• Title/Summary/Keyword: Upper motor function

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Feasibility of Virtual Reality for Enhancement of Upper Extremity Function Post Stroke (작업치료 임상에서 뇌졸중 환자의 상지기능 향상을 위한 가상현실 치료의 유용성에 관한 고찰)

  • Kwon, Jae-Sung;Yang, No-Yul
    • Therapeutic Science for Rehabilitation
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    • v.1 no.2
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    • pp.35-40
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    • 2012
  • The purpose of this review was to investigate feasibility of intensive virtual reality training to improve upper extremity function with brain plasticity of individuals with stroke through the literature. The recovery of the paretic upper extremity depends on regularity and intensity of training as use-dependent plasticity. In resent, virtual reality program has been widely used in the occupational therapy field of augmented stroke rehabilitation. There is a growing body of evidence that virtual reality training of the paretic extremity induces brain plasticity associated with motor improvement. In terms of therapeutic feasibility to improve paretic upper extremity, recent research has explored several important factors of virtual reality training for recovery of upper extremity motor function. These factors include high repetition intensity, high motivation like type of game, enhanced multisensory feedback regarding performance, and interactive task-oriented training. Therefore, occupational therapy combined with intensive and repetitive virtual reality training will enhance recovery of upper extremity motor function after stroke.

Comparison of Motor Function and Skill between Stroke Patients with Cerebellar and Non-cerebellar Lesion in Sub-acute Stage

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.423-427
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    • 2012
  • Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.

Effects of Upper Extremity Exercise Training Using Biefeedback and Constraint-induced Movement on the Upper Extremity Function of Hemiplegic Patients (바이오피드백과 건측 억제유도 운동을 이용한 상지운동훈련이 편마비 환자의 상지기능에 미치는 효과)

  • 김금순;강지연
    • Journal of Korean Academy of Nursing
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    • v.33 no.5
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    • pp.591-600
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    • 2003
  • Purpose: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients. Method: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the VIE motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality). Result: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. Conclusion: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

Consideration for therapy method and oral motor function character of children with cerebral palsy (뇌성마비 아동의 구강운동 기능 특성 및 치료방법에 관한 고찰)

  • Lim, Hyoung-Won
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.121-127
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    • 2006
  • Consideration for therapy method and oral motor function character of children with cerebral palsy. Therapists who treat for feeding disorder children owing the regression of oral motor function are necessary to gain knowledge about dysfunction of sensing, perception and cognition with baffling to eat and inhibition of primitive reflex, oral anatomy and function, and motor control (trunk, head, positioning of the upper limbs and the lower limbs and muscle tone). Oral motor function program is a comprehensive rehabilitation program which requires systematized enforcement and collaborated attempts to physiotherapists, occupational therapists, speech therapists, psychotherapists. Especially, physical therapists are not accustomed to oral motor program, hoping to provide diffusely and apply new therapy approach method for many areas (bell's palsy, respiratory failure, speech articulation). It will comprise to study owing to holistic approach with clinic.

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Comparison Before and After the Application of the Computerized Cognitive Rehabilitation Program(CoTras-C) for Children with Cerebral Palsy (뇌병변 장애 아동의 아동용 전산화 인지재활 프로그램(CoTras-C) 사용 전·후 비교)

  • Park, So-Won
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.9-18
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    • 2021
  • Purpose : In this study, we applied a computerized cognitive rehabilitation program (CoTras-C) for children with cerebral palsy. Research was conducted to investigate the impact of upper limb function, sensory function, and activities of daily living. Methods : The study period lasted 10 weeks from October 2019 to December 2019. The study subjects were 12 subjects according to the selection criteria, and a computerized cognitive rehabilitation program (CoTras-C) was conducted twice a week for 30 minutes before and after the application of basic occupational therapy. Results : As a result of the computerized cognitive rehabilitation program, scores of upper limb function (QUEST), sensory function (SSP-2), and daily life activity (WeeFIM) were significantly improved (p>.05). From the result of examining the motor area, improvement in fine-motor function and protective extension through touch pad or controller operation was found. It also showed improvement in activities of daily living including motor and activities of daily living including social cognition. In the sensory function evaluation, it was not significant in movement sensitivity. Significant differences were shown in the items excluding olfactory/taste sensitivity. Conclusion : The application of the computerized cognitive rehabilitation program (CoTras-C) showed significant results in upper limb function, sensory function, and daily life activities of children with brain lesions. Based on these results, future studies need to generalize the study by expanding the age or population of children with brain lesions, or by expanding the diversity of diseases and environments.

