• 제목/요약/키워드: Upper function

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로봇보조(Robot-assisted) 치료가 뇌졸중 환자의 상지기능에 미치는 영향 (Effects of Robot-assisted Therapy on Function of Upper Extremity in Stroke Patients)

  • 황선정;유두한
    • 대한지역사회작업치료학회지
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    • 제3권1호
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    • pp.33-42
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    • 2013
  • 목적 : 본 연구는 로봇보조 치료가 뇌졸중 환자의 상지기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 뇌졸중 편마비 환자를 대상으로 발병 12개월 이내의 입원 환자 4명과 발병 12개월 이후의 외래환자 7명에게 각각 5~6주간 로봇보조 치료를 실시하였다. 로봇보조 치료는 상지기능 훈련을 위한 다양한 운동프로그램을 가지고 있는데, 그 중 앞으로 팔 뻗기 훈련을 통해 환자의 능력에 적합한 운동모드를 치료사가 선택하여 이루어졌다. 환자는 30분간 3차원의 피드백을 제공하는 모니터를 바라보며 앞으로 팔뻗기 운동을 반복적으로 수행하였다. 대상자들의 상지기능 변화를 위해 장악력 검사(Grip strength test), 한글판 울프운동기능검사(Korean-Wolf Motor Function Test: K-WMFT), 상자와 나무토막검사(Box & Block Test: BBT)와 팔 뻗기 수행시간을 중재 전 후에 측정하였다. 결과 : 로봇보조 치료를 통한 상지기능의 변화를 살펴보기 위해 중재 전 후의 측정값의 변화량을 비교하여 살펴본 결과, 연구 대상자 모두에서 결과값의 향상을 보였다. 통계적인 유의성을 확인하기 위해 윌콕슨 부호 순위 검증을 실시한 결과, 외래환자의 장악력과 상지기능, 기민성, 수행시간에서 유의한 차이를 보였고(p<0.05), 입원 환자의 경우에는 통계학적으로 유의한 차이를 보이지 않았다(p>0.05). 결론 : 로봇보조 치료가 뇌졸중 환자의 상지기능 회복에 긍정적인 영향을 주는 것을 알 수 있었다. 따라서 향후 본 연구를 기초로 작업치료 영역에서도 로봇보조 치료를 통한 중재적 접근이 필요할 것으로 생각되며, 뇌졸중 환자의 기능회복을 위한 로봇보조 치료의 유용한 사용이 기대된다.

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자조활동 훈련 프로그램이 만성 뇌졸중 환자의 상지 운동기능 및 자기효능감에 미치는 영향 (Effects of Self Care Training Program on Motor Function of Upper Limb and Self-Efficacy in Chronic Stroke Patients)

  • 김기도;허명
    • 한국엔터테인먼트산업학회논문지
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    • 제13권7호
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    • pp.497-503
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    • 2019
  • 본 연구는 만성 뇌졸중 환자를 대상으로 과제 지향적 훈련을 기반으로 하는 자조활동 프로그램이 상지 운동기능 및 자기효능감에 미치는 영향을 알아보고자 하였다. 지역사회에 거주하는 만성 뇌졸중 환자 20명을 대상으로 연구를 진행하였다. 자조활동 훈련 프로그램은 상지 과제 지향적 훈련으로 총 6주간, 주 4회 40분의 프로그램으로 구성하였으며, 매주 1회 집단훈련을 통해 훈련 프로그램을 점검하였다. 상지 운동기능의 변화를 알아보기 위해 맨손기능 검사, 악력 검사를 실시하였으며, 자기효능감 변화를 알아보기 위해 자기효능감 척도를 이용하여 설문 조사를 실시하였다. 상지 운동기능 검사 결과, 자조활동 훈련 전에 비해 자조활동 훈련 후 맨손기능과 악력이 모두 증가되었으며, 통계적으로 유의한 차이를 나타내었다(p<.05). 자기효능감 변화를 관찰한 결과, 자조활동 훈련 전에 비해 자조활동 훈련 후 자기효능감이 향상되었으며, 통계적으로 유의한 차이를 나타내었다(p<.05). 이상의 결과를 종합해 볼 때 과제 지향적 훈련을 기반으로 하는 자조활동 훈련 프로그램이 만성 뇌졸중 환자의 상지 운동기능 향상에 효과적이며, 과제 성취감을 경험하게 함으로써 신체의 운동기능 회복뿐만 아니라 자기효능감에도 긍정적인 영향을 미친 것을 알 수 있었다.

