• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.502-508
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• 2022

Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

• PNF and Movement
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• 제13권4호
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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.

• 대한물리의학회지
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• 제3권4호
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• pp.269-276
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• 2008

Purpose : The purpose of this study was to evaluate the effects of mirror movements(MM) on upper extremity's function and measure the change of MM on stroke patients depending on the elapse of time. Methods : Sixteen stroke patients with MM and Sixteen stroke patients without MM were recruited for this study. Intended movements and MM were measured by two dynanometers of MP150 system(BIOPAC System Inc., Santa Barbara, U.S.A). The upper extremity's motor function was measured using manual function test(MFT), Fugl-Meyer assesment(FMA). Results : The change rates of upper extremity's motor function test showed significant group differences in FMA but not in MFT between the patients with MM and without MM from the first test to the second test. In each group motor function generally more increased. The magnitudes of MM decreased from the first test to the second test. Conclusion : These results indicate that stroke patients with MM have a significant motor deficit. But motor deficit could be recovered by spontaneous recovery or treatments and a clinical sign of MM was improved. In the future, we suggest that studies of assessments of MM after rehabilitation and treatment interventions of MM on stroke patients.

• Journal of Magnetics
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• 제19권2호
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• pp.170-173
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• 2014

The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

• International Journal of Contents
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• 제17권2호
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• pp.20-31
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• 2021

This study aimed to pilot test a newly developed bilateral upper limb rehabilitation training program for improving the upper limb function of individuals with chronic stroke using a visual feedback method. The double-group pretest-posttest design pilot study included 10 individuals with chronic stroke (age >50 years). The intervention (four weekly meetings) consisted of five upper limb training protocols (wrist extension; forearm supination and pronation; elbow extension and shoulder flexion; weight-bearing shift; and shoulder, elbow, and wrist complex movements). Upper limb movement function recovery was assessed with the FuglMeyer Assessment of the Upper Extremity, the Wolf Motor Function Test, the Trunk Control Test, the modified Ashworth Scale, and the visual analog scale at baseline, immediately after, and four weeks after the intervention. The Fatigue Severity Scale was also employed. The Fugl-Meyer Assessment of the Upper Extremity and Wolf Motor Function Test showed significant improvement in upper limb motor function. The Trunk Control Test results increased slightly, and the modified Ashworth Scale decreased slightly, without statistical significance. The visual analog scale scores showed a significant decrease and the Fatigue Severity Scale scores were moderate or low. The bilateral upper limb training program using the visual feedback method could result in slight upper limb function improvements in individuals with chronic stroke.

• 재활치료과학
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• 제1권2호
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• pp.35-40
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• 2012

본 연구에서는 가상현실 치료가 뇌졸중 환자의 뇌 가소성을 동반한 상지기능 향상에 미치는 영향을 알아보고 강도 높은 가상현실 훈련이 뇌졸중 환자의 상지기능 향상을 위한 집중치료로써 임상적으로 유용한 훈련인지 알아보고자 하였다. 뇌졸중 환자에게 있어 사용-의존성 즉 운동 강도와 반복은 마비 측 사지의 운동 기능향상에 중요한 치료적 요소이다. 최근에는 상지의 지속적 사용을 통한 뇌-가소성에 기반한 변화를 유도할 수 있는 치료방법으로 가상현실 치료가 대두되었다. 가상현실 치료는 재활 임상환경에서 운동기능 향상을 위한 훈련강도와 반복을 제공할 수 있는 기술적 방법으로 채택되기 시작하였다. 특히 뇌졸중 환자의 상지 기능을 향상시키기 위한 치료적 유용성 측면에서는 강도 높은 반복적 훈련이 가능하다는 것과 게임 같은 형식으로 높은 동기부여가 가능하다는 것, 실제 수행을 통한 다중감각적 피드백 제공, 상호작용이 가능한 과제지향적 치료가 가능하다는 장점을 가지고 있다. 임상 환경에서 작업치료와 더불어 부가적으로 가상현실 치료를 실시하는 것은 뇌졸중 환자의 상지 기능회복을 더욱 촉진할 것이다.

