• Title/Summary/Keyword: 환측

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Effects of Bimanual Intensive Training on Upper Extremity Function in Stroke Patients (양측 집중 훈련이 뇌졸중 환자의 상지기능 회복에 미치는 영향)

  • Hong, Ho-Jin;Park, Hae Yean;Kim, Jung-Ran;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.119-135
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    • 2020
  • Objective : The purpose of this study was to investigate the effects of bimanual intensive training on Upper Extremity Function and activities of daily living in stroke patients. Methods : The subjects were 18 patients who were diagnosed with hemiplegic stroke. They were randomly assigned to bimanual intensive training group (n=9) and unilateral intensive group (n=9). Bimanual training group performed bimanual task and unilateral training group performed one hand task for 1 hour per session, 5 times a week, for 4 weeks. Chi-square test, Wilcoxon signed rank test, and Mann-Whitney U test were used for analysis. Results : The results showed that, upper extremity motor function and bimanual coordination were significantly improved in patients in the bimanual training group (p<.05). Additionally, the ratio of affected hand use and amount of use/quality of movement in the hemiplegic upper extremity in activities of daily living for patients in the bimanual training group were significantly improved (p<.05). Although the unilateral group improved motor upper extremity function and activities of daily living in the upper extremity (p<.05), it was not significantly different from that in the bimanual training group. In between-group comparison, bimanual coordination and ratio of the affected hand use in a day were significantly different (p<.05). Conclusion : It is reasonable to conclude that bimanual intensive training therapy is an effective intervention method to improve upper extremity motor function, and activities of daily living in stroke patients.

The Effects of Visual Flow Speed's Modulation-Based Virtual Reality Program on Gait Function in Stroke Patients (시각 흐름 속도에 따른 가상현실 프로그램이 뇌졸중 환자의 보행에 미치는 영향)

  • Kang, Hyung-Kyu;Chung, Yi-Jung
    • 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.

Accelerometry of Unimanual and Bimanual Activities in Stroke Patients (뇌졸중 환자에서 한손 및 양손 활동 수행 시 가속도 분석)

  • Lee, Jeong-Eun;Kim, Do-Yeong;Kim, Tae-Hoon
    • 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.

Gait Initiation in a Patient With Spastic Hemiplegia Cerebral Palsy With and Without a Dynamic Ankle Foot Orthosis: A Pilot Study (강직성 편측 뇌성마비 환자의 보행 기시에 미치는 동적 단하지 보조기의 효과: 사전연구)

  • Jeon, Hye-Seon;Senesac, Claudia;Kaufman, Elizabeth
    • 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.

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The effects of microcurrent stimulation for gait improvement (미세전류 자극이 보행 개선에 미치는 효과)

  • Yu, Jae-Young;Jeong, Jin-Gyu
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.11
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    • pp.1283-1290
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    • 2014
  • This study was conducted to apply microcurrents of $500{\mu}A$ effective for ATP generation to leg muscles to which delayed onset muscle soreness (DOMS) had been induced in order to examine whether the microcurrent stimulation was effective for gait improvement. Forty subjects were randomly assigned to an experimental group of 20 subjects and a placebo group of 20 subjects. Microcurrents were applied immediately after inducing DOMS and 24 hours and 48 hours thereafter and changes in the center of pressure (COP), cadence, and affected stance phases were measured. According to the results of the measurement, changes in the COP, cadence, and affected stance phases at 48 hours after the induction of DOMS were statistically significant compared to the values before the induction. The COP of the experimental group became statistically significantly lower and the ratio of affected stance phases of the experimental group became statistically significantly higher compared to the placebo group at 48 hours after the induction of DOMS. Therefore, $500{\mu}A$ microcurrents showed effects for gait improvement by promoting the recovery and healing of damaged muscles.

Kinematics of Bimanual Complementary Movement in Stroke Patients (뇌졸중 환자에서 양손 보완운동의 운동형상학)

  • Kim, Taehoon
    • The Journal of the Korea Contents Association
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    • v.15 no.4
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    • pp.342-349
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    • 2015
  • The objective of this study was to compare the unimanual and bimanual complementary movements of the affected upper extremity. Thirty participants living in Busan area with post-stroke hemiparesis were involved in this study. They were selected according to twelve criteria. We used the Fitmeter accelerometer to measure Signal Vector Magnitude, peak acceleration and peak deceleration. The movement time and Signal Vector Magnitude of bimanual complementary movement were less than those of unimanual movement(p<0.05). Therefore, we suggest that bimanual complementary movement is more useful, as for the kinematic aspect, than unimanual movement when a person with stroke perform activities of daily living.

