• Physical Therapy Korea
• /
• v.17 no.2
• /
• pp.1-9
• /
• 2010

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was $0^{\circ}$, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was $90^{\circ}$, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

• The Journal of Korean Physical Therapy
• /
• v.16 no.4
• /
• pp.59-79
• /
• 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.

• Therapeutic Science for Rehabilitation
• /
• v.6 no.1
• /
• pp.71-83
• /
• 2017

Objective : This study aim is to identify whether smooth pursuit eye movement(SPEM) using portable device can alleviate chronic hemispatial neglect. Methods : We applied smooth pursuit eye movement to one chronic hemispatial neglect patient. Experimental duration was total 4weeks - 1week baseline, 2weeks SPEM intervention, 1week 2nd. baseline. The intervention was 10 SPEM sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 5 times a week. The SPEM was provided on the screen when patient sat in front of the screen(8.4 inch tablet pc, distance 40cm). The SPEM video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results : As a result of the SPEM for 2weeks, the degree of neglect tended to decrease compared to baseline A. The degree of the LBT tended to increase the at the baseline A'. In contrast, the SCT showed that tendency which the degree of the neglect maintained at the baseline A'. Conclusion : We identified that SPEM using portable device is effective intervention method for chronic hemispatial neglect.

• Science of Emotion and Sensibility
• /
• v.9 no.2
• /
• pp.93-100
• /
• 2006

This paper aims at the development and clinical evaluation of the wireless gyro-mouse system. The wireless gyro-mouse system is a computer interface with gyro-sensor and wireless communication, for the patients with upper-extremity disabled from the traffic accident or stroke to use the computer software i.e. internet browser. In the development, we focused on, firstly, to make the system wireless for the patients to manipulate the mouse easily even on the bed or wheelchair, secondly, to insert the gyro-sensor into a headband for easy don-and-doff and aesthetic appearance, thirdly, to devise a click switch in case of $C5{\sim}C6$ patients and a head nodding detection in case of C4 patients for sending click message to computer operating system. We performed evaluation experiment for patients with upper-extremities disabled from spinal cord injury. The results show that the displacement error of the cursor position against the target position during linear (vertical/horizontal) movement manipulation decreased with trial number. The click rate per minute also increased with trial number. This indicates the developed wireless gyro-mouse system would be more useful to the patients with repetitive use.

• Journal of the Korea Convergence Society
• /
• v.7 no.2
• /
• pp.43-52
• /
• 2016

The purpose of this study was to suggest the effective squat exercise position to strengthening vastus medialis oblique, and vastus lateralis in quadriceps. Subjects were twenty patients with patellofemoral pain syndrome (PFPS) volunteered to participate in this study. All subjects were applied to static squat convergence exercise with knee flexed $45^{\circ}$, $60^{\circ}$, and $90^{\circ}$ for 30 seconds total 5 times. Measurement variables were maximal voluntary isometric contraction (MVIC) of the quadriceps, Q angle and length of thigh. Those were measured before and after the squat exercise on knee joint angle, change rate of which were used for statistical analysis. As a result, squat exercise with knee flexed $90^{\circ}$ increase significantly among knee joint angle in the MVIC change rates of quadriceps (p<.05), however the rates of Q-angle and length change of thigh showed no significant difference. Therefore, this findings suggest that squat exercise with knee flexed $90^{\circ}$ strengthen quadriceps effectively in patients with PFPS.

• Journal of Biomedical Engineering Research
• /
• v.25 no.6
• /
• pp.479-487
• /
• 2004

Biopotential signals have been used as command in systems using electrical stimulation of motor nerves to restore movement after an injury to the central nervous system (CNS). In order to use the voluntary EMG (electromyography) among the biopotentials as a control signal for the electrical stimulation of the same muscle for CNS injury patients, it is necessary to remove M-wave of having high magnitude from raw data. We designed an optimal filter for removing the M-wave and preserving the voluntary EMG and showed that the optimal filter is eigen filter. We also proved that the previous method using the prediction error filter(PEF) is a suboptimal filtering in the sense of preserving the voluntary EMG. On basis of the data obtained from a model for M-wave and voluntary EMG and from actual CNS injury patients, with false-positive rate analysis, the proposed adaptive filter showed a very promising performance in comparison with previous method.

• Journal of Biomedical Engineering Research
• /
• v.24 no.6 s.81
• /
• pp.515-522
• /
• 2003

Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

• 재활복지
• /
• v.18 no.4
• /
• pp.221-235
• /
• 2014

Recently, the frequency of stroke disease is increased due to the rapid aging population, and is contributed to the major occurrence factors of the posteriori acquired disability. This study is about an postural change device for the control of supine posture which is an assisted equipment using in daily rehabilitation process for overcoming the disability by the aftereffects of the stoke disease. In this paper, the existing domestic and Japan postural appliances is examined and its comparison and categorization is performed according to its functions and purposes. Here, in order to control the supine posture state, the design method for advanced multi functional system is proposed, which is devised to have an unified mattress control operations of combining the bedsore prevention tube with the supine posture tilting tube. And also, in addition of an smart function, it is designed to enable to perform an RF functions such as the monitoring of the present device state, the alteration of the basic position and the control of alternative floating and supine posture. This system control hardware consists of three main parts : the sensor detection part, the motor driving /control part, and the system control part for bluetooth communication. In results, we confirmed that the system designed by this research is possible to make it practical as an advanced smart postural change device combined by IoT technology in the application field of the recent IT technology.

• Therapeutic Science for Rehabilitation
• /
• v.8 no.2
• /
• pp.79-88
• /
• 2019

Objective : Aphasia interferes with communication between the patient and conversation partner. Adequate communication is essential not only for the patient but also for caregiver education and training Method : This study examined the benefits of parental education and group training in terms of improving the communication of six aphasic patients and their caregivers(family members). Caregiver education provided caregivers with information on stroke and aphasia, and group training was conducted according to the experimental learning cycle. Result : As a result, communication increased in terms of sending and receiving messages or interactive communication. Furthermore, the questionnaire analysis showed that caregivers learned more about aphasia and had confidence in using facilitation strategies. Conclusion : Giving educational opportunities to patients and caregivers promotes caregiver's knowledge and positively interacts.

• Physical Therapy Korea
• /
• v.26 no.2
• /
• pp.24-33
• /
• 2019

Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed ($n_1=20$), young left-handed ($n_2=21$), and older right-handed ($n_3=20$) groups. The AAUT was assessed by dividing 63 subjects into young right-handed ($n_1=25$), young left-handed ($n_2=18$), and older right-handed ($n_3=20$) groups. Student's t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.