• 제목/요약/키워드: Sensorimotor function

검색결과 46건 처리시간 0.032초

뇌졸중 환자의 동적균형 및 보행에 대한 감각운동 훈련과 사이클링 운동의 효과 비교 : 개별사례연구 (Comparison of sensorimotor training and cycling exercise for dynamic balance and gait function stroke patient: Single subject design)

  • 양해덕;오덕원
    • 대한물리치료과학회지
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    • 제17권1_2호
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    • pp.1-9
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    • 2010
  • Background: The objective of this study was to determine whether sensorimotor training using an unstable surface affects dynamic balance and gait function in patients with hemiparesis, and to compare the effect of sensorimotor training with that of cycling exercise. Methods: Two subjects with post-stroke hemiparesis volunteered to participate in this study. Single-subject A-B design with alternating treatment was used for this study. Baseline(A) and intervention(B) phases were performed for 7 and 8 sessions, respectively. Sensorimotor training and cycling exercise were performed for 20 minutes in randomized order. Assessment tools were made by using a step test, timed up and go(TUG) test, and 6-minute walk test(6MWT). Results: Each of the participants improved in all three tests after the two interventions. Participants 1 and 2 showed the improvement for their assessment score after sensorimotor training in the step test by 42.1%(p<.05) and 58%, in the TUG, 31% and 19.5%, and in the 6MWT test, 32.3% and 10.6%(p<.05), respectively. After cycling exercise, participants 1 and 2 also improved in the step test by 32.5% and 53.1%, in the TUG, 27.4% and 18%, and in the 6MWT test, 28.8% and 3%. In statistical analysis between the two interventions, sensorimotor training showed a significant increased values in the step test for participant 1 and the 6MWT for participant 2 as compared with those of cycling exercise. Conclusion: Sensorimotor training and cycling exercise are helpful for improving dynamic balance and gait capacity. Furthermore, sensorimotor training may be more helpful than cycling exercise.

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Visuomotor Coordination Deficits of Ipsilateral Upper Limb in Stroke Patients with Shoulder Pain

  • Son, Sung-Min;Kim, Kyoung;Lee, Na-Kyung
    • The Journal of Korean Physical Therapy
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    • 제26권3호
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    • pp.163-168
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    • 2014
  • Purpose: The purpose of this study was to investigate whether ipsilateral shoulder pain affects the sensorimotor function of the same side shoulder in patients with stroke. Methods: Thirty stroke patients, who were divided into the ipsilateral shoulder pain group (n=15) and the ipsilateral shoulder non-pain group (n=15). Subjects were evaluated on performance of a tracking task, joint reposition test and 9-Hole pegboard test for sensorimotor functions, and Fugl-Meyer test and Motricity Index for functional ability of the contralateral side. Results: In comparison of the two groups, significant differences in performance on functional ability, including the Fugl-Meyer test(both upper and lower limb) and Motricity Index(only lower limb) were observed (p<0.05). With regard to sensorimotor functions, the ipsilateral shoulder pain group were observed significantly poor scores on the Accuracy Index, joint reposition score and 9-Hole pegboard test, when compared with the ipsilateral shoulder non-pain group (p<0.05). Conclusion: We found that ipsilateral shoulder pain could impede accurate performance of a movement and result in deteriorated proprioception of the ipsilateral shoulder. Therefore, careful evaluation and appropriate therapeutic intervention are essential for stroke patients who suffer from ipsilateral shoulder pain.

