• International Journal of Contents
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• 제17권2호
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• pp.20-31
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• 2021

This study aimed to pilot test a newly developed bilateral upper limb rehabilitation training program for improving the upper limb function of individuals with chronic stroke using a visual feedback method. The double-group pretest-posttest design pilot study included 10 individuals with chronic stroke (age >50 years). The intervention (four weekly meetings) consisted of five upper limb training protocols (wrist extension; forearm supination and pronation; elbow extension and shoulder flexion; weight-bearing shift; and shoulder, elbow, and wrist complex movements). Upper limb movement function recovery was assessed with the FuglMeyer Assessment of the Upper Extremity, the Wolf Motor Function Test, the Trunk Control Test, the modified Ashworth Scale, and the visual analog scale at baseline, immediately after, and four weeks after the intervention. The Fatigue Severity Scale was also employed. The Fugl-Meyer Assessment of the Upper Extremity and Wolf Motor Function Test showed significant improvement in upper limb motor function. The Trunk Control Test results increased slightly, and the modified Ashworth Scale decreased slightly, without statistical significance. The visual analog scale scores showed a significant decrease and the Fatigue Severity Scale scores were moderate or low. The bilateral upper limb training program using the visual feedback method could result in slight upper limb function improvements in individuals with chronic stroke.

• 대한물리의학회지
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• 제13권1호
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• pp.1-9
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• 2018

PURPOSE: This study investigated the neurophysiological and behavioral adaptation during one or both hands movement in chronic stroke patients. METHODS: The study included sixteen hemiplegic stroke patients. Neurophysiological data (brain activation and muscle activation) were examined by electroencephalography (EEG) and electromyography (EMG), and behavioral adaptation was examined by wrist extension angle during wrist extension with one hand or both hands. Outcome variables of one hand or both hands were; mu rhythm of the EEG, EMG amplitude of wrist extensor and flexor muscles, and wrist angle of Myomotion 3D motion analysis. RESULTS: Our results revealed that wrist extension angle was significant increased during both hands movement compared to one hand movement (p<.05). Furthermore, in affected sensorimotor area, there was significant increase in the brain activation during both hands movement compared to one hand movement (p<.05). However, there was no significant different between one hand and both hands movement in muscle activation (p>.05). CONCLUSION: According to the findings of this experiment, bilateral arm movement improved brain activity on affected sensorimotor area and wrist extension angle. Therefore, we suggest that bilateral arm movement would positive effect on stroke rehabilitation in terms of increase in brain activation on affected motor area and wrist extension during bilateral arm movement.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.113-124
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• 2002

The objectives of this study was to investiage the effects of sitting posture on carpal tunnel syndrome. Carpal tunnel syndrome (CTS) continues to be one of the most widely publicized maladies of the cumulative trauma disorder. Many studies have reported a positive association between CTS and highly repetitive work, high force, and poor posture. High force and repetitive work have especially been associated with CTS, but the evidence for work being a primary cause of CTS is strongest when these factors are combined. In addition to carpal tunnel syndrome, hand, wrist, and other disorders are attributed to these work-related movements. Such disorders are referred to as repetitive stress injuries, cumulative trauma disorder, overuse syndromes, and chronic upper limb pain syndrome. Incorrect posture also may play a role in the development of CTS in people who work at a computer and other types of keyboards. The tendency to roll the shoulders forward, round the lower back, and thrust the chin forward can shorten the neck and shoulder muscles, compressing nerves in the neck. This, in turn, can affect the wrist, fingers, and hand. The treatment and prevention of carpal tunnel syndrome continue to be approached with a segmental view of the human body. For example, the most common ergonomic solution for carpal tunnel syndrome associated with keyboard use is to keep the wrists in a neutral position by using a wrist rest in front of the keyboard and good sitting posture.

• Physical Therapy Rehabilitation Science
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• 제5권4호
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• pp.163-169
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• 2016

Objective: The purpose of this study was to investigate the effects of vibration resistance exercise (VRE) in patients with tennis elbow on strength, range of motion (ROM), function, pain and quality of life (QOL). Design: Randomized controlled trial. Methods: Twenty-seven participants were randomly assigned to either the VRE group (n=9), weight resistance exercise (WRE) group (n=9) or control group (n=9). Each group underwent hot compress for 15 minutes and electrotherapy for 15 minutes. The VRE group underwent exercises using a vibrating ball for 5 minutes. The WRE group underwent exercises using dumbbells for 5 minutes. All participants were evaluated on wrist extension strength using a hand-held dynamometer, grip strength level through an electric dynamometer, and ROM through a smartphone goniometer application before and after intervention. Patient-rated tennis elbow evaluation, Visual Analogue Scale and Short Form 8 were measured by questionnaires. Results: There were showed significant differences among the VRE, WRE and control group in wrist extensor muscle and hand grip strength, ROM, elbow function, pain and QOL after intervention (p<0.05). The VRE group showed a greater significant improvement in wrist extensor muscle strength and elbow function compared with the others (p<0.05). The VRE and the WRE groups had a more significant improvement in wrist extensor muscle and hand grip strength, ROM and pain compared with the control group (p<0.05). However, there were no significant differences in QOL among the three groups. Conclusions: Combining VRE with thermotherapy and electrotherapy appears to be more effective in improving wrist extension strength, ROM, elbow function, QOL in tennis elbow patients.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.120-124
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• 2016

