• 재활치료과학
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• 제2권2호
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• pp.5-20
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• 2013

강제유도 운동치료는 2주간 건측의 사용을 억제하기 위해 깨어 있는 시간의 90%를 제한하는 동시에 환측에 매일 6시간 이상 강도 높은 훈련을 실시하는 것이다. 하지만 강제유도 운동치료가 뇌졸중 환자의 임상 적용에 있어서 문제점을 보였고, 이를 최소화하기 위해 수정된 강제유도 운동치료가 고안되었다. 뇌졸중 환자를 대상으로 수정된 강제유도 운동치료의 적용이 다양한 방법으로 연구되어져 왔고, Motor Activity Log(MAL), Fugl-Meyer Assessment(FMA), Wolf Motor Function Test(WMFT), Action Research Arm Test(ARAT), Functional Independence Measure(FIM), Stroke Impact Scale(SIS)을 통해 뇌졸중 환자의 기능 향상에 대한 효과를 증명하였다. 수정된 강제유도 운동치료가 뇌졸중 환자의 상지기능, 일상생활활동과 삶의 질 향상을 위한 치료 방법으로써 작업치료 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• 한국콘텐츠학회논문지
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• 제13권11호
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• pp.288-296
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• 2013

본 연구의 목적은 수근관증후군 뇌졸중 환자에서 경직정도에 따른 정중신경 단면적, 신경전도속도 및 상지기능 차이를 알아보고자 하였다. 연구대상은 성인 뇌졸중 환자 42명에서 CTS군 21명과 Non-CTS군 21명으로 선정하였다. 측정방법으로는 정중신경 단면적, 신경전도속도, GST, FMAS, CTS-FSS로 측정하였다. 연구결과, CTS군과 Non-CTS군 간 각 등급에서 정상측(p<.001)과 마비측(p<.001)의 정중신경 단면적, 정중 운동신경과 감각신경 기시잠시는 통계학적으로 유의한 차이가 있었다. CTS군과 Non-CTS군 간 각 등급에서 GST(p<.05), FMAS(p<.05), CTS-FSS(p<.001)는 통계학적으로 유의한 차이가 있었다. 본 연구는 수근관에 대한 병리역학적 내용을 제시함으로서 뇌졸중 환자의 상지기능훈련 시 고려해야할 내용 중 하나임을 제시하였다.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.143-148
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• 2016

Objective: This study aimed to quantify one of the useful upper extremity movements to evaluate motor control abilities between the groups of people with mild and moderate arm impairments performing a door handling task. Design: Cross-sectional study. Methods: Twenty-one healthy participants and twenty-one persons with chronic stroke (9 mild stroke and 12 moderate stroke) were recruited for this study. Stroke participants were divided into 2 groups based on Fugle-Meyer Assessment scores of 58-65 (mild arm) and 38-57 (moderate arm). All they performed door handling task including the pronation and supination phases 3 times. We measured some movement factors which were reaction time, movement time, hand of peak velocity, hand of movement units to perform door handling task using the three-dimensional motion analysis. Results: The majority of kinematic variables showed significant differences among study groups (p<0.05). The reaction time, total and phase of movement time, hand of peak velocity, the number of movement units discriminated between healthy participants and persons with moderate upper limb stroke (p<0.05). In addition, reaction time, total and phase of movement time, the number of movement units discriminated between those with moderate and mild upper limbs of stroke patients (p<0.05). Conclusions: Three-dimensional kinematic motion analysis in this study was a useful tool for assessing the upper extremity function in different subgroups of people with stroke during the door handling task. These kinematic variables may help clinicians understand the arm movements in door handling task and consist of discriminative therapeutic interventions for stroke patients on upper extremity rehabilitation.

• 재활치료과학
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• 제8권1호
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• pp.41-50
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• 2019

목적: 본 연구의 목적은 건강한 성인을 대상으로 양측상지기능 훈련을 통해서 활성화 되는 대뇌 연결성에서 상상 훈련과 신체적 수행 간에 차이가 있는지를 알아보고자 한다. 연구방법: 연구 대상자는 건강한 성인 1명으로 상상훈련과 신체적 수행 시 EEG 측정이 이루어졌다. 양측상지기능 훈련은 대칭 과제와 비대칭 과제로 구성되었다. 대칭 과제는 양손으로 박스를 잡고 동시에 위의 선반으로 올렸다가 다시 내려놓는 과제이고, 비대칭 과제는 한 손으로 병을 잡고 다른 한 손으로 뚜껑을 여는 과제였다. EEG 전극은 Fp1, Fp2, F3, F4, T3, T4, P3 및 P4에 부착되었다. 데이터 분석은 EEG 전극 쌍 간의 상관 분석을 위해 Cross-Line Mapping을 사용하였다. 결론: 본 연구 결과 대칭 및 비대칭의 양측 상지 과제에서 대뇌 연결성 패턴은 운동과 감각 영역에서 유사한 패턴을 가지는 것으로 나타났다. 또한 본 연구를 통해 양측상지기능 훈련 시 상상훈련보다 신체적 수행에서 대뇌 연결성이 더 높은 상호상관을 갖는다는 것을 확인하였다.