국소 허혈성 뇌손상 흰쥐 모델에서 경두개직류전기자극이 앞다리 운동감각 기능 증진에 미치는 효과 (Effect of Improved Forelimb Sensorimotor Function on the Transcranial Direct Current Stimulation in a Focal Ischemic Brain Injury Rat Model)

  • 김기도;심기철;김경윤
    • 한국콘텐츠학회논문지
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    • 제11권4호
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    • pp.273-282
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    • 2011
  • 본 연구는 국소 허혈성 뇌손상 흰쥐 모델에서 tDCS의 자극 적용시간을 달리하였을 때, 앞다리 운동감각 기능변화와 신경영양인자(GAP-43)발현에 미치는 영향을 알아보고자 하였다. 뇌손상 모델은 Sprague -Dawley계 흰쥐 80마리를 'Longa'방법을 이용하여 중대뇌동맥(middle cerebral artery)을 폐색하여 유발하였고, 실험군을 4개로 나누었다; 실험군I은 허혈성 뇌손상 유발군(n=20), 실험군II는 허혈성 뇌손상 유발 후 tDCS(10분) 적용군(n=20), 실험군III은 허혈성 뇌손상 유발 후 tDCS(20분) 적용군(n=20), 실험군IV는 허혈성 뇌손상 유발 후 tDCS(30분) 적용군(n=20)으로 나누었다. 앞다리운동감각 기능검사를 위해 수정된 앞다리배치 검사와 단일 팰릿 닿기 검사를 실시하였으며, 신경가소성에 대한 면역조직화학적 검사로 운동감각 영역에서의 GAP-43 단백질 발현을 관찰하였다. 앞다리운동감각 검사는 14일에서 실험군III (p<0.05)이 다른 군들에 비해 유의한 차이를 보였으며, 단일 팰릿 닿기 검사는 14일에서 실험군III(p<0.01)과 실험군IV(p<0.05)에서 유의한 차이를 보였다. 또한, 면역조직학적 검사는 14일에 실험군III이 다른 군들에 비해 현저한 면역양성반응의 증가를 보였다. 따라서, 0.1 mA의 강도로 20분간 적용했을 때가 앞다리운동감각 기능과 신경가역성 인자 GAP-43 발현에 가장 좋은 조건임을 알 수 있었다.

목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향 (Effects of Cervical Sensorimotor Control Training on Pain, Function and Psychosocial Status in Patients With Chronic Neck Pain)

  • 민인기;김선엽
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.36-46
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    • 2021
  • Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

Effects of Isokinetic Strength Exercise of the Hemiparetic Knee Joint on Lower Extremity Sensorimotor and Gait Functions in Patients With Chronic Stroke: Open Kinetic Chain Versus Closed Kinetic Chain

  • An, Chang-man;Roh, Jung-suk
    • 한국전문물리치료학회지
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    • 제26권2호
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    • pp.49-60
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    • 2019
  • Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.

The Effects of tDCS and Montoya Stair Task on Sensorimotor Recovery and GFAP Expression in MCAo induced Stroke Rat Model

  • Sim, Ki-Cheol;Kim, Gi-Do;Kim, Kyung-Yoon;An, Ho-Jung;Lee, Joon-Hee;Min, Kyoung-Ok;Kim, Gye-Yeop
    • 국제물리치료학회지
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    • 제2권1호
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    • pp.193-200
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    • 2011
  • This study is intended to examine the tDCS and Montoya stair task(MST) on sensorimotor recovery and glial scar expression in MCAo induced stroke model of rat. To achieve this goal, this study selected 80 SD rats of 8 weeks. The experiment groups were divided them into four groups, and assigned 20 rats to each group. Group I was a experimental control group; GroupII was a tDCS application group after MCAo; Group III was a MST application group after MCAo; Group IV was a tDCS and MST application group after MCAo. In each group, neurological function test measurement, motor behavior test, montoya stair task test, immunohistochemistric finding of GFAP expression finding were analyzed. In motor behavior test, the outcome of group I was significantly difference than the other group, especially from 14days. In montoya stair task test, the outcome of group I was significantly lower than the other group especially, group II were significantly different on 14days and group IV was most significantly difference than the other group. In immunohistochemistric finding, group II, III, IV were decrease GFAP expression on depend on time stream. These results throughout the MCAo due to focal ischemic brain injury rat model four weeks tDCS and MST was applied, when the neurobehavioural, upper extremity function and ability, histopathologic data suggest that sensorimotor function recovery and a positive influence on glial scar decrease and confirmed that.

