• Physical Therapy Rehabilitation Science
• /
• 제11권4호
• /
• pp.502-508
• /
• 2022

Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

• 대한물리의학회지
• /
• 제11권1호
• /
• pp.133-140
• /
• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• 한국콘텐츠학회논문지
• /
• 제9권7호
• /
• pp.202-210
• /
• 2009

본 연구는 뇌졸중 후 상지기능의 관련 요인과 각 요인의 상대적 영향력을 알아보기 위해 시행되었다. MMSE-K(Mini Mental State Examination Korean version) 24점 이상인 100명의 뇌졸중 환자를 대상으로 하였다. 상지기능은 성별, 우세손, 뇌손상 원인, 뇌반구 손상부위, 신체마비 부위, 언어장애 유무와는 유의한 차이가 없었으나(p>0.05), 아탈구 유무는 상지기능에 유의한 차이를 보였다(p<0.05). 상지기능은 상지근력(Manual Muscle Testing), 고유수용성감각(Proprioception), 근 긴장도 (Modified Ashworth Scale), 장악력(Grip strength), 통증(Visual Analog Scale)과 상관관계를 보였다(p<0.05). 위의 변수를 모두 포함하여 분석하면 77.6%의 상지기능 설명력을 보였고 이 중 상지근력이 가장 높은 설명력을 보였다. 뇌졸중 환자의 상지기능 재활을 위해서는 특히 상지근력 강화와 더불어 고유수용성감각, 근 긴장도, 장악력, 통증 그리고 아탈구 유무의 관련 요인들을 포괄적으로 중재에 포함시켜야 할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
• /
• 제43권4호
• /
• pp.182-185
• /
• 2008

Objective : The purpose of the present study is to assess the long-term results of microsurgical dorsal root entry zonotomy (MDT) for the treatment of medically intractable upper-extremity spasticity. Methods : The records of nine adult patients who underwent MDT by one operating neurosurgeon from March 1999 to June 2004 were retrospectively reviewed by another investigator who had no role in the management of these patients. In all patients, MDT was performed on all roots of the upper limb (from C5 to T1) for spasticity of the upper extremity. The degree of spasticity was measured by the Modified Ashworth Scale (grade 0-4). Severity of the pain level was determined using the Numeric Rating Scale (NRS, score 0-10). Also, patient satisfaction of the post-operative outcome was assessed. Results : Comparing the preoperative and postoperative spasticity using the Modified Ashworth Scale, we observed improvement in all patients, particularly in five of the nine patients (55.6%) who improved by three grades over an average of 66.4 months (range, 40-96). Regarding patient satisfaction, seven patients (77.8%) had affirmative results. None of the patients experienced severe, life-threatening, postoperative complications. We observed a decrease in the intensity of painful spasms to less than three scores as measured by NRS in all four patients with associated pain. Conclusion : This study shows that MDT provides significant, long-term reduction of harmful spasticity and associated pain in the upper limbs.

• 한국정밀공학회지
• /
• 제22권11호
• /
• pp.24-29
• /
• 2005

• Journal of Acupuncture Research
• /
• 제21권5호
• /
• pp.249-256
• /
• 2004

Objectives : Wilson's disease is an autosomal recessive abnormality in the hepatic excretion of copper that results in toxic accumulation of the metal in liver, brain, and other organs. The purpose of this case study is to show a case with Wilson's disease treated with acupuncture therapy. Methods : We experienced a 17 year old male patient with a Wilson's disease whose main symptoms are neurological symptoms, such as spasticity, quadripleia and dysphagia. The patient was treated with acupuncture therapy for 3 weeks. Results : Spasticity was assessed by the modified Ashworth scale in an every week. 1. Lt. elbow, wrist and ankle joint improved Gr.III to Gr.II. 2. Rt. each joints and Lt. knee joint seemed to improve a little but no grade changed. Conclusions : This study is just one case and the period of acupuncture therapy is short, which make this case study less sufficient to decide the effect of acupuncture therapy. However, in this case study, acupuncture therapy seems somewhat effective to neurological symptoms of Wilson's disease, such as spasticity and quadriplegia. We suggest that oriental medicine should be studied to cure Wilson's disease from now on.

• 대한중풍순환신경학회지
• /
• 제8권1호
• /
• pp.40-47
• /
• 2007

Many patients have difficulties after stroke. Spasticity is an important one of that difficulties. So in these days, its management is becoming a major issue in rehabilitation. Gagamyounjo-tang was administered to a patient have had spasticity after stroke include Hyulhu(血虛) symptoms. And check the modified Ashworth Scale, Motor grade and VAS for being in the hospital. After treated with Gagamyounjo-tang, Modified Ashworth Scale, Motor grade and VAS have improved, and most of all symptoms about hyulhu(血虛) was disappeared. Based on this result, this study shows that Gagamyounjo-tang was effective in spasticity after stroke especially included Hyulhu(血虛) symptoms.

