• The Journal of Korean Physical Therapy
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• 제23권3호
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• pp.7-12
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• 2011

Purpose: The cane is one of the most popular assistive devices for stroke patients. Clinical complaints of sensorimotor functions on the ipsilateral upper limb were appealed in stroke patients who had used a cane for a long period. Therefore, we investigated whether cane usage for a long-term period affected sensoriomotor dysfunctions on the non-affected upper limb, in terms of pain presence, shoulder joint sense, a nine-hole pegboard test, and a tracking task. Methods: We recruited 12 stroke patients, who were divided into the cane-using (CU) group or the non-cane using (NCU) group, according to cane usage experience. We evaluated joint position sense for the integrity of proprioceptive reposition sense in the shoulder joint, used a nine-hole pegboard test for upper limb dexterity evaluation, and a tracking task for visuomotor coordination. Results: Four patients in the CU group had complained of shoulder pain none did in the NCU group. In addition, the CU group showed more reposition errors on the shoulder joint than the NCU group did. In addition, the CU group had more difficulty in proprioceptive sense perception and in performance of the nine-hole pegboard teat and tracking task, compared with the NCU group. Conclusion: Our findings suggest that cane usage for a long period in stroke patients could give rise to trigger joint pain and decrease proprioceptive sense. In addition, complex motor performance in the ipsilateral upper limb could deteriorate. In stroke patients who had used acane for long period, careful observation and proper intervention will be necessary.

• 국제물리치료학회지
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• 제10권1호
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• pp.1734-1738
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• 2019

Background: Stroke patients usually have arm weakness, which affects trunks and arms. Objective: To investigate the effects of paretic side and non-paretic side arm training on trunk control and upper limb functions. Design: Randomized Controlled Trial (single blind). Methods: Twenty patients with stroke in hospital were enrolled in the study. Twenty subjects were randomly assigned to paretic side arm training group (PATG, n = 10) or non-paretic side arm training group (NATG, n = 10). Trunk impairment scale (TIS) was used for trunk control, and box and block test (BBT) was used for upper limb function. Training was conducted for 4 weeks. Results: PATG showed significant difference in TIS (static balance, dynamic balance, coordination, total score) and BBT. NATG showed significant differences in static balance, and dynamic balance and total score except for coordination and BBT. PATG also showed a more significant difference in BBT and coordination and total score than NATG. Conclusions: The arm training performed on the paretic side are more effective than those performed on the non-paretic side in improving both upper limb function and trunk control in stroke patients.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권12호
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• pp.5878-5904
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• 2017

This paper proposes a novel intelligent wheelchair vehicle system that enables upper limb exercises, lower limb standing exercises and rehabilitation training in a daily life. The proposed system, which can be used to prevent at least the degeneration of body movements and further atrophy of musculoskeletal system functions, considers the characteristics and mobility of the old and the disabled. Its main purpose is to help the old and the disabled perform their daily activities as much as they can, minimizing the extent of secondary disabilities. In other words, the system will provide the old and the disabled with regular and quantitative rehabilitation exercises and diagnosis using the wheelchair-based upper/lower limb rehabilitation vehicle system and then verify their effectiveness. The system comprises an electric wheelchair, a biometric module to identify individual characteristics, and an upper/lower limb rehabilitation vehicle. In this paper the design and configuration of the developed vehicle is described, and its operation method is presented. Moreover, to verify the tracking performance of the proposed system, dangerous situations according to biosignal changes occurring during the rehabilitation exercise of a non-disabled examinee are analyzed and the performance of the upper/lower limb rehabilitation exercise function depending on muscle strength is evaluated through a neural network algorithm.

• 한국인터넷방송통신학회논문지
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• 제19권3호
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• pp.115-120
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• 2019

뇌졸중 후 편마비(Hemiplegic) 환자들의 상지기능 저하는 손을 많이 쓰는 일상생활 수행에 있어서 신체적 동작뿐만 아니라 심리적인 불편함이 매우 크다. 본 논문에서는 편마비 환자들의 상지기능 개선을 위하여 자체 제작한 상지 재활 보조장치를 이용하였다. 이 장치는 팔이 움직일 수 있는 관절가동범위(Range Of Motion)와 손의 악력 크기를 사용하여 훈련 콘텐츠를 수행할 수 있다. 이 장치를 이용한 훈련 콘텐츠는 환자의 흥미와 능동적인 참여를 유도하기 위해 VR(Virtual Reality)로 구현되었으며, 환자 혼자서 훈련하는 심리적 부담을 덜어주기 위해 멀티플레이 환경으로 구성하여 환자의 재활훈련에 간병인이 함께 참여할 수 있도록 하였다. 본 연구에서 제작된 장치와 훈련 콘텐츠를 사용하여 손의 악력 크기와 팔의 관절가동범위의 변화를 정량적으로 측정하고 시각적으로 보여줌으로써 환자나 간병인이 쉽게 상지기능 개선정도를 확인할 수 있는 장점이 있다.

