• 제목/요약/키워드: Upper extremity functions

검색결과 52건 처리시간 0.021초

뇌졸중 환자에서 자기력에 의해 유도되는 재활운동기기 (Outcome of Rehabilitation Device Driven by Magnetic Force in Stroke Patients)

  • 박지우;김민수
    • 대한물리의학회지
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    • 제15권4호
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    • pp.101-109
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    • 2020
  • PURPOSE: This study investigates the therapeutic effect of a prototype of a hand rehabilitation device based on magnetic forces. METHODS: Using an electromagnet and permanent magnets, we developed an end effector type device that induces various movements of the finger in accordance with the magnetic field direction. A total of 26 subacute stroke patients were enrolled and assigned to two groups in this randomized controlled trial. The intervention group received 30 minutes hand rehabilitation therapy per day for 4 weeks, using the device developed by us. Conventional physical therapies were conducted equally twice a day, 30 minutes per session, during the same period in both groups. RESULTS: After 4 weeks, rate of the Wolf Motor Function Test as a primary outcome measure showed significant improvement in the intervention group as compared to control group(p = .036). Scores of the Manual Function Test and Fugl-Meyer Assessment of upper limb were also significantly increased in the intervention group as compared to control group(p = .038 and p = .042, respectively). Moreover, the Korean version of Modified Barthel Index tended to improve after subjecting to physical therapy in both groups. CONCLUSION: Our results indicate that the novel hand rehabilitation device developed using a magnetic force, improves the hand motor functions and activities of daily life in subacute stroke patients.

정상 성인에서 구혈대에 의한 신경기능의 변화 (The Effect of Tourniquet Inflation on Neural Functions: A Volunteer Study)

  • 전희정;최윤;정헌석;김태엽;정성량;임중우
    • The Korean Journal of Pain
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    • 제12권1호
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    • pp.16-20
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    • 1999
  • Background: Tourniquet pain has important impacts on anesthesia. Tourniquet pain and accompanying cardiovascular changes are important factors that make patients in distress during anesthesia. As tourniquet pain may be modified by anesthesia, a study on the changes in the neural functions by tourniquet inflation in normal volunteers is important. Methods: Time-dependent changes in tourniquet pain, heart rate, phantom limb sensation, motor function, pain to pressure on upper extremity of 10 healthy and unpremedied volunteers were measured. Each parameter were measured every 5 minutes starting from 10 minutes before inflation to 15 minutes after deflation of tourniquet. Tourniquet was deflated when the subject felt unbearable pain (score 100 with visual analog scale). Results: Subjects manifested time-dependent pain responses to tourniquet inflation, characterized by increase in VAS, systolic and diastolic blood pressure. Mean duration of tourniquet inflation was 36.4 minutes, volunteers experienced motor paralysis at 27.6 minutes and sensory loss at 33.1 minutes. Pain to pressure decreased over time in both arms. The degree of decrease was greater in the arm on which tourniquet was applied than that in the non-applied arm. Phantom limb sensation occurred in 3 subjects. Conclusions: This study demonstrated dynamic changes in the neural functions during tourniquet inflation period. Tourniquet-induced pain and resultant hypertension occurred in all subjects. Appropriate anesthetic management is needed for the surgery using tourniquet.

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편측 뇌손상 환자에서 특정 과제에 한정된 동측 상지의 운동 결함 분석 (Ipsilateral Motor Deficit during Three Different Specific Task Following Unilateral Brain Damage)