• 대한의용생체공학회:의공학회지
• /
• 제22권1호
• /
• pp.49-58
• /
• 2001

본 연구에서는 진자 실험을 통하여 중추신경계 질환인 경직을 정량적으로 판정할 수 있는 새로운 LCL(Logically Classified Level) 척도(scale)가 개발되었다. 새로운 척도개발에는 총 30개의 변수가 사용되었다. 이를 위하여 실험결과의 통계적 분석이 수행되었고 이들 중 진자 실험에서 경직의 특성이 가장 잘 반영되는 변수가 대표변수로 선정되었다. 사용된 30개의 변수 중 20개는 새로 도출된 변수이며 10개는 선행된 연구자들에 의하여 개발된 변수이다. 새로운 20개의 변수들은 진자 실험에서 발생되는 특성들인 각도, 각속도, 근육 모델, EMG가 고르게 반영될 수 있도록 이들의 조합으로 도출되었다. 이변량 상관분석결과 총 30개의 변수들 중 11개의 변수들은 서로 밀접한 상관성이 있음이 파악되었다. 11개의 서로 강한 상관성을 보이는 변수 중 논리적인 모순이 없는 L11이 대표변수로 선택되었다. 28명의 환자 데이터는 대표변수인 L11를 기준으로 4개의 그룹으로 분리되었고 최종으로 이들 그룹의 경향을 예측할 수 있는 회귀 방정식을 유도하였다. 새로운 척도에 사용된 대표변수인 L11은 환자들에게서 나타날 수 있는 여러 경우에 적합한지 검토되었는데 미소한 환자의 상태까지 잘 반영하고 있음이 드러났다. 따라서 새로운 LCL 척도는 기존의 준 정량적인 척도인 MAS(Modified Ashworth Scale)를 대체할 수 있을 것으로 기대된다. 특히 환자의 초기 진단뿐만 아니라 동일한 환자의 치료전후, 병적 호전에 대하여 정밀하게 파악할 수 있어 약물의 처방량 조절, 치료기간 등 치료의 전략에 사용될 수 있을 것으로 기대된다.

• 대한한방내과학회지
• /
• 제35권4호
• /
• pp.573-584
• /
• 2014

Objectives: This study was performed to evaluate the efficacy of Korean Medicine on post-stroke patients with upper limb pain due to complex regional pain syndrome diagnosed by three-phase bone scan, digital infrared thermal imaging, and International Association for the Study of Pain diagnostic criteria Methods: To evaluate the effectiveness of the treatments, visual analogue scale, medical research council grade, Brunnstrom stage of motor recovery, modified Ashworth scale, and Korean modified Barthel index were used. Results: After Korean medical treatments like acupuncture, herb medication, bee-venom therapy and rehabilitation therapy for 4 weeks, upper limb pain was considerably less and function of upper limbs was improved. Conclusions: Korean medical treatments have some good effects on post-stroke patients with complex regional pain syndrome.

• 한국산학기술학회논문지
• /
• 제13권9호
• /
• pp.4098-4106
• /
• 2012

본 연구는 경직성 양하지 뇌성마비 아동을 대상으로 하여 체간 근력 강화 운동이 앉은 자세 균형 수행력과 근 긴장도 변화에 어떠한 영향을 미치는지 알아보고자 하였다. 대상자는 대운동 분류 시스템 제 IV단계의 경직성 양하지 뇌성마비 아동 16명을 무작위로 배분하여 주 3회 6주 동안 실시하였고, 실험군은 체간 근력 강화 운동을 대조군은 기본 물리치료만 실시하였다. 체간 근력 강화 운동은 복부근과 배부근 강화를 위한 2가지 운동으로 구성하였다. 대상자들의 균형 수행력 측정은 BPM(Balance Performance Monitor)를 사용하였고 근 긴장도 측정은 MMAS(Modified Modified Ashworth Scale)를 사용하였다. 연구 결과, 앉은 자세 균형수행력 변화에서 실험군과 대조군의 동요거리, 동요속도에서 유의한 차이가 있었고(p<.05), 앉은 자세 균형 수행력 변화 비교에서 실험군과 대조군 사이에 동요속도, 동요거리에서 유의한 차이가 있었다(p<.05). 또한 근긴장도 측정 결과 실험군과 대조군의 무릎관절 굽힘근, 엉덩관절 모음근에서 유의한 차이가 나타나지 않았다(p>.05). 따라서 실험군과 대조군 모두에서 균형 수행력 향상이 나타났지만 실험군에서 조금 더 유의하게 향상되었고, 근 긴장도의 변화는 두 군에서 나타나지 않았다. 경직성 양하지 뇌성마비 아동에게 체간 근력 강화 운동은 근 긴장도의 변화 없이 앉은 자세 균형 수행력을 향상시키는데 효과적임을 알 수 있었다.