• Title/Summary/Keyword: Upper extremity

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The Effect of Rhythmic Neurodynamic on the Upper Extremity Nerve Conduction Velocity and the Function for Stroke Patients

  • Kang, Jeong-Il;Moon, Young-Jun;Jeong, Dae-Keun;Choi, Hyun
    • The Journal of Korean Physical Therapy
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    • v.29 no.4
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    • pp.169-174
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    • 2017
  • Purpose: The purpose of this study was to resolve, in an efficient manner, the mechanoreceptor problems of the part far from the paretic upper extremity in stroke patients, as well as to provide clinical basic data of an intervention program for efficient neurodynamic in stroke patients, by developing a rhythmic neurodynamic exercise program and verifying functional changes depending on the increase in the upper extremity nerve conduction velocity. Methods: Samples were extracted from 18 patients with hemiplegia, caused by stroke, and were randomly assigned to either the experimental group I for the general upper extremity neurodynamic (n=9) and the experimental group II for rhythmic upper extremity neurodynamic (n=9). An intervention program was applied ten times per set (three sets one time) and four times a week for two weeks (once a day). As a pre-test, changes in the upper extremity nerve conduction velocity and functions were assessed, and two weeks later, a post-test was conducted to re-measure them in the same manner. Results: The wrist and palm sections of the radial nerve and the wrist and elbow sections of the median nerve, as well as the wrist, lower elbow, upper elbow, and axilla sections of the ulnar nerve had significant differences with respect to the upper extremity nerve conduction velocity between the two groups (p<0.05)(p<0.01), and significant differences were also found in the upper extremity functions (p<0.05). Conclusion: Rhythmic neurodynamic accelerated the nerve conduction velocity more in broader neural sections than the general neurodynamic. In conclusion, rhythmic neurodynamic was proven to be effective for improving the functions of upper extremity.

Reconstruction of Soft Tissue Defect of Lower Extremity with Anterolateral Thigh Perforator Flap (전외측 대퇴부 천공지 피판을 이용한 하지 연부조직 결손의 재건)

  • Kim, Kyung-Chul;Chung, Chae-Ik;Kim, Seong-Eoun;Kim, Hak-Soo;Rhyou, In-Hyeok
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.70-76
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    • 2006
  • This study investigated the clinical application of anterolateral thigh (ALT) perforator flap in reconstruction of soft tissue defect of lower extremity. There were twenty-one patients who had been taken soft tissue reconstruction with anterolateral thigh perforator flap. There were 19 males and 2 females between 3 and 65 years (mean, 36 years). This study included 4 cases of pedatric case of under 10-year-old. All cases were a cutaneous flap. Flap size averaged $160\;cm^2\;(20{\sim}450\;cm^2)$. 19 cases were musculocutaneous perforator flaps and 2 were septocutaneous perforator. T-shaped pedicle were used to reconstruct and to preserve major artery of lower extremity in 2 cases. 19 cases flaps survived completely and 2 cases flap were marginal necrosis partially. There was venous congestion in one case of type of reverse island flap but that was improved after salvage procedure with leech. While the donor sites were closed directly in 5cases, 16 cases underwent skin graft. ALT flap is suitable for coverage of defects in lower extremity where have various condition and reliable in children as in adult.

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The Effects of Virtual Reality Therapy With Compensation Inhibition and Feedback on Upper Extremity Function in Hemiplegic Patients With Chronic Stroke (보상작용 억제와 피드백을 제공한 가상현실 치료가 만성 뇌졸중 편마비 환자의 상지기능에 미치는 영향)

