• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.247-253
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• 2012

The purpose of this study was to evaluate the effects of a visual flow speed's modulation-based VR(virtual reality) program on gait function in stroke patients. Thirty one stroke patients were randomly selected at Dep. of Rehabilitation medicine of M hospital in Seoul. We carried out the gait analysis by dividing them with four conditions : one condition had applied without the visual flow modulation-based VR and another had done three visual flow speed's modulation-based VR(0.25, 1, 2 times). The gait analysis was used with GaitRite system. The data were collected using gait velocity, cadence, stride length, step length, single support time, and double support time during treatment. The results were as follows. First, the slow visual flow(0.25 times)-based VR program on the condition was significant decrease gait velocity, cadence, stride length, step length and increase single support time, double support time(p<.05). Second, the fast visual flow(2 times)-based VR program on the condition was significant increase gait velocity, cadence, stride length, step length, single support time on paretic lower limb and decrease single support time on non-paretic lower limb, double support time(p<.05). Third, the normal visual flow(1 times)-based VR program on the condition was not significant differ gait velocity, cadence, stride length, step length, single support time, double support time. In conclusion, the visual flow speed's modulation-based VR program improves gait function in chronic stroke patients.

• Therapeutic Science for Rehabilitation
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• v.10 no.1
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• pp.129-140
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• 2021

Objective : This study evaluated the differences between the upper and lower arm activities of the affected and non-affected sides in stroke patients performing activities of daily living. It was intended to gather basic data for the measurement of daily activities. Methods : The participants in the study consisted of 20 patients, 10 had left hemiplegia and 10 had right hemiplegia. Between September and November 2017, they performed drinking and dressing as unimanual and bimanual tasks. The 3-axes accelerometers were placed 2cm below the lateral epicondyle on the upper arm and 2cm below the radial styloid on the lower arm. The data were collected at intervals of 1/32 Hz and analyzed. Results : In patients with right hemiplegia, the tendon activity was significantly higher in the lower arm when performing a bimanual activity (p<.05), for all the other activities, those of the lower arm were significantly higher than those of the upper arm (p<.01, p<.05). There was no significant difference between the unimanual and bimanual activities of the affected and tendon sides in patients with left hemiplegia (p>.05). In both hands, the activity of the lower arm was significantly higher than that of the activities of the upper and lower arms, except on the affected side (p<.05). In all patients, the activities of the upper and lower arms were significantly higher (p<.05), and the activity of the lower arm was significantly higher than that of the upper (p<.001, p<.05). Conclusion : The activity was higher on the non-affected side than the affected side during the dressing task, and the overall activity was higher in the lower arm than the upper arm.

• Physical Therapy Korea
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• v.7 no.4
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• pp.39-46
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• 2000

본 연구는 강직성 편측 뇌성마비 환자의 보행 기시(gait initiation)의 특성을 파악하고, 동적 단하지 보조기(dynamic ankle foot orthosis : DAFO)가 이런 환자들의 보행 기시에 미치는 영향을 알아보기 위하여 실시하였다. 연구대상자는 19세 선천성 강직성 우측 뇌성마비를 가진 여자 대학생이었다. 연구대상자는 4개의 다른 보행 기시 조건에서 각 조건당 7회의 보행 기시를 하였는데, 각각의 보행 기시 조건은: 1) 보조기 없이 좌측 하지로 보행 기시; 2) 우측 하지 보조기 착용 상태에서 좌측하지로 보행 기시; 3) 보조기 없이 우측 하지로 보행 기시; 4) 우측 하지 보조기 착용 상태에서 우측 하지로 보행 기시였다. 두개의 힘 판(force plate) 위에서 본인이 선택한 가장 편안한 방법과 속도로 2 m를 걷도록 하였다. 연구대상자가 보행 기시를 하는 동안 양쪽 가자미근과 앞정강근에 부착된 4개의 표면 전극으로부터 근 전도 신호와 보행 기시를 하는 연구 대상의 양 발 아래 놓인 두개의 힘 판의 자료를 분석하여 체중(body weight : BW)으로 정량화 하였다. 실험결과는 각 조건마다 7회 실시된 측정값들의 평균을 이용하였다. 본 사전연구의 결과는 다음과 같다. 1. 보행 기시 전 양다리로 선 상태에서 환측보다 건측으로 많은 체중지지를 하였으나(환측 42.57%BW, 건측 58.03%BW) 보조기의 착용이 환측으로의 체중지지를 향상시켰다(환측 44.46%BW, 건측 55.54%BW). 2. 보행 기시 중 가자미근과 앞정강근의 동시수축(coactivation)이 계속되었는데 이러한 양상은 보조기의 착용 유무에 따라 크게 달라지지 않았다. 3. 힘 판에서 들어온 지면 반발력(ground reaction force)의 수직 분력(vertical element, Fz)과 전후 분력(anterior-posterior element, Fx)을 분석한 결과, 건측 다리로 보행 기시를 할 때 보조기 착용은 가속을 촉진시켜 역학적으로 유리하였다. 이상의 연구 결과는 보조기의 착용이 건측 다리로 보행 기시를 할 때 미치는 신경학적, 역학적 장점들에 대한 구체적 연구의 필요성 및 근거를 제시하고, 환자들의 보행훈련 접근에 보다 효율적인 보행방법을 소개하는데 이용될 수 있다.

