• 한국전문물리치료학회지
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• 제12권1호
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• pp.71-79
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• 2005

The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

• 대한물리의학회지
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• 제11권3호
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• pp.125-131
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• 2016

PURPOSE: The objective of this research is to investigate the effectiveness of mental practice on function and muscle activation of upper extremity (UE) in stroke patients. METHODS: The mental practice was conducted on 12 subjects for 10 minutes and the related existing work treatment for 20 minutes. The evaluation for the function of UE proceeded with Fugl-Meyer assessment of motor function (FMA) and muscle activity analysis instrument. Furthermore we analyzed patients' reaching activity by two stages, reaching phase and returning to original position phase. RESULTS: According to the research results, the subjects' upper limb function improved in all of the measured items and the total scores after the mental practice (p<.05). In muscle activity, CCR value was used to efficiently analyze the patients' reaching activity in the two stages of reaching stage and returning to the original position phase. While the elbow movement only had a bit of positive change (1.1%) in the reaching stage, both the shoulder (-12.3%) and elbow (-18.2%) movements had a positive change in the returning to original position phase. CONCLUSION: This research confirmed that the mental practice is effective for the enhancement of UE function for stroke patients. The result of this research can contribute to the progress of mental practice in clinical environment.

• Journal of Magnetics
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• 제19권2호
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• pp.170-173
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• 2014

The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.82-85
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• 2014

Upper extremity replantation is relatively less commonly performed than finger or hand replantation. We have experienced one case of forearm replantation and one case of upper arm replantation. After the replantation, limb volume at the biceps brachii muscle level below the replantation level appeared to be appropriate, however, the motor function of the muscles and the sensitivity were disappointing. For replantation of forearm and upper arm, restoration of the motor function and sensitivity of the extremity below the amputation level as well as the morphologic reconstruction have to be considered.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.169-174
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• 2017

Purpose: The purpose of this study was to resolve, in an efficient manner, the mechanoreceptor problems of the part far from the paretic upper extremity in stroke patients, as well as to provide clinical basic data of an intervention program for efficient neurodynamic in stroke patients, by developing a rhythmic neurodynamic exercise program and verifying functional changes depending on the increase in the upper extremity nerve conduction velocity. Methods: Samples were extracted from 18 patients with hemiplegia, caused by stroke, and were randomly assigned to either the experimental group I for the general upper extremity neurodynamic (n=9) and the experimental group II for rhythmic upper extremity neurodynamic (n=9). An intervention program was applied ten times per set (three sets one time) and four times a week for two weeks (once a day). As a pre-test, changes in the upper extremity nerve conduction velocity and functions were assessed, and two weeks later, a post-test was conducted to re-measure them in the same manner. Results: The wrist and palm sections of the radial nerve and the wrist and elbow sections of the median nerve, as well as the wrist, lower elbow, upper elbow, and axilla sections of the ulnar nerve had significant differences with respect to the upper extremity nerve conduction velocity between the two groups (p<0.05)(p<0.01), and significant differences were also found in the upper extremity functions (p<0.05). Conclusion: Rhythmic neurodynamic accelerated the nerve conduction velocity more in broader neural sections than the general neurodynamic. In conclusion, rhythmic neurodynamic was proven to be effective for improving the functions of upper extremity.

• 대한물리치료과학회지
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• 제28권3호
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• 대한물리치료과학회지
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• 제12권3호
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• pp.59-69
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• 2005

The purpose of this study was to investigate the effect of mental practice on the upper extremity function of the hemiplegic Patients, 8 subjects with hemiplegia patients participated in this study. They did the Mental Practice programme for twenty minute, two times a week, three weeks. The Mental practice effects was evaluated by Fugl-Meyer Assessment(FMA), Action Research Arm Test(ARA), Stroke Rehabilitation Assessment of Movement(STREAM). The data were analyzed using paired t-test. The result of this study are as follows: FMA score were significant difference test-retest(p<.05), ARA score were statistically significant improvement between test-retest(p<.05), On the STREAM, the patients had the score improved on 4 of the 10 items of the upper-extremity Scale. The result suggest that mental practice is a potentially useful method of practicing motor skills. Mental practice may be a cost-effective, non-invasive tool with wuhich patients with stroke can receive additional practice of functional skills, and realize greater outcome, than if therapy alone were used.

• 대한지역사회작업치료학회지
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• 제4권1호
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• pp.33-45
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• 2014

목적 : 본 연구에서는 뇌졸중 환자 중에서 편측무시가 있는 군과 없는 군 각각에 대해 4주간의 거울치료를 적용하여 그 효과를 알아보고자 하였다. 또한 거울치료를 통하여 상지의 기능 향상과 일상생활동작에 어떠한 효과가 있는지에 대해서도 알아보고자 한다. 연구방법 : 창원시 C병원에 입원하여 작업치료를 받는 성인 편마비 환자로써 편측무시가 있는 환자 10명, 편측무시가 없는 환자 10명, 총20명을 대상으로 실시하였고 치료사와 1:1로 30분씩 주5회 총 4주간 걸쳐 거울치료 프로그램을 실시하였다. 편측무시 유무를 확인하고 거울치료 중재 전, 후 비교를 위해 알버트 검사를 사용하였다. 상지기능평가로써 Fugl-Meyer motor function Assessment(FMA), Box & Block Test(BBT)을 사용하였으며 일상생활활동평가는 Functional Independence Measure(FIM)를 사용하였다. 결과 : 거울치료는 편측무시를 가진 뇌졸중 환자에게 효과가 있었다(p<.05). 또한 뇌졸중환자의 편측무시 유무에 관계없이 상지기능과 일상생활활동에 효과가 있었다(p<.05). 결론 : 거울치료가 뇌졸중 환자의 마비측 상지기능과 일상생활활동 능력을 향상시킬 뿐만 아니라 편측무시 증상을 가지고 있는 뇌졸중 환자에게서도 편측무시 감소를 보였다. 결론적으로 거울치료는 편측무시 감소를 보일 뿐만 아니라 뇌졸중 환자의 기능적인 회복과 일상생활활동 수행능력 향상을 위한 치료방법으로써 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.93-98
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• 2019

Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.131-139
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• 2020

Objective: The purpose of this study was to evaluate the effect of virtual reality (VR)-based core stabilization exercise on upper extremity function, postural control, and depression among persons with stroke with hemiplegia. Design: Randomized controlled trial. Methods: This study was conducted with the inclusion of 24 participants and were randomly assigned to either the VR-based trunk stability exercise group (n=12) or control group (n=12). The VR-based trunk stability exercise group performed core stabilization exercises in a VR environment for 30 minutes. Meanwhile, the control group conducted general core stabilization exercises for 30 minutes. The participants trained 3 times a week for 4 weeks. The manual functional test (MFT), Box and Block Test (BBT), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), the Geriatric Depression Scale (GDS) were used to assess all participants before and after the intervention. Results: The VR-based core stabilization exercise group had a significant improvement in upper extremity function (MFT, BBT) and postural control (BBS) compared with the control group (p<0.05). The VR-based core stabilization exercise showed a significant difference after intervention in the TIS and GDS scores (p<0.05), but they did not significantly differ between the two groups. Conclusions: The result showed that VR-based core stabilization exercise can be effective in improving upper extremity function and postural control among patients with stroke more than the sole application of general physical therapy.