• 대한통합의학회지
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• 제11권4호
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• pp.281-289
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• 2023

Purpose : In this study, we aimed to determine how frequencies different of repetitive transcranial magnetic stimulation applied to the less affected contalesional corticomotor area affect upper extremity motor function in patients with acute stroke within 3 months of onset. By doing so, we aimed to propose a new method of rTMS intervention based on the degree of damage and recovery status of the patient, rather than the generalized rTMS intervention that has been used uniformly. Methods : The rTMS intervention was applied on the contralesional side of the cerebral hemisphere damage. 15 subjects in the HF-rTMS group, 12 subjects in the LF-rTMS group, and 14 subjects in the SF-rTMS group were randomized to receive the rTMS intervention in each group for a total of 10 sessions on five consecutive weekdays for two weeks, and underwent FMA-U to determine changes in upper extremity function following the intervention in each group. FMA-U was performed within 24 hours before and after the rTMS intervention. Results : When the FMA-U was performed to determine the pre- and post-intervention changes in upper extremity motor function within the groups, no statistically significant differences were found in the SF-rTMS group before and after the intervention, but significant statistical differences were found in the HF-rTMS group (p=.006) and the LF-rTMS group (p=.020), with greater significance in the HF-rTMS group than the LF-rTMS group. Conclusion : This study confirmed that compensatory action by activating the less affected contralesional corticomotor area based on the bimodal balance-recovery model can support upper extremity recovery patients with acute stroke within 3 months of onset, depending on the degree of damage level and recovery status. Therefore, the results of the contralesional HF-rTMS application in this study may provide a basis for proposing a new rTMS intervention for upper extremity recovery in stroke patients.

• Safety and Health at Work
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• 제1권2호
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• pp.158-166
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• 2010

Objectives: This study aimed to find gender distinctions in terms of the sociology of the population; to determine work-related factors; to analyze gender differences in daily living, work, sports, and art performances; and to identify gender-related factors that limited performance of daily living and work activities. Methods: A questionnaire was designed that included disabilities of the arm, shoulder, and hand (DASH), accident history, disease history, work duration at current workplace, marital status, job satisfaction, job autonomy, and physical demands of the job. Out of 1,853 workers surveyed, 1,173 questionnaires (63.3%; 987 males, 186 females) included responses to DASH disability and DASH optional work and were judged acceptable for analysis. Results: Upper extremity functional limitation during work and daily living was higher for females than males. The limitations for males increased according to their household work time, accident history, work duration, job satisfaction, physical demand, and job autonomy. Meanwhile, female workers' upper extremity discomfort was influenced by their disease history, job satisfaction, and physical demands. In addition, the size of the company affected male workers' upper extremity function, while marriage and hobbies influenced that of female workers. Conclusion: This study addressed sociodemographic factors and work-related factors that affect each gender's upper extremity function during daily living and working activities. Each factor had a different influence. Further studies are needed to identify the effect that role changes, not being influenced by risks at work, have on musculoskeletal disorders.

• 대한물리의학회지
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• 제11권1호
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• pp.115-125
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• 2016

PURPOSE: The purpose of this study was to compare the effects of task-oriented training and virtual reality training on upper extremity function, balance ability, depression in stroke patients. METHODS: Forty stroke patients were randomly allocated into a task oriented training group (TTG, n = 20), a virtual reality training group (VRG, n = 20). Both groups received the usual physical therapy. In addition, TTG patients underwent task training such as sweeping the table, cup stacking, carrying wood block. VRG patients underwent virtual reality training using X-box kinect. Both groups received 30 minutes of training per day, five times per week, for twelve weeks. RESULTS: After intervention, both groups showed significant improvement on upper extremity function, balance ability, and depression. VRG showed more improvement on upper extremity function, balance ability, and depression than TTG. CONCLUSION: According to the results of this study, task-oriented training and virtual reality training are feasible and suitable for stroke patients. And virtual reality training is more effective method than task oriented training.

• 재활간호학회지
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• 제18권2호
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• pp.67-74
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• 2015

Purpose: The purpose of this study was to identify the effects of auricular acupressure therapy on the upper extremity function, perceived health status and Activities of Daily Living for rehabilitation among stroke patients at home. Methods: As a quasi-experimental study, non-equivalent control group pretest-posttest design was used. Data were collected from August 1st to September 31st, 2012. Participants were 28 (Experimental 17, Control 11) stroke patients at home. Using the SPSS/WIN 12.0 program, data were analysed by the $x^2$-test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed rank test. Results: Upper extremity function (U=28.00, p=.001) and activities of daily living (U=47.50, p=.029) were significantly higher in the experimental group compared to the control group. However, perceived health status was not significantly different between the two group. Conclusion: This study proved that auricular acupressure therapy was effective for upper extremity function and activities of daily living among stroke patients at home.

