• Korean Journal of Adult Nursing
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• v.16 no.4
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• pp.626-635
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• 2004

Purpose: The purpose of this study was to explain the effects of upper extremity exercise program on hemiplegic stroke patients. Method: The research was designed by a non-equivalent pretest-posttest way. The data were collected from February to August 2003 at a community health center located in Seoul. The study subjects were a conveniently selected group of 27 hemiplegic patients. The subjects were divided into two groups, the experimental group and the control group. 14 subjects were assigned to the experimental group in which the subjects did the upper extremity exercise training for 2 hours once a week during four weeks, while 13 subjects were assigned to the control group. The outcomes were evaluated on the basis of the upper extremity motor ability(hand power, pinch power, upper extremity ROMs), amount of motor use and the degree of depression. Result: 1. After treatment, the motor abilities of the affected upper extremity(hand power, pinch power, ROMs of wrist flexion/extension, shoulder extension) were significantly different between the two groups. However, there were no significant differences in elbow and shoulder flexion between experimental and control group. 2. After treatment, amount of motor use of affected upper extremity were significantly different between the two groups. 3. After treatment, the degree of depression were significantly different between the two groups. Conclusion: In considering these results, the upper extremity exercise program could be effective for hemiplegic patients by improving the function of their upper extremity. Long-term studies are needed to determine the effects of upper extremity exercise program.

• Physical Therapy Korea
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• v.18 no.2
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• pp.67-75
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• 2011

The purpose of this study was to investigate the effects of virtual reality (VR) therapy with compensation inhibition and feedback (CIF) on upper extremity function in chronic stroke patients. Seven chronic stroke patients participated in this study, which was a randomized controlled trial with a crossover design. Self upper extremity exercise, conservative VR therapy, and VR therapy with CIF were performed for one hour per session, 5 times per week, over a 3 week period. The main outcome measures involved range of motion (ROM) including shoulder, elbow, and wrist joints, a Manual Function Test (MFT), and a Motor Activity Log (MAL). Data were calculated as posttest and pretest changes in every session and were analyzed using Friedman and Wilcoxon signed-rank tests at p<.05. The results were as follows: 1) Statistically significant increase in ROM measurements of shoulder and elbow joints were seen with VR therapy with CIF compared to VR therapy and self upper extremity exercise (p<.05), whereas no significant increasing was noted for the wrist joint (p>.05). 2) Statistically significant increase in the MFT was seen with VR therapy with CIF compared with VR therapy and self upper extremity exercise (p<.05). 3) VR therapy with CIF also resulted in statistically significant increase in both activity of use (AOU) (p<.05) and quality of movement (QOM) (p<.05) on the MAL test when compared with VR therapy and self upper extremity exercise, respectively. In conclusion, VR therapy with CIF was more effective than conservative VR therapy and self upper extremity exercise in improving the upper extremity function in hemiplegic patients with chronic stroke.

• The Journal of Korean Medicine
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• v.45 no.1
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• pp.45-64
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• 2024

Objectives: This study is purposed to investigate the effect and safety of laser therapy for stroke patients by systematic review and meta-analysis of the randomized controlled trials (RCTs). Methods: RCTs on the treatment of laser therapy for stroke patients were selected among the literature published from January 2000 to June 2022 in twelve domestic and foreign databases. The quality of the literature was evaluated using the Cochrane's Risk of Bias tool and RevMan 5.4 was used for the synthesis of results. Results: Total 2,598 patients with stroke were finally selected from 18 RCTs. Meta-analysis showed that laser therapy was effective in significantly improving activities of daily living (MBI), motor function (effective rate), upper motor function (FMA-UE), shoulder pain related factors (CGRP, ET-1, BK). Overall, the risk of bias was uncertain or low in the quality assessment of the literature. Conclusions: Although it is unclear that laser therapy is more effective than sham laser, laser therapy might be more effective in improving symptoms than conventional rehabilitation alone. Furthermore, no serious adverse events were founded in laser therapy studies. However, the quality of the selected literature was generally low. Therefore, further studies with high methodological quality on laser therapy for stroke patients would be required in the future.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.125-131
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• 2016

PURPOSE: The objective of this research is to investigate the effectiveness of mental practice on function and muscle activation of upper extremity (UE) in stroke patients. METHODS: The mental practice was conducted on 12 subjects for 10 minutes and the related existing work treatment for 20 minutes. The evaluation for the function of UE proceeded with Fugl-Meyer assessment of motor function (FMA) and muscle activity analysis instrument. Furthermore we analyzed patients' reaching activity by two stages, reaching phase and returning to original position phase. RESULTS: According to the research results, the subjects' upper limb function improved in all of the measured items and the total scores after the mental practice (p<.05). In muscle activity, CCR value was used to efficiently analyze the patients' reaching activity in the two stages of reaching stage and returning to the original position phase. While the elbow movement only had a bit of positive change (1.1%) in the reaching stage, both the shoulder (-12.3%) and elbow (-18.2%) movements had a positive change in the returning to original position phase. CONCLUSION: This research confirmed that the mental practice is effective for the enhancement of UE function for stroke patients. The result of this research can contribute to the progress of mental practice in clinical environment.

• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.54-60
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• 2000

As a surgical treatment of ulnar nerve entrapment syndrome includes simple decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve into a subcutaneous or submuscular bed have been widely used. Despite many reports of these surgical procedure, there is little to guide the choice of one surgical technique. The purpose of our study is to analyse clinical and electrodiagnostic result after minimal invasive decompression by decompression and medial epicondyloplasty(deepening of ulnar groove). We have experienced 9 cases of ulnar nerve entrapment syndrome who were treated with decompression and medial epicondyloplasty. Male were five and female were four. The mean age at operation was 36 years ranging from 23 to 47 years. Operative procedure was to incise the medial intermuscular septum and aponeurotic arch of flexor carpiulnaris and to deepen the ulnar groove. Patients are allowed to do range of motion(ROM) exercise on the average 5days. All patient were relieved pain and improved motor and sensory function, and this procedure allows early ROM exercise after operation because the muscle have not been detached.

• Research in Community and Public Health Nursing
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• v.17 no.4
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• pp.482-491
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• 2006

Purpose: Hemiplegia patients who were attacked by a stroke suffer from hemiplegic disabilities as well as motor disabilities. For them, rehabilitation cure is being carried out broadly. However, it is not enough for them to use the upper extremity than the lower extremity. For the use of the upper extremity, we examined the effect of constraint-induced movement therapy developed in this research on patients who experienced a stroke following hemiplegia. Method: For this study we selected 36 stroke patients who were registered at the community health center through accidental sampling, and assigned 21 of them to the experimental group, and 15 to the control group. The experimental group had constraint-induced movement therapy for 5 days and 7 hours a day from 9 to o'clock in the morning 9 to 4 o'clock in the afternoon 4 including warmup exercise and main exercise in the rehabilitation room, whereas the control group were restricted. Result: As a result of constraint-induced movement therapy, affected side elbow joint flexion range, side shoulder joint extension range and side shoulder joint of the flexion range of motions increased obviously in the experimental group compared to those in the control group. Conclusion: The result above clearly shows that constraint-induced movement therapy is an effective intervention for the rehabilitation of hemiplegia patients in increasing affected side elbow joint of the flexion range of motion, the shoulder joint extension, and the increase of flexion range of motion.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Therapeutic Science for Rehabilitation
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• v.9 no.4
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• pp.7-20
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• 2020

Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.

• Journal of Institute of Control, Robotics and Systems
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• v.21 no.5
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• pp.421-426
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• 2015

Need to develop human body's posture supervised robots, gave the push to researchers to think over dexterous design of exoskeleton robots. It requires to develop quantitative techniques to assess human motor function and generate the command to assist in compliance with complex human motion. Upper limb rehabilitation robots, are one of those robots. These robots are used for the rehabilitation of patients having movement disorder due to spinal or brain injuries. One aspect that must be fulfilled by these robots, is to cope with uncertainties due to different patients, without significantly degrading the performance. In this paper, we propose chattering free sliding mode control technique for this purpose. This control technique is not only able to handle matched uncertainties due to different patients but also for unmatched as well. Using this technique, patients feel active assistance as they deviate from the desired trajectory. Proposed methodology is implemented on seven degrees of freedom (DOF) upper limb rehabilitation robot. In this robot, shoulder and elbow joints are powered by electric motors while rest of the joints are kept passive. Due to these active joints, robot is able to move in sagittal plane only while abduction and adduction motion in shoulder joint is kept passive. Exoskeleton performance is evaluated experimentally by a neurologically intact subjects while varying the mass properties. Results show effectiveness of proposed control methodology for the given scenario even having 20 % uncertain parameters in system modeling.

• Physical Therapy Korea
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• v.13 no.4
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• pp.39-46
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• 2006

The purpose of this study was to determine the effects of slump sitting postures on the masticatory, neck, shoulder, and trunk muscles associated with work-related musculoskeletal disorders (WRMD). Eleven healthy adults (age, $23.3{\pm}2.7$ yrs; height, $174.0{\pm}4.1$ cm; weight, $61.4{\pm}6.6$ kg) participated in this study. The participants were free of injury history and neurologic deficits in the masticatory, neck muscles and upper extremities at the time of participation. The subjects were asked to perform erect and slump sitting postures under the guidance of physical therapists. The surface electromyography (EMG) was recorded from the anterior temporalis, masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique, gluteus maximus muscles of 11 adults as they performed visual terminal display work, which are known as the weakened and tightened muscles owing to WRMD. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. The results of study were as follows: The masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique muscles significantly differed in the slump sitting posture (p<.05). The muscle activities of the serratus anterior, middle trapezius muscle, and external abdominal oblique were significantly lower and that of the masseter, upper trapezius, L3 paraspinal muscles were significantly higher. Further research is needed to assess the motor control problems and the function of the deep muscles in posture stability of patients with WRMD.