Objective: Chronic lateral epicondylitis is a condition which becomes sore and tender on the lateral side of the elbow joint damaged from overuse and repetitive use of the extensor muscles of the forearm. The purpose of this study was to investigate the effects of flexion degrees in the elbow joint on extensor carpi radialis longus and brevis and biceps brachii muscles in individuals with healthy young adults. The main purpose of this study was to suggest the feasibility of optimal elbow angle during therapeutic eccentric exercise with resistance for strengthening of wrist extensors. Design: Cross-sectional study. Methods: Thirty health young adults (male 15, female 15) participated in this study. This study measured muscle activation in four different conditions of elbow flexion, $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ during eccentric exercise with weight loading in wrist extensors, extensor carpi radialis longus and brevis and biceps brachii muscles using surface electromyography. Results: The muscle activation of extensor carpi radialis showed a negative relationship with the degrees of elbow joint flexion. With increasing elbow flexion angles, the ECRL muscle activation amount was significantly lower (p<0.05). In contrast, the muscle activation of the ECRB muscle activation amount was significanlty higher (p<0.05). Conclusions: This study suggests that the eccentric exercise of wrist extension with selected activation of wrist extensor muscles according to elbow flexion positions, and suggests that the extensor carpi radialis longus and brevis will need to be strengthened for preventing and treating chronic lateral epicondylitis regardless of degrees of elbow joint flexion.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.38-46
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• 2006

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.1-6
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• 2014

Objective: Low level laser treatment (LLLT) is widely used in physical therapy practice. It is combined with physical therapy or LLLT alone. The purpose of this study is to evaluate the effectiveness of LLLT on patients' perception of general wrist pain. Design: Longitudinal study. Methods: Forty-eight subjects with wrist pain who were in the age range of 18-70 years old were examined. The subjects were asked, via an interview and a visual analog scale, to grade their wrist pain. They were asked to rotate their wrists through full range of motion and the angle at which any pain occurred was assessed. Each subject was then exposed to one of the following: 1) treatment with an infrared laser with the power turned off (placebo), 2) treatment with an infrared therapeutic laser, 3) treatment with a red therapeutic laser, 4) treatment with an ultraviolet laser, 5) treatment with a blue laser, 6) treatment with a Mickey Mouse flashlight. The duration of the treatment was 3 sessions in 3 days. Results: The results of the experiments showed that while pain was reduced both immediately after and the next day after laser therapy (p<0.05), there was no significant difference between the laser groups and the placebo group. However, the Mickey Mouse flashlight treatment groups had a greater range of motion than the laser groups (p<0.05). Conclusions: While pain was reduced in all laser groups, it was probably a placebo effect. The Mickey Mouse flashlight group probably received benefit from the heat of the flashlight.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.374-378
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• 2021

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

• PNF and Movement
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• 제16권1호
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• pp.85-92
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• 2018

Purpose: We sought to examine whether using the rhythmic stabilization (RS) technique before proprioceptive neuromuscular facilitation (PNF) wrist taping affected pain and grip strength in patients with wrist pain to provide a basis for the application of PNF taping. Methods: The study consisted of 41 badminton enthusiasts (aged 20-40 years) who reported discomfort and pain due to overuse of their wrists. The subjects were randomly assigned to an experimental group (n=20) or a control group (n=21). In the experimental group, PNF wrist taping was applied after application of the PNF RS technique, and PNF wrist taping was applied after stretching in the control group. The tape was applied five times a week for 3 weeks. Pain was measured using the visual analog scale (VAS). Grip strength was measured using a dynamometer. The paired t-test was performed to compare grip strength and pain within the groups before and after the intervention. Covariance analysis was conducted to compare differences between the experimental group and control group. The level of significance was set as ${\alpha}=0.05$. Results: Within-group changes in grip strength and VAS were significantly different in the control group and experimental group (p<0.01). Grip strength and VAS showed more improvement in the experimental group than in the control group (p<0.01). Conclusion: PNF wrist taping after stretching and the PNF RS technique both significantly reduced pain and improved grip strength in club badminton players with wrist pain. These improvements were significantly greater in the experimental group in which the PNF RS technique was applied. The results suggest that PNF may be considered useful to improve grip strength and reduce wrist pain.

• 재활복지공학회논문지
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• 제7권2호
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• pp.69-74
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• 2013

본 연구에서는 손목 움직임의 추정을 위한 근전도 신호 기반 동작 분류 알고리즘을 제안한다. 근전도의 특징점을 추출하기 위하여 절대차분표준편차(DASDV)과 제곱평균제곱근(RMS)을 사용하며, 측정 된 근전도 신호를 이용하여 동작 마다 30개의 특징점(RMS, DASDV)을 추출한다. 근전도 신호를 특정한 패턴으로 나타내어 적용시키기 위하여 평균값을 기준으로 집단을 두 부분으로 나누고, 패턴분류 방법인 k-NN으로 패턴을 학습시킨 후, 집단을 나누지 않은 방법을 사용한 기존의 연구와 비교하여 제안한 알고리즘의 성능을 검증한다. 실험결과 제안한 알고리즘은 92.59%의 인식률을 보였으며, 이전 연구 결과보다 0.84% 포인트의 성능 개선을 보였다.