• Title/Summary/Keyword: upper limb motor function

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A Review of the Plasticity and Constraint Induced Movement Therapy : Children With Spastic Hemiplegic Cerebral Palsy (신경가소성 원리를 이용한 강제유도운동치료에 대한 고찰: 경직성 편마비형 뇌성마비 아동을 대상으로)

  • Cho, Sang-Yoon
    • 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.

The Effects of Mirror Therapy with Functional Electrical Stimulation Therapy on Upper Extremity Motor Function and Activities of Daily Living for the Stroke Patients (뇌졸중 환자에 대한 기능적 전기 자극치료를 병행한 거울치료가 상지 기능수행과 일상생활활동에 미치는 효과)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.3
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    • pp.123-130
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    • 2018
  • Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.

Change of activation of the supplementary motor area in motor learning: an fMRI case study (운동학습에 따른 대뇌 보조운동영역의 활성화 변화: fMRI 사례연구)

  • Park, Min-Chull;Bae, Sung-Soo;Lee, Mi-Young
    • The Journal of Korean Physical Therapy
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    • v.23 no.2
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    • pp.85-90
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    • 2011
  • Purpose: The contribution of the supplementary motor area (SMA) to the control of voluntary movement has been revealed. We investigated the changesin the SMA for motor learning of the reaching movement in stroke patient using functional MRI. Methods: The subject was a right-handed 55 year-old woman with left hemiparesis due to an intracerebral hemorrhage. She performed reaching movement during fMRI scanning before and after reaching training in four weeks. The motor assessment scale and surface EMG were used to evaluate the paretic upper limb function and muscle activation. Results: In the fMRI result, contralateral primary sensorimotor cortex (SM1) was activated before and after training. SMA was only activated after training. In addition, muscle activation of the paretic upper limb was similar to that of the unaffected upper limb after training. Conclusion: These findings suggest SMA is related to the execution of a novel movement pattern resulting in motor learning in stroke patients.

Effects of Mental Practice in Conjunction with Repetitive Transcranial Magnetic Stimulation on the Upper Limbs of Sub-acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon;Cha, Hyun-Gyu
    • Journal of Magnetics
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    • v.19 no.4
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    • pp.353-356
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    • 2014
  • The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

Brain Activation During the Wrist Movement Using Symmetrical Upper Limb Motion Trainer (대칭형 상지 운동기구를 이용한 손목 운동 시 뇌 활성도 패턴)

  • 태기식;김사엽;송성재;이소영;박기영;손철호;김영호
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.1303-1306
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    • 2004
  • We developed a symmetrical upper limb motion trainer for chronic hemiparetic subjects. This trainer enabled the practice of a forearm pronatio $n^ination and wrist flexion/extension. In this study, we have used functional magnetic resonance imaging(fMRI) with the developed symmetrical upper limb motion device, to compare brain activation patterns elicited by flexion/extension wrist movements of control and hemiparetic subject group. In control group, contralateral somatosensory cortex(SMC) and bilateral cerebellum were activated by dominant hand movement(Task 1), while bilateral movements by dominant hand(Task 2) activated the SMC in both cerebral hemispheres and ipsilateral cerebellum. However, in hemiparetic subject group, contralateral supplymentary motor area(SMA) was activated by unaffected hand movement(Task 1), while the activation of bilateral movements by unaffected hand(Task 2) showed only SMA in the undamaged hemisphere. This study, demonstrating the ability to accurately measure activation in both sensory and motor cortex, is currently being extended to patients in clinical applications such as the recovery of motor function after stroke.ke.

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Effects of Self Care Training Program on Motor Function of Upper Limb and Self-Efficacy in Chronic Stroke Patients (자조활동 훈련 프로그램이 만성 뇌졸중 환자의 상지 운동기능 및 자기효능감에 미치는 영향)

  • Kim, Gi-Di;Heo, Myoung
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.497-503
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    • 2019
  • The purpose of this study was to investigate the effect of self care training program on motor function of upper limb and self-efficacy in chronic stroke patients. This study selected 20 chronic stroke patients in local community men. The subjects carried out self care training program be composed of task oriented training for 40 minutes, 4 times per week for 6 weeks. Manual function test(MFT), digital grip dynamometer, self-efficacy scale were used to evaluate motor function of upper limb and self-efficacy during pre and post intervention. In MFT and hand grip force test, the post outcome were significantly increase than the pre outcome(p<.05). In self-efficacy evaluation, the post outcome of was significantly improve than the pre outcome(p<.05). The result of this study show that the self care training program be composed of task oriented training may be appropriate for improving the motor function of upper limb and self-efficacy in chronic stroke patients. This will enable the application of self care training program in rehabilitation therapy of chronic stroke patients and it will help guide the selection of the therapist as one therapeutic basis