  • 권용현;김중선
    • The Journal of Korean Physical Therapy
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    • 제17권2호
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    • pp.67-87
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    • 2005
  • Impaired sensorimotor function of the hand ipsilateral to a unilateral brain damage has been reported in a variety of motor task. however, it is still the controversial issue because of the difficulty of detection in clinical situation, patients' variability(time after onset, contralateral upper extremity severity, other cognitive functions including apraxia), and the performed various motor task. The purpose of this study is to determine the presence of ipsilateral motor deficit following unilateral brain damage in three different specific tasks(hand tapping, visual tracking and coin rotation) compared with healthy age-sex matched control group using the same hand and to investigate the lateralized motor control in each hemispheric function. Findings revealed that stroke patients with unilateral brain damage experienced difficulties with rapid-simple repetitive movement, visuomotor coordination, complex sequencing movement on ipsilateral side. Also, Comparison of the left-hemispheric stroke groups and the right-hemispheric stroke groups revealed that patients with a left-hemisphere damage tended to be more variable in performing all of the three tasks. These results show that stroke patient with left hemisphere damage has more ipsilateral motor deficit, and the left hemisphere contributes to the processing of motor control that necessary for the executing actions with ipsilateral hand.

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Development and Evaluation of Tip Pinch Strength Measurement on a Paretic Hand Rehabilitation Device

  • Kim, Jung-Yeon;Cha, Ye-Rin;Lee, Sang-Heon;Jung, Bong-Keun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제11권2호
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    • pp.1201-1216
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    • 2017
  • In this study, we described the development of a methodology to measure tip-pinch strength on the paretic hand rehabilitation device and aimed to investigate reliability of the device. FSR sensors were embedded on the device, and tip pinch strength was estimated with data collected from the sensors using a developed equation while participants were demonstrating tip pinch. Reliability tests included inter-rater, test-retest, and inter-instrument reliability. B&L Engineering pinch gauge was utilized for the comparison. Thirty-seven healthy students participated in the experiment. Both inter-rater and test-retest reliability were excellent as Intraclass Correlation Coefficients (ICCs) were greater than 0.9 (p<0.01). There were no statistically significant differences in tip-pinch strengths. Inter-instrument reliability analysis confirmed good correlation between the two instruments (r = 0.88, p < 0.01). The findings of this study suggest that the two instruments are not interchangeable. However, the tip-pinch mechanism used in the paretic hand rehabilitation device is reliable that can be used to evaluate tip pinch strength in clinical environment and can provides a parameter that monitors changes in the hand functions.

손목관절의 기능적 운동 특성의 동작 분석 (Functional Motion Analysis of Wrist Joints)

  • 한정수
    • 대한의용생체공학회:의공학회지
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    • 제24권6호
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    • pp.543-548
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    • 2003
  • Injuries of wrist in upper extremity is common onset in industrialized world. The development of joint arthroplasty and mechanical joint is area of research for biomechanical engineer and surgeon for a decade. Therefore. the knowledge of characteristic of joint motion is essential to develop the artificial wrist joint. In this study. the joint motions of wrist required for activities of daily living (ADLs). including personal hygiene and care. and general home activity were measured using flexible electrogoniometer. Total of 25 different daily activities were separated into four groups and tested on 15 subjects who did not show any abnormality of their joint functions. The maximum functional range of motion required for ADLs were obtained and standardized for analysis and comparison. Also. a least functional range of motion for ADLs were investigated. Results revealed that any significant differences were not found in least functional range of motion between left and right wrist to perform ADLs. However. a significant difference was found in different ADLs. Therefore. least range of motion obtained in this study can be used as basic data to design artificial joint and set a goal for surgeon to achieve appropriate treatment from patients.

Effect of Home Activity Support Program on Daily Living Performance Skills in Children with Cerebral Palsy and their Parents

  • Ko, Seok-Ho;Kim, Jae-Eun;Koo, Jung-Wan
    • Physical Therapy Rehabilitation Science
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    • 제11권1호
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    • pp.24-31
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    • 2022
  • Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.

