• 대한중풍순환신경학회지
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• 제14권1호
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• pp.80-89
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• 2013

■ Objectives The aim of study is to analyze the change of gait pattern by arm sling in a hemiplegic patient. ■ Methods We analyzed the change of gait pattern under three conditions using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) First, the patient didn't have arm sling on her upper limb, second, the patient have arm sling on her affected upper limb, third, patient have arm sling on her unaffected upper limb. ■ Results In terms of spatiotemporal gait values, swing phase, step time, step length of unaffected lower limb increased. Furthermore, stride time and stride length also increased when the patient had arm sling on her unaffected upper limb. In terms of displacement of Center of pressure(CoP), anterior/posterior position and lateral symmetry of CoP increased. Furthermore, lateral symmetry of decreased when the patient had arm sling on her affected upper limb. ■ Conclusion Arm sling applied on affected side would be advantage to gait improvement in hemiplegic patients.

• The Journal of Korean Physical Therapy
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• 제17권4호
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• pp.493-504
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• 2005

The purpose of this study is to determine the effect of constraint-induced movement therapy on the involved hand function and ADL in stroke patients. Five subjects with fixing unaffected arms by CIMT were assigned to the experimental patient group and the other five patients to control group without fixing unaffected arms. The function of hand for both groups were evaluated by using Jebsen-Taylor hand function test and ADL for both groups were evaluated by FIM(Functional Independence Measure) before and after task practice. In conclusion, results of this study showed that improved hand function and ADL by CIMT in stroke patients. We concluded that CIMT can improved the involved hand function and ADL in stroke patients.

• 국제물리치료학회지
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• 제11권3호
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• pp.2140-2146
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• 2020

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.

• 대한물리치료과학회지
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• 제12권3호
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• pp.7-12
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• 2005

Constraint-induce therapy(CIT) has been documented to improve motor function in the upper extremity of people with hemiparesis. The exercise program uses the training technique 'shaping'. Shaping involves repetitive exercise that are progressed in small steps, where only positive feedback is given to the patients. It involves 14 days of using a restraint on the unaffected arm after stroke for 90% of waking hours. In conjunction with this, ten days of intensive exercise with the affected arm are undertaken for around six hour daily. CIT produces great improvement of motor function with a period of 2 weeks, that the treatment effect remains stable for many months after the end of therapy, and that it transfers into the everyday lives of patients. The purpose of this study is to introduce about the principles of CIT charactieristic, techniques, therapeutic effects-throughout reference books.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.374-378
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• 2021

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

• Radiation Oncology Journal
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• 제23권1호
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• pp.32-42
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• 2005

목적 : 본 연구의 목적은 유방암 치료 후 상지의 림프부종, 어깨관절 운동범위 감소, 주관적 증상과 이에 영향을 미치는 변수를 파악하기 위함이다. 대상 및 방법 : 본 대학 병원에서 유방암 진단을 받고 수술 또는 수술 후 방사선치료 및 항암치료를 받은 환자 159 명을 대상으로 림프부종 정도와 어깨관절 운동범위를 측정하였고, 질문지를 이용하여 주관적 증상을 측정하였다. 대상 환자의 $47.2\%$인 75명이 40대였으며 89의 환자가 병기 I 또는 II 이었다. 결과 : 림프부종(건측과 환측의 차이가 2 cm 이상)은 52명($32.7\%$)의 환자에서 발생하였다. 이 중 상지 하부 림프부종은 3명, 상지 상부 림프부종은 34명에서 발생하였으며 상지 상부와 하부 모두 림프부종이 발생한 경우는 15명이었다. 각 부위별 발생 빈도는 손목으로부터 10 cm 지점에서 $6.3\%$, 20 cm 지점에서 $10.7\%$, 30 cm 지점에서 $22.6\%$, 40 cm 지점에서 $23.3\%$이었다. 어깨관절 운동범위 감소(건측과 환측의 차이가 $20^{\circ}$ 이상)의 빈도는 굴곡에서 $37.2\%$, 외전에서 $37.7\%$, 내회전에서 $48.4\%$, 외회전에서 $24.5\%$이었다. 이 중 내회전의 경우 정상운동범위의 $50\%$ 이상 감소되는 경우도 흔하였다. 주관적 증상으로 통증 호소가 $63.5\%$, 팔을 움직이기 힘들다고 하는 경우가 $48.4\%$, 팔저림 호소가 $59.8\%$, 뻣뻣함(stiffness) 호소가 $69.2\%$이었다. 특히 림프부종이 없는 108명의 환자 중 65명($61.1\%$)이 통증을 호소하였다. 림프부종의 발생과 유의한 관계가 있는 요인으로는 연령, 체질량지수(BMI), 치료방법 및 수술 후 경과 기간이 있었고, 어깨관절 운동범위 감소의 경우 치료방법과 수술 후 경과기간이었다. 주관적 증상의 경우는 치료방법과 수술 후 경과기간 그리고 항암화학요법 종류가 유의한 관계가 있는 요인이었다. 다변량분석 결과 체질량지수(BMI)와 수술 후 경과기간이 림프부종에 영향을 미치는 유의한 변수인 것으로 나타났다. 결론 : 림프부종은 수술 후 기간이 경과되어도 계속 진행되며 특히 체질량지수가 유의한 요인으로 확인되어 지속적인 체중관리를 포함한 예방대책이 필요하다. 그리고 어깨관절 운동범위의 감소도 환자의 약 1/3에서 발생하였으며 특히 굴곡, 외전, 내회전 운동범위의 감소가 빈번하였고 내회전의 경우 그 정도가 심하였으며 이를 근거로 한 치료 후 재활관리 프로그램이 환자에게 도움을 줄 것으로 기대한다.

