• Title/Summary/Keyword: Upper-limb Rehabilitation

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Lumbar stabilization exercises using the sling system (슬링(sling) 시스템을 이용한 요부 안정화 운동)

  • Kim, Suhn-Yeop;Kwon, Jae-Hoak
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.2
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    • pp.23-39
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    • 2001
  • Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

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Effects of Exercise Intervention Programs on Recovery of Functional and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta Analysis (유방암 환자 대상의 운동 중재 프로그램이 기능회복과 삶의 질에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Park, Seo-A;Cho, Moon-Ju
    • Korean Parent-Child Health Journal
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    • v.22 no.1
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    • pp.10-21
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    • 2019
  • Purpose: This study was carried out to evaluate the efficacy of exercise program on recovery of functional and quality of life in breast cancer patients through systematic literature review and meta-analysis. Methods: The following databases were used to search the literature: RISS, KISS, KMbase, and KoreaMed. Keywords included 'breast cancer', 'mastectomy' 'exercise', 'rehabilitation', 'intervention' and the evaluated articles were published from 2009 to 2018. The statistical was used R program, the effect size of shoulder functionality, grip strength, upper limb, pain and QOL were calculated by random-effects model. Results: 7 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of exercise program was flexion (g=1.11), abduction (g=0.97) as indicated by a "large effect size". Conclusion: It is necessary to study the develop and apply a exercise programs to improve the function and quality of life in breast cancer patients.

Short-term Effect of Robot-assisted Therapy on Arm Reaching in Subacute Stroke Patients (상지로봇치료가 아급성기 뇌졸중 환자의 팔뻗기 움직임에 미치는 단기 효과)

  • Hong, Won-Jin;Kim, Yong-Wook;Kim, Jongbae;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.79-91
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    • 2018
  • Objective : The purpose of this study was to investigate the short-term effect of robot-assisted therapy to improve upper extremity function in subacute stroke. Method : This study was a retrospective study using the medical record. The subjects were 20 patients who were diagnosis with stroke within 6 months. All patients received general rehabilitation intervention during the experimental period and robot-assisted therapy and task-oriented training. Robot assisted therapy was composed of 1 sessions, 1hour per person and task-oriented training was same. For result analysis, descriptive statistics, paired t-test were used. Results : After intervention, all participants got 3D motion analysis about reaching. For the result, there was statistically significant improvement in smoothness in robot assisted therapy(p<.05). there was no statistically significant difference between robot assisted therapy and task-oriented training in speed, time. In this result, we knew the robot assisted therapy can short term effect in elbow joint during arm reaching. Conclusion : Robot assisted therapy is considered as alternative choice in clinical occupational therapy for improving upper extremity function in subacute stage stroke patients.

Study of the Effects of Sa-am Acupuncture on Upper Limb Spasticity in Patients with Chronic Post-stroke Hemiparesis using Real-time Sonoelastography (실시간 탄성초음파를 이용한 만성 뇌졸중 후 편마비 환자의 상지 강직에 대한 사암침 효과 연구)

  • Baek, Kyung-Min;Kwon, Dong-Rak;Park, Gi-Young
    • The Journal of Internal Korean Medicine
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    • v.35 no.1
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    • pp.1-11
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    • 2014
  • Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

Clinical Features and Long-Term Outcome in Adult Stroke Patient due to Moyamoya Disease : A Single Subject Study

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.126-131
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    • 2013
  • This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

A Study of Symmetry in the Patterns of Muscle Coordination and Interjoint Coordination in the Upper Limb Activity Among Subjects With Stroke (뇌졸중 환자의 상지에서 근육협응 패턴과 관절협응 패턴의 유사성에 관한 연구)

  • Lee, Jung-Ah;Shin, Hwa-Kyung;Chung, Yi-Jung;Cho, Sang-Hyun
    • Physical Therapy Korea
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    • v.13 no.1
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    • pp.54-60
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    • 2006
  • This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

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Effects of Virtual Reality Program on Recovery of Functional in individuals Stroke: A Systematic Review and Meta Analysis (뇌졸중 환자 대상의 가상현실 운동프로그램이 기능회복에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Park, Seo-A;Kim, Hye-Young
    • Journal of Digital Convergence
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    • v.17 no.5
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    • pp.235-247
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    • 2019
  • This study was carried out to evaluate the efficacy of Virtual Reality(VR) program on recovery of functional in Stroke through systematic literature review and meta-analysis. The following databases were used to search the literature: RISS, KISS, KMbase. Keywords included 'stroke', 'CVA' 'virtual reality', 'rehabilitation', 'virtual reality program' and the evaluated articles were published from 2009 to November 2018. The statistical was used R program, the effect size of upper limb, balance and ADL were calculated by random-effects model. As a result, 9 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of VR program was balance(g=.77), ADL(g=.80) as indicated by a "large effect size". Therefore, VR program is large effective in reducing balance and ADL in strokes. It is necessary to develop and apply a virtual reality-based program using more efficient program development.