유리섬유 제조업체 근로자의 건강장해 (Medical Surveillance of Glass Fiber Workers in Korea)

  • 이세휘;김규상;최정근;김양호;강성규;최경숙;문영한
    • Journal of Preventive Medicine and Public Health
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    • 제29권2호
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    • pp.187-198
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    • 1996
  • The industrial use of MMMF(man-made mineral fibers), has been increasing, particularly since the banning of most asbestos products. Fibrous minerals can cause health abnormalities currently associated with occupational exposure to glass fiber. This study was conducted to evaluate health risks of glass fiber manufactory workers within the country. We examined questionaries, physical examination including auscultation, chest x-ray, pulmonary function test for 488 male workers, to go through their dermal itching symptoms and respiratory evaluation. we had the results as follows. 1. In 45% of the workers itching had been expressed at their entrance. At that time we was investigating, 18.5% had itching, and most of them complained it when they fall asleep and night. The Sequent itching site is waist and groin, upper and lower extremity in order, and it had been expressed mainly during summer and winter. 2. As the results of ventilatory functions test, 6.0% were obstructive type, 1.0% were restrictive type. So, glass fiber exposures should be controlled or elimination by protective devices in the workplace. 3. The means of FVC, $FEV_1,\;FEV_1%$ were in normal range. As the comparison of ventilatory functions by age groups, MMF was decreased significantly for the group, 50 years old and more than other groups. And the comparison by the serving periods at glass fiber producing factory, MMF was decreased for the workers had worked for $11\sim15$ years. Therefore, MMF be more sensitive index in the evaluation of ventilatory impairments caused by glass fiber workers.

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뇌졸중 환자를 위한 가상현실 기반의 원격재활 효과에 관한 체계적 고찰 (A Systematic Review on the Effects of Virtual reality-based Telerehabilitation for Stroke Patients)

  • 임영명;이지용;조성준;안예슬;유두한
    • 대한지역사회작업치료학회지
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    • 제7권1호
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    • pp.59-70
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    • 2017
  • 목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 가상 현실 기반의 원격재활 효과를 체계적으로 고찰하여 그 효과와 국내 적용방법을 알아보고자 하였다. 연구방법 : 자료의 검색을 위해 EMBASE, CINAHL의 데이터베이스를 이용하였다. 주요 용어는 "Virtual Reality", "Telerehabilitation", "Stroke"으로 관련 연구를 검색하였다. 선정기준에 적합한 총 7편의 연구를 대상으로 질적 수준, 일반적 특성, PICO를 사용하여 연구 주제에 따른 자료를 분석하였다. 결과 : 선정된 7편의 연구는 가상현실 기반으로 한 원격재활 시스템으로 중재를 실시하였으며, 가상현실은 게임 프로그램과 수동적인 팔 보조 그리고 Balance Trainer등을 활용하여 원격재활 중재를 실시하였다. 주된 결과 측정도구는 상지기능, 균형 및 보행, 일상생활 등을 평가하기 위한 도구가 사용되었다. 가상현실 기반의 원격재활 중재방법은 모든 연구에서 상지기능, 균형감각능력에서 효과를 보였으며, 일상생활 활동에서의 부분적인 효과를 확인하였다. 환경적 특이성을 보완하기 위한 원격재활 서비스는 클라이언트의 만족감을 향상시키고 기능의 유지를 위한 중재법으로 그 효과를 확인할 수 있었다. 결론 : 가상현실 기반의 원격재활 시스템은 대부분 상지기능과 균형감각, 일상생활 활동을 위한 중재가 적용되었으며, 가정환경에서도 치료사의 중재, 감독, 교육 등을 통해 기능향상에 도움이 되는 것으로 나타났다. 본 연구는 가상현실 기반의 원격재활의 임상적 적용에 대한 근거와 가능성을 제시하고자 한다. 향후 연구에서 다양한 가상현실의 중재방법과 원격재활을 활용한 재활 프로그램 개발과 같은 추가적인 연구가 필요할 것이다.

수정된 강제유도 운동치료가 편마비를 가진 뇌성마비 아동의 상지 기능에 미치는 영향 (The Effects of Modified Constraint-Induced Movement Therapy on Hand Functions of Children With Hemiplegic Cerebral Palsy)

