• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.221-230
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• 2023

Purpose : This study was performed to evaluate the effects of virtual reality combined robot assist gait training (VRG) on improvement of balance and respiratory function in chronic stroke patients. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 35 chronic stroke patients. They were randomly allocated 2 groups; VRG group (n=18) and conservative treatment group (CG; n=17). The VRG group received 30 minutes robot assisted gait training combined virtual reality training, robot assisted gait training was conducted in parallel using a virtual reality device (2 sessions of 15 minutes in a 3D-recorded walking environment and 15 minutes in a downtown walking environment). In the conservative treatment group, neurodevelopmental therapy and exercise therapy were performed according to the function of stroke patients. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome balance and respiratory function were measured by a balance measurement system (BioRescue, Marseille, France), Berg balance scale, functional reach test for balance, Spirometry (Cosmed Micro Quark, Cosmed, Italy) for respiratory function Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), and maximum expiratory volume (PEF) were measured according to the protocol. The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in balance and respiratory function during intervention period. VRG revealed significant differences in balance and respiratory function as compared to the CG groups (p<.05). Our results showed that VRG was more effective on balance and respiratory function in patients with chronic stroke. Conclusion : Our findings indicate that VRG can improve balance and respiratory function, highlight the benefits of VRG. This study will be able to be used as an intervention data for recovering balance and respiratory function in chronic stroke patients.

• Physical Therapy Korea
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• v.28 no.3
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• pp.215-226
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• 2021

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

• The Journal of Korean Physical Therapy
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• v.33 no.5
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• pp.231-237
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• 2021

Purpose: This study sought to investigate the effects of robot-assisted gait training on balance in total hip arthroplasty (THA) patients after bilateral avascular necrosis (AVN). Methods: This case study in two patients utilized an 'A-B-A' single-subject experimental design that included five days of pre-intervention, followed by five days of intervention, and five days of post-intervention. The intervention involved the use of a standing inclined robot (R-bot) for 15 minutes. The outcome measures were evaluated using the Functional Reaching Test (FRT), Time Up to Go (TUG), and the Modified One Leg Standing Test (OLST). Results: Patient 1 showed improvement based on data gathered from baseline A to intervention period B, with results as follows: FRT improved from 27.7 cm to 41.28 cm, OLST LT from 14.03 seconds to 67.37 seconds, OLST RT from 2.94 seconds to 35.97 seconds, and TUG from 12.96 seconds to 7.82 seconds. Patient 2 also showed improvement from baseline A to intervention period B, with results as follows: FRT improved from 17.18 cm to 24.3 cm, OLST LT from 11.53 seconds to 52.01 seconds, OLST RT from 12.99 seconds to 62.19 seconds, and TUG from 27.31 seconds to 12.99 seconds. Conclusion: Based on the results of this study, robotic rehabilitation during the early stages after surgery is effective for promoting balance in patients who have undergone THA due to bilateral AVN.

• Therapeutic Science for Rehabilitation
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• v.7 no.1
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• pp.79-88
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• 2018

Objective : Conventional therapy approaches for stroke survivors have required considerable demands on therapist's effort and patient's expense. Thus, new robotics rehabilitation therapy technologies have been proposed but they have suffered from less than optimal control algorithms. This article presents a novel technical healthcare solution for the real-time, simultaneous and propositional myoelectric control for stroke survivors' upper limb robotic rehabilitation therapy. Methods : To implement an appropriate computational algorithm for controlling a portable rehabilitative robot, a linear regression model was employed, and a simple game experiment was conducted to identify its potential of clinical utilization. Results : The results suggest that the proposed device and computational algorithm can be used for stroke robot rehabilitation. Conclusion : Moreover, we believe that these techniques will be used as a prominent tool in making a device or finding new therapy approaches in robot-assisted rehabilitation for stroke survivors.

• Physical Therapy Korea
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• v.27 no.1
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• pp.11-18
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• 2020

Background: As technology has progressed, various robot-assisted devices have been developed to reduce therapists' labor and assist in therapy. However, due to their many limitations, it is more practical to use traditional mechanical devices. The grahamizer is one such traditional mechanical device used clinically to rehabilitate the upper extremities. No study has yet established the efficacy of the grahamizer in individuals with stroke. Objects: This study investigated the immediate change in arm reaching after the use of a grahamizer. Methods: Twenty-two stroke survivors participated in this study (11 males and 11 females). The reaching of the more-affected arm was measured three times using the three-dimentional electromagnetic motion tracking system "trakSTAR". After the first measurement, the subjects performed 500 rotatory arm exercises using the grahamizer. To assess the grahamizer's effect, the subjects were remeasured in the same way. Results: There were significant increases in the reaching distance (p < 0.05) and movement smoothness (p < 0.05) of the more-affected arm after using the grahamizer. Conclusion: Our study confirms that using the grahamizer is beneficial in the rehabilitation for improving movement of the more-affected arm in stroke survivors.