Gesture Control Gaming for Motoric Post-Stroke Rehabilitation

  • Andi Bese Firdausiah Mansur
    • International Journal of Computer Science & Network Security
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    • v.23 no.10
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    • pp.37-43
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    • 2023
  • The hospital situation, timing, and patient restrictions have become obstacles to an optimum therapy session. The crowdedness of the hospital might lead to a tight schedule and a shorter period of therapy. This condition might strike a post-stroke patient in a dilemma where they need regular treatment to recover their nervous system. In this work, we propose an in-house and uncomplex serious game system that can be used for physical therapy. The Kinect camera is used to capture the depth image stream of a human skeleton. Afterwards, the user might use their hand gesture to control the game. Voice recognition is deployed to ease them with play. Users must complete the given challenge to obtain a more significant outcome from this therapy system. Subjects will use their upper limb and hands to capture the 3D objects with different speeds and positions. The more substantial challenge, speed, and location will be increased and random. Each delegated entity will raise the scores. Afterwards, the scores will be further evaluated to correlate with therapy progress. Users are delighted with the system and eager to use it as their daily exercise. The experimental studies show a comparison between score and difficulty that represent characteristics of user and game. Users tend to quickly adapt to easy and medium levels, while high level requires better focus and proper synchronization between hand and eye to capture the 3D objects. The statistical analysis with a confidence rate(α:0.05) of the usability test shows that the proposed gaming is accessible, even without specialized training. It is not only for therapy but also for fitness because it can be used for body exercise. The result of the experiment is very satisfying. Most users enjoy and familiarize themselves quickly. The evaluation study demonstrates user satisfaction and perception during testing. Future work of the proposed serious game might involve haptic devices to stimulate their physical sensation.

Double Threshold Method for EMG-based Human-Computer Interface (근전도 기반 휴먼-컴퓨터 인터페이스를 위한 이중 문턱치 기법)

  • Lee Myungjoon;Moon Inhyuk;Mun Museong
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.471-478
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    • 2004
  • Electromyogram (EMC) signal generated by voluntary contraction of muscles is often used in a rehabilitation devices such as an upper limb prosthesis because of its distinct output characteristics compared to other bio-signals. This paper proposes an EMG-based human-computer interface (HCI) for the control of the above-elbow prosthesis or the wheelchair. To control such rehabilitation devices, user generates four commands by combining voluntary contraction of two different muscles such as levator scapulae muscles and flexor-extensor carpi ulnaris muscles. The muscle contraction is detected by comparing the mean absolute value of the EMG signal with a preset threshold value. However. since the time difference in muscle firing can occur when the patient tries simultaneous co-contraction of two muscles, it is difficult to determine whether the patient's intention is co-contraction. Hence, the use of the comparison method using a single threshold value is not feasible for recognizing such co-contraction motion. Here, we propose a novel method using double threshold values composed of a primary threshold and an auxiliary threshold. Using the double threshold method, the co-contraction state is easily detected, and diverse interface commands can be used for the EMG-based HCI. The experimental results with real-time EMG processing showed that the double threshold method is feasible for the EMG-based HCI to control the myoelectric prosthetic hand and the powered wheelchair.

Effects of Participating in Tele-rehabilitation Service on Health Promotion and Quality of Life for Individuals with disability (원격재활서비스 참여가 지역사회 장애인의 건강증진 및 삶의 질에 미치는 영향)

  • Cha, Yerin;Jung, Bong-Keun;Lee, Seong A
    • 재활복지
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    • v.22 no.3
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    • pp.169-188
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    • 2018
  • The aims of this study was to investigate the effect of the Tele-rehabilitation service on health promotion and quality of life for individuals with disability. The subjects were 3 men who agreed with participating in service and were assessed of health promotion level with physical/psychological scales and quality of life. The service consists of 20 sessions for 13 weeks. The results are as follows: First, all participants improved psychosocial health promotion (subjective health level) factor. Second, physical health promotion (upper limb function, strength, range of motion) maintained and improved, but there was little change. Third, the quality of life was higher than before. In addition, qualitative research showed that participants experienced a positive change in subjective health status, emotional stability, benefit, and self efficacy, and they were satisfied with the service. Based on the results, it was shown that participation helps improve the health and quality of life of the individuals with disability in the community. This study can be used it as a basic data for establishing a Tele-rehabilitation service for individuals with disability in local community.