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

• 동의생리병리학회지
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• 제35권1호
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• pp.28-35
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• 2021

To analyze the clinical efficacy of acupuncture for spastic hemiplegia after stroke, this study was accomplished by considering Randomized Controlled Trials. We searched for papers that performed acupuncture for spastic hemiplegia after stroke in the China Academic Journal of the China National Knowledge Infrastructure, from January 1, 2017 to June 30, 2020. In total, 23 reports were included in this review. There are 18 studies conducted with more than 50 subjects and less than 100 subjects. The largest number of treatment was 20 times. 28days(4weeks) was the largest number of treatment period, which accounted 10 studies. The most frequently used evaluation index was The Fugl-Meyer Assessment(FMA) and Clinical Efficacy, each used 21 times and 17 times. The most frequently used acupuncture point was LI3, which was used 13 times. The retention time was 30 minutes and 11 studies were conducted. Western medicine treatment was the most common control group in 15 studies. Most of studies showed result of the intervention group was statistically significant, compared with the control group. These results suggest that acupuncture for spastic hemiplegia after stroke was effective and it was statistically more significant than the control group. However, it is difficult to confirm a conclusion, because the quality of most of studies was low.

• 재활치료과학
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• 제7권3호
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• pp.23-33
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• 2018

목적 : 본 연구는 국외 학술지를 대상으로 한 체계적 문헌고찰 연구를 통해 경직을 가지고 있는 뇌졸중 환자를 대상으로 진동자극의 효과를 제시하는 데에 목적이 있다. 연구방법 : 전자 데이터베이스인 NDSL과 RISS를 사용하여 2009년 4월부터 2017년 10월까지의 논문을 검색하였다. 주요 검색 용어로 'Vibration therapy', 'Focal vibration ', 'Somatosensory', 'Upper limb'와 'Spasticity after stroke를 사용하였다. 선정기준과 배제기준을 통해 최종적으로 6개의 논문이 선정하였다. 결과 : 국소 진동자극의 효과를 알아보기 위한 중재방법으로는 진동자극만을 적용한 중재부터 과제기반 진동자극 중재부터 다양하였다. 중재효과를 알아보기 위해 경직, 상지기능, 일상생활동작 평가도구가 사용되었다. 국소 진동자극은 뇌졸중 환자의 경직 감소와 상지기능에 긍정적인 영향이 있는 것으로 나타났으며, 대뇌피질의 활성화에도 유의미한 효과가 있는 것으로 나타났다. 결론 : 본 연구를 통해 치료사들은 국소 진동자극 적용에 필요한 정보 및 근거를 찾을 수 있을 것이다. 하지만 다양한 국소 진동자극의 적용 방법으로 인해 효율적인 진동수, 진폭의 크기 및 진동을 적용할 위치를 확인하는 데에는 어려움이 있었다. 향후 국내연구에서는 국소 진동자극의 효과를 극대화 할 수 있는 체계적인 중재 프로토콜에 대한 연구가 필요하다.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.59-79
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• 2004

The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.11-28
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• 2005

Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had hemiplegia due to stroke. All subjects randomly assigned to 3 group: manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.