• 대한통합의학회지
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• 제7권2호
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• pp.69-76
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• 2019

Purpose : This study examined the effects of a virtual reality rehabilitation program on stroke patients' upper extremity functions and activities of daily living (ADL). Methods : The subjects were equally and randomly divided into an experimental group (n=16) to whom a virtual reality rehabilitation program was applied and a control group (n=16) who received traditional occupational therapy. The intervention was applied five times per week, 30 minutes per each time, for six weeks. Jebsen-Taylor hand function test was conducted and the subjects' Manual Function Test was measured to examine their upper extremity functions before and after the treatment intervention, and a Korean version of modified Barthel index was calculated to look at their activities of daily living. Results : After the intervention, the upper extremity functions and activities of daily living of the participants in both groups significantly improved (p<.05). However, the improvements in these parameters among the participants in the virtual reality rehabilitation program were significantly greater than those in the control group (p>.05). Conclusion : The virtual reality rehabilitation program is a stable and reliable intervention method for enhancing the upper limb functions and activities of daily living of stroke patients.

• 성인간호학회지
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• 제16권4호
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• pp.626-635
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• 2004

Purpose: The purpose of this study was to explain the effects of upper extremity exercise program on hemiplegic stroke patients. Method: The research was designed by a non-equivalent pretest-posttest way. The data were collected from February to August 2003 at a community health center located in Seoul. The study subjects were a conveniently selected group of 27 hemiplegic patients. The subjects were divided into two groups, the experimental group and the control group. 14 subjects were assigned to the experimental group in which the subjects did the upper extremity exercise training for 2 hours once a week during four weeks, while 13 subjects were assigned to the control group. The outcomes were evaluated on the basis of the upper extremity motor ability(hand power, pinch power, upper extremity ROMs), amount of motor use and the degree of depression. Result: 1. After treatment, the motor abilities of the affected upper extremity(hand power, pinch power, ROMs of wrist flexion/extension, shoulder extension) were significantly different between the two groups. However, there were no significant differences in elbow and shoulder flexion between experimental and control group. 2. After treatment, amount of motor use of affected upper extremity were significantly different between the two groups. 3. After treatment, the degree of depression were significantly different between the two groups. Conclusion: In considering these results, the upper extremity exercise program could be effective for hemiplegic patients by improving the function of their upper extremity. Long-term studies are needed to determine the effects of upper extremity exercise program.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.69-78
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• 2015

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

• 재활복지
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• 제22권2호
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• pp.161-174
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• 2018

본 연구는 순환식 과제지향 운동이 만성 뇌졸중 환자의 상지기능과 자기효능감에 미치는 영향을 알아보기 위하여 실시하였다. 선정 기준에 부합하는 28명을 순환식 과제지향 운동을 시행한 실험군 14명과 일반적 과제지향 운동을 시행한 대조군 14명으로 무작위 배정하였다. 중재는 주 5회 30분씩 4주간 실시하였으며 중재 전 후 상지기능과 자기효능감을 비교 분석하기 위해 뇌졸중 기능 회복 평가와 자기효능감 척도를 평가하였다. 순환식 과제지향 운동군은 중재 후 상지기능의 어깨/팔꿈치/아래팔, 손, 협응력과 속도 항목에서 유의하게 향상되었으며, 자기효능감 척도에서 유의하게 향상되었다. 그러나 일반적 과제지향 운동군은 중재 후 상지기능의 어깨/팔꿈치/아래팔 항목에서만 유의하게 향상되었다. 순환식 과제지향 운동군과 일반적 과제지향 운동군을 비교한 결과 상지기능의 어깨/팔꿈치/아래팔, 손 항목에서 그룹 간의 유의한 차이가 있었다. 그러나 자기효능감 척도에서는 그룹 간의 유의한 차이가 없었다. 본 연구의 결과를 통해 순환식 과제지향 운동이 일반적 과제지향 운동보다 상지기능을 증진시킨 것을 알 수 있다.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.171-177
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• 2020

Objective: This study aimed to investigate the upper limb strength, active joint range of motion (AROM), and upper limb function in persons with chronic stroke using virtual reality training in combination with upper limb sensory stimulation. Design: Two-group pretest-posttest design. Methods: 20 subjects were divided into two groups of 10, the sensory motor stimulation and virtual reality training (SMVR) and virtual reality training (VR) groups. The training was conducted for 30 minutes per session, three times a week for 8 weeks.The participants' upper limb strength was measured via the hand-held dynamometer, joint angle AROM was measured via dual inclinometer, function was measured using the Jebson-Taylor hand function test and the manual function test. Results: Significant differences were observed in all groups before and after the training for upper extremity strength, AROM, and function (p<0.05). Between the two groups, the SMVR group showed significant improvement in muscle strength, AROM, and Jebsen-Taylor hand function test scores compared with the VR groups (p<0.05). Conclusions: In this study, we confirmed that sensory stimulation and VR had positive effects on upper extremity strength, AROM, and function of persons with chronic stroke. The results suggest that in the future, VR in combination with sensory stimulation of the upper limb is likely to become an effective method (a rehabilitation training program) to improve the upper limb function of persons with chronic stroke.

