• PNF and Movement
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• v.16 no.3
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• pp.451-460
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• 2018

Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.202-222
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• 2003

Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

• The Journal of Korea Robotics Society
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• v.18 no.4
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• pp.376-384
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• 2023

In this paper, we introduce an upper extremity rehabilitation robot, NREH (NRC End-effector based Rehabilitation arm at Home). Through NREH, stroke survivors could continuously exercise their upper extremities at home. NREH allows a user to hold the handle of the end-effector of the robot arm. NREH is a end-effector-based robot that moves the arm on a two-dimensional plane, but the tilt angle can be adjusted to mimic a movement similar to that in a three-dimensional space. Depending on the tilting angle, it is possible to perform customized exercises that can adjust the difficulty for each user. The user can sit down facing the robot and perform exercises such as arm reaching. When the user sits 90 degrees sideways, the user can also exercise their arms on a plane parallel to the sagittal plane. NREH was designed to be as simple as possible considering its use at home. By applying error augmentation, the exercise effect can be increased, and assistance force or resistance force can be applied as needed. Using an encoder on two actuators and a force/torque sensor on the end-effector, NREH can continuously collect and analyze the user's movement data.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.141-150
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• 2021

Objective : In this study, the upper extremity use, executive function, and occupational performance effects of cognitive orientation to daily occupational performance (CO-OP) interventions for patients with stroke were assessed. Methods : The study was designed as a single-group pre-post test with 20 sessions. The participants were five hospitalized patients with stroke who were present in a rehabilitation setting, and their onsets were more than 3 months previously. Outcomes were measured using the Canadian Occupation Performance Measure (COPM), Performance Quality Rating Scale (PQRS), Executive Function performance Test - Korean version (EFPT-K), and Motor Activity Log (MAL). The Wilcoxon signed-rank test was conducted to determine the difference between the pre-and-post of CO-OP interventions. The statistical significance level was p<.05. Results : The upper extremity function showed significant changes and the execution function showed significant changes in preparation, sequencing, judgment and safety, and closing, except for items to be started. The performance of the task also showed significant changes. Conclusion : Through 20 sessions of CO-OP interventions, especially in patients with chronic stroke, the upper extremity function, execution function, and task performance were improved. We found that CO-OP intervention had a positive effect on the improvement of detailed task elements as well as the performance of tasks overall, in patients with stroke.

• International journal of advanced smart convergence
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• v.12 no.2
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• pp.167-172
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• 2023

In this study, the absolute and relative strength of six upper extremity resistance exercises were measured by classifying resistance exercise experts and non-experts. As a result, the skilled group showed higher absolute and relative muscle strength than the unskilled group in the 6 upper extremity resistance exercises. These results are judged to be the hypertrophy of fast-twith muscles, the mobilization of motor units, and the increase in the speed of nerve conduction while the skilled person consistently performs resistance exercise. Experts use intermuscular coordination efficiently to stably perform the load according to the movement and exercise intensity performed during exercise, whereas the inexperienced person uses relatively large muscle groups rather than efficiently using intermuscular coordination. It is considered that exercise motion and load were performed by mobilizing. In addition, as a result of comparing the absolute and relative muscle strength between the 6 types of upper limb resistance exercises, there was a difference between the 6 types of upper limb resistance exercises in the two groups. It can be judged that greater muscle strength and endurance were created through liver coordination.

• Journal of the Korean Society of Safety
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• v.23 no.5
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• pp.105-110
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• 2008

This study focused on the decreased effect of the work load on using the lower extremity supporter in kneeling posture. Fatigue measures included subjective discomfort ratings through the use of the Borg's CR-10 scale based parameters. The resting period and work method were considered as independent variables. The break time conditions are grouped into 10 seconds after work for 1 min and not exist break time. The method of work conditions are divided into four types. There are kneeling with the lower extremity supporter, kneeling with the knee protector, just kneeling and squatting. The result of the ANOVA of the shift value of subjective discomfort showed the followings: 1) There were differences as regards to the method of the work, the break time and the part of body($p{\leq}0.05$). 2) The lower extremity supporter showed the least subjective discomfort in other part of body except the upper leg.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.27-33
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• 1990

