• 국제물리치료학회지
• /
• 제1권2호
• /
• pp.143-148
• /
• 2010

The present study examined the effects of functional electrical stimulus(group 1), proprioceptive neuromuscular facilitation(group 2) and combined training of functional electrical stimulus and proprioceptive neuromuscular facilitation(group 3) with scapula adductor muscles on scapula movement, upper limb function and gait in fifteen subjects stroke patients. The training was thirty minutes a day, five times a week for six weeks, obtained result as follow, upper limb function was significant difference in the group 2(p<.05) but no significant difference in other groups. The change of weight bearing were significant difference in all the groups(p<.05), and increase of gait velocity were significant difference in all the group(p<.05). In conclusion, when applied with functional electrical stimulus, proprioceptive neuromuscular facilitation and combined training to the scapular adductor muscles, it was oberved in the course of the experiment that proprioceptive neuromuscular facilitation was the most effective treatment among the three methods applied to the scapula adductors.

• 여성건강간호학회지
• /
• 제13권1호
• /
• pp.43-50
• /
• 2007

Purpose: There is a need to apply the Tai Chi program to help early mastectomy patients improve their upper limb functions and for the emotional state as well. Method: Participants were recruited at breast cancer centers of two general hospitals from February 17 to April 25, 2005. Twenty-five subjects in the experimental group and 23 subjects in the control group participated for 12 weeks. The Tai chi program consisted of breast cancer self management education and a Tai Chi exercise program. Range of motion of the shoulder joint was determined by the Uni-level inclinometer, and functional assessment of the shoulder was evaluated with the tool. Data was analyzed by SPSS 11. Results: The experimental group had significantly increased shoulder range of motion, especially in external rotation, upper limb function and emotional state compared with the control group after program for 12 weeks. Conclusion: This program makes it possible to be independent and have a positive everyday life. In addition, it can help keep a healthy lifestyle in mastectomy women.

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

• Physical Therapy Rehabilitation Science
• /
• 제8권4호
• /
• pp.187-193
• /
• 2019

Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.

• PNF and Movement
• /
• 제15권1호
• /
• pp.27-33
• /
• 2017

Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.

• 재활치료과학
• /
• 제11권3호
• /
• pp.37-50
• /
• 2022

목적 : 최근 3년간 국내 및 국외 학회지에 게재된 뇌졸중 편마비 환자의 상지 운동 또는 기능 평가에 근전도가 사용된 연구에 대해 알아보았다. 연구방법 : 뇌졸중 환자의 상지 운동 또는 기능 평가에 근전도가 사용된 연구를 검토하기 위해 데이터베이스 PubMed, EMBASE, Scopus, RISS, KISS를 사용하여 문헌을 검색하였다. 검색어는 ('stroke' OR 'hemiplegia') AND ('EMG' OR 'electromyography' OR 'electromyogram' OR'muscle activity') AND ('Upper limb' OR 'Hand') 또는 (뇌졸중 OR 편마비) AND (근전도 OR 근활성도) AND (상지 OR 상지기능 OR 손)을 사용하였다. 검색 기간은 2018년 1월 1일부터 2021년 12월 31일로 설정하였다. 결과 : 최종적으로 15편의 연구가 도출되었으며, 뇌졸중 편마비 환자를 근전도를 사용해 평가할 때 근활성도를 평가하는 연구가 가장 많았으며, 일상생활과 밀접한 과제를 수행하는 중재, 보조도구를 사용한 중재, 단순 동작의 반복을 제공하는 중재 등이 가장 빈번하게 사용되었다. 결론 : 근전도 검사를 사용해 상지기능을 평가할 때, 연구 목적에 따라 함께 사용할 수 있는 평가도구를 제시하고, 평가 시 근전도 검사를 활용할 수 있는 중재를 설정하는 근거를 제공한다는 의의가 있다.

• 한국엔터테인먼트산업학회논문지
• /
• 제14권6호
• /
• pp.269-277
• /
• 2020

본 연구의 목적은 감각 결손이 있는 만성 뇌졸중 환자를 대상으로 경 두개 직류 전류 자극을 체성감각피질에 적용했을 때, 감각의 회복과 상지 기능의 회복을 알아보고자 하는 것이다. 만성 뇌졸중 환자 20명을 실험군 10명, 대조군 10명으로 나누어 실시하였다. 실험군은 환측 체성감각피질에 경 두개 직류 전류 자극을 적용하였으며, 대조군은 위상 자극을 실시하였다. 중재는 총 2주간, 10회, 회기 당 20분씩 진행되었다. 체성감각 평가는 The Erasmus MC modifications to the (revised) Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME), 상지기능 평가는 퍼글마이어평가(FMA), 운동 활동 척도(MAL), 가속도계를 사용하였다. 연구 결과, 실험군은 대조군보다 전체적인 촉각 감각과 고유수용성 감각, 피질 감각, 지각의 민감도에서 유의한 개선을 보였으며, 환측 상지의 사용량에서 통계학적 유의한 차이를 나타냈다. 본 연구 결과를 기반으로 체성감각 회복과 상지기능의 회복을 위한 tDCS의 효과적인 임상 적용의 가능성을 높일 수 있을 것으로 생각된다.