• 기본간호학회지
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• 제14권3호
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• pp.270-279
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• 2007

Purpose: In this study, the effects of meridian massage and hand massage on the affected upper extremity of patients with a stroke were identified. Method: A nonequivalent control group non-synchronized design was used. Participants were 84 (Experimental. 1: 28, Experimental. 2: 28, Control.: 28) patients with a stroke who were hospitalized in K oriental medical center. Experimental treatment for patients in experimental group 1 was the meridian massage for 10 minutes daily for 2 weeks, and for those in experimental group 2, hand massage for 2 minutes, 30 seconds each, daily for 2 weeks. Outcome variables were upper extremity function (grip power, shoulder pain, edema, ROM), ADL, and depression. Data were analyzed using SPSS PC+ version. Results: The score for upper extremity functions and ADL were significantly higher in experimental group 1 who had meridian massage than for experimental group 2 or the control group. Experimental group 1 showed less depression than experimental 2 or the control group. Conclusion: Meridian massage can be an effective nursing intervention to improve upper extremity function and ADL, and to decrease depression in patients stroke who have had a stroke.

• PNF and Movement
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• 제18권1호
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.

• 디지털융복합연구
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• 제15권2호
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• pp.411-419
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• 2017

본 연구는 어깨뼈 설정 운동과 몸통 교정 테이핑 융합이 뇌졸중 환자의 몸통 근활성도, 몸통 균형 및 팔 기능개선에 효과적인지 알아보고자 하였다. 뇌졸중환자 20명을 연구군(테이핑+어깨뼈 설정) 10명과 대조군(어깨뼈 설정) 10명으로 나눈 뒤 4주간 주당 30분의 중재를 실시하였다. 연구군은 몸통 교정 테이핑을 적용받았고 동시에 어깨뼈 설정운동을 받았다. 측정은 몸통 근활성도, 몸통손상척도(Korean version Trunk Impairment Scale, K-TIS), 팔 기능검사 (Manual Function Test of upper extremity, MFT)를 실시하였다. 중재 전 후 연구군에서 몸통 근활성도, K-TIS, MFT 점수에 유의한 증가를 보였고(P<.05), 대조군 보다 K-TIS와 MFT 점수에 유의한 개선을 보였다(P<.05). 본 연구를 통해 어깨뼈 설정 단일 운동 보다 몸통 교정테이핑 융합 적용이 뇌졸중 환자의 몸통 근활성도, 몸통 균형 및 팔 기능개선에 더욱 효과적인 것을 알 수 있었다. 향후 연구에서 개별 근수축 개시시간(onset time)에 관한 변화를 확인한다면 더욱 임상적 의의가 있겠다.

• 디지털융복합연구
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• 제16권12호
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• pp.417-425
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• 2018

본 연구의 목적은 뇌졸중 환자의 상지기능, 일상생활활동, 치료적 몰입과 삶의 질 간의 상관관계를 알아보고, 삶의 질에 영향을 미치는 요인을 파악하기 위함이다. 총 13개 병원에서 입원중인 뇌졸중 환자 249명을 대상으로 상지기능, 일상생활활동, 치료적 몰입과 삶의 질을 치료사와 연구자가 평가하였다. 그 결과, 뇌졸중 환자의 상지기능(r=.312, p<.001), 일상생활활동(r=.605, p<.001), 치료적 몰입(r=.525, p<.001)이 양의 상관관계를 나타내었다. 그리고 뇌졸중 환자의 삶의 질에 영향을 미치는 요인을 분석한 결과, 치료적 몰입(${\beta}=.344$, p<.001), 일상생활활동(${\beta}=.293$, p<.001), 발병기간(${\beta}=.145$, p<.05)은 뇌졸중 환자의 삶의 질에 유의한 영향을 미치는 변수로 확인되었으며, 이들 요인은 삶의 질을 35.9% 설명하는 것으로 나타났다(F=35.736, p<.001). 이를 통하여 치료적 몰입은 삶의 질에 영향을 미치는 중요한 요인임을 확인할 수 있었으며, 향후 치료적 몰입에 대한 계속적인 연구가 요구된다.

• 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.