• Proceedings of the Korean Society of Computer Information Conference
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• 2014.07a
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• pp.21-24
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• 2014

본 연구는 뇌손상(뇌졸중, 외상성 뇌손상, 뇌성마비 등)으로 인하여 손의 능동적 움직임이 결여되어 발생하는 관절의 구축, 근육의 단축, 근육의 탄력성 저하 등의 문제점을 분석하여 인체 역학적 모델에 따른 과학적 설계를 기반으로 환자의 손 기능 회복을 위하여 로봇 기술과 스마트폰의 융합을 통한 재활 로봇 보조 치료기를 설계하고 구현하였다. 제안된 시스템은 일반적인 근 경직을 치료하는 방법을 응용하여 IT 기술과 로봇기술을 융합하여 치료사들의 부담을 덜어 주고, 환자들에게 오랫동안 정확한 운동을 반복적으로 할 수 있도록 하는데 목적이 있다. 하나의 구동기로 2자유도의 움직임을 조절 할 수 있는 링크 매커니즘과 링크의 길이를 조절하여 신전(extension)과 과신전(Hyperextension)의 범위 조절이 가능하도록 로봇 플랫폼을 설계하였다. 또한 환자의 재활정도 및 상태에 적합한 운동속도, 운동반복횟수 등을 손쉽게 조작할 수 있는 등의 개인 맞춤형 재활훈련이 가능한 사용자 인터페이스를 설계 및 구현하였다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.562-568
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• 2016

This study to investigated the therapeutic effect of robot-assisted rehabilitation (Lokomat) with virtual reality (VR) on Pusher syndrome (PS) after stroke. A total of 10 patients presented with PS after stroke were recruited. The participants were divided into two groups: Lokomat (n=5) and control groups (n=5). Lokomat and conventional physical therapy (CPT) were performed together in the experimental group, and the patients in the control group were treated with CPT only twice a day. One session of intervention was carried out for 30 minutes five times per week for 4 weeks. Scale for contraversive pushing (SCP), Berg balance scale (BBS), falling index (FI), and Timed up and go test (TUG) were measured before and after the intervention. The Lokomat group produced significantly better outcomes in SCP (p=0.046), BBS (p=0.046), FI (p=0.038), and TUG (p=0.038) compared with the control group after 4 weeks of intervention. In addition, there were significant correlations between SCP and BBS (p=0.024), FI (p=0.039), and TUG (p=0.030). In conclusion, Lokomat with VR more effectively aided recovery from PS after stroke, and restoration of PS symptoms was related with improvement of balance and gait function.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.471-477
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• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.2
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• pp.1201-1216
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• 2017

In this study, we described the development of a methodology to measure tip-pinch strength on the paretic hand rehabilitation device and aimed to investigate reliability of the device. FSR sensors were embedded on the device, and tip pinch strength was estimated with data collected from the sensors using a developed equation while participants were demonstrating tip pinch. Reliability tests included inter-rater, test-retest, and inter-instrument reliability. B&L Engineering pinch gauge was utilized for the comparison. Thirty-seven healthy students participated in the experiment. Both inter-rater and test-retest reliability were excellent as Intraclass Correlation Coefficients (ICCs) were greater than 0.9 (p<0.01). There were no statistically significant differences in tip-pinch strengths. Inter-instrument reliability analysis confirmed good correlation between the two instruments (r = 0.88, p < 0.01). The findings of this study suggest that the two instruments are not interchangeable. However, the tip-pinch mechanism used in the paretic hand rehabilitation device is reliable that can be used to evaluate tip pinch strength in clinical environment and can provides a parameter that monitors changes in the hand functions.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.557-561
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• 2010

In the treatment of myasthenia gravis, thymectomy is generally accepted as the standard of therapy. For thymectomy, there have been various conventional open approaches including sternal splitting, but recently minimally invasive approaches have been increasingly applied. A 28-year-old man presenting with weakness of both hands and fatigability was diagnosed as having myasthenia gravis with thymic hyperplasia. He underwent a robot-assisted thymectomy with the 'da Vinci' surgical system. Through the right thoracic cavity, two thirds of the thymic gland was dissected, and the remainder was resected through the left; these procedures took, respectively, 1 hour and 30 minutes. The patient was discharged on the 8th postoperative day without complications. The minimally invasive approach with the 'da Vinci' surgical system is emerging as a popular choice and various advantages have been reported. Here we report the first successful case of robot-assisted thymectomy.