• Title/Summary/Keyword: Upper extremity functions

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Effects of the Dual-Task Training on Stroke Patients : A Systematic Review and Meta-analysis (이중과제 훈련이 뇌졸중 환자에게 미치는 영향 : 체계적 고찰 및 메타분석)

  • Won, Kyung-A;Lim, Seung-Ju;Park, Hae Yean;Park, Ji-Hyuk
    • 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.

The Effect of Cognitive Rehabilitation Program Using Virtual Reality (VR) Contents on Cognitive function, Depression, Upper Extremity Function and Activities of Daily Living in the Elderly (가상현실(Virtual Reality) 콘텐츠를 활용한 인지재활프로그램이 노인의 인지기능, 우울감, 상지기능 및 일상생활능력에 미치는 영향)

  • Kim, Young-June;Park, Jin-Hong;Cho, Young-Suk;Kim, Keum-Sook
    • Journal of Convergence for Information Technology
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    • v.10 no.8
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    • pp.203-212
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    • 2020
  • The purpose of this study was to investigate the effects of cognitive rehabilitation programs using Virtual Reality(VR) content on the daily living abilities such as cognitive abilities, depression, and upper extremity functions of the elderly. The study group analyzed the effectiveness by separating the experimental group, which is the virtual reality cognitive rehabilitation application group, and the control group, the universal cognitive stimulation program application group. As a result of the study, the MMSE-K score improved by 13.0% in the experimental group and 2.3% in the control group. The improvement in each area of the experimental group was found to be 3.1% MBI, 7.1% MFT(Rt.), 3.5% MFT(Lt.), and 25.4% K-GDS. As a result of comparing the pre-post score change between each group, there was a significant difference between groups in daily living ability (p<.001) and MFT(Rt.)(p<.01). In addition, as a result of comparing the changes in absolute alpha waves to confirm the degree of depression through brain waves, there was no statistically significant difference. However, in the experimental group, it was confirmed that the average value increased to a positive value. This study is an experiment to verify the effectiveness of the cognitive rehabilitation program using virtual reality contents, and suggests a new intervention method to maintain and improve the daily life ability, cognitive function, depression and upper extremity function of the elderly.

A Preliminary Study on the Correlation Between ICF and Functions of Upper Limbs of Chronic Stroke Patients : ICF Activities, Participations, and Environmental Factors (만성 뇌졸중 환자의 상지 기능과 ICF와의 상관관계 예비 연구 : ICF 활동, 참여 및 환경영역 중심으로)

  • Im, Jong-Woo;Shin, Kyu-Hyun;Lee, Young-Min
    • PNF and Movement
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    • v.16 no.3
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    • pp.485-493
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    • 2018
  • Purpose: This study provides a treatment for central nervous system development in patients with chronic stroke by investigating changes in the upper limb function over time. The correlations among the activities, participation, and environmental factors of the international classification of functioning (ICF), disability and health are also examined. Methods: The subjects of this study are 18 patients with chronic stroke who were hospitalized and treated at 00 hospital in the Chungcheongbuk-do province. Their upper extremity functions are evaluated using the manual function test (MFT). The activities, participation, and environmental factors are evaluated using the ICF generic form. The correlations between the total scores of the affected and unaffected sides and the ICF items are analyzed using the Pearson correlation analysis. The significance level is p<0.05. Results: When the correlations between the activities and participation areas of ICF and the total score of the affected side of MFT were examined, significant correlations (p<0.05) were found in the following items: changing basic body position (D410), lifting and carrying objects (D430), moving around using equipment (D465), using transportation (D470), washing oneself (D510), caring for body parts (D520), and dressing (D540). When the correlations between the activities and participation areas of ICF and the total score of the unaffected side of MFT were examined, significant correlations (p<0.05) were found among writing (D170), speaking (D330), eating (D550), and drinking (D560). In addition, when the correlation between the environment area of ICF and the total score of the unaffected side of the MFT were examined, significant correlations (p<0.05) were found between products and technology for personal use in daily living (E115) and immediate family (E310). Conclusion: The MFT of patients with chronic stroke is closely correlated with the activities, participation, and environmental factors of ICF. This result suggests that ICF can be used as a useful tool to comprehensively evaluate the abilities of the patient, including the upper extremity function.

