• Title/Summary/Keyword: Upper Limb Function

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Impact of Transcranial Direct Current Stimulation Combined With Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Systematic Review (뇌졸중 환자의 상지기능 향상을 위한 경두개 직류 자극과 강제 유도 운동 치료의 결합 중재 효과에 대한 체계적 고찰)

  • Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.8 no.4
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    • pp.7-18
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    • 2019
  • Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.

The Impact of Neurocognitive Rehabilitation Therapy on Upper Limb Functions and Activity of Daily Living of Patients with Stroke (신경인지재활치료가 뇌졸중 환자의 상지기능과 일상생활동작에 미치는 영향)

  • Kim, Sun Hee;Kim, Kwang kee;Jeong, Won Mee;Lee, Jeong Weon
    • 재활복지
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    • v.17 no.4
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    • pp.401-420
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    • 2013
  • This study was performed to investigate the impact of the Neurocognitive Rehabilitation Therapy on the upper limb function recovery of patients with stroke and their abilities to perform daily activities and to provide basic data for a long-term treatment. A total of 30 patients with hemiplegia that occurred due to stroke were recruited as subjects of the present study, and 15 patients were randomly assigned to a Neurocognitive Rehabilitation Therapy group and a conventional treatment group, respectively. And, tests were performed over four weeks, five times a week, and 30 minutes a session. Manual Function Test(MFT), Fugl-Meyer Assessment Scale(FMA), and Korean-Modified Bathel Index(K-MBI) were used to measure the degree of the functional recovery before and after the experiment. According to the data of this study, in the upper limb function test, the Neurocognitive Rehabilitation Therapy group showed significant increase of the measurement values of MFT and FMA(p <.05), and when the difference between the two groups were compared, the upper limb function showed a statistically significant difference. In the daily activity performance test, only the Neurocognitive Rehabilitation Therapy group showed a significant improvement of K-MBI value(p <.05). Based on the results of the present study, it was demonstrated that the Neurocognitive Rehabilitation Therapy was effective in enhancing the upper limb functions and daily activity performance of patients with stroke.

Effects of Mental Practice in Conjunction with Repetitive Transcranial Magnetic Stimulation on the Upper Limbs of Sub-acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon;Cha, Hyun-Gyu
    • Journal of Magnetics
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    • v.19 no.4
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    • pp.353-356
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    • 2014
  • The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

Evaluation of Upper-Limb Motor Recovery after Brain Injury: The Clinical Assessment and Electromyographic Analysis (뇌손상 후 상지 운동기능 회복 평가: 임상적 평가 및 운동반응 근전도 분석)

  • Kim, Young-Ho;Tae, Ki-Sik;Song, Sung-Jae
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.91-99
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    • 2005
  • We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

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Measuring Range of Motion and Muscle Activation of Flower Arrangement Tasks and Application for Improving Upper Limb Function (꽃꽂이 작업의 관절가동범위와 근육활성도 측정 및 상지기능 향상을 위한 적용사례)

  • Lee, Son-Sun;Park, Sin-Ae;Kwon, Oh-Yun;Song, Jong-Eun;Son, Ki-Cheol
    • Horticultural Science & Technology
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    • v.30 no.4
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    • pp.449-462
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    • 2012
  • The objectives of this study were to measure the range of motion for joints and muscle activation of upper limb for flower arrangement tasks for physical rehabilitation and to test horticultural therapy programs using flower arrangement tasks for improving upper limb function of the patients with stroke. Major flower arrangement tasks were classified with eight tasks (cutting 1, thick stem; cutting 2, thin stem; fixing 1, long stem; fixing 2, short stem; rolling a leaf; bending 1, thick stem; bending 2, thin stem; and winding, using a wire) based on the occupational analysis. When eight male university students (mean age $24.1{\pm}2.5$ years) conducted the eight flower arrangement tasks, range of motion for joints and muscle activation of upper limb were measured by a 3D motion analyzer and electromyography, respectively. Based on the results of the range of motion and muscle activation of upper limb, horticultural therapy programs using flower arrangement tasks (total 33 sessions) for improving upper limb function of the patients with stroke was conducted at a rehabilitation hospital, Seoul, South Korea and then the range of motion, grip strength, and upper limb function of the patients were tested. Among the eight flower arrangement tasks, cutting 1, winding, and bending 1 induced the highest value for the range of motion in joints of shoulder, elbow, and wrist, respectively (P < 0.001). In terms of muscle activation, eight flower arrangement tasks performed in this study showed various patterns of muscle activation and several muscles were simultaneously used for each task (P < 0.001). In addition, thickness and length of the materials used in a task had a prominent effect on the range of motion for joints and muscle activation of upper limb (P < 0.001). The stroke patients had positive effects for their range of motion of upper limb (shoulder, forearm, and elbow), grip strength, and overall upper limb function through the horticultural therapy program. Thus, this study suggested that flower arrangement tasks would be a potential horticultural activity for physical rehabilitation program. It would be interesting to apply a customized horticultural therapy program using flower arrangement tasks according to the symptoms of patient for physical rehabilitation.