유방수술 후 발생한 견관절 기능장애와 상지 저림에 대한 치험 2례 (Traditional Korean Medicine Management of Complications of Breast Surgery - A Case Report of Complications After Breast Surgery)

  • 권지명;김동철
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.176-186
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    • 2010
  • Purpose: To review the effectiveness affecting to the shoulder functionalities and upper numbness by Traditional Korean Medical treatment who are given a surgical operation for breast resection by breast tumor Method: To report the patients with dysfunction of shoulder joint and numbness in upper limb after breast surgery who improved by Traditional Korean Medical treatment and to study Traditional Korean Medicine(TKM) management of complications of breast surgery. Results: After about 2weeks treatment, patient's symptoms and signs were improved. TKM management was effective in recovery of shoulder function and upper limb numbness after breast surgery. Conclusion: We need to actively participate in management of complications of breast surgery as adjuvant therapy. And more study is needed for developing Traditional Korean Medical indication of complications of breast surgery.

파라미터 불확실성을 갖는 선형 시스템에 대한 준최적 강인 칼만필터 설계 (Design of Suboptimal Robust Kalman Filter for Linear Systems with Parameter Uncertainty)

  • 진승희;김경근;박진배;윤태성
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 1997년도 하계학술대회 논문집 B
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    • pp.620-623
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    • 1997
  • This paper is concerned with the design of a suboptimal Kalman filter with robust state estimation performance for system models represented in the state space, which are subjected to parameter uncertainties in both the state and measurement matrices. Under the assumption that the uncertain system is quadratically stable, if the augmented system composed of the uncertain system and the filter is controllable, the proposed filter can provide the upper bound of the estimation error variance for all admissible uncertain parameters. This upper bound can be represented as the convex function of a parameter introduced in the design procedure, and the optimized upper bound of the estimation error variance can also be found via the optimization of this convex function.

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시변 불확정성을 갖는 선형 시스템의 강인 극점 배치 (Robust Pole Assignment of Linear Systems with Time-Varying Uncertainty)

  • 김진훈
    • 대한전기학회논문지:전력기술부문A
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    • 제48권1호
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    • pp.31-35
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    • 1999
  • In this paper, we consider the robust pole assignment and the upper bound of quadratic cost function for the linear systems with time-varying uncertainy. The considered uncertainties are both the norm bounded unstructured case and the structured case that has the matrix polytope type uncertain structure. We derve conditions that guarantee the robust pole assignment inside a disk in the L.H.P. and the robust stability. Also, we derive the upper bound of quadratic cost for thil pole assigned systems. Finally, we show the usefulness of our results by an example.

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함수 개념의 현상학 (Phenomenology of the concept of functions)

  • 유윤재
    • 한국수학사학회지
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    • 제23권3호
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    • pp.75-90
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    • 2010
  • 함수 개념을 실제로 사용되고 있는 측면에서 분석하면 인과, 명명, 연산, 변화, 도형, 형태, 변수, 범함수, 작용소 등 적어도 9가지의 양상이 존재한다. 이러한 분석을 통하여 함수 개념은 현재 3단계로 성장해 왔다는 것이 밝혀졌다.

동작관찰훈련이 뇌졸중 환자의 마비측 상지기능에 미치는 영향: 단일사례연구 (The Effect of Action Observation on Motor Function of Paretic Upper Extremity in Stroke Patients: Single Subject Study)

  • 정우식;윤태원;최연정;이홍균
    • 대한물리의학회지
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    • 제8권2호
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    • pp.271-280
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    • 2013
  • PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.

The Effect of Comprehensive Art Therapy on Physical Performance and Activities of Daily Living in Children with Cerebral Palsy

  • Baek, Suejung;Lee, Myeungsu;Yang, Chungyong;Yang, Jisu;Kang, Eunyeong;Chong, Bokhee
    • 대한통합의학회지
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    • 제7권3호
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    • pp.51-59
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    • 2019
  • Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.

Relationships between upper extremity performance and unified Parkinson's disease rating scale-motor exam

  • Hwang, Wonjeong;Hwang, Sujin;Lee, Kyoungsuk;Chung, Yijung
    • 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.

스마트폰을 이용한 뇌졸중 후 상지 편마비 환자의 상지 게임재활훈련 프로그램 개발 및 임상적 유용성 평가에 대한 예비연구 (Development and Clinical Evaluation of the Upper Extremity Rehabilitation Game Program for Patients with Upper Extremity Hemiplegia After Stroke Using Smartphone: Preliminary Study)

  • 임현미;최윤희;백남종;구정훈
    • 대한의용생체공학회:의공학회지
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    • 제36권5호
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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.