• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.36-41
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• 2013

Purpose: To investigate whether the long-term use of a cane induces pain in the unaffected lower limb of stroke patients. Methods: A total of 107 stroke patients with chronic hemiparesis were recruited in this study and classified into two groups; a cane-use group (n=49) and non-cane-use group (n=58). The existence of pain in the unaffected lower limb was assessed on a visual analog scale in the hip, knee, and ankle joint, and the University of Alabama pain behaviors scale (UAB pain behavior scale) used to measure the intensity of pain. In addition, the Motricity Index (MI) was tested in the upper and lower extremities. Results: The proportion of pain in each joint of the lower limb was significantly higher in the cane-use group, compared to the non-cane-use group (p<0.05). In addition, significant differences were observed on the UAB pain behavior scale between the two groups. The lower MI score was significantly lower in the cane-use group, compared with the control group. However, no difference was observed in MI scores of the upper limb between the two groups. Conclusion: These findings reveal that long-term cane usage can induce pain in the unaffected lower limb of stroke patients. We suggest careful consideration when prescribing a cane, depending on functional ability in hemiparetic patients, and recommend continuous evaluation for pain in the affected lower limb.

• Therapeutic Science for Rehabilitation
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• v.2 no.1
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• pp.13-23
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• 2013

Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.

• Journal of the Korean Society for Precision Engineering
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• v.20 no.11
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• pp.171-179
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• 2003

This paper presents a rehabilitation exercise system which utilizes a 6 DOF robot as a motion generator. This system was proposed for a stroke patient or a patient who has hemiplegia. A master-slave system was designed to exercise either paralysis or abnormal limb by using normal limb motion. The study on the human body was applied to calculate the motion range of elbows and shoulders. In addition, a force-torque sensor was applied to the slave robot to estimate the rehabilitation extent of the patient. Therefore, the stability of the rehabilitation robot could be improved. By using the rehabilitation robot. the patients could exercise by themselves without assistance. In conclusion, the proposed system was verified by computer simulations and system experiment.

• Horticultural Science & Technology
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• v.30 no.4
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• pp.449-462
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• 2012

The objectives of this study were to measure the range of motion for joints and muscle activation of upper limb for flower arrangement tasks for physical rehabilitation and to test horticultural therapy programs using flower arrangement tasks for improving upper limb function of the patients with stroke. Major flower arrangement tasks were classified with eight tasks (cutting 1, thick stem; cutting 2, thin stem; fixing 1, long stem; fixing 2, short stem; rolling a leaf; bending 1, thick stem; bending 2, thin stem; and winding, using a wire) based on the occupational analysis. When eight male university students (mean age $24.1{\pm}2.5$ years) conducted the eight flower arrangement tasks, range of motion for joints and muscle activation of upper limb were measured by a 3D motion analyzer and electromyography, respectively. Based on the results of the range of motion and muscle activation of upper limb, horticultural therapy programs using flower arrangement tasks (total 33 sessions) for improving upper limb function of the patients with stroke was conducted at a rehabilitation hospital, Seoul, South Korea and then the range of motion, grip strength, and upper limb function of the patients were tested. Among the eight flower arrangement tasks, cutting 1, winding, and bending 1 induced the highest value for the range of motion in joints of shoulder, elbow, and wrist, respectively (P < 0.001). In terms of muscle activation, eight flower arrangement tasks performed in this study showed various patterns of muscle activation and several muscles were simultaneously used for each task (P < 0.001). In addition, thickness and length of the materials used in a task had a prominent effect on the range of motion for joints and muscle activation of upper limb (P < 0.001). The stroke patients had positive effects for their range of motion of upper limb (shoulder, forearm, and elbow), grip strength, and overall upper limb function through the horticultural therapy program. Thus, this study suggested that flower arrangement tasks would be a potential horticultural activity for physical rehabilitation program. It would be interesting to apply a customized horticultural therapy program using flower arrangement tasks according to the symptoms of patient for physical rehabilitation.

