• Physical Therapy Korea
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• v.11 no.4
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• pp.7-17
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• 2004

Individuals who propel wheelchairs have a high prevalence of upper extremity injuries (i.e., carpal tunnel syndrome, elbow/shoulder tendonitis, impingement syndrome). Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. To better understand the mechanisms of upper extremity injuries, this study investigates the motion of the wrist during wheelchair propulsion. This study also examines changes in the variables that occur with fatiguing wheelchair propulsion to determine how the time parameters of wheelchair propulsion and the state of fatigue influence the risk of injury. A two dimensional (2-D) analysis of wrist movement during the wheelchair stroke was performed. Twenty subjects propelled a wheelchair handrim on a motor-driven treadmill at two different velocities (50, 70 m/min). The results of this study were as follows; The difference in time parameters of wheelchair propulsion (cadence, cycle time, push time, recovery time, and PSP ratio) at two different velocities was statistically significant. The wrist kinematic characteristics had statistically significant differences at two different velocities, but wrist radial deviation and elbow flexion/extension had no statistically significant differences. There were statistically significant differences in relation to fatigue in the time parameter of wheelchair propulsion (70 m/min) between initial 1 minute and final 1 minute. The wrist kinematic characteristics between the initial 1 minute and final 1 minute in relation to fatigue had statistically significant differences but the wrist flexion-extension (50 m/min) had no statistically significant differences. According to the results, the risk of musculoskeletal injuries is increased by fatigue from wheelchair propulsion. To prevent musculoskeletal injuries, wheelchair users should train in a muscle endurance program and consider wearing a splinting/grove. Moreover, wheelchair users need education on propulsion posture, suitable joint position, and proper recovery patterns of propulsion.

• Horticultural Science & Technology
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• v.30 no.4
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• pp.449-462
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• 2012

The objectives of this study were to measure the range of motion for joints and muscle activation of upper limb for flower arrangement tasks for physical rehabilitation and to test horticultural therapy programs using flower arrangement tasks for improving upper limb function of the patients with stroke. Major flower arrangement tasks were classified with eight tasks (cutting 1, thick stem; cutting 2, thin stem; fixing 1, long stem; fixing 2, short stem; rolling a leaf; bending 1, thick stem; bending 2, thin stem; and winding, using a wire) based on the occupational analysis. When eight male university students (mean age $24.1{\pm}2.5$ years) conducted the eight flower arrangement tasks, range of motion for joints and muscle activation of upper limb were measured by a 3D motion analyzer and electromyography, respectively. Based on the results of the range of motion and muscle activation of upper limb, horticultural therapy programs using flower arrangement tasks (total 33 sessions) for improving upper limb function of the patients with stroke was conducted at a rehabilitation hospital, Seoul, South Korea and then the range of motion, grip strength, and upper limb function of the patients were tested. Among the eight flower arrangement tasks, cutting 1, winding, and bending 1 induced the highest value for the range of motion in joints of shoulder, elbow, and wrist, respectively (P < 0.001). In terms of muscle activation, eight flower arrangement tasks performed in this study showed various patterns of muscle activation and several muscles were simultaneously used for each task (P < 0.001). In addition, thickness and length of the materials used in a task had a prominent effect on the range of motion for joints and muscle activation of upper limb (P < 0.001). The stroke patients had positive effects for their range of motion of upper limb (shoulder, forearm, and elbow), grip strength, and overall upper limb function through the horticultural therapy program. Thus, this study suggested that flower arrangement tasks would be a potential horticultural activity for physical rehabilitation program. It would be interesting to apply a customized horticultural therapy program using flower arrangement tasks according to the symptoms of patient for physical rehabilitation.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.35-47
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• 2016

Objective: The aim of this study was to identify the driving rehabilitation for on-road driving through a systematic review. Methods: We systematically examined papers published in journals from December 2014 to January 2015, using CINAH, Embase, Pubmed, PsycINFO, and The Cochrane Library. Eventually, 15 studies were included in the analyses. Results: The evidence of 15 studies was from levels I, III, and V. The subjects included in the analyses were patients with stroke(40.0%), older driver(20.0%), traumatic brain injury(20.0%), acquired brain injury(13.3%) and spinal cord injury(6.7%). The intervention types were driving simulator training(53.3%), cognitive skills training(26.6%), off-road educational training(6.7%), adaptation of assistive device(6.7%), and behind-the-wheel training(6.7%). The effects of driving rehabilitation were different depending on the types of intervention. However, driving simulator training showed significant improvement of on-road assessments in all studies included this study. Conclusions: Driving rehabilitation for on-road driving has been used in various types. Specially, the effect of the driving simulator training has been proved by many studies. Future studies are to be required with client from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving on-road driving.