• Physical Therapy Rehabilitation Science
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• 제2권2호
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• pp.99-103
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• 2013

Objective: Clinical measures that quantify upper extremity function are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the relationship between the Unified Parkinson's Disease Rating Scale (UPDRS)-Motor Exam and upper extremity performance as a quantifying clinical tool of upper extremity function in persons with Parkinson's disease. Design: Cross-sectional study. Methods: Thirty-two idiopathic Parkinson's Disease persons participated in this study. To investigate the relationship between the UPDRS-motor exam, Box and Block test (BBT), and Action Research Arm Test (ARAT) by two physical therapists. The examination took up to 1 hour, and the participants were invited to rest between each clinical measure in order to minimize the effects of fatigue. Clinical measures were assessed while the subjects were in the "on" phase of their medication cycle, generally 1-3 hour after taking their anti-Parkinson's medications. Results: In more affected side, the UPDRS-motor exam was significantly negative correlated with the BBT (p<0.05) but it was not significantly correlated with the ARAT. In less affected side, only positively correlation was significantly shown between BBT and ARAT (p<0.05). On the other hand, between BBT and ARAT were not significantly correlated with the UPDRS-motor exam. Conclusions: The UPDRS-motor exam is effective tool which was significantly correlated with manual dexterity in more affected upper extremity. But The UPDRS-motor exam is not effective tool in less affected upper extremity.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.69-78
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• 2015

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.52-59
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• 2019

Objective: The purpose of this review was to investigate whether motor imagery training has an effect on the recovery of upper extremity function in individuals with hemiparetic stroke or not. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to December 18th, 2018 and randomized controlled trials (RCTs) evaluating motor imagery training on upper extremity function in persons with a diagnosis of hemiparetic stroke were included. This review selected the following information from each study: surname of the first author, published year, nation, population, intervention, therapeutic intensity of intervention, therapeutic comparison, outcome measures, additional therapy, summary of results, and descriptive statistics of outcome measures. Results: This review selected seventeen RCTs with 487 stroke survivors and the following intervention methods: six motor imagery training with additional therapeutic technology, two motor imagery training with additional modified constraint-induced therapy, four mirror therapy, and five motor imagery training. Ten RCTs were eligible for meta-analysis after systematic review. The motor imagery group were more effective than the control group based on the Fugl-Meyer assessment (3.43; 95% confidence interval [CI], 1.65 to 5.22; heterogeneity [$chi^2=8.03$, df=8, $I^2=0%$], test of overall effect Z=3.76; test for subgroup differences [$chi^2=2.56$, df=2, $I^2=21.8%$]) and the Action Research Arm Test (1.32; 95% CI, -8.12 to 10.76; heterogeneity [$Tau^2=70.74$, $chi^2=15.22$, df=3, $I^2=80%$], test of overall effect Z=3.76). Conclusions: The results of this review suggests that motor imagery shows positive effectiveness on improving upper extremity function in persons with hemiparetic stroke.

• PNF and Movement
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• 제18권3호
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• pp.445-452
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• 2020

Purpose: The purpose of this study was to evaluate the analysis of the association between upper extremity function and the Wolf Motor Function Test (WMFT) for chronic hemiparetic stroke patients and investigate the evidence of the WMFT as a clinical tool of upper extremity function in individuals with chronic hemiparetic stroke. Methods: This study applied an observational, cross-sectional design in outpatients at three local rehabilitation units in Seoul. Forty-nine individuals who had a diagnosis of first stroke participated in this study. All participants were analyzed for four clinical measures, including the Box and Block Test (BBT), the WMFT, grip strength, and the Canadian Occupational Performance Measure (COPM). Results: Upon analysis, a significant relationship was found between the WMFT scores and BBT scores as well as the grip strength. The WMFT score was statistically and positively associated with the COPM satisfaction score; however, it was not related to the COPM performance score. Conclusion: The results of this study suggest that the WMFT is positively related to simple tasks, such as hand muscle strength and manual dexterity. However, the WMFT does not have a relationship with complex tasks, which are measured by COPM performance abilities.