• Journal of the Korean Society of Physical Medicine
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• 제8권2호
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• pp.271-280
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• 2013

PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.

• PNF and Movement
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• 제21권2호
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• pp.265-272
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• 2023

Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

• Therapeutic Science for Rehabilitation
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• 제7권2호
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• pp.17-27
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• 2018

Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.

• Journal of the Korean Society of Physical Medicine
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• 제12권2호
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• pp.75-82
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• 2017

PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

• Journal of Acupuncture Research
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• 제25권5호
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• pp.151-165
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• 2008

Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$). After stimulation of Head Acupuncture in Sishencong($HN_1$), $GB_{18}$, $GB_9$, $TH_{20}$ of Left versus Upper and Lower Limbs Acupuncture($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$ of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When $ST_{36}$ was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter-Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points($LI_1$, $LI_{10}4, $LV_3$, $ST_{36}$), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When $ST_{36}$ was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points' sensitivity and different sensory receptor to response acupuncture stimulation.

• The Journal of Korean Physical Therapy
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• 제25권3호
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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.

• Annals of Clinical Neurophysiology
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• 제15권2호
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• pp.59-62
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• 2013

Man-in-the-barrel syndrome (MIBS) is a clinical syndrome of bilateral upper limb weakness with normal lower extremity function. It can be caused by various neurological conditions such as bilateral cerebral hypoperfusion, syringomyelia, motor neuron disease, or cervical myelopathies. We report a patient with MIBS after cervical spinal cord ischemia. It is postulated to be caused by ischemic insults of anterior spinal artery from repeated and prolonged neck extension.

• Journal of the Korean Society of Physical Medicine
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• 제7권4호
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• pp.481-491
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• 2012

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL's. And we also found relationship among somatosensory, hand function, and ADL performance.

• The Korean Journal of Pain
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• 제12권1호
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• pp.16-20
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• 1999

Background: Tourniquet pain has important impacts on anesthesia. Tourniquet pain and accompanying cardiovascular changes are important factors that make patients in distress during anesthesia. As tourniquet pain may be modified by anesthesia, a study on the changes in the neural functions by tourniquet inflation in normal volunteers is important. Methods: Time-dependent changes in tourniquet pain, heart rate, phantom limb sensation, motor function, pain to pressure on upper extremity of 10 healthy and unpremedied volunteers were measured. Each parameter were measured every 5 minutes starting from 10 minutes before inflation to 15 minutes after deflation of tourniquet. Tourniquet was deflated when the subject felt unbearable pain (score 100 with visual analog scale). Results: Subjects manifested time-dependent pain responses to tourniquet inflation, characterized by increase in VAS, systolic and diastolic blood pressure. Mean duration of tourniquet inflation was 36.4 minutes, volunteers experienced motor paralysis at 27.6 minutes and sensory loss at 33.1 minutes. Pain to pressure decreased over time in both arms. The degree of decrease was greater in the arm on which tourniquet was applied than that in the non-applied arm. Phantom limb sensation occurred in 3 subjects. Conclusions: This study demonstrated dynamic changes in the neural functions during tourniquet inflation period. Tourniquet-induced pain and resultant hypertension occurred in all subjects. Appropriate anesthetic management is needed for the surgery using tourniquet.

• Therapeutic Science for Rehabilitation
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• 제7권3호
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• pp.59-78
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• 2018

Objective : The purpose of this study was to investigate the effect of robot-assisted therapy on upper extremity function. Methods : This study used a single-subject experimental A-B-A' design. Three Parkinson's disease patients took part. Each subject received a robot-assisted therapy intervention (45 min/session, 5 sessions/week for 4 weeks). Upper extremity movement was evaluated with the Reo Assessment tool in Reogo. The Jebsen-Taylor hand motor function test, Fugle-Mayer Assessment score, Box and Block Test, and Nine-hole pegboard test were assessed pre- and post-intervention. Results : After intervention, all subjects underwent 3D motion analysis of reaching function. There was overall improvement in resistance, smoothness, direction accuracy, path efficiency, initiation time, and time to moving target with robot-assisted therapy. Robot-assisted therapy may have a positive effect on upper extremity movement in Parkinson's disease. Conclusion : Robot-assisted therapy is considered an alternative in clinical occupational therapy to improve upper extremity function in Parkinson's disease.