• 제목/요약/키워드: The Upper Limb Disabilities

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The Effect of Sling Exercise Therapy with Vibration Balls on Upper Limb Muscle Activity for Paraplegia-Spinal Cord Injury

  • Oh, Ju Hwan;Kwon, Tae Kyu
    • 한국운동역학회지
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    • 제28권3호
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    • pp.187-191
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    • 2018
  • Objective: The purpose of the present study is to investigate the effect of a muscle activity by applying the complex exercise method of sling in accordance with the provision of various vibration intensities for paraplegia-spinal cord injury. Method: The subjects of the study were 15 men in their 40s and 50s with lower limb disabilities and low potential risk, who were randomly divided into a sling exercise group (SG n=4), a sling with low frequency vibration group (SLVG n=4), a sling with mid-frequency vibration group (SMVG n=4), and a sling with high frequency group (SHVG n=4) in accordance with the provision of slings and vibration stimuli. The vibratory intensity provided was divided into low frequency (30 Hz), mid-frequency (50 Hz), and high frequency (70 Hz). The anterior deltoid (AD), the posterior deltoid (PD), the pectoralis major (PM), the upper trapezius (UT), the latissimus dorsi (LD), and the multifidus (MF) were measured to compare and analyze muscle activity. Results: The closed kinetic chain (CKC) exercise to the shoulder joint showed higher muscle activity in most muscles for the SMVG, and statistically significant differences in the anterior deltoid (AD), the pectoralis major (PM), and the multifidus (MF) in particular. Conclusion: The intermediate frequency (50 Hz) string vibration was the effective vibration stimuli for Closed kinetic chain (CKC) exercises.

소아 복합부위통증증후군 환자에서 경부와 흉부 척수 자극술 -증례보고- (Cervical and Thoracic Spinal Cord Stimulation in a Patient with Pediatric Complex Regional Pain Syndrome -A case report-)

  • 박정주;문동언;박승재;최정일;심재철
    • The Korean Journal of Pain
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    • 제20권1호
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    • pp.60-65
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    • 2007
  • Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist. (Korean J Pain 2007; 20: 60-65)

겨드랑이막증후군을 가진 유방암 환자들의 도수림프배출법과 고주파 투열치료가 통증, 부피, 기능 및 삶의 질에 미치는 효과 : 사례군 연구 (Effects of Manual Lymphatic Drainage and High Frequency Diathermy on Pain, Volume, Function of Upper Extremity and Quality of Life in Breast Cancer Patients with Axillary Web Syndrome : a Study of Five Case Reports)

  • 안수연;신원섭
    • 대한통합의학회지
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    • 제9권4호
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    • pp.19-28
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    • 2021
  • Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

장애인용 핸드컨트롤을 이용한 가속 및 제동 페달을 동작할 때의 상지 근육 EMG 분석 및 운전 성능 평가 (Analysis of Muscle Activities and Driving Performance for Manipulating Brake and Accelerator Pedal by using Left and Right Hand Control Devices)

  • 송정헌;김용철
    • 대한의용생체공학회:의공학회지
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    • 제38권2호
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    • pp.74-81
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    • 2017
  • The purpose of this study was to investigate the EMG characteristics of driver's upper extremity and driving performance for manipulating brake and accelerator pedal by using left and right hand control devices during simulated driving. The people with disabilities in the lower limb have problems in operation of the motor vehicle because of functional loss for manipulating brake and accelerator pedal. Therefore, if hand control device is used for adaptive driving controls in people with lower limb impairments, the disabled people can improve their quality of life by driving a motor vehicle. Six subjects were participated in this study to evaluate driving performance and muscle activities for operating brake and accelerator pedal by using two different hand controls (steering column mounted hand control and floor mounted hand control) in driving simulator. We measured EMG activities of six muscles (posterior deltoid, middle deltoid, triceps, biceps, flexor carpi radialis, and extensor carpi radialis) during pushing and pulling movement with different hand controls for acceleration and braking. STISim Drive 3 software was used for the performance test of different hand control devices in straight lane course for time to reach target speed and brake reaction time. While pulling the hand control lever toward the driver, normalized EMG activities of middle deltoid, triceps and flexor carpi radialis in subjects with disabilities were significantly increased (p < 0.05) compared to the normal subjects. It was also found that muscle responses of posterior deltoid were significantly increased (p < 0.05) when using the right hand control than left hand control. While pushing the hand control lever forward away from the driver, normalized EMG activities of posterior deltoid, middle deltoid and extensor carpi radialis in subjects with disability were significantly increased (p < 0.05) compared to the normal subjects. It was shown that muscle responses of middle deltoid, biceps and extensor carpi radialis were significantly increased when using the right hand control than left hand control. Brake reaction time and time to reach target speed in subjects with disability was increased by 12% and 11.3% on average compared to normal subjects. The subjects with physical disabilities showed a tendency to relatively slow acceleration at the straight lane course.