In the past decades there has been a growth of interest in the use of stellate ganglion block (SGB) as part of the diagnosis and therapy for the disease of the head, neck and upper extremities. For the evaluation of changes in hemodynamics and temperature of the affected extremity after the SGB, unilateral SGB (either right or left) was performed by local injection of 10 ml of 1% lidocaine without epinephrine in 45 patients (right side SGB: 25, left side SGB: 20) with various diseases. Systolic and diastolic blood pressure, pulse rate and skin temperature of the ipsilateral hand were studied before and 1, 2, 3, 4, 5, 10, 15, 30 and 60 minutes after the block. The results were as follows: 1) Changes of blood pressure: Systolic and distolic blood pressure after either right or left side SGB showed no statistically significant change. 2) Changes of pulse rate: While the left side SGB showed a mild decrease without statistical significance, the right side SGB showed a statistically significant decrease at 30 and 60 minutes after the block (p<0.05). 3) Changes of skin temperature of the blocked hand: Either side SGB produced a gradual increase in temperature with time and showed statistical significance from 10 minutes in the left side block (p<0.01), and a from 10 minutes after the block in the right side (p<0.01). Both sides SGB showed a maximal increase at 30 minutes after the block and a small decrease at 60 minutes after the block compared to the 30 minutes value. 4) Despite the successful SGB. 4 of 45 patients failed to produce a significant increase in skin temperature on the affected upper extremity. In conclusion, unilateral SGB with 1% lidocaine at the 6th cervical vertebral level is a safe method for use on an outpatient basis, and an increase in skin temperature in the affected upper extremity is necessary to confirm the successful therapeutic effect on disease of the upper extremity.

• Research in Community and Public Health Nursing
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• v.17 no.4
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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.

• Journal of Biomedical Engineering Research
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• v.36 no.5
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• pp.155-161
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• 2015

In the paper, we developed the mobile based rehabilitation system for patients with upper extremity hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built in the smartphone were used to track patients' upper limb motion and the movements was transferred to the tablet PC through bluetooth connection so that the game contents could be interact with the movements. The rehabilitation game contents was based on Brunnstrom stage(B-stage), and was designed to lead accurate movement of upper limb. For the clinical evaluation of the effectiveness, 11 patients were recruited and make them perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The change of upper limb motor function was measured using fugl-meyer assessment(FMA), Brunnstrom stage(B-stage). And the change of quality of life was measured using EuroQoL-5 Dimension(EQ-5D), Beck Depression Inventory(BDI). The results showed significant improvement in upper limb function but not in quality of life. We verified mobile based rehabilitation program could be useful and effective for the clinical use.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.117-125
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• 2019

Purpose : The purpose of this study was to determine the effects of simultaneous application of focal vibration stimulation and task-oriented training on the improvement in upper extremity motor function after stroke. Methods : The study period was from January to April 2019; 23 patients who fulfilled the study eligibility criteria were enrolled. The participants were divided into two groups: the experimental group with vibration stimulation and task-oriented training and the control group with only task-oriented training. Training was conducted in a total of 20 sessions, 5 times a week for 30 minutes a day for 4 weeks. The amount of use of the affected and unaffected side by accelerometers, and Box and Block test (BBT), Action Research Arm Test (ARAT) was measured with a pre-test, a post-test. Wilcoxon Signed Rank Test and Analysis of Covariance were used to compare and analyze the changes within and between the groups. Results : Both the groups showed statistically significant changes in the results of the BBT and the ARAT, as well as the amount of use of the affected and unaffected side. Regarding the use of the affected side, BBT results, and the grasp and gross movement item of the ARAT showed significant changes in the experimental group compared with the control group. Conclusion : We found that simultaneous application of focal vibration stimulation and task-oriented training was more effective than task-oriented training alone. A large-scale comparative study involving a group that is only given vibration stimulation should be conducted for more generalizable results.