Repetitive Transcranial Magnetic Stimulation Combined with Task Oriented Training to Improve Upper Extremity Function After Stroke

  • Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.19 no.2
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    • pp.170-173
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    • 2014
  • The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

Imagery training effects of Upper limb function and Activities of daily living in Subacute stroke patients (상상훈련이 아급성뇌졸중환자의 상지기능 및 일상생활수행능력에 미치는 영향)

  • Bang, Dae-Hyouk;So, Yoon-Jie;Cho, Hyuk-Shin
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.235-242
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    • 2013
  • This study aimed to evaluate the effectiveness of imagery training on upper limb function and activities of daily living in subacute stroke patients. This study included 16 voluntary participants with subacute stroke. Subjects were randomly assigned to either experimental or control group, with 8 in each group. Imagery training group performed imagery training during 30 minutes and then task-oriented training 30 minutes a day, 5 times a week for 4 weeks. Control group performed task-oriented training during 30 minutes during a day, 5 times a week for 4 weeks. Assessments were made using the Wolf Motor Function Test (WMFT) and Fugl-Meyer motor function assessment (FMA) to evaluate the changes of upper function. And modified Barthel Index (MBI) was measured to evaluate the activities of daily living. The results showed that imagery training group was more significant increase than control group in WMFT, FMA, and MBI (p<.05). Small to huge effect sizes of 1.59, 2.02, 0.37 were observed for WMFT, FMA, and MBI, respectively. This study indicated that imagery training may be helpful in improving the upper limb function and activities of daily living for subacute stroke patients, and support the clinical feasibility of the imagery training.

Effects of the Probody Massage on the Physical Characteristics, Gross Motor Function and ROM in Youth with Cerebral Palsy : Case study (프로바디마사지가 뇌병변 장애우의 신체적 특성과 대동작 기능 및 관절 가동범위에 미치는 영향 : 사례연구)

  • Kim, Eui-Suk;Yang, Jeong-Ok;Lee, Joong-Sook
    • Korean Journal of Applied Biomechanics
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    • v.25 no.4
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    • pp.453-463
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    • 2015
  • Objective : The purpose of this study was to investigate the effects of the Probody Massage Program on the physical characteristics, gross motor function and ROM (Range Of Motion) of children with cerebral palsy. Method : The subjects of this study were two children who have been diagnosed with first grade cerebral palsy that utilized T development support center located in B Metropolitan city for 8 weeks, twice a week, to carry out the Probody Massage Program for 30 minutes. Physiological reactions (height, weight, BMI, blood pressure (an index of inflammation), pulse rate) and large operating functions (sitting, crawling and the joints' range of motion as an angle of the shoulders' upper limb articulation) were measured pretest, after 4 weeks, and after 8 weeks. Results : The Probody Massage Program showed positive changes in physical characteristics (blood pressure, sitting, and crawling), gross motor function (upper limb shoulder movement), joint range of motion, height, body weight, metabolic activation and blood circulation of children with cerebral palsy. Conclusion : We believe making a practical impact on the growth and development, functional recovery of daily life, and improvement of quality of life of children with cerebral palsy by utilizing Probody Massage Program improves blood pressure (an index of inflammation), pulse, sitting, crawling, and the joints' range of motion as an angle of the shoulder joints' upper limb movement of children with cerebral palsy.

Effect of Bee-venom Acupuncture on Upper Limb Spasticity of Stroke Patients (중풍 환자의 상지 경직에 대한 봉약침의 효과)

  • Noh, Ju-Hwan;Park, Jung-Ah;Cho, Sung-Woo;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm;Kim, Cheol-Hong
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.115-125
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    • 2010
  • Objectives : The purpose of this study is to determine the effect of Bee-venom Acupuncture on upper limb spasticity control in stroke patients. Methods : Ten stroke patients with upper limb spasticity were randomly divided into two groups, a Bee-Venom Acupuncture group(group I) and a normal saline group(group II). After 1 week resting phase, this trial was used a cross-over trial. The numbers of Pharmacopuncture treatment were 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), WMFT(Wolf Motor Function Test), The 10-second Test were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p<.05) in MAS, WMFT, The 10-second Test. But Group II showed no significant improvement(p<.05) in MAS, WMFT, The 10-second Test. The results showed significant difference in WMFT, The 10-second Test, but no significant difference in MAS between two groups. Conclusions : These results showed that Bee-venom Acupuncture might decrease upper limb spasticity and increase arm motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on upper limb in spasticity by Bee-Venom Acupuncture.