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.
De Quervain's disease is caused by stenosing tenosynovitis of the first dorsal compartment of the wrist. The first dorsal compartment at the wrist includes the tendons of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB). Patients with De Quervain's usually report pain at the dorsolateral aspect of the wrist with referral of pain toward the thumb and/or lateral forearm. This condition responds well to nonsurgical treatment. Objective : The aim of this study was to find out the therapeutic effect of the Cervus elaphus Herbal-acupuncture in the treatment of patients with De Quervain's Disease. Design : A prospective study of Cervus elaphus Herbal-acupuncture was conducted. Setting : The study was conducted in the Kang-nam Oriental Hosp. of Dong-Guk University. Patients : The study comprised 4 patients with De Quervain's Disease. Methods : We investigated 4 cases patients the De Quervain's Disease. We evaluated wrist function that before and after Cervus elaphus Herbal-acupuncture treatment by VAS score, tenderness and Finkelstein test. the treatment is operated every other day. Results : Pain reduction(VAS) was found out in the case treated with Cervus elaphus Herbal-acupuncture. Conclusions : Clinical results show that Cervus elaphus Herbal-acupuncture has a good analgesic effect in De Quervain's Disease.
Objectives : The purpose of this study was to compare differences in muscle activities according to distance changes, and success or failure in relation to approaches during a round of golf in order to obtain basic data on golf swings. Methods : To achieve our research goal, we asked eight professional golfers playing for the Korea Professional Golfers' Association (height: $1.76{\pm}0.05m$, weight: $73.87{\pm}9.21kg$, career duration: $12.87{\pm}4.48yr$) to perform approach swings at distances of 30, 50, and 70 m. Results : No differences were observed in the muscle activity of the extensor carpi radialis that were caused by the distance changes. In addition, we found that the wrist extensors seemed unaffected by the increase in approach distance. Also, we found that the powers of the approach shots were driven by efficient movements rather than by the strength of the arms. We confirmed that when the distance of the approach increased, the golfers should perform their back-swing tops and follow-through right from the right to the left pelvic limb. To achieve successful approach swings despite distance changes, golfers should first work on the activity of the erector spinae to prepare for rotatory power in the P1 section. Moreover, golfers should increase the activity of the erector spinae on the left when they need to deal with the distance improvements in the P2 and P3 sections. Conclusion : In the light of the discussion above, we may infer that despite approach distance changes during a round of golf, ideal swings can be realized by consistent activities of the wrist extensor muscles and improved performances of the pelvic limb muscles. Furthermore, this study suggests that golfers should improve the consistency of muscle activities in all the other body parts to achieve the ideal swing.
Engagement is an important factor in the field of rehabilitation as it is a known factor that have a positive influence on functional gaining in people who receive rehabilitation therapy. Although a number of measurements for engagement have been recently developed, investigation of possible factors that may have influence on engagement is not well established. Currently available evidence suggests that engagement is affected by mood and it is hypothesized that a personal factor may contribute to engagement. Therefore, this study aims to test the hypothetical relationship between mood and engagement while performing a manual dexterity task through an experiment in healthy participants prior to investigation on people with medical condition who requires rehabilitation therapy. After inducing target mood (positive or negative mood) for study participants by asking them to recall autobiographical memories, change in muscle activity, which was operationalized as an indicator of engagement, was investigated. Electromyogram (EMG) was recorded from four muscle areas in non-dominant hand side to quantify muscle activity. The results show that the target moods were appropriately induced with the method. Although there were subtle differences in the level of engagement between different moods, certain variables derived from muscle activity were significantly different; mean amplitude for wrist extensor EMG showed significant difference between different moods (Z = -2.023, p < .05) indicating that muscle activities in the wrist extensor are greater for positive mood than negative mood region during manual dexterity task. Meanwhile, performance outcomes of Minnesota Manual Dexterity Test (MMDT), such as mean completion time and number of errors, between moods showed no significant difference in two different moods, resulting in MMDT administration may not be useful task in distinguishing the level of rehabilitation engagement.
Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbo${\ddot{o}}$ck disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbo${\ddot{o}}$ck disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbo${\ddot{o}}$ck disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbo${\ddot{o}}$ck's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.
