• Journal of Biomedical Engineering Research
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• v.43 no.5
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• pp.361-368
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• 2022

The purpose of this study was to develop a hand rehabilitation training system for hemiplegic patients. We also tried to find out five hand postures (WF: Wrist Flexion, WE: Wrist Extension, BG: Ball Grip, HG: Hook Grip, RE: Rest) in real-time using multi-channel EMG-based deep learning. We performed a pre-processing method that converts to Spider Chart image data for the classification of hand movement from five test subjects (total 1,500 data sets) using Convolution Neural Networks (CNN) deep learning with an 8-channel armband. As a result of this study, the recognition accuracy was 92% for WF, 94% for WE, 76% for BG, 82% for HG, and 88% for RE. Also, ten physical therapists participated for the usability evaluation. The questionnaire consisted of 7 items of acceptance, interest, and satisfaction, and the mean and standard deviation were calculated by dividing each into a 5-point scale. As a result, high scores were obtained in immersion and interest in game (4.6±0.43), convenience of the device (4.9±0.30), and satisfaction after treatment (4.1±0.48). On the other hand, Conformity of intention for treatment (3.90±0.49) was relatively low. This is thought to be because the game play may be difficult depending on the degree of spasticity of the hemiplegic patient, and compensation may occur in patient with weakened target muscles. Therefore, it is necessary to develop a rehabilitation program suitable for the degree of disability of the patient.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.201-201
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• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• CELLMED
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• v.13 no.14
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• pp.16.1-16.14
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• 2023

Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

• Physical Therapy Korea
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• v.13 no.2
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• pp.52-60
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• 2006

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

• The Journal of Korean Physical Therapy
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• v.1 no.1
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• pp.27-45
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• 1989

This study aims at helping cerebrally palsied children to overcome and minimize their sufferings, inducing them to perform ordinary activities of daily living for themselves by coducting ADL Tests which are fundamental activities in daily life and presenting treatment plan for their overall rehabilitation and basic data for achieving the training objective. For that purpose, 173 cerebrally palsied children were selected and given ADL performance Tests from Dec. 1987 to Oct. 1988 and the following results were obtained. 1. Correlation coefficients for each ADL category indicated significant statistical value at .01 level. 2. Correlation coefficient between school-year variable and ADL category variable was significant at .01 level. 3. Correlation between age variable and ADL variable category proved significant at .01 level as well. 4. Correlation coefficients between each category in terms of functional state of extremities were significant at .01 level. 5. The difference in ADL achievements between each category by school year were as follows ; 1) In the category of meeting nature's tall, the age span of more than 4 school years showed statistical significance. 2) In the category of putting off and on clothing, the age span of 3 school years indicated statistical significance. 3) In taking meals statistical significance was found in the age span of 4 school years. 4) In finger movements the age span of more the 4 school years indicated statistical significance. 5) In walking activities statistical significance was noticed in the age span of 2 or 3 school years. Besides, in category by school year, and exceptional case was noticed that the 6th graders were lower than the 5th graders in self-reliance rate. 6. the difference in ADL achievements by type of palsy, children of triplegia were the lowest, while those of monoplegia were the highest. 7. The difference in ADL achievements by kind of palsy, patients of athetosis showed lower rate of self-reliance than those of spasticity, and particularly the latter showed a high rate of self-reliance in taking meals$(83.5\%)$. The former were relatively low in self-reliance and lowerst in meeting nature's call $(59.8\%)$.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.2
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• pp.61-72
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• 2007

INTRODUCTION: Local heat and cold application has been frequently used as means of muscle relaxation and blood circulation or reinforcing muscle strength, relaxing muscle tension in clinical situation. In particular, it has been known that long-term heat and cold application for relaxing muscle tension inhibits muscle spasticity or tension. But, it has been rarely reported that what influences of heat and cold application on activation of muscle action potential. Therefore, this study aims to analyze surface temperature and electromyography activities according to the heat and cold application. METHODE: Subjects of this research were 10 normal men and women (5 men, 5 women). Hot pack and cold pack was applied to vastus medialis muscle of thigh and rectus femoris muscle for 20 min. Surface temperature of vastus medialis muscle and rectus femoris muscle was measured, knee joint of subjects was in $45^{\circ}$ flexion, sitting on a chair, maximal isometric contraction was induced, surface electromyography (sEMG) signals were collected and root mean square (RMS) and median frequency (MOF) were analyzed. All measurements were conducted before and immediately after experiment, 10 min., 20 min. and 30 min. after experiment. Data were analyzed with SPSS 12.0 program, comparison of changes in superficial temperature and sEMG signals through repeated measurement was conducted with repeated measures ANOVA and significance level $\alpha$ was 0.05. RESULTS: Changes of surface temperature of vastus medialis muscle according to cold application were radically decreased immediately after application, but it was recovered after 30 min. of application and it showed significant difference (F4. 36=72.216, P<0.001). Surface temperature of rectus femoris also showed radical decrease immediately after application, but it was recovered after 30 min. of application and showed significant difference (F4. 36=88.930, P<0.001). Changes of surface temperature of vastus medialis muscle according to heat application were radically increased immediately after application, but it was recovered after 30 min. of application and it showed significant difference (F4. 36=27.267, P<0.001). Surface temperature of rectus femoris also showed radical decrease immediately after application, but it was recovered after 30 min. of application and showed significant difference (F4. 36=19.774, P<0.001). Changes of sEMG by heat and cold application were no statistical difference. Surface temperature of skeletal muscle after heat and cold application showed significant change for 30 min., but it was found that increase or decrease of surface temperature had not great influence on sEMG activities.