• 대한한방소아과학회지
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• 제28권1호
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• pp.24-31
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• 2014

Objectives The purpose of this study is to know the effect of acupuncture on brachial plexus palsy due to birth injury. Methods We decided to treat one week of Vojta therapy and occupational therapy, but other were combined, and then add three weeks of acupuncture treatment as well. Results Right clavicle fracture at birth brachial plexus injury due to decreased locomotion of the right upper extremity, muscle weakness in children aged 7 months to Vojta therapy, occupational therapy and acupuncture, when performed in conjunction mobility increase of the shoulder joint, elbow support improvement, recovery of motor function of the hand grip, etc. to obtain a significant motor function recovery improvement. Conclusion Acupuncture was a good treatment of choice for the better shoulder, joint and hands movements.

• 대한물리치료과학회지
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• 제12권3호
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• pp.7-12
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• 2005

Constraint-induce therapy(CIT) has been documented to improve motor function in the upper extremity of people with hemiparesis. The exercise program uses the training technique 'shaping'. Shaping involves repetitive exercise that are progressed in small steps, where only positive feedback is given to the patients. It involves 14 days of using a restraint on the unaffected arm after stroke for 90% of waking hours. In conjunction with this, ten days of intensive exercise with the affected arm are undertaken for around six hour daily. CIT produces great improvement of motor function with a period of 2 weeks, that the treatment effect remains stable for many months after the end of therapy, and that it transfers into the everyday lives of patients. The purpose of this study is to introduce about the principles of CIT charactieristic, techniques, therapeutic effects-throughout reference books.

• 지역사회간호학회지
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• 제17권4호
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• pp.482-491
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• 2006

Purpose: Hemiplegia patients who were attacked by a stroke suffer from hemiplegic disabilities as well as motor disabilities. For them, rehabilitation cure is being carried out broadly. However, it is not enough for them to use the upper extremity than the lower extremity. For the use of the upper extremity, we examined the effect of constraint-induced movement therapy developed in this research on patients who experienced a stroke following hemiplegia. Method: For this study we selected 36 stroke patients who were registered at the community health center through accidental sampling, and assigned 21 of them to the experimental group, and 15 to the control group. The experimental group had constraint-induced movement therapy for 5 days and 7 hours a day from 9 to o'clock in the morning 9 to 4 o'clock in the afternoon 4 including warmup exercise and main exercise in the rehabilitation room, whereas the control group were restricted. Result: As a result of constraint-induced movement therapy, affected side elbow joint flexion range, side shoulder joint extension range and side shoulder joint of the flexion range of motions increased obviously in the experimental group compared to those in the control group. Conclusion: The result above clearly shows that constraint-induced movement therapy is an effective intervention for the rehabilitation of hemiplegia patients in increasing affected side elbow joint of the flexion range of motion, the shoulder joint extension, and the increase of flexion range of motion.

• 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.

• The Journal of Korean Physical Therapy
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• 제18권4호
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• pp.1-9
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• 2006

Recently, several investigations revealed that after unilateral brain damage, movement abnormalities were exposed on the ipsilateral side as well as the upper extremity contralateral to the damaged hemisphere. Even the motor abilities had significantly recovered from ipsilateral motor deficits on not only simple sensoriomotor function, also clinical assessments since subacute stage, although could not completely returned. Such motor deficits were detected in a diversity of motor tasks depending on the interhemispheric specialization, further in clinical evaluation and a daily of activities. In the clinical features, muscular weakness, sensory loss and impaired manual dexterity were observed. In a laboratory experiment, there were increasing evidences that the kinematic processing deficits was founded in various-specific motor tasks, which ranged from simple basic element to complex tasks, such as tapping task, step-tracking, goal directional aiming task, and iso(and non-)directional interlimb coordination. In the point of view, the manifest understanding in related to ipsilateral deficits provide the clinicians with an important information for scientific management about brain injured patient's prognosis and therapeutic guidelines.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.77-87
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• 2010

The present case study highlights the effects of a novel Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST) on morphological changes and associated upper extremity (UE) muscle strength and motor performance in a child with spastic quadriplegic cerebral palsy (CP). The Child, a 10-year-old girl with spastic quadriplegic CP, was treated with CHRIST for 60 minutes a day, five times a week, for 5 weeks. The CHRIST was designed to improve motor function and strength. Clinical tests including the modified Wolf Test, Jebsen-Taylor Hand Function Test, and Pediatric Motor Activity Log questionnaire were used to determine motor function. Ultrasound imaging was performed to determine the changes in the cross-section area (CSA) of the extensor carpi radialis (ECR) and triceps brachii (TRI). Muscle strength was measured with a dynamometer at pretest, and post-test, and 3-month follow-up. Ultrasound imaging data showed that the CSAs of both ECR and TRI muscles were enhanced as a function of the intervention. These changes were associated with muscle strength and motor performance and their effects remained even at a 3-month follow-up test. Our results suggest that the CHRIST was effective at treating muscle atrophy, weakness and motor dysfunction in a child with spastic quadriplegic CP.