• 한국전문물리치료학회지
• /
• 제14권2호
• /
• pp.1-10
• /
• 2007

The purpose of this experiment was to investigate the applicability of audio-visual modeling for improving the efficiency of rehabilitative programs by analyzing the effects of observing these various models on the capacity of stroke patients to perform upper limb activities. Twenty-one stroke patients participated in the experiment and were randomly assigned to either task modeling, sport modeling, or control group. During 2 weeks of intervention, subjects in all groups participated in the physical practice of experimental tasks. These tasks comprised of a Nine Hole Peg Test, the Jebsen-Taylor Hand Function tests, and locomotion. These tasks were performed 5 days a week, 30 min per day. In addition to the physical practice, the task modeling group observed a model performing experimental tasks and locomotive activities for 20 min, while the sport modeling group observed a model performing various sport activities for 20 min. Subjects' ability to perform the experimental tasks was measured 3 times, before, immediately after, and 1 week after the intervention. Analyses of the capacity to perform upper extremity activities displayed significant improvement from the pre-test to immediate and delayed post-tests in all groups. However, the amount of improvement was the highest in the task modeling group. The task modeling group was superior to the control group in the post-test of all experimental tasks, whereas the sport modeling group did not display significant differences from the control group. These results suggest that audio-visual modeling can be used as an effective cognitive intervention for facilitating the rehabilitation of stroke patients, and its rehabilitative effect can be maximized when the program is comprised of performance scenes directly related to the target task.

• 인간행동과 음악연구
• /
• 제11권1호
• /
• pp.1-19
• /
• 2014

본 연구는 패턴화된 감각 증진(Patterned Sensory Enhancement, PSE) 기법이 뇌졸중 환자의 상지 기능에 미치는 즉각적인 효과를 알아보기 위해 PSE와 단순 리듬 자극 간의 차이를 비교분석 하였다. 연구 대상은 서울시와 수원시 소재의 재활병원에서 입원 치료 중인 뇌졸중 편마비 환자 16명이며 실험군과 대조군으로 각각 8명씩 배치하였다. 본 연구의 종속변인은 뇌졸중 환자의 환측 상지 기능으로 6가지 동작의 관절가동범위(ROM, range of motion)와 장악력이며 실험군에게는 PSE를, 대조군에게는 메트로놈으로 제공되는 단순 리듬 자극을 제공하였다. 실험은 음악 자극이 없을 때와 있을 때의 같은 상지 기능을 측정하는 순서로 진행되었으며 측정한 값의 경향을 정확하게 파악하기 위해 동일한 실험을 총 2회 실시하여 평균값을 도출하였다. 연구 진행 결과, PSE를 제공받은 실험군은 음악을 들으며 동작을 수행할 때 상지 관절가동범위가 유의미하게 향상되는 즉각적인 효과를 보였으나(p < .05), 대조군은 즉각적인 효과를 보이지 않았다. 이는 단순 리듬 자극보다 PSE가 상지 운동 향상에 더 적절하게 적용될 수 있다는 것과 음악의 청각적 패턴이 운동 범위의 확장 즉, 운동 향상에 영향을 줄 수 있다는 것을 보여주었다. 본 연구는 PSE가 상지 운동 기능에 미치는 즉각적인 영향을 단순 리듬 자극과 비교분석하였다는 점에서 의의가 있으며 음악 요소의 특징이 유도하고자 하는 신체 운동의 목표와 밀접한 연관성을 가질 때 효과적으로 영향을 미칠 수 있음을 시사한다.

• Physical Therapy Rehabilitation Science
• /
• 제7권2호
• /
• pp.67-71
• /
• 2018

Objective: Participation restrictions are serious problems that stroke survivors experience while reintegrating into family, work, community, and social situations after participating in rehabilitation programs. The purpose of this study was to explore the factors affecting participation in activities of daily living (ADL), as well as social and leisure activities of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: The study involved 96 participants who were diagnosed with a first stroke 6 months before the study (58 men, 38 women; $60.3{\pm}14.3years$). The Berg Balance Scale, Modified Barthel Index, Manual Function test, and Activity Card Sort were used to assess static and dynamic balance function, upper limb function, level of independence, and their level of participation within the community. A regression analysis was used to identify the influence of factors affecting participation in ADL, social and recreational activities. Results: The Activity Card Sort scores were significantly affected by the Manual Function test and Modified Barthel Index scores (p<0.05). Participation in leisure activities was affected by the level of independence. Participation in social activities was affected by the balance function and level of independence of the participants. Conclusions: The results of this study have shown that participation restrictions are affected by upper limb function, balance function, and the level of independence in individuals with hemiparetic stroke.