• 대한한의학회지
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• 제23권2호
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

• 대한간호학회지
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• 제38권5호
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• pp.730-738
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• 2008

Purpose: The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly. Methods: Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program. Results: There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls. Conclusion: For the effective management and prevention of community-dwelling older adults' falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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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.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.374-378
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• 2021

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.80-91
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• 1996

A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.

• 대한인간공학회지
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• 제34권1호
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• pp.11-18
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• 2015

Objective: The aim of this study was to understand the effects of phone weight on the typing performance and muscle recruitment in the neck and upper extremity while typing a text message with dominant hand. The iPhone4 and iPhone5 were compared due to their 28-gram differences in weight. Background: Too much use of a cellular phone can lead the musculoskeletal disorders in the upper extremity. Phone makers tend to make their new models bigger, lighter, faster and smarter. Method: Fourteen healthy volunteers without any history of neuromuscular disorders or ongoing pain who used their smartphone more than one year were recruited. A 112g phone (iPhone5) and a 142g phone (iPhone4) were used for typing the lyric of the Korean national anthem with their dominant hand. Typing duration, the typing error, the perceived fatigue, and preference was investigated. Muscle recruitment and the resting gap of neck (middle trapezius and levator scapula), shoulder (infraspinatus and mid deltoid), elbow (biceps brachii and brachioradialis), thumb (extensor and abductor policis brevis) were collected using surface electromyography. Typing error was counted and typing speed was calculated in characters per min. The data were analyzed using a paired t-test and chi-square (${\chi}^2$) analysis for the effects of phone weight on the typing performance parameters and muscle recruitment. Results: Typing text message with iPhone5 took longer but had less muscle recruitment in brachioradialis, and extensor policis brevis muscles. Lighter weight of iPhone5 made biceps brachii to rest less without increasing the mean %EMG. Conclusion/Application: Findings of this study can be valuable information for phone designers to develop more productive device and for smartphone users to prevent the musculoskeletal disorders in the upper extremities.

• 대한물리치료과학회지
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• 제31권1호
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• pp.98-109
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• 2024

Background: The purpose of this study is to investigate changes in physical and cognitive function according to the level of independence in performing activities of daily living in stroke patients. Design: Retrospective study. Method: This study is a retrospective study analyzing medical records. This study utilized data collected from 123 stroke patients at admission in a local rehabilitation hospital between 2019 and 2022. Stroke patients were classified into 5 groups based on the scores of the Korean Modified Barthel index (K-MBI) evaluated at the time of hospitalization at a rehabilitation hospital, and investigated the change in physical (spasticity (modified Ashworth scale), muscle strength (manual muscle test), gait ability (functional ambulation category), upper extremity function (manual function test), and balance function (berg balance scale)) and cognitive function (Korean mini mental status examination) according to the level of independence in performing activities of daily living. Result:: As a results, significant differences were observed in the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive functions of stroke patients according to the level of independence in performing activities of daily living (p<0.05). However, there was no significant difference in upper and lower extremities spasticity. Conclusions: Through the results of this study, we found that the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive function were influenced by the level of independence in performing activities of daily living in stroke patients.

• 한국전문물리치료학회지
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• 제16권2호
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• pp.67-76
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• 2009

In order to prevent upper extremity musculoskeletal disorders, effective keyboard selection is an important consideration. The aim of this study was to compare upper extremity muscle activity according to transverse plane angle changes during vertical keyboard typing. Sixteen healthy men were recruited. All subjects had a similar typing ability (rate of more than 300 keystrokes per minute) and biacromion and forearm-fingertip lengths. Four different types of keyboard (vertical keyboard with a transverse plane angle of $60^{\circ}$, $96^{\circ}$, or $120^{\circ}$, and a standard keyboard) were used with a wrist support. The test order was selected randomly for each subject. Surface electromyography (EMG) was used to measure upper extremity muscle activity during a keyboard typing task. The collected EMG data were normalized using the reference contraction and expressed as a percentage of the reference voluntary contraction (%RVC). In order to analyze the differences in EMG data, a repeated one-way analysis of variance, with a significance level of .05, was used. Bonferroni correction was used for multiple comparisons. There were significant differences in the EMG amplitude of all seven muscles (upper trapezius, middle deltoid, anterior deltoid, extensor carpi radialis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris) assessed during the keyboard typing task. The mean activity of each muscle had a tendency to increase as the transverse plane angle increased. The mean activity recorded during all vertical keyboard typing was lower than that recorded during standard keyboard typing. There was no significant difference in accuracy and error scores; however, there was a significant difference between transverse plane angles of $60^{\circ}$ and $120^{\circ}$ with regard to comfort. In conclusion, a vertical keyboard with a transverse plane angle of $60^{\circ}$ would be effective in reducing muscle activity compared with vertical keyboards with other transverse plane angles.

• 한국전문물리치료학회지
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• 제8권2호
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• pp.29-39
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• 2001

The purpose of this study was to examine the effect of the upper limb nerve mobilization (ULNM) on functional recovery of upper extremity in hemiplegic patients following stroke. Twenty patients who had functional impairment on upper extremity were participated. Subjects were randomly divided into two groups: Control group (n=10) received traditional physical therapy only for 4 weeks; Experimental group (n=10) received ULNM treatment along with traditional physical therapy for the same period. Upper extremity functions were assessed by manual muscle test (MMT), modified Ashworth scale (MAS), and Fugl-Meyer assessment (FMA) before and after the treatment. In both experimental and control group, upper extremity functions were significantly improved in MMT (p<.01) and FMA (p<.01), however only experimental group showed significant improvement in FMA after the treatment (p<.05). Moreover, experimental group showed significantly greater improvement than control group in MMT (p<.05), MAS (p<.05), and FMA (p<.05). We conclude that the upper extremity functions is a useful additional therapeutic technique for the effective treatment of upper extremity deficits in hemiplegic patients.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.117-123
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• 2022

Background: Push-up are effective exercises for shoulder stability. Previous studies have documented the effects of support plane and hand position and width on muscle activities during a push-up. Objects: This study aimed to investigate the changes in muscle activities in the upper extremity when performing the standard and the knee-flexed push-up with different hand shapes. Methods: A total of twenty-six healthy males participated in this study. Three different hand shapes (finger abduction, finger adduction, and fists) and two types of push-up posture (standard and knee-flexed push-up) were set as the independent variables. Electrograms were used to measure the muscle activity of the upper trapezius (UT), triceps brachii (TB), pectoralis major (PM), and serratus anterior (SA). Each participant performed the randomly assigned push-up to the sound of the metronome. The mixed-effect linear regression model was used to detect the changes in muscle activities after changing the hand shape and push-up posture. Statistical significance was set at α = 0.05. Results: The UT muscle activity was statistically significantly higher when performing push-up with fists than finger abduction (p = 0.035) or finger adduction (p = 0.044). During the standard push-up, the muscle activity in all muscles was that the push-up with fists showed the highest muscle activity compared to the finger abduction (p < 0.01) and finger adduction (p < 0.01). Regardless of the shape of the hand, UT had the lowest muscle activity compared to other muscles (p < 0.001). In contrast, the SA muscle had the highest muscle activity among four muscles during the standard push-up. Conclusion: Based on the results of this study, we suggest hand shape is related to the difficulty level of push-up either in the standard or the knee-flexed push-up, especially in the push-up with fists. In addition, knee push-up can be recommended as shoulder muscle-strengthening exercises for individuals with low shoulder muscle strength.