  • Chon, Seung-Chul;Chang, Ki-Yeon
    • Physical Therapy Korea
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    • v.18 no.2
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    • pp.67-75
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    • 2011
  • The purpose of this study was to investigate the effects of virtual reality (VR) therapy with compensation inhibition and feedback (CIF) on upper extremity function in chronic stroke patients. Seven chronic stroke patients participated in this study, which was a randomized controlled trial with a crossover design. Self upper extremity exercise, conservative VR therapy, and VR therapy with CIF were performed for one hour per session, 5 times per week, over a 3 week period. The main outcome measures involved range of motion (ROM) including shoulder, elbow, and wrist joints, a Manual Function Test (MFT), and a Motor Activity Log (MAL). Data were calculated as posttest and pretest changes in every session and were analyzed using Friedman and Wilcoxon signed-rank tests at p<.05. The results were as follows: 1) Statistically significant increase in ROM measurements of shoulder and elbow joints were seen with VR therapy with CIF compared to VR therapy and self upper extremity exercise (p<.05), whereas no significant increasing was noted for the wrist joint (p>.05). 2) Statistically significant increase in the MFT was seen with VR therapy with CIF compared with VR therapy and self upper extremity exercise (p<.05). 3) VR therapy with CIF also resulted in statistically significant increase in both activity of use (AOU) (p<.05) and quality of movement (QOM) (p<.05) on the MAL test when compared with VR therapy and self upper extremity exercise, respectively. In conclusion, VR therapy with CIF was more effective than conservative VR therapy and self upper extremity exercise in improving the upper extremity function in hemiplegic patients with chronic stroke.

The Effect of Trunk Stabilization Posture Wearing Spiral Elastic Band on Upper Extremity Function in Stroke Patients (나선형 탄력밴드를 착용한 몸통 안정화 자세가 뇌졸중 환자의 팔 기능에 미치는 효과)

  • Kim, Min-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.93-103
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    • 2021
  • Purpose : This study aimed to investigate the effect of trunk postural stability maintained wearing a spiral elastic band on the upper extremity function of patients with stroke who undertook a functional activity program and to provide fundamental data useful for the application of therapeutic interventions in the clinical environment of occupational therapy. Methods : The research subjects included 16 patients with stroke who were evenly divided into an experimental group and a control group. The eight-week intervention consisted of a functional activity program aimed at improving the function of the affected-side upper extremity. The experimental group performed the functional activity program while maintaining a stable trunk posture by wearing a spiral elastic band. The control group followed the program without wearing the band. Upper extremity function was assessed before and after the intervention using a manual function test (MFT) and a motor activity log (MAL), and the effectiveness on the upper extremity function of the affected side was confirmed. Results : First, in the within-group comparison of the upper extremity function scores before and after the intervention, the experimental group showed a statistically significant difference in the MFT and MAL assessment(p<.05). The control group showed a statistically significant difference in the MAL assessment(p<.05). Second, in the between-group comparison of the change in scores after the intervention, a statistically significant difference was observed between the two groups in all assessments(p<.05). Conclusion : This study confirmed the positive effect on upper extremity function of trunk stabilization posture using a spiral elastic band. The results could be useful when implementing a task-oriented training program in the clinical environment of occupational therapy in the future, as application of the training while maintaining trunk postural stability by wearing a spiral elastic band could be more effective for improving the upper extremity function of patients with stroke.

Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

  • Cho, Ki Hun;Song, Won-Kyung
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.93-98
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

Relationships among Pain, Upper Extremity Function, and Anxiety in the Breast Cancer Survivors (유방암 생존자의 상지기능, 통증 및 불안과의 관계)

  • Lim, Jeong-Sun;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.19 no.1
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    • pp.37-45
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    • 2012
  • Purpose: This study was to compare pain, upper extremity function, and anxiety among disease characteristics in the breast cancer survivors and to clarify the relationship among these variables. Methods: One hundred twenty two participants with breast cancer survivors over the age of 30 were recruited from a general hospital. Data were collected from November 1 to December 25, 2006 using a structured questionnaire. Results: The mean age was 51.17 and their mean survival period was 38.08 months. The breast cancer survivors who had received radiation therapy reported lower levels of pain and upper extremity function, and higher levels of anxiety than those who had other treatments. Pain and anxiety were positively related, and upper extremity function was negatively related to pain and anxiety. Conclusion: The breast cancer survivors experienced pain, upper extremity function disorder and anxiety. This study indicates that nursing interventions for the breast cancer survivors may be needed to improve upper extremity function, and to reduce pain and anxiety.