The Effect of Prism Adaptation Following Traumatic Brain Injury: A case report

  • Jeong, Eun-Hwa;Min, Yoo-Seon
    • Therapeutic Science for Rehabilitation
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    • v.6 no.2
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    • pp.37-45
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    • 2017
  • Background: The presence of visuospatial impairment can make patients slow functional recovery and impede the rehabilitation process in TBI patients. Objective: The aim of this study is to investigate effects of prism adaptation treatment for functional outcomes in patients following traumatic brain injury. Methods: The subject received prism adaptation treatment for 2 weeks additionally during traditional rehabilitation for 4 weeks. The Patient has prism adaptation treatment while wearing wedge prisms that shift the external environment about $12^{\circ}$ leftward. The patient received 10 sessions, 15-20min each session. Outcome measures were visuospatial deficit(line bisection, latter cancellation), Visual and spatial perception(LOTCA-visual perception and spatial perception), motor function of upper extremity(FMA U/E; Fugl-Meyer motor assessment upper extremity, ARAT; Action research arm test), balance(BBS; Berg Balance Scale), mobility(FAC; Functional ambulation classification) and functional level(FIM; Functional independent measure). All Assessments took place on study entry and post-treatment assessments were performed at discharge from the hospital. Results: After prism adaptation, the visuospatial impairment scores improved as indicated in the line bisection(-15.2 to -6.02), latter cancellation(2 to 0) and LOTCA- spatial perception scores(7 to 9). The upper motor function improved as indicated in the scores of affected FMA U/E(21 to 40) and ARAT(4 to 22). Ambulation and balance improved as indicated in the BBS scores(25 to 38) and FAC scores(0 to 4). ADL function improved as indicated in the FIM total scores 54 to 70(motor 34 to 61, cognition 20 to 29). Conclusion: Prism adaptation did improve functional level such as motor functions and ADL abilities in TBI patient. Further research is recommended.

Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study

  • Midha, Divya;Arumugam, Narkeesh
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.318-323
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    • 2020
  • Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

The study of clinical usefulness of Si-Zong-Sue-Ge(四總穴歌) (사총혈가(四總穴歌)에 관(關)한 연구(硏究))

  • Yang, Gi-Joong;Bae, Geyn-Tae;Yoon, Jong-Hwa
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.1-12
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    • 2000
  • Ge-Fu(歌賦) means prose and poetry individually, and they both have a meaning of all the rhythmical poetrical compositions making it ease for people to remember the content. All the Ge-Fus used in oriental medicine are made in Yuan(元), Mine(明)and Qing(靑)dynasty, and they have been largely used in most of all the fields of medicine such as Ben-Cao(本草), Tang-Ye(湯液), Zhen-Jiu(鍼灸), Zhen-Duan(診斷). Zhen-Jiu-Ge-Fu(鍼灸歌賦) has about 90 poetries and 10 proses and they contain the names of meridian; courses of meridian streams; accurate positions of acupuncture points; functions; effects; meanings of the name of acupuncture points; usages and effects of special points; manipulations of reinforcing and reducing method; contraindications of acupuncturing; principles of selections and orders of acupuncture points in therapy; and eight diadgoses. Zhen-Jiu-Ge-Fu is subdivided into Jing-Xue(經穴歌), Zhi-Jiu-Ge(刺灸歌), Shu-Xue-Ge(輸穴歌), Zhi-Liao-Ge(治療歌). And In Zhi-Liao-Ge, the most brief and essential Ge-Fu-Si-Zong-Sue-Ge- contains theraputic designs using far apart acpuncture points from the right painful areas in the body. In this study, the author opinionated the Si-Zong-Sue-Ge can be the prototype of the distant needling; the research on this can open the importance of Ge-Fus. On conclusion, 1. "Upper and lower Abdomen - Zu-San-Li($S_{36}$) (肚腹三里留)" means when there are problems and disorders in upper and lower abdomen, distinctively, such as gastric pain, maldigestion, flatulence, abdominal pain, constipation, diarrhea, vomiting, menstrual disorer, knee pain and tonic functioning, 족삼리 can be a right choice for distant needling point for treating. 2. "Face and Eye-He-Gu($Li_4$) (面目合谷收)" means when there are problems and disorders in facial, eye, ear, nose, throat, mouth regions, distinctively, such as facial edema, toothache, headache, sore throat, rhinorrhea, frontal headache, abdominal pain, dizziness, He-Gu can be a right choice for distant needling point for treating. 3. "Upper and lower back - Wei-Zhong($B_{40}$) (腰背委中求)" means when there are problems and disorders in upper and lower back, distinctively, such as upper back pain, lumbargo, hamstring muscle pain, popliteal region pain, lower extremity compartment syndrom, Inguinal region pain, muscle twitch, vomiting and diarrhea, hemorrhoidal bleeding, skin rash, Wei-Zhong can be a right choice for distant needling point for treating. 4. "Head and neck - Lie-Que($L_7$) (頭項審列缺)" means when there are problems and disorders in capital and nuchal area, distinctively, such as migraine, frontal headache, rhinorrhea, asthmatic dyspnea, aphasia, coughing, neck stiffness, occipital headache, upper extremity pain, Lie-Que can be a right choice for distant needling point for treating.