• Journal of Korea Entertainment Industry Association
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• v.14 no.7
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• pp.511-518
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• 2020

The purpose of this study was to provide useful data for clinical occupational therapy by examining the correlation between the use of affected and unaffected sides measured using an accelerometer and upper limb function in chronic stroke patients. In this study, accelerometer, Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and Yonsei-Bilateral Activity Test(Y-BAT) was measured on 40 stroke patients who were hospitalized in Won-ju city Y hospital between May 2, 2019 and July 18, 2020. As a result of the study, there was a significant negative correlation between amount of use on the unaffected side and FMA and MAL's Amount of Use(AOU), Quality of Movement(QOM), the quality and satisfaction of performing both hands through Y-BAT. The amount of use on the affected side showed a significant positive correlation with FMA and MAL's AOU, QOM, satisfaction of performing both hands. This study is meaningful in that it suggested the possibility that the actual amount of use on the affected and unaffected side measured using an accelerometer could be used as an evaluation item for upper limb function in stroke patients.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.7-12
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• 2007

Purpose: The purpose of our study was to determine the concentrations of cytokines in ACL deficient knee, the changes of cytokines from injury as the time progressed, and changes of cytokines after ACL reconstruction. Materials and Methods: Twenty-five patients with ACL-injured knee were enrolled. Synovial fluid lavages were collected at the time of surgery. Before surgery, twenty-five patients were aspirated synovial fluid from their injured and uninjured knees. Twelve patients were aspirated synovial fluid after 9 months postoperatively. The samples were analysed for $IL-1{\beta},\;TNF-{\alpha}$, MMP-3, IL-6 and TIMP-1 using ELISA. Results: The $IL-1{\beta}\;and\;TNF-{\alpha}$ concentrations were below detectable ranges in all uninjured knees and ACL ruptured knees. There were no significant difference between the mean concentrations of the uninjured and ACL injured knees for TIMP-1 and IL-6. The mean concentration of MMP-3 in ACL injured knees was significantly higher than in the uninjured knees. In the 12 cases after 9 months postoperatively, the mean concentration of MMP-3 was no significant difference between preoperative cytokine levels. Conclusion: The concentration of MMP-3 was only higher in the ACL injured knee than uninjured knee and no significant change was examined after 9 months postoperatively.

• Progress in Medical Physics
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• v.16 no.1
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• pp.1-9
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• 2005

The effect of the developed symmetric upper extremity motion trainer on the cortical activation pattern was investigated in three chronic hemiparetic patients using both fMRI and Fugl-Meyer test. The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer tests were performed every two weeks during the training. fMRI was performed at 3T scanner with wrist flexion-extension in two different tasks before and after the training program: the only unaffected hand movement (Task 1) and passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral SMC. Task 2 showed cortical reorganizations in bilateral SMC, PMA and SMA. Therefore, it seems that the cortical reorganization in chronic hemiparetic patients can be induced by the training with the developed symmetric upper extremity motion trainer.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.7-11
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• 2001

Purpose : To evaluate the neurologic abnormalities in the donor limb after contralateral C7 transfer in brachial plexus injury. Materials and Methods : From August 1996 to December 1999, five patients with brachial plexus injury were treated with contralateral C7 nerve root transfer. The average follow up was 16 months(range, 5 to 36 months). The clinical findings were assessed using the British Medical Research Council Grading System, and also measured grip power, pinch power of hand and two point discrimination of the fingers. Results : We had no difference in shoulder abduction and elbow flexion after contralateral C7 transfer. The grip and pinch strength were recovered within 4weeks. Sensory loss occurred in all patients and was noted to be more severe on index and middle finger. Four patients recovered within 2 weeks, one continued till one year. Subjective numbness and pain on percussion minimally persisted until last follow-up. Conclusion : The division of the C7 nerve root resulted in minimal and temporary functional deficit in the donor upper limb.