• Physical Therapy Korea
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• v.8 no.2
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• pp.29-39
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• 2001

The purpose of this study was to examine the effect of the upper limb nerve mobilization (ULNM) on functional recovery of upper extremity in hemiplegic patients following stroke. Twenty patients who had functional impairment on upper extremity were participated. Subjects were randomly divided into two groups: Control group (n=10) received traditional physical therapy only for 4 weeks; Experimental group (n=10) received ULNM treatment along with traditional physical therapy for the same period. Upper extremity functions were assessed by manual muscle test (MMT), modified Ashworth scale (MAS), and Fugl-Meyer assessment (FMA) before and after the treatment. In both experimental and control group, upper extremity functions were significantly improved in MMT (p<.01) and FMA (p<.01), however only experimental group showed significant improvement in FMA after the treatment (p<.05). Moreover, experimental group showed significantly greater improvement than control group in MMT (p<.05), MAS (p<.05), and FMA (p<.05). We conclude that the upper extremity functions is a useful additional therapeutic technique for the effective treatment of upper extremity deficits in hemiplegic patients.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.257-266
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• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.19 no.3
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• pp.115-120
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• 2019

Hemiplegic patients who suffered from a stroke struggle with a deterioration in upper limb functions, which can both be psychologically and physically discomforting; this can also limit patients' daily tasks involving any upper limb motions. In this study, we developed an assistive device for hemiplegic patients to improve their upper limb functions. It was manufactured to train patients by using their grip strength and the range of motion of the arm. Furthermore, we produced game contents in virtual reality to induce users' immersion and interaction. It was configured as a multi-player game to help ease the mental burden of receiving the training alone, hence allowing the patient and the caregiver to join the rehabilitation training simultaneously. The assistive device and game contents developed in this study enables patients and caregivers to easily check the degree of improvements in upper limb function by viewing quantitative analysis and visualized results.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.4
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• pp.313-318
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• 2014

In this paper, we propose a method for correcting the measurement axis twist that occurs in the process of wearing and each estimation method of joint in which the inertial measurement unit based in health arm by the method of operation upper limb rehabilitation equipment of hemiplegic patients. In order to verify the proposed method, it is fitted with a inertial measurement unit of the upper arm and forearm of the experimenter left arm, verified by comparing actual joint angle is detected by photographing the arbitrary posture, the angle that the estimated joint. Then, it was verified by comparing the applied front / rear techniques for correcting the measurement axis twist. A result of the experiment, before applying the measurement axis twist correction, joint, after but each match rate showed a weak concordance rate in 89.16% and were corrected, measurement axis twist, each concordance rate of joint agreement of 93.28% I understand that it has been 4.12% improvement in the rate.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.43-48
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• 2020

Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

• Journal of the Ergonomics Society of Korea
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• v.29 no.3
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• pp.311-320
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• 2010

This study aimed to examine the development and characteristics of the workers with upper limb musculoskeletal symptoms and disorders and to analyze the upper limb musculoskeletal symptoms and disorders for its relationship with the individual socio-demographic characteristics. This study investigated the effect on the limitations of physical activities using standardized surveillance tool and clinical diagnosis. Musculoskeletal symptoms and the limitations of physical activities were examined. The clinical diagnosis of musculoskeletal disorders were carried out by physical examination, radiological examination and electromyography-electroneuronography for 22 workers in kitchen hood assembly process and 50 workers in toggle process of leather product manufacturing. The proportion of workers with musculoskeletal disorders was higher and the DASH score was also statistically higher in female and aged workers with longer working hours, longer household working hours, less leisure/hobby activity and higher physical load. Physical activities component score increased in the following order: workers in normal health, workers with musculoskeletal symptoms, and workers with musculoskeletal disorders as clinically diagnosed. Score for each DASH component increased in the following order: sports/performing arts ability, social activities, specific physical functional activities, work or other regular daily activities, work ability, psychological activities, insomnia and upper limb symptoms. The overall and each component DASH scores were higher in workers with symptoms of status praesens and of more severity, and receiving medical intervention. Musculoskeletal symptoms and disorders are associated with individual socio-demographic characteristics, and DASH score for physical activities of upper limb was higher in workers with musculoskeletal disorders. Musculoskeletal symptoms and disorders have a remarkable epidemiological significance for physical activities, social activities, work or other regular daily activities, upper limb symptoms and insomnia, where work ability, sports/performing arts ability and preventive measure is needed.