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Predictive Analyses for Activities of the Upper Extremity and Daily Living based on Impairment of the Upper Extremity in People with Stroke - Preliminary Study using Clinical Scales - (뇌졸중 환자의 위팔 손상 수준에 따른 위팔 활동과 일상생활 활동의 예측도 분석 - 임상적 평가를 이용한 예비 연구 -)

  • Jung, Young-Il;Woo, Young-Keun
    • PNF and Movement
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    • v.16 no.3
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    • pp.495-503
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    • 2018
  • Purpose: This study analyzes the predictive power of upper extremity activity and the activities of daily living in patients with stroke using an easy-to-use evaluation tool. Methods: The Fugl-Meyer assessment (FMA) of the upper extremity and action research arm test (ARAT) are performed, and the Korean modified Barthel index (K-MBI) is measured. The predictive power of the upper extremity activity level and the daily activity level are analyzed using regression analysis. The statistical significance level is 0.05. Results: The coefficient of determination, R2, for predicting the ARAT using FMA was high at 0.88, but the regression equation for predicting the K-MBI using the FMA and ARAT did not show a statistically significant difference. Conclusion: The assessment of the upper extremity should be performed at the activity level, as well as the impairment level. The assessment for predicting the activities of daily living should be carried out for each level of the international classification of functioning (ICF), disability, and health, which can be linked to daily life, in addition to the assessment of the upper arm. Future research should conduct more diverse analyses using the ICF assessment tools at various levels.

The Coordination and Contribution of Body Segments during Functioning (기능에서 신체분절의 협응과 기여)

  • Chae, Jung-Byung
    • PNF and Movement
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    • v.15 no.1
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    • pp.13-25
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    • 2017
  • Purpose: This study investigated the coordination and contribution of body segments during functioning. Methods: The relevant literature related to body segments and function were reviewed. Results: Efficient control of function is considered with regard to a participant's ability to perform a sequence of movements in body segments, which progresses from the head to the arm, trunk, pelvis, and leg segments. Each segment performs a specific role, which environment explorer using visual information for the head, reaching and grasping for the arms, a stabilizer for the trunk, and the distribution of COM in the pelvis and leg. Conclusion: During any of the movements, the momentum generated by the proximal segments is transferred to the adjacent distal segments in an appropriate sequence. In assessing function for clinical intervention strategies, the segment coordination, segment sequence, transfer of the center of body mass, asymmetrical ratio, muscle activity, and compensatory strategies should be considered.

The Effect of Upper and Lower Extremity Coordination Training with Elastic Band on Balance and Functional Ability for Chronic Stroke Patients (탄력밴드를 이용한 팔과 다리 협응 훈련이 만성 뇌졸중 환자의 균형 및 기능에 미치는 영향)

  • Kim, Hee-Dong;Choi, Jae-Won;Cho, Yong-Ho
    • PNF and Movement
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    • v.17 no.1
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    • pp.119-127
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    • 2019
  • Purpose: The purpose of this study is to show the effect of elastic band on balance and functional ability in chronic stroke patients living in community. Methods: The subjects who participated in the study were 9 patients with chronic stroke. One of them gave up during the study, finally 8 patients performed. The intervention was conducted once a week for 10 weeks. In this study functional reach test (FRT), timed up and go test (TUG), Tinetti performance oriented mobility assessment (Tinetti-POMA) were measured for balance. The coordination training of arms and legs using the elastic band was performed in three positions as supine, side lying, sitting. One arm performed flexion-adduction- external rotation with elbow flexion pattern and the opposite side(diagonal) leg was performed flexion-adduction-external rotation with knee flexion pattern, the other arm's pattern was extension-abduction-internal rotation with elbow extension and the opposite side (diagonal) leg was in extension-abduction-internal rotation with knee extension pattern. The training was performed in each position for 15 minutes in per position. The participants had a five minute break after each training. Results: The results are as follows. FRT and Tinetti-POMA showed significant increase statistically in each position. The TUG showed significant decrease statistically in each position. Conclusion: Even though the coordination training with elastic band had performed once a week, it showed positive effects on balance in chronic stroke patients. Therefore, if we can suggest the appropriate frequencies of coordination training of arms and legs using the elastic band, it can be a method to improve daily life and life quality to patients with chronic stroke.