The Effect of Action Observation Training on Dexterity of Affected Upper Extremity Motor Function and ADL in Stroke Patients (과제지향적 동작관찰훈련이 뇌졸중 환자의 환측 상지기민성과 일상생활활동에 미치는 영향)

  • Eom, Sook;Kim, Su-Kyoung
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.55-66
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    • 2013
  • Objective : The purpose of present study was to determine effects of task oriented action observation training on dexterity of upper limb function after stroke. Training was progressed to imitation and intensive training after observation to required action in ADL. Method : 15 stroke patients were selected and one group pretest-posttest design was applied. Targets observed performance actions of task orientated task through a video and limitated action repeatedly, Training was performed 3 times a week and 20~30 minutes for each round for 3 weeks. Manual function test and 10-second test and Box and block test were performed for a dexterity of upper extremity motor function, Modified Barthel index and Motor activity log were performed for ADL. Result : After the training, a dexterity of affected upper extremity motor function of the target showed significant difference between before and after intervention, ADL showed significant improvement between before and after intervention. Conclusion : Task orientated Action observation lead a positive effect of recovering a dexterity of upper extremity motor function and ADL. Therefore, this study suggest a action observation training as one strategy of an intervention type of th e occupational therapy.

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The Effect of Amount of Use on the Affected and Unaffected Side Using an Accelerometer in Stroke Patients on the Upper Limb Function Assessment for Improving Life Care (가속도계를 활용한 뇌졸중 환자의 환측과 건측의 사용량이 라이프 케어 증진을 위한 상지 기능 평가에 미치는 영향)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • 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.

The Effect of Constraint-Induced Movement Therapy(CIMT) With Cognitive-Perceptual Training on Upper Extremity Function of Stroke Patients With Mild Cognitive Impairment (경도 인지손상을 가진 뇌졸중 환자의 상지 기능에 미치는 강제유도운동치료(CIMT)와 인지-지각 훈련의 병행 효과)

  • Kim, Hun-Ju;Shin, Joong-Il;Kam, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5684-5691
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    • 2011
  • The purpose of this study is to examine effects of constraint-induced movement therapy(CIMT) and/or cognitive-perceptual training(CPT) on the change of hand function in cerebrovascular accident(CVA) patients and to evaluate the change in the amount and quality of use of the affected upper extremity in performing daily living tasks. The subjects of study were 10 patients who had been under rehabilitation for more than three months after CVA onset. They were all determined as mild cognition impairment according to NCSE or MVPT test. For CIMT group, to restrict the movement of the unaffected hand the subjects had been worn modified resting arm-splint in daytime for 4 weeks. For CIMT+CPT group, the subjects were performed CPT with CIMT and control group had been under conventional occupational therapy for the same period. CIMT+CPT group showed significant improvement in simulated feeding, lifting large light objects, and lifting large heavy objects of Jebsen-Taylor Hand Function Test. CIMT group also showed significant improvement compared with control group. The mean changes of the amount of use(AOU) of the affected arm had a statistically significant difference among groups (p<.05). While CIMT+CPT group had the biggest change in the quality of movement(QOM) of upper extremity of the affected side, CTL group showed the smallest change. Both CIMT and CIMT+CPT groups had statistically significant difference in the change in the quality of movement in upper extremity of affected side with CTL group(p<.05), but there was not significant difference between CIMT group and CIMT+CPT group. CIMT performed to the patients of stroke, with mild impairment in cognitive perceptual abilities showed the improvement in hand movement and AOU and QOM of upper extremity in the affected side and the combination of CIMT with CPT showed synergic effects.

CLINICAL STUDY ON BRAINSTEM EVOKED RESPONSE AUDIOMETRY IN ACOUSTIC NEUROMA (청신경종에서의 뇌간유발반응검사 소견에 대한 임상적 고찰)

  • 노관택;이용식;이상일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.8.1-8
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    • 1987
  • 청신경종은 제8 뇌신경에서 기원하는 종양으로서 초기에 발견될수록 제거가 용이하기 때문에 조기진단이 중요한 의미를 갖는다. 뇌간유발반응검사는 청신경종의 초기에 객관적으로 청신경종의 유무를 확인할 수 있는 방법으로 사용되고 있다. 이에 저자들은 1982년부터 1986년까지 본원 이비인후과와 신경외과에 입원하여 수술한 청신경종 환자 27례에 대하여 뇌간유발반응검사를 검토하고 다음과 같은 결과를 얻었다. 27례중 9례에서 환측에서 제 1파만이 관찰되었고 이중 6례는 순음청력검사상 60 ㏈이하의 역치를 보였다. 13례에서는 환측의 반응이 전혀 없었고 5례에서는 양측에 이상이 있었다. 대개의 경우 진행된 상태에서 발견되어 수술을 시행했기 때문에 뇌간유발반응 검사상 특이 소견을 찾기 어려웠으나 청력이 남아 있는 감각신경성난청환자에 있어서는 진단적 의의가 있음을 알 수 있었다.

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