therapy for five sessions for 30 minutes, each for three weeks. Left and right hemiplegia group practiced additional action observational training for five sessions for 20 minutes each for three weeks. They participated in three weeks of action observational training coupled with immediate physical practice (intervention), followed by a final assessment. The duration of each action observation video sequence was 10 minutes, followed immediately by practice of the observed motor skill (10 minutes). The gait velocity, cadence, swing time, step length, and BOS (base of support) were examined using the GAITRite system. Results: The results of this study showed significant improvement in the gait function. The outcomes of the gait abilities from gait velocity, cadence, swing time, step length of the affected side, and BOS (base of support) were improved significantly in the right hemiplegia group (p<0.05). In the left hemiplegia group, there was no significant improvement in the gait velocity, cadence, and BOS except for the swing time and step length of the affected side. The left and right group comparisons between the groups were not significant (p<0.05). Conclusion: Action observation training improves the gait function. These results suggest that action observational training is feasible and suitable for stroke patients.
Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.
Purpose: This study was to explore the effects of trunk exercise using PNF combined with treadmill training on balance and walking ability in patients with Parkinson's disease. Methods: This study included 16 patients with Parkinson's disease. Participants were randomly assigned to 2 groups: an experimental group (n=8) and a control group (n=8). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (trunk exercise using PNF) and control group (conventional training) participated in a 30-minute exercise program. Both groups performed the training 5 times per week for 4 weeks. Disease severity (determined using the unified Parkinson's disease rating scale motor subscale, UPDRS-3), balance (determined using the Berg balance scale, BBS), walking speed (determined using the 10-meter walking test, 10MWT), and walking endurance (determined using the 6-minute walking test, 6MWT) were measured at baseline and after 4 weeks. Results: Pre- to post-intervention improvement was noted on all outcome measures for both groups (p<0.05). Post-intervention, there was a significant improvement in the experimental group as compared to the control group for the following measured outcomes (p<0.05): UPDRS-3 (p=0.03; 95% CI, -5.52 to -0.24), BBS (p=0.04; 95% CI, 0.59 to 6.45), 10MWT (p=0.01; 95% CI, -2.19 to -0.42), and 6MWT (p=0.04; 95% CI, 1.81 to 96.72) Conclusion: The results of this study revealed that trunk exercise using PNF plus treadmill training improves balance and walking ability as compared to conventional training plus treadmill training in patients with Parkinson's disease.
Journal of the Korean Society of Physical Medicine
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v.6
no.1
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pp.1-8
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2011
Purpose : The purpose of this study was to find out the effect of closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius on gait in stroke. Methods : 30 hemiplegic patients voluntarily participated in this study. Subjects were divided into experimental group(n=15) and control group(n=15). Experimental group was given closed kinetic chain exercise with FES of the gluteus medius and control group was given only closed kinetic chain exercise for 4 weeks. All subjects were measured 10m-walking speed, cadence, functional walking category(FAC) and modified motor assessment scale(MMAS) before and after intervention. Results : In experimental group, gait velocity, cadence, FAC and MMAS showed significant difference between pre and post test(p<.05). In control group, gait velocity, cadence and FAC showed significant difference between pre and post test(p<.05). Before intervention, gait velocity, cadence, FAC and MMAS were not significant difference between experimental group and control group(p>.05), but after intervention, gait velocity, FAC and MMAS were significant difference(p<.05). Conclusion : This study show that closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius is beneficial intervention for increase the wlking ability in stroke.
Acute ischemic stroke results from sudden decrease or loss of blood supply to an area of the brain, resulting in a coinciding loss of neurological function. The antioxidant action of melatonin is an important mechanism among its known effects to protective activity during ischemic/reperfusion injury. The focus of this research, therapeutic efficacy of melatonin on recovery of neurological function following long term treatment in ischemic brain injured rats. Male Sprague-Dawley rats (n=40; 8 weeks old) were divided into the control group, and MCAo groups (Vehicle, MT7 : MCAo+ melatonin injection at 7:00, MT19 : MCAo+melatonin injection at 19:00, and MT7,19 : MCAo+melatonin injection at 7:00 and 19:00). Rat body weight and neurological function were measured every week for 8 weeks. After 8 weeks, the rats were anesthetized with a mixture of zoletil (40 mg/kg) and xylazine (10 mg/kg) and sacrificed for further analysis. Tissues were then collected for RNA isolation from brain tissue. Also, brain tissues were analyzed by histological procedures. We elucidated that melatonin was not toxic in vital organs. MT7,19 was the most rapidly got back to mild symptom on test of neurological parameter. Also, exogenous melatonin induces both the down-regulation of detrimental genes, such as NOSs and the up-regulation of beneficial gene, including BDNF during long term administration after focal cerebral ischemia. Melatonin treatment reduced the loss of primary motor cortex. Therefore, we suggest that melatonin could be act as prophylactic as well as therapeutic agent for neurorehabilitative intervention.
Journal of the Korean Society of Physical Medicine
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v.8
no.2
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pp.271-280
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2013
PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.
Objective: To investigate the association between one-leg standing ability and postural control for chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Forty individuals who had a first diagnosis of stroke with hemiparesis before six months and over had participated in this study. To analyze the relationship between one-leg standing ability and postural control in the participants, six clinical measurement tools were used for assessment, including the Timed-Up-and-Go (TUG) test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Fugl-Meyer Assessment (FMA), 5 times sit-to-stand (5TSTS) and one-leg standing (OLS). Results: After analyzation, the OLS scores in the more-affected side showed significant positive correlations with BBS scores (r=0.469, p<0.01), DGI scores (r=0.459, p<0.01).and FMA scores (r=0.425, p<0.01). The OLS scores in the more-affected side showed significant negative correlations with TUG score (r=-0.351, p<0.05). The OLS score in the less-affected side showed significant positive correlations with BBS scores (r=0.485, p<0.01), DGI scores (r=0.488, p<0.01) and FMA score (r=0.352, p<0.05). The OLS scores in the less-affected side showed significant negative correlation with TUG scores (r=-0.392, p<0.05) and 5TSTS (r= -0.430, p<0.01). The OLS scores in the more-affected side showed significant positive correlations with the OLS scores in less-affected side (r=0.712, p<0.01). Conclusions: The results of the study suggest that the OLS time may be moderately correlated with static and dynamic postural stabilities and motor recovery following stroke. This study also suggests that the OLS test is as a simple clinical tool for predicting postural control performance for individuals with chronic hemiparetic stroke.
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