• Journal of Korean Physical Therapy Science
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• v.4 no.2
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• pp.405-419
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• 1997

This research has been conducted to provide the spinal cord injured patients with comprehensive necessity of and backup data for their rehabilitation in the community and make the aware of importance of overall community support to patients. The data was collected through questionnaire made to 83 patients charged to general hospital in Jeonbuk Province between 1 and 31 March 1997 to analyse the patients ability on activities of daily living through the research on general characteristics and Modified Barthel Index(MBI). As a result the outcome of the research was as follows : 1. Sexual distribution represented that 57 male (68.7%) and 26 female(31.3%) and in the age distribution majority group was 36 thirties (43.4 %) most active in social activities. 2. Analysis on occupation of patients showed majority group was in technicians, 21 people representing 25.4 % and the major cause of injury was traffic accident, 45people representing 54.2%, fall down, 17 people representing 20.5% and industrial accident, 13 people representing 15.7%, respectively. 3. In the multiple choice questionnaire on complications, the rate of appealing pain was highest and spasticity, pressure sore, contracture, depression which restrict the patients from activities of daily living ability were also appeared. 4. The theoretical points in MBI Should lie between 1 and 115 and the average point be 58 but the average point of the MBI among 83 patients was 63. 5. The MBI point by the level of injured represented statistically critical difference(P<0.001) and the MBI points tested by Duncan's Multiple Area Testing in lumbar(80.1) and in thoracic (65.8) represented critically higher than the one in cervical(42.5). 6. In the distribution of the method of Urination after spine injury, the intermittent catheterization represented highest numbar of 34(41.1 %). Testing by Duncan's Multiple Area Testing, as we found the critical difference in the analysis on MBI points(P<0.001), the point in independent self voiding patients ($90.87{\pm}29.34$) was higher than the one in other self voiding patients(P<0.05). 7. In th category of social activities after spine injury, the number of people classified in others, 41 people representing 49.5% was highest and in the MBI points of the spinal cord injured people in religious activity, hobby activity, private club, occupation was critically higher than the people classified in miscellancous(P<0.01) who are the spinal cord injured people and mostly depend on their family's assistance at home in their daily activities.

• The Journal of Korean Academy of Sensory Integration
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• v.14 no.2
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• pp.1-10
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• 2016

Objective: This study aims investigating the effects of functional electrical stimulation (FES) on hand function of children with spastic cerebral palsy. Methods: The participants of this study are 20 children with spastic cerebral palsy aged between 11 to 16 years old. All the subjects underwent 24 sessions of FES during 8 weeks. Each FES was 20 minutes per session, and 3 sessions of FES were provided in a week. Measurements used to assess hand function are Jebsen Hand Function Test, Modified Ashworth Scale and 3D Motion Analysis. After establishment of the baseline for each client by all the measurements, reevaluations were performed every 2 weeks using Jebsen Hand Function Test and the Modified Ashworth Scale. The 3D Motion Analysis was performed only before- and after the 8 weeks of FES treatment. Results: After the FES, there was significant decrease in completed time for the all 6 subtasks of Jebsen Hand Function Test were (p<.05) and also significant decrease in spasticity score of Modified Ashworth Scale as well (p<.05). 3D Motion Analysis showed that the hand tapping and the finger tapping has been significantly improved (p<.05), and the pronation-supination movement of lower arm has been significantly improved as well. Conclusion: Based on the results of this study, it is evidenced that functional electrical stimulation is effective treatment for hand function of children with cerebral palsy. For future research, it is recommended to examine various protocols of FES including impact of long-term application.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.91-99
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• 2020

Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1342-1345
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• 2008

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare white matter disorder, first described in the early 1990s. The brain in patients with MLC appears swollen on MRI, with diffuse white matter abnormalities; in addition, there is an invariable presence of subcortical cysts, primarily in the anterior temporal region sparing the deep white matter, basal ganglia, thalami, and cerebellum. Patients with MLC present with macrocephaly and neurological abnormalities such as motor deterioration, ataxia, spasticity, and cognitive deficits. We report a twenty-month-old boy who presented with seizures and macrocephaly, delay in development, and abnormal brain MRI findings compatible with the diagnosis of MLC. The brain MRI revealed bilateral hypersignal intense subcortical white matter regions in the frontal, temporal, and parietal lobes on T2-weighted images, which were not yet associated with cystic changes. During follow-up, the frequency of seizures decreased after anticonvulsant medication was started, but the head circumference remained above the 97th percentile, and the patient continued to have developmental delay.