• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.4
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• pp.295-303
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• 2016

Rehabilitation of upper limb motor function of hemiplegic patient must maintain interest and demand a device for a quantitative evaluation of rehabilitation training. In this paper, we developed the device that is composed of arm cradle, handle, and balance ball for rehabilitation exercise. We have performed experiment for validity as to whether to use the rehabilitation device when tilting the upper extremity training device developed to measure changes in the EMG signal to the main upper limb muscles for 7 healthy volunteers. We have analyzed muscle activation signals on agonist and antagonist as a reference in the muscle contraction and relaxation in the upper limb extension and flexion when the balance-handle device is tilted to front-rear and left-right. The experimental results showed that a tendency of muscle activation of biceps, triceps, and deltoid used in upper limb motor function of hemiplegic patients from extension and flexion evaluation items of Fugl-Meyer Assessment(FMA). These results may be helpful for rehabilitation training for upper limb motor function of hemiplegic patients by utilizing a developed unit.

• Therapeutic Science for Rehabilitation
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• v.8 no.4
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• pp.7-18
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• 2019

Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.

• Therapeutic Science for Rehabilitation
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• v.2 no.1
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• pp.13-23
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• 2013

Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.

• Journal of the Ergonomics Society of Korea
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• v.22 no.3
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• pp.75-91
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• 2003

Evaluation of repetitiveness for hand-intensive tasks is essential to determine the level of risk for upper-extremity musculoskeletal disorders at the workplace. Many measures and methods have been introduced for repetitiveness assessment: however, our understanding of the differences among these measures and methods is lacking. The present study compared the repetitiveness measures and measurement/analysis methods to help practitioners apply the proper repetitiveness assessment methodology in the workplace. By reviewing 51 studies of repetitiveness assessment, measures and corresponding measurement/analysis methods were surveyed. Of the repetitiveness measures, two types of dimensions (frequency and time) and corresponding types of analysis scopes were identified. According to the dimensional and analysis-scope types. the repetitiveness measures were categorized and then the surveyed studies were counted for each measure. It is identified that frequency measures have used 2.7 times higher than time measures and the frequency of wrist motions has been most frequently used in repetitiveness assessment. Furthermore, the measurement methods were categorized into objective and subjective methods, and the analysis methods into statistical and spectral methods. Lastly, eight factors (accuracy, reliability. sensitivity. efficiency. ease of use. applicability. interference. and robustness) were listed to be considered in selecting the appropriate assessment methodology.

• Physical Therapy Korea
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• v.2 no.1
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• pp.80-87
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• 1995

The purpose of this case study was to introduce a myoelectric hand prosthesis for upper extremity amputee and prosthetic training program. Limb loss can result from disease, injury, or congenital causes. Trauma has been increasingly important role as the cause of amputaion in young, vigorous, and otherwise healthy individuals. The higher the level of amputation the greater the functional loss of the part, and the more the amputee must depend on the prostheis for fuction and cosmesis. Myoelectrical control of prostheses is a recent development and has been steadily gaining in clinical use over the past 20 years. Such a prosthesis uses signals from muscle contraction within the stump to activate a battery driven moter that operates specific component fuctions of the prosthesis. This twenty years old male case was operated a right above-elbow amputation due to tracffic accident and admitted to Yonsei Rehabilitaion hospital for the preprosthetic and prosthetic training. The case was able to successfully complete his myoelectric hand prosthesis training in the February of 1995.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.104-108
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• 2018

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.24-44
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• 2020

Objective : To develop an occupation-based bilateral upper extremity training protocol that can be effectively applied in a medical setting Methods : The research process using the delphi technique was carried out in 3 stages. The first stage was an open questionnaire development stage, The first draft is prepared through literature review and open questions were developed through preliminary research based on the draft. The second stage was the delphi survey. Based on the responses of the experts obtained through the open Delphi survey, the adequacy of the training protocol was shown on a Likert 5 point scale. The items were edited and deleted, reconstructed by analyzing the mean and standard deviation, stability, convergence degree, consensus, and content validity ratio through the questionnaire. The third step was the completion of the protocol. After discussions between researchers, the finalized protocol contents were reorganized to complete the occupation-based bilateral upper extremity training protocol for medical setting. Results : The final protocol consisted of 9 items across 3 areas in the occupation-based intervention selection domain and 81 items across 4 areas in the bilateral upper extremity training domain, intervention period, and evaluation. Conclusions : This study suggests an evidence-based method that collects the opinions of occupational therapists in order to use occupation-based activities as interventions in a situation that currently sees occupational therapy primarily performed in hospitals. It is also meaningful that the bilateral upper extremity training can be applied effectively in clinical situations by concretely presenting.

• The Journal of the Korea Contents Association
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• v.13 no.2
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• pp.348-358
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• 2013

This study aimed to investigate the effect of a lap board that was developed to prevent musculoskeletal disorders caused by the use of a computer mouse. Study participants were 10 college students in their 20s who did not have any musculoskeletal symptoms. We analyzed the difference in upper limb movements, electromyographic activity, task performance, and subjective discomfort between 2 conditions: use of a mouse with the lap board and use of a mouse placed on a desk. Results of behavior analysis showed that there was a significant difference between the 2 conditions in terms of the average angle of shoulder flexion, shoulder internal rotation, and forearm pronation(p< 0.05). However, electromyographic activity, task performance, and subjective discomfort showed no significant differences between the 2 conditions. When subjects used the mouse with the lap board, their upper extremity was located much closer to the torso than when they used the mouse placed on the desk. Six of 10 participating students preferred the lap board. We expect that advanced research on prevention of musculoskeletal disorders due to the use of the computer mouse will be conducted in the near future.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.7-16
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• 2002

This study was conducted to assess the changes in the functional levels of affected upper extremities after treating hemiplegic patients by applying constraint-induced movement therapy(CIMT). The subjects were selected from 20 hemiplegic patients with scores of 25 or more in Mini Mental State Examination(MMSE-k), transferred to the departments of physical therapy in two university hospitals in Busan from December, 2001 to march, 2002, and were divided into two groups. Eleven subjects with fixing unaffected arms by CIMT were assigned to the experimental patient group and the other 9 patients to control group without fixing unaffected arms. The function of upper arms for both groups were evaluated by using Actual Amount of Use Test(AAUT) and Motor Active Log(MAL) before and after physical therapy. The malts were as follows: The recovery rates of upper extremity by AOU(Activity of Use) and QOM(Quality of Movement) were 23.9% and 27.3% for CIMT treated group, and by 8.3% and 4.6% for the control group on the average, respectively, in AAUT after physical therapy, showing statistically significant differences between two groups. And in MAL, the average recovery rates were 27.3% by AOU and 22.6% by QOM for CIMT treated group while 3.1% by both AOU and QOM for the control group, and were significantly different between twogroups.