• 재활복지
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• v.22 no.3
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• pp.209-224
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• 2018

The purpose of this study is to provide a basic data about the virtual reality rehabilitation therapy to the occupational therapist in the domestic clinical field by systematically analyzing the types and effects of the rehabilitation therapy using the virtual reality program. Research articles were retrieved from January 2007 to December 2017 using the Research Information Sharing Service (RISS), Google Scholar, and Pubmed database. The main search terms were 'Virtual Reality AND Rehabilitation' and 'Virtual reality AND Effect'. Finally, 10 foreign studies were selected as the subjects of this study. Selected studies were organized using PICO (Patient, Intervention, Comparison, Outcome) format. The results were as follows: The subjects were divided into 4 types, stroke, brain tumor, Parkinson 's disease, and kidney disease. The tools used for arbitration were three IREX (30 %), two X-box Kinect (20 %), two Nintendo Wii (20 %), one [Existing tool + VR] (10 %), one [Mobile application + VR] (10 %). As a result of the intervention, improvement of function was observed in all 10 studies from overseas, and physical function was 24 times (66 %), mental function 6 times (17 %), cognitive function 5 times (14 %), Activity of daily living 1 time (10 %). this study could be used as a basic resource to enhance the professionalism and quality of rehabilitation services and expand the scope by organizing virtual reality-based rehabilitation and its effects.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.392-399
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• 2015

Purpose: This study investigated whether the strength imbalance between two muscles can affect the score of EMG based biofeedback game, and whether the EMG based biofeedback game score can be used as predictable indicator of the degree of muscle balance alternating the conventional strength measuring equipment. Methods: 40 participated in this study. Biodex was used to measure the peak torque/weight in order to calculate the muscle strength balance index between plantar flexor and dorsiflexor of ankle joint. And muscle balance index (MBI) was calculated. The EMG biofeedback game scores of dorsiflexor and plantar flexor were acquired, so that the EMG electrodes were attached at tibialis anterior and gastrocnemius. The relationship between the game score and the muscle balance index were analyzed. Results: There was negative correlation between the muscle balance index between plantar flexor and dorsiflexor and the peak torque/weight of plantar flexor (r=-0.70). And there was negative correlation between the muscle balance index between plantar flexor and dorsiflexor and the game score of plantar flexor (r=-0.83). Conclusion: The EMG biofeedback game score had significant relationship with muscle imbalance at ankle joint, so it seems that the game score can be used for predicting the degree of muscle imbalance as a parameter.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.1
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• pp.95-101
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• 2012

Purpose : The purpose of this study was to investigate the variations in gait parameters according to arm swing use in post stroke hemiparesis. Methods : Sixteen patients participated in this study and walked at self-selected speeds on a Rs-scan systems. The were randomly assigned conditions: self-selected arm swing, constraint arm swing, emphasis arm swing. Results : In the comparison of parameters in each trial, both affected step length, non affected step length, affected stride length, non affected stride length, affected single support time, and non affected single support time were significantly increased and double support time was significantly decrease in emphasis arm swing when compared with both self-selected arm swing and constraint arm swing(p<.05). However, Asymmetrical ratio was significantly increased in both emphasis arm swing and self-selected arm swing when compared constraint arm swing(p<.05). Conclusion : Therefore, In this study, gait rehabilitation of patients with hemiplegia depending on what you need to apply the arm swing is considered.

• Physical Therapy Korea
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• v.5 no.2
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• pp.23-38
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• 1998

The objective of this study was to identify the effects of pelvic tilting exercise on gait patterns of hemiplegic patients. The subjects of this study were 31 hemiplegic in- and out-patients of the Rehabilitation Hospital, Yonsei University Medical Center, from September 24, 1997 through November 5, 1997. Pre- and post-treatment change in gait patterns were measured using a ink foot-print. The data were analyzed by the paired t-test, one-way ANOVA, and independent t-test. The findings were as follows: The difference in gait patterns between pre- and post-treatment was statistically significant, with an increase in gait velocity to 7.98 cm/sec post-treatment; an increase in cadence to 7.29 steps/min; a narrowing of the base of support to 1.33 cm; an increase in step length of 3.92 cm on the less affected side and 3.73 cm on the more affected side; an increase in stride length of 5.82 cm on the less affected side and 5.92 cm on the more affected side(statistically not significant in foot angle). In relation to sex, age, cause of stroke, and laterality of paralysis, the difference in gait patterns between pre- and post-treatment was not statistically significant. Where there was no significant difference of the effects of pelvic exercise regarding the degree of spasticity, the presence of a decrease in proprioception, and the duration of treatment. In conclusion, hemiplegic pelvic tilting exercise was found to have transmitting positive effect in improving gait patterns.

• The Journal of Korean Physical Therapy
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• v.27 no.1
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• pp.78-80
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• 2015

Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.520-530
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• 2003

Purpose: The objective of the study was to identify the effects of the meridian massage therapy on hand edema and hand functions in patients with hemiplegia. Method: The experiment was conducted in the Oriental Medical ward of "K" hospital during the period of 2000. 12. 15 - 2001. 03. 15. Fifty five subjects with hemiplegia following a stroke participated in the study. Volumetric size of the hand and the circumference of the index finger of each patient was measured and functional points were recorded for pre and post experiment. Result: 1. Apparent decrease in volumetric size of the hand and the circumference of the index finger(p=.022. p=.021), and higher functional points(p=.003) in the experimental group in comparison to the control group. 2.Volume of hands & their functions appeared to be irrelevant(r=-.195, p=.154). 3. Circumference of the index finger & their functions also turned out to be irrelevant (r=-.110, p=.424). Conclusion: Meridian massage is an effective nursing interventional therapy to relieve hand edema and improve hand functions in hemiplegic patients and has great potential for use in a wide range of medical fields as an efficient supplementary treatment for stroke rehabilitation.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.34-45
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• 2003

A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.