Design Development Process for Clothing of Upper Limb Assistive Wearable Soft Robot (상지 보조 소프트로봇의 의복화를 위한 디자인 개발 프로세스)

  • Hong, Yuhwa;Park, Juyeon;Nam, Yun Ja;Park, Daegeun;Cho, Kyu-Jin;Kim, Youn Joo
    • Fashion & Textile Research Journal
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    • v.23 no.1
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    • pp.106-117
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    • 2021
  • This study proposes a design process for an upper limb assistive wearable soft robot that will enable the development of a clothing product for an upper limb assistive soft robot. A soft robot made of a flexible and soft material that compensates for the shortcomings of existing upper limb muscle strength assistive devices is being developed. Consequently, a clothing process of the upper limb assistive soft robot is required to increase the possibility of wearing such a device. The design process of the upper limb auxiliary soft robot is presented as follows. User analysis and required performance deduction-Soft robot design-upper limb assistive wearable soft robot prototype design and production-evaluation. After designing the clothing according to the design process, the design was revised and supplemented repeatedly according to the results of the clothing evaluation. In the post-production evaluation stage, the first and second prototypes were attached to actual subjects, and the second prototype showed better results. The developed soft robot evaluated if the functionality as a clothing function and the functionality as the utility of the device were harmonized. The convergence study utilized a process of reducing friction conducted through an understanding and cooperation between research fields. The results of this study can be used as basic data to establish the direction of prototype development in fusion research.

The Effect of Task oriented Imagination Training on the Function of Upper limb and Daily Activities of Chronic Stroke Patients (과제 지향적 상상훈련이 만성 뇌졸중 환자의 상지 기능과 일상생활활동에 대한 다중회귀분석)

  • Son, Young-Hyo;Kim, Seung-Il;Jung, Hwa-Shik;Park, Soo-Hee;Chung, Hyun-Ae
    • The Journal of the Korea institute of electronic communication sciences
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    • v.10 no.10
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    • pp.1163-1174
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    • 2015
  • This study is aimed at identifying the effect the task-oriented imagination training of chronic stroke patients have on the function of upper limb and their daily activities(: ADL). The research subjects were composed of 30 chronic stroke patients with over three months of ailment history, with each group composed of 15 patients assigned to the experiment group and the control group, respectively. The experiment group was subjected to the task-oriented training and the imagination training at the same time, while the control group was subjected to the task-oriented training only. All Interventions were performed for 5 times per week over the period of 8 weeks and 30 minutes per session. In order to monitor the changes as a result of the Intervention program, the MFT and OPTIMAL were employed for the upper limb function while the MBI was employed for the ADL to measure the values before and after the Intervention, respectively, with the results shown below. As a result, MFT, OPTIMAL and MBI showed significant difference between before and after in group. And Mental practice group showed more improvement.

Effect of Bee-venom Acupuncture on Upper Limb Spasticity of Stroke Patients (중풍 환자의 상지 경직에 대한 봉약침의 효과)

  • Noh, Ju-Hwan;Park, Jung-Ah;Cho, Sung-Woo;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm;Kim, Cheol-Hong
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.115-125
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    • 2010
  • Objectives : The purpose of this study is to determine the effect of Bee-venom Acupuncture on upper limb spasticity control in stroke patients. Methods : Ten stroke patients with upper limb spasticity were randomly divided into two groups, a Bee-Venom Acupuncture group(group I) and a normal saline group(group II). After 1 week resting phase, this trial was used a cross-over trial. The numbers of Pharmacopuncture treatment were 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), WMFT(Wolf Motor Function Test), The 10-second Test were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p<.05) in MAS, WMFT, The 10-second Test. But Group II showed no significant improvement(p<.05) in MAS, WMFT, The 10-second Test. The results showed significant difference in WMFT, The 10-second Test, but no significant difference in MAS between two groups. Conclusions : These results showed that Bee-venom Acupuncture might decrease upper limb spasticity and increase arm motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on upper limb in spasticity by Bee-Venom Acupuncture.

Development and Clinical Evaluation of the Upper Extremity Rehabilitation Game Program for Patients with Upper Extremity Hemiplegia After Stroke Using Smartphone: Preliminary Study (스마트폰을 이용한 뇌졸중 후 상지 편마비 환자의 상지 게임재활훈련 프로그램 개발 및 임상적 유용성 평가에 대한 예비연구)

  • Lim, Hyunmi;Choi, Yoon-Hee;Paik, Nam-Jong;Ku, Jeonghun
    • Journal of Biomedical Engineering Research
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    • v.36 no.5
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    • pp.155-161
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    • 2015
  • In the paper, we developed the mobile based rehabilitation system for patients with upper extremity hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built in the smartphone were used to track patients' upper limb motion and the movements was transferred to the tablet PC through bluetooth connection so that the game contents could be interact with the movements. The rehabilitation game contents was based on Brunnstrom stage(B-stage), and was designed to lead accurate movement of upper limb. For the clinical evaluation of the effectiveness, 11 patients were recruited and make them perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The change of upper limb motor function was measured using fugl-meyer assessment(FMA), Brunnstrom stage(B-stage). And the change of quality of life was measured using EuroQoL-5 Dimension(EQ-5D), Beck Depression Inventory(BDI). The results showed significant improvement in upper limb function but not in quality of life. We verified mobile based rehabilitation program could be useful and effective for the clinical use.

The Effects of Mirror Therapy with Functional Electrical Stimulation Therapy on Upper Extremity Motor Function and Activities of Daily Living for the Stroke Patients (뇌졸중 환자에 대한 기능적 전기 자극치료를 병행한 거울치료가 상지 기능수행과 일상생활활동에 미치는 효과)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.3
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    • pp.123-130
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    • 2018
  • Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.