The Effects of Weight-Bearing Exercise on Upper Extremity Activities Performance in the Female Stroke Patients

  • Lee, SungEun;Cho, SungHyoun;Kim, Kyoung
    • International Journal of Contents
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    • v.9 no.1
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    • pp.65-70
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    • 2013
  • The purpose in the present study was to examine the effects of weight-bearing exercises on stroke patients' ability to perform upper extremity activities. Experiments were conducted with 24 female stroke patients who were randomly assigned to either a control group (CG) that performed general exercise or an experimental group that performed weight-bearing exercise (WBG). The experiments were conducted for 30 minutes per time, three times per week for six weeks. The upper extremity functions, grasping power, and the ability to manipulate the fingers were measured for both groups before the experiments and again six weeks after the beginning of the experiments. Although the scores for upper extremity functions relating to raising the arms that correspond to proximal upper extremity functions increased in both groups, the WBG showed more significant improvement. The WBG showed significant changes in grasping power compared to the CG. Based on these results, weight-bearing exercise can be effective in improving the ability to perform upper extremity movements and grasping power and thus can be used in stroke rehabilitation.

Effects of Seated Exercise of Thoracic and Abdominal Muscles on Upper Extremity Function and Trunk Muscles Activity in Patients with Chronic Stroke

  • Park, Shinjun;Kim, Sangduk
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.2
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    • pp.2065-2070
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    • 2020
  • Background: Weakness of the abdominal and mid thoracic muscles the lead to thoracic kyphosis of stroke patients. The trunk muscles activity of stroke patients is significantly related to upper extremity. Objectives: To investigate the effect of seated exercise of thoracic and abdominal muscles on upper extremity function and trunk muscles activity in stroke patients. Design: One-group pretest-posttest design. Methods: A total of 27 stroke patients were recruited. All stroke patient were given seated abdominal exercise (posterior pelvic tilt exercises) and thoracic exercise (postural-correction exercise). All exercises were conducted for 30 minutes, three times a week for four weeks. The manual function test (MFT) and electromyography (EMG) were measured, and EMG electrodes were attached to thoracic paraspinal muscles and lower rectus abdominal muscles. EMG signal is expressed as %RVC (reference voluntary contraction). Results: Experimental group showed significant increases in abdominal muscles, paraspinal muscles activity and MFT total score, items of arm motion (forward elevation of the upper extremity, lateral elevation of the upper extremity, touch the occiput with the palm) in MFT after four weeks. Conclusion: These results suggest that, in stroke patients, seated exercise of thoracic and abdominal muscles contribute to improve trunk muscles activity and upper extremity function in stroke patients.

Effect of Extracorporeal Shock-wave Therapy on Pain, Grip Strength, and Upper-extremity Function in Patients with Lateral Epicondylitis (체외충격파치료가 팔꿉관절 가쪽위관절염 환자의 통증과 악력 및 팔 기능에 미치는 영향)

  • Song, Min-Jeong;Kang, Tae-Woo;Kim, Beom-Ryong
    • PNF and Movement
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    • v.18 no.1
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    • pp.117-126
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    • 2020
  • Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.

Effects of Action Observational Physical Training Based on Mirror Neuron System on Upper Extremity function and Activities of Daily Living of Chronic Stroke Patients (거울신경세포시스템에 근간한 동작관찰-신체훈련이 만성 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 영향)

  • Ko, Hyo-Eun
    • PNF and Movement
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    • v.13 no.4
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    • pp.175-180
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    • 2015
  • Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.