유방암 치료 후 신체 재활을 위한 비약물적 중재의 연구 동향 : 주제범위 문헌고찰 (Research Trends in Non-Pharmacological Interventions for Physical Rehabilitation after Breast Cancer Treatment: A scoping review)

  • 이정우;서태화
    • 대한통합의학회지
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    • 제12권3호
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    • pp.101-120
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    • 2024
  • Purpose : This study aimed to carry out a scoping review to investigate the research trends in non-pharmacological interventions for physical rehabilitation following breast cancer treatment. Methods : A scoping review was conducted according to the five steps outlined by Arksey and O'Malley and PRISMA-ScR. We searched three domestic databases (ScienceOn, Riss, KCI) and two international databases (PubMed, Cochrane Central) between January 2014 and April 2024. The keywords used were 'breast cancer surgery', 'breast cancer treatment', 'breast cancer lymphedema', 'intervention', 'management', 'therapy', 'disorder', and 'dysfunction'. Results : In terms of publication, the number of studies in the past five years has increased compared to the previous five years, with most studies focusing on patients aged 41 to 60 and who underwent surgical treatment for breast cancer. A total of 43 different types of non-pharmacological interventions were applied: 21 single interventions and 22 combination interventions. Among the intervention methods, complete decongestive treatment (CDT), resistance training, and manual lymphatic drainage were the most frequently utilized. The most common duration of intervention turned out to be 4~5 weeks and more than 8 weeks, with frequencies of 2~3 sessions per week and more than 4 sessions per week. The most frequently used dependent variables included range of motion (ROM) and disabilities of the arm, shoulder and hand (DASH) for the function and disorder of the upper limb category; arm circumference or volume and bio-impedance for the lymphedema category; visual analogue scale (VAS) and numerical rating scale (NRS) for the pain category; and the European organization for research and treatment of cancer quality of life questionnaire breast cancer module (EORTC QLQ) and functional assessment of cancer therapy-breast (FACT-B) for the quality of life category. Conclusion : The findings of this scoping review provide valuable mapping data for non-pharmacological interventions for physical rehabilitation following breast cancer treatment. We recommend further research, particularly systematic reviews and meta-analyses, to build upon these findings.

Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

  • Imai, Takaki;Gotoh, Masafumi;Fukuda, Keiji;Ogino, Misa;Nakamura, Hidehiro;Ohzono, Hiroki;Shiba, Naoto;Okawa, Takahiro
    • Clinics in Shoulder and Elbow
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    • 제24권2호
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    • pp.80-87
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    • 2021
  • Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

4가지 종류의 좌측 핸드 컨트롤 장치에 대한 사용자의 EMG 분석 및 운전 성능 평가 (Analysis of EMG Activities and Driving Performance for Operating Four Types of Left Hand Control Devices)

  • 송정헌;김용철
    • 대한의용생체공학회:의공학회지
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    • 제38권4호
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    • pp.143-152
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    • 2017
  • The main purpose of this research was to examine the EMG characteristics of driver's upper limb and driving performance for operating accelerator and brake pedal by using four types of left hand control devices(Push/Pull, Push/Right angle, Push/Rock, Push/Twist) during simulated driving. The persons with disabilities in the lower extremity have problems in operation of the vehicle because of functional impairments for controlling accelerator and brake pedal. Therefore, if hand control device is used for adaptive driving controls in persons with lower extremity loss, the disabled people could improve their quality of mobility life by driving a car. Twenty subjects were involved in this research to assess driving performance and EMG activities for operating accelerator and brake pedal by using four types of left hand controls in driving simulator. We measured EMG responses of six muscles(posterior deltoid, middle deltoid, biceps, triceps, extensor carpi radialis, and flexor carpi radialis) during pulling and pushing movement with four types of left hand controls for acceleration and braking. STISim Drive 3 program was used for evaluation test of four types of left hand control devices in straight lane course for time to reach target speed and brake reaction time. While operating the four types of left hand controls for acceleration, EMG activities of posterior deltoid in normal subjects were significantly increased(p < 0.05) compared to the disabled subjects. It was also found that EMG responses of triceps and posterior deltoid were significantly increased(p < 0.05) when using the Push/Right angle type than Push/Pull type. While operating the four types of left hand controls for braking, EMG activities of flexor carpi radialis and triceps in subjects with disability were significantly increased(p < 0.05) compared to the normal subjects. It was shown that muscle responses of posterior deltoid, middle deltoid and triceps were significantly increased when using the Push/Right angle type than Push/Rock type. Time to reach target speed and brake reaction time in subjects with disability was increased by 2.5% and 4.6% on average compared to normal subjects. The person with disabilities showed a tendency to relatively slow performance in acceleration at the straight lane course.