  • 방현수;장상훈
    • 대한지역사회작업치료학회지
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    • 제7권1호
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    • pp.25-35
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    • 2017
  • 목적 : 본 연구의 목적은 수정된 강제유도 운동치료가 편마비 뇌성마비 아동의 상지 기능과 관련된 요소들에 미치는 영향을 알아보는 것이다. 연구방법 : 8세에서 11세 사이의 편마비 뇌성마비 아동 4명을 대상으로 실험을 실시하였다. 수정된 강제유도 운동치료는 하루 5시간 동안의 건측 제한과 이 시간동안 2시간의 환측의 집중적인 과제훈련, 주당 5회, 총 8주를 실시하였고, 수정된 강제유도 운동치료가 상지 기능과 관련된 요소에 미치는 영향을 확인하기 위하여 Jebsen Hand Function Test와 3차원 동작분석을 실시하였다. Jebsen Hand Function Test는 실험 2주마다 반복 측정을 실시하였고, 3차원 동작분석의 경우에는 실험 전과 실험 후에 측정을 실시하였다. 결과 : 수정된 강제유도 운동치료 후, Jebsen Hand Function Test에서는 하위 검사 모두에서 경과 시간의 유의한 감소가 나타났고(p<.05), 3차원 동작 분석 결과 수정된 강제유도 운동치료 적용 전에 비해 8주의 경과 후 손바닥 두드리기 검사와 검지 두드리기 검사에서 통계학적으로 유의한 감소가 나타났고(p<.05), 아래팔의 회내와 회외 운동에서는 수정된 강제유도 운동치료 적용 전에 비해 8주의 경과 후 통계학적으로 유의한 증가가 나타났다. 결론 : 본 연구의 결과를 통하여, 수정된 강제유도 운동치료는 편마비 뇌성마비 아동의 상지 기능과 관련된 요소를 효과적인 치료하는 방법임을 알 수 있었다. 그리고 향후 수정된 강제유도 운동치료를 위한 개별화된 적용 방법과 개인의 상태에 따른 다양한 적용 기간의 연구가 필요할 것으로 생각된다.

Bupivacaine 주입에 의한 지속적 경부경막외마취의 임상적 연구 (Clinical Study of Continuous Cervical Epidural Anesthesia with Bupivacaine)

  • 길선희;황경호;박욱
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.20-27
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    • 1988
  • Continuous cervical epidural anesthesia with two different concentrations of bupivacaine had been performed in 43 cases for surgery of upper extremity and cervical spine. After the initial dose of 0.33% bupivacaine 15ml to Group I(n=22) and 0.5% bupivacaine 15ml to Group II(n=21) was injected respectively, we observed the circulatory and pulmonary functions to be changed, and evaluated the duration of those analgesic action. The number of spinal segment to be affected and the complications were checked. Statistical significance of changes after the initial dose in both groups was determined by student's t-test. All values are impresed as mean$\pm$1S.D.. The results were as follows: 1) Circulatory functions; Systolic B.P. and Pulse rate were decreased by 10~15torr and 5~6 beats per minute respectively between 10~30 minutes following the initial dose, which were statistically significant in both groups. 2) Pulmonary functions; The diminution of minute volume showed to 20% and a rise of $PaCO_2$ level to 5~6 torr respectively between 30~60 minutes following the initial dose, which were statistically significant in both groups. There were no significant changes in self respiration and respiratory rate in both groups. 3) The duration of analgesic action was $72.3{\pm}25.7$(min) in Group I and $83.5{\pm}28.5$(min) in Group II which was not statistically significant between two groups, and the number of affected spinal segment at ore hour following the Anesthusia was $8.7{\pm}2.0$ in Group I and $10.5{\pm}2.4$ in Group II which was statistically significant between two groups. 4) Complications; a. Hypotension(below 80torr in systolic pressure) was appeared in 5% of all patients. b. Bradycardia(below 60 beats per minutes) was appeared in 25% of all patients. c. Inadvertent dural puncture was developed in only one patient, In conclusion, the 0.33% bupivacaine as well as 0.5% bupivacaine were enough for those analgesic effect in the above mentioned surgery even though the duration of analgesic action was about 10 minutes shorter in Group I than that of Group II. The cardiopulmonary function was clinically rather stable in Group I than that of Group II. Therefore we thought 0.33% bupivacaine was satisfactory for the clinical practicality in the cervical epidural anesthesia.

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