The purposes of this study were to analyze the kinematics and electromyographic variables of the upper extremity for the backhand clear motion according to the type of hitting in badminton. Seven elite male university players were selected as the subjects. Four digital video cameras and Noraxon Telemyo 2400 were used to collect the 3D kinematics and electromyographic data. The results were as follows: 1) in the phase of impact, the time of motion for the overhead backhand clear was the longest, 2) in the event of impact, the distance of step toward X direction was the longest and the distance of step toward Y direction was the shortest for the overhead backhand clear, 3) in the event of backswing, the rotation angles of shoulder and pelvis and the flexion angle of shoulder for the overhead backhand clear were the biggest, 4) the maximum flexion angular velocity of shoulder and the maximum extension angular velocity of elbow for the overhead backhand clear were the biggest, and 5) in the phase of impact, mean EMG of the wrist flexor, triceps, and trapezius muscle for the overhead backhand clear was bigger than that for the underhand stroke and in the phase of follow-through, mean EMG of the wrist flexor and extensor, biceps, triceps, and trapezius muscle for the overhead backhand clear was the biggest.
The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia. Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.
This study examined differences in the activity of upper limb muscles according to how an ultrasound head is gripped. Twenty-two adult males were participated in the study. Each participant was asked to apply ultrasound treatment on to a lump of pork meat by two different ultrasound head grip patterns: spherical and cylindrical grips. Muscle activity was measured in the extensor carpi radialis longus (ECRL), flexor carpi ulnaris (FCU), and pronator teres (PT), triceps brachii (TB), middle deltoid (MD), and upper trapezius (UT) muscles. There were no significant differences in the EMG signals of any muscle according to the ultrasound head grip pattern (p>.05). There were significant differences in the EMG signal of each type of muscle (p<.05). The EMG signal of UT was the lowest and that of TB was lower than ECRL and FCU. There were interactions between ECRL and FCU, between ECRL and PT, between FCU and ECRL, and between FCU and MD. The EMG signal of ECRL using the cylindrical head was low and that of FCU with the cylindrical head was high, while the opposite was the case with the spherical head ($p_{adj}$ <.05/15). The results of this study indicate that the wrist muscles worked actively when the participants applied ultrasound therapy using both spherical and cylindrical heads. A spherical head might induce imbalanced muscle activity among the wrist muscles, leading to deviation of the wrist joint. Therefore, the cylindrical head is recommended for ultrasound therapy because it produced a constant, repeated force.
Purpose: Behavior and movement are accomplished by voluntary contractions of skeletal muscles. There are three types of muscle contractions: concentric, isometric and eccentric. The aim of our study was to determine whether there is a difference in the cortical activation pattern between concentric contraction and eccentric contraction of the wrist extensor muscle. Methods: Four healthy right-handed volunteers without any previous history of physical or neurological illness were recruited. fMRI scanning was done during 4 repeated blocks of concentric and eccentric exercise of the wrist joint. Subjects exercised for 12 seconds and then rested for 12 seconds before beginning the second set of exercises. To determine the excitability of cortical neurons during exercise, voxel count and intensity index were analyzed. Results: For right hand movements, when concentric contractions of the right wrist were done, only the left primary motor area was activated. In contrast, during eccentric contraction, both the primary motor area and secondary motor area were activated. For left hand movements, both concentric and eccentric contractions induced only the supplementary motor cortex and the contralateral primary motor cortex. Conclusion: During eccentric contractions, both the primary motor area and secondary motor area are activated in ipsilateral and contralateral brain areas. Thus, eccentric contractions require more complex and difficult movements than concentric contractions do.
Purpose: This study aimed to determine the effects of various wheelchair handling directions on the upper limb muscle activities of wheelchair attendants while climbing a ramp. Methods: For the study participants, healthy males over 20 years of age were chosen, and the order of the direction of wheelchair handle grip was determined using a randomized method. The handling directions for pushing the wheelchair up a ramp included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The muscle activities in the participants' upper limbs were measured using surface electromyography. For statistical data processing, SPSS 18.0 was used to perform repeated measures ANOVA in order to compare the muscle activity among the intervention groups. A contrast test was also conducted among the participants. The significance level (${\alpha}$) was set to 0.05. Results: There was a significant difference between groups using a general grip and a medial grip in the biceps brachii, triceps brachii, and flexor carpi radialis muscles (p<0.05). There was also a significant difference between using a general grip and a neutral grip in the biceps brachii and flexor carpi radialis muscles (p<0.05), and there was a significant difference between using a medial grip and a neutral grip in the biceps brachii and extensor carpi radialis brevis muscles (p<0.05). Conclusion: In this study, the wheelchair assistants' wrist muscle activity was the lowest with a neutral grip while ascending a ramp. Accordingly, this study proposes that wheelchair assistants push wheelchairs up ramps with a neutral grip.
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