• 재활치료과학
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• 제5권1호
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• pp.7-22
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• 2016

목적 : 본 연구는 양측상지기능 평가도구의 체계적 고찰을 통해, 대상자, 평가방법, 신뢰도, 타당도, 민감도 등을 분석하여 임상 및 연구에서의 자료로 활용하고자 하였다. 연구방법 : 2014년 12월 한달 동안 PubMed 데이터베이스에서 'upper extremity'와 'motor actiity' 'activities of daily living'와 'assessment instrument' 'disability evaluations'의 키워드로 검색하여, 최종적으로 68개의 연구에서 44개의 상지기능 평가도구를 추출하였다. 추출된 평가도구에서 양측상지기능 평가도구의 비율, 대상자, 측정방법, 신뢰도, 타당도, 민감도를 비교분석하였다. 결과 : 상지기능 평가도구 중 양측상지기능 평가도구는 2개로 가장 적었다. 모두 뇌졸중 환자를 대상으로 하였으며, 환자의 양측 상지수행을 통해 환측의 기능을 측정하는 평가도구였다. 평가도구의 신뢰도, 타당도, 민감도는 높은 것으로 조사되었다. 결론 : 본 연구를 통해 양측상지기능 평가도구의 개발 및 연구가 필요하며, 이를 통해 양측상지기능 치료 효과를 보기 위한 평가도구로 활용될 수 있기를 기대해 본다.

• 대한물리의학회지
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• 제11권1호
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• 한국콘텐츠학회논문지
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• 제20권6호
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• pp.114-123
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• 2020

본 연구는 뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행 및 상지 기능에 미치는 효과에 대해서 알아보았다. 신경계 손상 환자가 있는 병원을 기반으로 해서 하지 근력 강화에 대한 연구 방법을 만들어서 진행하였고, 무작위대조시험을 적용하였다. 24명의 뇌졸중 환자를 두 군으로 분류하였다. 하지 근력 강화 프로그램그룹 (Lower extremity strengthening program group, LESPG) (12명)과 트레드밀 훈련그룹 (Treadmill trainig group, TTG) (12명)으로 실험하였다. LESPG는 마비측에 하지 근력 강화프로그램을 수행하였다. TTG는 하루 30분 동안 트레드밀 운동을 적용하였다. 평가 도구는 일어나서 보행 검사(Timed Up and Go test, TUG), 기능적 보행평가 (Functional Gait Assessment, FGA) 및 뇌졸중 상지 기능검사(Manual Function Test, MFT)를 적용하였다. 균형, 보행 및 상지 기능에 대한 두 군 간의 TUG, FGA 및 MFT 점수는 LESPG가 TTG보다 유의한 차이가 있었다(p<.01). 4주간의 하지 근력강화 프로그램의 효과는 뇌졸중 후 편마비 환자의 균형, 보행 및 상지 기능에 효과가 있었다.

• PNF and Movement
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• 제20권2호
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• pp.147-156
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• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• 한국콘텐츠학회논문지
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• 제20권9호
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• pp.520-530
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• 2020

본 연구의 목적은 작업기반 양측성 상지 훈련과 경 두개 직류 전류 자극이 뇌졸중 환자들의 상지기능에 미치는 효과를 알아보는 것이었다. 만성 뇌졸중 환자를 대상으로 작업기반 양측성 상지훈련과 경두개 직류전류자극을 실시한 실험군 13명, 작업기반 양측성 상지훈련만 실시한 대조군 13명으로 나누어 총 4주간, 50분씩, 주 5회 실시하였으며, 캐나다 작업수행 평가(Canadian Occupational Performance Measure;COPM), 가속도계 (Accelerometer), 퍼글 마이어 검사(Fugle-Meyer Assessment;FMA), 운동 홛동 척도(Motor Activity Log;MAL)를 사용하여 평가하였다. 연구 결과, 실험군과 대조군은 작업 만족도와 수행도, 환측과 건측의 사용량, 상지 기능의 회복과 움직임의 질에서 모두 유의미한 개선을 보였으며, 특히, 환측 사용량에서 실험군은 대조군 보다 유의한 차이를 나타냈다. 따라서 작업기반 양측성 상지 훈련과 경 두개 직류 전류 자극의 결합 중재가 뇌졸중 환자의 상지기능회복에 긍정적인 효과를 보임을 알 수 있었다.

• 대한물리의학회지
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• 제14권4호
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• pp.115-123
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• 2019

PURPOSE: This study compared the scores of the Mini-Mental State Examination-Korean version (MMSE-K) and Korean version Montreal Cognitive Assessment (K-MOCA), which assess cognitive function, the Fugl- Meyer Upper-Extremity Assessment (FMA), which assess the upper extremity function; and Modified Barthel Index (MBI), which that assesses activities of daily living among patients receiving inpatient treatment following a diagnosis of stroke to determine the correlations among MMSE-K, K-MOCA, FMA, and MBI. METHODS: The study assessed the cognitive function using the MMSE-K and K-MOCA, upper extremity function using FMA, and activities of daily living using MBI. The data were analyzed using Pearson's correlation analysis and multiple regression analysis. RESULTS: An analysis of the differences in the MMSE-K, K-MOCA, MBI, and FMA scores according to the affected side, revealed differences in the, K-MOCA scores according to the affected side, where patients with right hemiplegia showed better cognitive function (p <.05). Correlation analysis among MMSE-K, K-MOCA, FMA, and MBI Showed significant correlations (p <.05). The results indicate that those with higher cognitive and upper extremity functions had higher performance of activities of daily living. CONCLUSION: The cognitive and upper extremity functions were correlated with the activities of daily living in stroke patients. Accordingly, applying physical therapy with a focus on improving the cognitive function and training activities of daily living could assist in the functional recovery of stroke patients significantly.