• 한국전문물리치료학회지
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• 제8권2호
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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.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.91-99
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• 2005

We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

• 재활복지
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• 제17권4호
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• pp.401-420
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• 2013

본 연구는 신경인지재활치료가 뇌졸중 환자의 상지기능 회복과 일상생활동작 수행능력에 미치는 효과를 알아보고 장기적인 치료를 위한 기초자료를 제시하고자 한다. 연구대상은 뇌졸중으로 인한 편마비 환자 총 30명을 대상으로 신경인지재활치료군과 전통적인 작업치료군을 각각 15명씩 무작위로 선정하였으며, 실험은 1회 30분, 주 5회, 4주 동안 적용하였다. 대상자의 실험 전과 후의 기능회복 정도는 뇌졸중 상지기능검사(Manual Function Test; MFT)와 Fugl-Meyer Assessment Scale(FMA), 한국판 수정바델지수(Korean-Modified Bathel Index; K-MBI) 점수를 활용하였다. 연구 결과 신경인지재활치료군이 상지기능검사에서 MFT와 FMA 측정값이 유의하게 증가하였으며(p<.05), 두 군 간의 차이를 비교한 결과 상지기능이 통계학적으로 유의한 차이를 보였다. 일상생활동작 검사에서는 신경인지재활치료군에서만 K-MBI 값이 유의하게 향상되었다(p <.05). 연구결과를 통하여 신경인지재활치료가 뇌졸중 환자의 상지 기능과 일상생활동작 수행능력향상에 효과적임을 알 수 있었다.

• 로봇학회논문지
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• 제18권4호
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• pp.359-366
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• 2023

In order to fully utilize the functions of the hand which is the end effector of the upper limb, other parts of the upper limb have to perform their own roles. Among them, the pronation and supination of the forearm, which allows the hand to rotate along the longitudinal direction of the forearm, play an important role in activities of daily living. In this paper, a soft wearable robot that assists the pronation and supination of the forearm for individuals with weakened or lost upper limb function is proposed. The wearable robot consists of an anchoring part with polymer (wrist strap, elbow strap), a tendon with a belt and wire, and an actuation module. It was developed based on the requirements with respect to friction of anchoring part, forearm compression, and friction of the tendon. It was confirmed that these requirements were satisfied through literature review and experiments. Since all components exist within the forearm when worn, it is expected to be easy to combine with the already developed soft wearable robots for the hand, wrist, elbow, and shoulder.

• 농촌의학ㆍ지역보건
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• 제44권4호
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• pp.209-219
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• 2019

이 연구는 치과위생사의 직무스트레스와 상지의 근골격계 기능 장애의 관련성을 알아보고자 수행하였다. 연구 대상자는 부산·경남 지역의 병원급 이상, 치과의원에 근무하는 치과위생사를 220명을 편의 표집하여 설문지를 배포한 후 최종 수거된 200부에서 응답이 부실한 2부를 제외하고 최종적으로 198명의 자료를 분석하였다. 설문문항으로는 일반적 특성, 직무스트레스, 작업관련 상지 근골격계 통증, 동작수행능력에 따른 기능평가 문항으로 구성하였다. 치과위생사의 대한 상지근골격계질환 통증은 목 39.4%, 어깨 54.6%, 팔/팔꿈치 14.7%, 손/손목/손가락 50.0% 였다. 그리고, 상지의 기능 장애는 치과위생사에서 호발하는 건강관련 문제로 불편한 작업자세와 상지 부위별 근골격계 통증을 보정하더라도 직무스트레스와 유의한 관련이 있었다. 즉, 팔꿈치를 굽혔다 펴는 반복 작업, 팔꿈치 부위에 통증이 있는 경우외에도 직무스트레스 역시 상지의 기능 장애와 관련이 있었다. 치과위생사의 직무스트레스는 이들의 상지 기능 장애로 이어져 결과적으로 의료서비스의 저하로 이어지므로, 장단기 계획하에 근무환경개선 등을 통하여 직무 스트레스를 감소시킬 수 있는 방안을 모색하여야 할 것이다.

• 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.