슬링(sling) 시스템을 이용한 요부 안정화 운동 (Lumbar stabilization exercises using the sling system)

  • 김선엽;권재확
    • 대한정형도수물리치료학회지
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    • 제7권2호
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    • pp.23-39
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    • 2001
  • Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

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뇌종양 환자에서 BOLD 기법을 이용한 기능적 자기공명영상 (Functional MR Imaging Using BOLD Technique in Patients with Brain Tumors)

  • 김정;임남열;신상수;임효순;윤웅;정태웅;정용연;정광우;박진균;강형근;정신;강삼석;서정진
    • Investigative Magnetic Resonance Imaging
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    • 제7권2호
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    • pp.124-131
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    • 2003
  • 목적 : 뇌종양 환자에서 감각운동과 언어 자극을 통해 기능적 자기공명영상(fMRI)을 시행하여 fMRI에서 감각운동 그리고 언어중추와 병변과의 해부학적인 관계를 관찰하여 수술 계획수립에 도움을 줄 수 있는지 알아보고자 하였다. 대상 및 방법 : 뇌종양이 감각운동중추 혹은 언어중추 부위에 발생한 오른손잡이 환자 12명을 대상으로 하였다. 12명의 환자 중 11명에서 감각운동중추의 활성화 여부를 관찰하였고 이 중 6명은 언어중추의 활성화를 함께 관찰하였으며, 1명은 언어중추의 활성화 여부만을 관찰하였다. fMRI를 얻기 위해서 1.57 MR Scanner를 사용하여 EPI-BOLD 기법으로 영상을 얻어, SPM99 분석 프로그램과 자체제작 프로그램을 이용하였다. 분석은 감각운동, 그리고 언어 자극이 대뇌중추를 활성화시킬 수 있는지 관찰하였고, 감각운동중추 및 언어중추와 병변과의 위치 관계를 확인하여 수술 계획수립에 도움을 줄 수 있는지 알아보았다. 또한 환자의 신경학적 기능평가를 수술전후 시행하여 변화여부를 알아보았다. 결과 : 뇌종양환자 12명 모두에서 활성화 영상을 얻을 수 있었고, 대뇌활성화 영역과 병변의 해부학적인 관계를 파악할 수 있었다. 감각운동중추의 활성화영상을 성공하였을 11명 중 9명에서 수술전후 신경학적 수기운동검사에서 등급의 변화를 보이지 않았으며, 1명은 수술 후 오히려 등급이 높아져 운동기능의 회복이 있었고, 1명은 수술 후 한 등급 낮아지는 운동기능의 저하를 보였다. 언어중추의 활성화영상을 성공적으로 얻을 수 있었던 7예에서 수술 후 언어기능의 저하를 보인 경우는 없었다. 결론 : fMRI는 감각운동중추나 언어중추 부위에 발생한 뇌종양을 가진 환자에서 수술을 위한 최적의 접근 경로를 결정하는데 많은 도움을 줄 수 있으리라 생각된다.

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뇌졸중 환자의 상지 체감각 자극을 통한 감각, 손 기능, 자세조절 및 일상생활수행력의 변화 (Effect of Somatosensory Stimulation on Upper Limb in Sensory, Hand Function, Postural Control and ADLs within Sensorimotor Deficits after Stroke)

  • 송보경
    • The Journal of Korean Physical Therapy
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    • 제24권5호
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    • pp.291-299
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    • 2012
  • Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

Functional Electric Stimulation-assisted Biofeedback Therapy System for Chronic Hemiplegic Upper Extremity Function

  • Kim, Yeung Ki;Song, Jun Chan;Choi, Jae Won;Kim, Jang Hwan;Hwang, Yoon Tae
    • The Journal of Korean Physical Therapy
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    • 제24권6호
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    • pp.409-413
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    • 2012
  • Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.