• 재활치료과학
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• 제2권2호
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• pp.5-20
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• 2013

강제유도 운동치료는 2주간 건측의 사용을 억제하기 위해 깨어 있는 시간의 90%를 제한하는 동시에 환측에 매일 6시간 이상 강도 높은 훈련을 실시하는 것이다. 하지만 강제유도 운동치료가 뇌졸중 환자의 임상 적용에 있어서 문제점을 보였고, 이를 최소화하기 위해 수정된 강제유도 운동치료가 고안되었다. 뇌졸중 환자를 대상으로 수정된 강제유도 운동치료의 적용이 다양한 방법으로 연구되어져 왔고, Motor Activity Log(MAL), Fugl-Meyer Assessment(FMA), Wolf Motor Function Test(WMFT), Action Research Arm Test(ARAT), Functional Independence Measure(FIM), Stroke Impact Scale(SIS)을 통해 뇌졸중 환자의 기능 향상에 대한 효과를 증명하였다. 수정된 강제유도 운동치료가 뇌졸중 환자의 상지기능, 일상생활활동과 삶의 질 향상을 위한 치료 방법으로써 작업치료 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.8-14
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• 2016

Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome.

• 한국신뢰성학회지:신뢰성응용연구
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• 제16권1호
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• pp.64-70
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• 2016

Purpose: The purpose of this study was to evaluate performance reliability of stroke patients using kinematic analysis. Methods: A protocol to evaluate performance reliability was performed for three tasks on 20 stroke patients and 10 normal people. The tasks include hand to head (HH) task, hand to mouth (HM) task, and hand to target (HT) task. Results: The affected arms showed smaller joint angle, slower peak velocity, longer time to peak velocity for task performances than control group. Also, slower peak velocity and longer movement time for task performance in unaffected arm of stroke patients were obtained compared with the control group. Conclusion: Kinematic analysis is very useful quantitative tool to provide understanding on upper extremity function of stroke patients.

• 대한통합의학회지
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• 제7권3호
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• pp.117-125
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• 2019

Purpose : The purpose of this study was to determine the effects of simultaneous application of focal vibration stimulation and task-oriented training on the improvement in upper extremity motor function after stroke. Methods : The study period was from January to April 2019; 23 patients who fulfilled the study eligibility criteria were enrolled. The participants were divided into two groups: the experimental group with vibration stimulation and task-oriented training and the control group with only task-oriented training. Training was conducted in a total of 20 sessions, 5 times a week for 30 minutes a day for 4 weeks. The amount of use of the affected and unaffected side by accelerometers, and Box and Block test (BBT), Action Research Arm Test (ARAT) was measured with a pre-test, a post-test. Wilcoxon Signed Rank Test and Analysis of Covariance were used to compare and analyze the changes within and between the groups. Results : Both the groups showed statistically significant changes in the results of the BBT and the ARAT, as well as the amount of use of the affected and unaffected side. Regarding the use of the affected side, BBT results, and the grasp and gross movement item of the ARAT showed significant changes in the experimental group compared with the control group. Conclusion : We found that simultaneous application of focal vibration stimulation and task-oriented training was more effective than task-oriented training alone. A large-scale comparative study involving a group that is only given vibration stimulation should be conducted for more generalizable results.