• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.141-150
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• 2021

Objective : In this study, the upper extremity use, executive function, and occupational performance effects of cognitive orientation to daily occupational performance (CO-OP) interventions for patients with stroke were assessed. Methods : The study was designed as a single-group pre-post test with 20 sessions. The participants were five hospitalized patients with stroke who were present in a rehabilitation setting, and their onsets were more than 3 months previously. Outcomes were measured using the Canadian Occupation Performance Measure (COPM), Performance Quality Rating Scale (PQRS), Executive Function performance Test - Korean version (EFPT-K), and Motor Activity Log (MAL). The Wilcoxon signed-rank test was conducted to determine the difference between the pre-and-post of CO-OP interventions. The statistical significance level was p<.05. Results : The upper extremity function showed significant changes and the execution function showed significant changes in preparation, sequencing, judgment and safety, and closing, except for items to be started. The performance of the task also showed significant changes. Conclusion : Through 20 sessions of CO-OP interventions, especially in patients with chronic stroke, the upper extremity function, execution function, and task performance were improved. We found that CO-OP intervention had a positive effect on the improvement of detailed task elements as well as the performance of tasks overall, in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.257-266
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• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.7-25
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• 2020

Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.59-78
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• 2018

Objective : The purpose of this study was to investigate the effect of robot-assisted therapy on upper extremity function. Methods : This study used a single-subject experimental A-B-A' design. Three Parkinson's disease patients took part. Each subject received a robot-assisted therapy intervention (45 min/session, 5 sessions/week for 4 weeks). Upper extremity movement was evaluated with the Reo Assessment tool in Reogo. The Jebsen-Taylor hand motor function test, Fugle-Mayer Assessment score, Box and Block Test, and Nine-hole pegboard test were assessed pre- and post-intervention. Results : After intervention, all subjects underwent 3D motion analysis of reaching function. There was overall improvement in resistance, smoothness, direction accuracy, path efficiency, initiation time, and time to moving target with robot-assisted therapy. Robot-assisted therapy may have a positive effect on upper extremity movement in Parkinson's disease. Conclusion : Robot-assisted therapy is considered an alternative in clinical occupational therapy to improve upper extremity function in Parkinson's disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.7
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• pp.3109-3116
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• 2011

We studied the effects of vibration stimulation method on upper limbs spasticity in patients with brain lesion. 21 patients with spasticity of the upper limbs selected and divided randomly 3 groups. And then vibratory stimulation was applied to the triceps brachii muscle in group I(n=7), to biceps brachii muscle in group II (n=7), and to both muscles in group III (n=7). Using Neuro-EMG_Micro to investigate the changes in spinal neuronal excitability, F-waves were measured at before and directly after stimulation, and 10 minutes later and 20 minutes later after stimulation especially. MAS(Modified Ashworth Scale) test for muscle tone and MFT(Manual Function Test) for the upper extremity motor function were performed before stimulation and 20 minutes later after stimulation for the purpose of clinical evaluation. In our study, MAS was significant decreased in all groups, F wave and F/M ratio parameters were decreased in all groups and more decreased specially in group III. MFT was increased in group II and III, and more increased specially in group III. Vibration stimulation reduced the neuronal excitability of spinal cord and also muscle tone, and improved the motor function of the upper extremity. These results suggested that vibration stimulation giving to both muscles(triceps and biceps brachii muscle) at the same time was more efficiency in reducing the neuronal excitability of spinal cord and improving the motor function of the upper limbs.

• The Journal of Korea Robotics Society
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• v.8 no.4
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• pp.273-282
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• 2013

The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(Amadeo(R)) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in Amadeo(R), and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of Amadeo(R), finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.

• Journal of Korea Multimedia Society
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• v.20 no.12
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• pp.1980-1991
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• 2017

Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.5-20
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• 2013

Constraint Induced Movement Therapy(CIMT) is intense in that patient's unaffected arm is restrained for 90% of waking hours during a two-week period while they also participate in activity sessions using the affected arm for 6 hours/day. However CIMT showed that an issue for applying it to clinics of patients with stroke, and then modified constraint induced movement therapy(mCIMT) was designed to minimize the issue. Application on mCIMT for the patients has been studied in various ways. As a result, it has proved the effect on functional improvement of patients with stroke through methods such as MAL, FMA, WMFT, ARAT, FIM, SIS and so forth. It's considered that modified constraint induced movement therapy can be useful applied on clinical experiments of occupational therapy, as it is a way of treatment of upper extremity function, activities of daily living and an improvement of the quality of life for stroke patients.

• The Journal of the Korea Contents Association
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• v.13 no.11
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• pp.288-296
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• 2013

The purpose of this study were carpal tunnel syndrome in stroke patients according to the degree of spasticity in the median nerve cross-sectional area, nerve conduction velocity, and to evaluate differences in upper extremity function. The subjects of this study was in adult patients with stroke 42 patients from 21 patients CTS group and 21 patients Non-CTS group were selected. Measurement of median nerve-cross sectional area, nerve conduction velocity, GST, FMAS, CTS-FSS was measured. The study results were each group between the unaffected side and the affected side CTS and Non-CTS group in each grade between groups unaffected side(p<.001), and affected side(p<.001) median nerve-cross sectional area, median motor and sensory nerve onset latency, there was a statistically significant difference. CTS and Non-CTS group between groups in each grade GST(p<.05), FMAS(p<.05), CTS-FSS(p<.001), there was a statistically significant difference. In this study, the carpal tunnel pathokinesiology ever presented by the contents of upper extremity functional training in stroke patients is one of the information that you need to consider when presented.