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Risk Assessment and Intervention of Ergonomic Risk Factor in Beekeeping (치과위생사의 직무스트레스 그리고 작업자세와 상지의 증상여부 및 기능과의 관련성)

  • Kwon, Yu-jin;Kang, Yong Ju;Seo, Sung-Hyo;Kim, Bokyoung;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.209-219
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    • 2019
  • Objectives: This study investigated musculoskeletal symptoms in upper limbs according to the working environment (job stress) of dental hygienists and examine their relationship with upper limb functions. Methods: The subjects include 198 dental hygienists in dental hospitals and dental clinics in Pusan and Gyeongnam. The questionnaire was consisted of general characteristics of the subjects, job stress, musculoskeletal symptoms in upper limbs and function (Disability Measurement Tool for Upper Extremity Disorders-11, DASH-11). Results: The study was analyzed their musculoskeletal symptoms in upper limbs according to their general characteristics and found that the symptoms occurred in the neck (39.4%), the shoulders (54.6%), elbows (14.7%), and the hands (50.0%). Job stress was associated with upper limb functions (DASH-11) (model 3, B=5.210, p=0.012) and repeated elbow bending and spreading posture was associated with DASH-11 (model 3, B=6.561, p=0.029). Elbow symptoms were associated with DASH-11 in the upper limbs (B=10.679, p=0.003). Conclusion: Dental hygienists are experiencing limitations of upper limb function due to job stress. In particular, even if the correction of their uncomfortable posture is significantly related to the job stress and upper limb function, in order to improve the upper limb function of the dental hygienist, efforts to reduce the job stress as well as the uncomfortable posture are necessary.

Effects of Home-based Virtual Reality on Upper Extremity Motor Function for Stroke - An Experimenter Blind Case Study (가정-중심 가상현실이 만성뇌졸중환자의 팔 운동기능에 미치는 영향 - 실험자 맹검 단일실험연구)

  • Lee, Jung-Ah;Hwang, Su-Jin;Song, Chiang-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3023-3029
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    • 2012
  • The purpose of this study was to investigate the effect of the home-based virtual reality (VR) on upper extremity motor function in hemiparetic stroke patients. Two matched subjects with left hemiplegia were volunteered to participate in this study. One subject received the home-based VR whereas the other subject recovered a modified home-based constraint-induced movement therapy (CIMT). Both interventions were given for 4 hours x 5 times a week for 4 weeks. Outcome measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Wolf Motor Function Test (WMFT). The VR-trained subject showed considerable improvement in all the tested motor functions when compared with the home-based CIMT. Specifically, the FMA measure demonstrated that the VR subject showed 17% enhancement whereas the CIMT subject showed 5% increase. Similarly, Amount of Use (AOU) and Quality of Movement (QOM) of the MAL scores of the VR subject showed 40% and 20% increase whereas the CIMT subject showed 0% and 20% increase, respectively. The WMFT scores of the VR subject and CIMT subject showed 20% increase. Our home-based VR was effective in upper extremity motor recovery of chronic hemiparetic patients even when compared with the well-established CIMT approach in stroke victims.

Simulation of Whole Body Posture during Asymmetric Lifting (비대칭 들기 작업의 3차원 시뮬레이션)

  • 최경임
    • Journal of the Korea Safety Management & Science
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    • v.4 no.2
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    • pp.11-22
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    • 2002
  • In this study, an asymmetric lifting posture prediction model was developed, which was a three-dimensional model with 12 links and 23 degrees of freedom open kinematic chains. Although previous researchers have proposed biomechanical, psychophysical, or physiological measures as cost functions, for solving redundancy, they lack in accuracy in predicting actual lifting postures and most of them are confined to the two-dimensional model. To develop an asymmetric lifting posture prediction model, we used the resolved motion method for accurately simulating the lifting motion in a reasonable time. Furthermore, in solving the redundant problem of the human posture prediction, a moment weighted Joint Range Availability (JRA) was used as a cost function in order to consider dynamic lifting. However, it is known that the moment weighted JRA as a cost function predicted the lower extremity and L5/S1 joint motions better than the upper extremities, while the constant weighted JRA as a cost function predicted the latter better than the former. To compensate for this, we proposed a hybrid moment weighted JRA as a new cost function with moment weighted for only the lower extremity. In order to validate the proposed cost function, the predicted and real lifting postures for various lifting conditions were compared by using the root mean square(RMS) error. This hybrid JRA reduced RMS more than the previous cost functions. Therefore, it is concluded that the cost function of a hybrid moment weighted JRA can be used to predict three-dimensional lifting postures. To compare with the predicted trajectories and the real lifting movements, graphical validations were performed. The results also showed that the hybrid moment weighted cost function model was found to have generated the postures more similar to the real movements.

Effects of Constraint-Induced Movement Using Self-Efficacy Enhancing Strategies on the Upper Extremity Function of Chronic Hemiplegic Patients (자기효능증진전략을 이용한 건측억제유도운동이 편마비 환자의 상지기능에 미치는 효과)

  • Kang, Ji-Yeon
    • Journal of Korean Academy of Nursing
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    • v.36 no.2
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    • pp.403-414
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    • 2006
  • Purpose: The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E. Method: A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal. Result: After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups. Conclusion: The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.