The Effect of Exercising on a Stable and Unstable Surface on Young Female University Students' Arms (안정된 지지면과 불안정한 지지면에서의 운동이 20대 여대생의 팔에 미치는 영향)

  • Kim, Jwa-Jun;Park, Mi-Yeon;Shin, Ha-Lim;Lee, Eun-Kyung;Lee, Hyun-Joo;Hwang, Ryu-Kyung
    • PNF and Movement
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    • v.12 no.4
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    • pp.233-241
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    • 2014
  • Purpose: The purpose of this study is to investigate the effects of exercising on a stable and unstable surface for a period of six weeks on the arms of female university students in their twenties. Methods: The subjects consisted of 20 female university students. The experimental group consisted of ten individuals who exercised on an unstable surface, and the control group consisted of ten individuals who exercised on a stable surface. The exercise program was composed of aerobic exercises (i.e. Back and forth movements for clapping and raising cross with both arms) and muscle-strengthening exercises (i.e. Push-ups and raising arms). We measured the subjects before the experiment and after the exercise program using the following measurements tool: a ruler and T-scan plus. The same person measured changes in arm size with a ruler three times and calculated the average to minimize any errors in measurement. We controlled the subjects to measure the amount of arm muscle with a T-scan plus. Twelve hours before the measurements were taken subjects were not permitted to exercise, and four hours before the measurements were taken subjects were not permitted to eat anything. Results: The two groups had no significant difference, but each group felt the effect of the exercise program. Conclusion: There was no difference between the experimental group and the control group. However, it was determined that the exercise had a greater effect on an unstable surface than a stable surface.

Understanding the constraint induced movement and Self-efficacy in Stroke Patients (뇌졸중 환자의 건측억제유도와 자기효능에 대한 이해)

  • Shin, Hyung-Soo;Kim, Chung-Sun
    • PNF and Movement
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    • v.3 no.1
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    • pp.35-45
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    • 2005
  • Objectives : The purpose of this study was to understanding the constraint induced movement and Self-efficacy with arm training on upper motor function in Stroke Patients. Methods : Stroke, the leading cause of functional disability, causes a variety of impairments that compromise quality of life. Upper limb hemiparesis, a commonly seen impairment, is particularly problematic given its impact on activities of daily living. Because stroke was a disease to correspond to the first during domestic cause of death, and was accompanied by a lot of side aftereffects after a survival, stroke rehabilitation bought a patient and a family and a physical therapist, and it was main concern of. Results : Looks into upper extremity excrise of a subacute stroke patient estranged a acute convalescence later by a rehabilitation treatment in this consideration, and evaluates an effect to wind up constraint induced movement for an early treatment of stroke and Self efficacy, and help is one to an early rehabilitation of an stroke patient. Conclusions : Overuse sound tends after the stroke occurrence in the early stage in order to recompense for stroke, and at the time of a new aspect called learned nonuse syndrome by a movement of a paralysis part dusting off wealth with this step thing later. Constraint induced movement using self efficacy could be an effective for improving function of stroke.

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The Effect of Trunk Stability Exercises on Trunk Control Ability and Daily Living Activities on the Osmotic Demyelination Syndrome of a Patient with Hyponatremia -A Case Study- (체간안정화운동이 저나트륨혈증 환자에게 발생한 삼투성 탈수초 증후군에서 체간조절능력과 일상생활동작에 미치는 영향(단일사례연구))

  • Jung, Du-Kyo
    • PNF and Movement
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    • v.12 no.4
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    • pp.249-258
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    • 2014
  • Purpose: This study examines deficits in upper-extremity function and trunk control ability on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Using a proprioceptive neuromuscular facilitation program, this case report aims to describe the effects of trunk stability exercises on trunk control ability, hand function, and daily living activities as well as its effects on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Methods: The patient is a 47-year-old woman with osmotic demyelination syndrome as well as trunk and upper extremity impairment. She participated in this training intervention for four weeks. Results: The patient demonstrated improvements in trunk control ability, hand function, and performance of ADL. The following outcomes were measured before and after the training program: trunk impairment scale, hand power, Jebsen-Taylor hand function test, the Chedoke arm and hand inventory, and the modified Barthel index. Conclusion: The results suggest that trunk stability exercises in the form of a proprioceptive neuromuscular facilitation program in Hyponatremia and Hypokalemia patients may increase trunk control ability, increase hand function, and improve ADL.

The Effect of an 8-week Shoulder Strengthening Exercise on Shoulder Muscle Strength of Caregivers (8주간의 어깨 강화 운동이 요양보호사들의 어깨 근력에 미치는 영향)

  • Shin, Jae-Wook;Lee, Seung-Min;Jung, Dae-Youn;Kim, Dong-In;Park, Jae-Sung;Lee, Byeong-Soo;Song, Se-Hee;Park, Lee-Dae;Kim, Moon-Jeong;Kim, No-Yong;Lee, Kwang-Hoon;Kim, Jae-Yong
    • PNF and Movement
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    • v.16 no.1
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    • pp.43-50
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    • 2018
  • Purpose: This study examined the effects of a shoulder-strengthening exercise on muscle strength of shoulder flexors and extensors of caregivers. Methods: The study consisted of 19 caregivers (2 males and 17 females) employed by Medical Center B. All the participants took part in an 8-week shoulder muscle strengthening exercise, based on previous studies. In the first week, the subjects took part in a stretching exercise enhance the range of motion. In the second week, they participated in an exercise aimed at improving shoulder blade stability. From the third to seventh weeks, a resistance exercise of different intensities was applied in a phased manner. Finally, in the eight week, the subjects took part in plyometric exercise. Peak torque, average power, and total work of shoulder flexors and extensors in both sides were measured before and after the exercise at an angular speed of 120deg/sec using an isokinetic device. Wilcoxon's singed-ranks test was conducted to analyze differences in muscle strength before and after the intervention. Results: After the exercise, there was a significant improvement in peak torque and average power of flexors of the right arm. After the exercise, peak torque, total work, and average power showed a significant improvement in the flexors of the left arm (p<0.05). However, there was no statistically significant difference in extensor muscle strength in either arm after the exercise. Conclusion: Shoulder flexors of caregivers are utilized frequently in the workplace. Implementation of extensor-strengthening exercises, in addition to flexor-strengthening exercises, can contribute to reducing the incidence rate of shoulder injuries among caregivers.