• Journal of Korean Academy of Nursing
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• v.36 no.2
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• pp.403-414
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• 2006

Purpose: The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E. Method: A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal. Result: After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups. Conclusion: The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.2
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• pp.73-78
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• 2014

In this paper we propose a wearable elbow rehabilitation robot applied the mirror therapy for elbow rehabilitation. To implement the mirror therapy, a data suit for measuring healthy elbow motion is developed. A powered elbow exoskeleton wearing in paralyzed arm is controlled by the measured data from the healthy elbow motion. In experiments, the elbow rehabilitation exercise by the mirror therapy is performed. From the experimental results we show the wearable exercise robot including the data suit is applicable to the mirror therapy for elbow rehabilitation.

• Physical Therapy Korea
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• v.5 no.4
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• pp.1-8
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• 1998

본 연구의 목적은 장애물 높이에 따른 상지 팔운동 제한이 스텝안정화(stabilization step)에 영향을 주는지 알아보기 위하여 실시하였다. 연구대상자는 대학생 남자 14명, 여자 16명으로 총 30명이였으며, 평균 연령은 21.5세이었다. 스텝 안정화는 FASTEX(functional activity System for testing and exercise, Cybex Division of Lumex, Inc., USA)를 이용하여 측정하였다. 장애물의 조건은 1) 장애물이 없는 조건 2) 15 cm 장애물 3) 25 cm 장애물이었고, 팔 운동의 제한 조건은 1) 팔운동을 제한하지 않은 조건 2) 우세 팔의 운동 제한 3) 양쪽 팔을 모두 제한하는 3개의 조건에서 스텝 안정화 시간을 측정하였다. 장애물 요인과 팔운동 제한 요인간에 안정화 시간(stabilization time)의 차이가 있는지 알아보기 위하여 반복이 있는 2요인 분산분석을 실시하였고, 남녀간에 안정화 시간에 차이가 있는지 알아보기 위하여 t-검정을 실시하였다. 장애물이 없는 조건에서 양팔의 운동을 제한하지 않고 측정한 안정화 시간의 평균은 0.89초이었고, 건측의 상지운동을 제한한 상태에서의 평균은 0.88초이었으며, 양쪽 팔의 운동을 모두 제한했을 때의 평균은 0.84초이었다. 15 cm의 장애물이 있는 조건에서 양팔의 운동을 제한하지 않고 측정한 안정화 시간은 평균 0.98초이었고, 건측의 상지운동을 제한한 상태에서의 펑균은 1.00초이었으며, 양쪽 팔의 운동을 모두 제한했을 때의 평균은 1.14초이었다. 25 cm의 장애물이 있는 조건에서 양팔의 운동을 제한하지 않고 측정한 안정화 시간은 평균 1.09초이었고, 건측의 상지운동을 제한한 상태에서의 평균은 1.28초이었으며, 양쪽 팔의 운동을 모두 제한했을 때의 평균은 1.57초이었다. 남녀간의 스텝 안정화 시간에 차이가 있는지 알아본 결과 각각의 조건에서 통계학적으로 유의한 차이가 없었다. 장애물과 팔운동 제한 조건에 따른 스텝 안정화 시간의 차이가 있는지 알아보기 위하여 반복이 있는 2요인 분산분석을 실시한 결과, 장애물의 높이에 따라 스텝 안정화 시간에는 유의한 차이가 있었고(p<0.05), 15 cm, 25 cm 장애물 조건에서는 팔운동 제한 조건에 따른 스텝 안정화 시간에도 유의한 차이가 있었지만(p<0.05), 장애물이 없는 조건에서는 팔운동 제한에 따른 안정화 시간에는 유의한 차이가 없었다. 이상의 결과는 보행중 장애물을 넘고, 한발로 기립하여 안정성을 유지할 때 팔의 운동이 스텝 안정성에 영향을 미친다는 것을 알았고, 이러한 결과는 한팔 또는 두 팔을 사용할 수 없는 편마비환자나 상지 절단환자의 균형 평가나 치료시 고려되어져야 할 것이다.