Evaluation of Upper-Limb Motor Recovery after Brain Injury: The Clinical Assessment and Electromyographic Analysis (뇌손상 후 상지 운동기능 회복 평가: 임상적 평가 및 운동반응 근전도 분석)

  • Kim, Young-Ho;Tae, Ki-Sik;Song, Sung-Jae
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.91-99
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    • 2005
  • We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

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The Effects of Core Stability on Postural Control, Balance and Upper Motor Function in Patients with Stroke (CORE 안정성 훈련이 뇌졸중 환자의 자세조절, 균형 및 상지기능에 미치는 효과)

  • Lee, Byoung-Hee;Kim, Seong-Yeol;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.3
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    • pp.69-80
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    • 2009
  • Objectives : The purpose of this study was to evaluate the effects of core stability training on postural control and balance of hemiplegia patients who are difficult to control posture due to stroke. Methods : Subjects of the study were consisted of 25 adult hemiplegia patients(experimental 12, control 13) who were receiving rehabilitation therapy in hospital. Its group had a core stability training program by a physical therapists for 40 minutes, five times a week for nine-week period. Measurements of postural assessment scale for stroke(PASS), berg balance scale(BBS) and manual function test(MFT) were evaluated at initial presentation(pretest) and after completion of the each therapy program(posttest). Independent t-test and paired t-test was utilized to detect the mean difference between the groups. Results : Firstly, the result of PASS showed that postural control was significantly increased after the completion of core stability training(p<.01). Secondly, the result of BBS showed that balance control was significantly increased after the completion of core stability training(p<.01) and general physical therapy(p<.01). Lastly, the result of MFT showed that upper extremity's motor function was significantly increased after the completion of core stability training(p<.001). Conclusions : This study showed that core stability training is an effective treatment strategy on postural control, balance and upper extremity's motor function.

The Functional Results of Forearm and Upper Arm Replantation: Report on Two Cases

  • Yu, Chang Eun;Chae, Young Ju;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.82-85
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    • 2014
  • Upper extremity replantation is relatively less commonly performed than finger or hand replantation. We have experienced one case of forearm replantation and one case of upper arm replantation. After the replantation, limb volume at the biceps brachii muscle level below the replantation level appeared to be appropriate, however, the motor function of the muscles and the sensitivity were disappointing. For replantation of forearm and upper arm, restoration of the motor function and sensitivity of the extremity below the amputation level as well as the morphologic reconstruction have to be considered.

Effects of sensory stimulation on upper limb strength, active joint range of motion and function in chronic stroke virtual reality training

  • Kim, Dong-Hoon;Lee, Suk-Min
    • Physical Therapy Rehabilitation Science
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    • v.9 no.3
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    • pp.171-177
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    • 2020
  • Objective: This study aimed to investigate the upper limb strength, active joint range of motion (AROM), and upper limb function in persons with chronic stroke using virtual reality training in combination with upper limb sensory stimulation. Design: Two-group pretest-posttest design. Methods: 20 subjects were divided into two groups of 10, the sensory motor stimulation and virtual reality training (SMVR) and virtual reality training (VR) groups. The training was conducted for 30 minutes per session, three times a week for 8 weeks.The participants' upper limb strength was measured via the hand-held dynamometer, joint angle AROM was measured via dual inclinometer, function was measured using the Jebson-Taylor hand function test and the manual function test. Results: Significant differences were observed in all groups before and after the training for upper extremity strength, AROM, and function (p<0.05). Between the two groups, the SMVR group showed significant improvement in muscle strength, AROM, and Jebsen-Taylor hand function test scores compared with the VR groups (p<0.05). Conclusions: In this study, we confirmed that sensory stimulation and VR had positive effects on upper extremity strength, AROM, and function of persons with chronic stroke. The results suggest that in the future, VR in combination with sensory stimulation of the upper limb is likely to become an effective method (a rehabilitation training program) to improve the upper limb function of persons with chronic stroke.

The Effects of Complex Exercise Program for Upper Extremity Function and Balance Proficiency in Person With Stroke: A Case-Study (복합운동프로그램이 뇌졸중 환자의 상지 기능 및 균형 능력에 미치는 영향 : 사례연구)

  • Choi, Yoo-Im;Lee, Sang-Heon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4374-4381
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    • 2010
  • The purpose of this research was to investigate the effects of complex exercise program for upper extremity function and balance proficiency in person with stroke. The subject in this study was a 68 year old woman with left hemiplegia after stroke, and the study period was from April 16th, 2005 to August 30, 2007. Complex exercise program was compromised of range of motion exercises, strengthening exercises, and repetitive task-oriented activities and so on, and the subject performed exercises three times a week, one hour a day. The upper extremity function of the subject was evaluated by the Brunnstrom Hand Recovery Stage, the Brunnstrom Upper Extremity Recovery Stage, the Fugl-Meyer Assessment of Motor Function, and the Manual Function Test, and the balance proficiency was measured by the Tinetti Gait & Balance Scale, and the One Leg Standing Test. The results indicated that the upper extremity test scores were all improved, the balance proficiency test marks were maintained and improved, therefore complex exercise program was effective method to forward upper extremity and balance proficiency in person with stroke.