Effects of Angular Joint Mobilization on the Pain, Range of Motion, and Functional Improvement in a Patient with Shoulder Adhesive Capsulitis -A Case Report- (각 관절 가동술(Angular Joint Mobilization)이 어깨 유착성 관절주머니염 환자의 통증, 관절 가동 범위, 기능 향상에 미치는 영향 -사례 보고-)

  • Lee, Seung-Hoo;Yun, Ji-Hyeon;Kim, Young-Hoon;Lee, Gyu-Chang
    • PNF and Movement
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    • v.16 no.2
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    • pp.169-178
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    • 2018
  • Purpose: This study aimed to investigate the effect of angular joint mobilization (AJM) on the shoulder pain, range of motion, and functional improvement in a patient with shoulder adhesive capsulitis. Methods: The patient diagnosed with right shoulder adhesive capsulitis by an orthopedic surgeon was a 60-year-old male, right hand/arm dominant, with a height of 175 cm and weight of 75 kg. The patient received 12 sessions of AJM once or twice per week for eight weeks. AJM was applied for 5 min each of flexion, abduction, external rotation, internal rotation, for a total of 20 min per session. The visual analog scale, the goniometer, and the Oxford shoulder score were used to measure pain, range of motion, and shoulder pain & disability index, respectively. Results: After all the treatments, the pain decreased from 6 to 2 points. The range of motion increased in flexion by $54.3^{\circ}$ from $125^{\circ}$ to $179.3^{\circ}$, abduction by $38^{\circ}$ from $140^{\circ}$ to $178^{\circ}$, external rotation by $54.4^{\circ}$ from $30.3^{\circ}$ to $84.7^{\circ}$, and internal rotation by $25^{\circ}$ from $45^{\circ}$ to $70^{\circ}$. The shoulder disability index decreased from 33 points to 17 points. Conclusion: This study found that AJM has a positive effect on the improvement of shoulder pain, range of motion, and function in a patient with shoulder adhesive capsulitis. Further studies on AJM are needed in the future.

The Effects of Hold-relax Techniques after Inducing Delayed Muscle Pain on the Pain and Range of Motion of Joints (지연성 근육통 유발 후 유지-이완 기법이 통증과 관절가동범위에 미치는 영향)

  • Kim, Ji-Seon;Woo, Young-Keun;Ki, Kyong-Il
    • PNF and Movement
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    • v.14 no.1
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    • pp.15-21
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    • 2016
  • Purpose: The purpose of the present study was to compare the effects of both general hold-relax techniques and hold-relax techniques using pumping on pain due to delayed muscle pain and on the range of motion (ROM) of joints. Methods: Thirty-nine young adult males and females were randomly assigned either to a hold-relax technique application group of 20 subjects or to a group of 19 subjects with hold-relax techniques applied using a pumping application. Tenderness thresholds, the ROM of joints, and pain intensities were measured on the biceps of the nondominant arm of the subjects in both groups before exercises were performed to induce delayed muscle pain. Tenderness thresholds were again measured 24hours, 48hours, and 72 hours after inducing delayed muscle pain. The relevant intervention methods were applied to the two groups after conducting the measurement at 48hours. As a statistical analysis method, repeated measure ANOVAs were conducted to examine the tenderness thresholds, ROMs of elbow joints, and pain intensities in the individual groups at the time points. Results: At 48 hours and 72 hours after application of the interventions, the general hold-relax technique application group showed greater changes in the tenderness thresholds, the ROMs of elbow joints, and the pain intensities than did the group applying hold-relax techniques using a pumping application (p>0.05). Conclusion: Based on the results of the present study, the application of hold-relax techniques is thought to have beneficial effects on pain resulting from delayed muscle pain and on limited ROMs of joints.

The Effects of Action Observation Combined with Modified Constraint-induced Movement Therapy on Upper-extremity Function of Subacute Stroke Patients with Moderate Impairment -A Single-blinded Randomized Controlled Trial-

  • Bang, Dae-Hyouk;Lee, Soon-Hyun
    • PNF and Movement
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    • v.18 no.1
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    • pp.23-34
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    • 2020
  • Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.