• 대한물리의학회지
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• 제11권3호
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• pp.119-124
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• 2016

PURPOSE: The aim of this study was to evaluate activation of accessory respiratory muscles using electromyography during chest expansion upper extremity flexion, abduction, and external rotation exercises with an elastic band in children with cerebral palsy. METHODS: The subjects were 10 children with cerebral palsy. The inclusion criterion for participation was a Gross Motor Function Classification System level of I to III. The subjects were instructed to perform upper extremity flexion, abduction, and external rotation exercises with inspiration, and extension, adduction, and internal rotation exercises with expiration while seated on a chair without a backrest. PM (Pectoralis major), SCM (sternocleidomastoid), RA (rectus abdominis), and EO (external oblique) muscle activities were measured using electromyography. RESULTS: All tested muscles showed a statistically significant increase in activity after elastic band exercise. There were significant differences in PM, SCM, RA, and EO results after chest expansion exercise using elastic band. SCM showed the largest increase in activity after use of elastic bands, at $52.37{\pm}45.88$%, followed by the RA ($50.56{\pm}79.31$), EO ($35.42{\pm}35.45$), and PM ($31.72{\pm}25.64$). The increase in the SCM was greatest, followed by increases in the RA, EO, and PM CONCLUSION: These finding suggest that activity of accessory respiratory muscles increases with use of elastic bands during chest expansion exercise in cerebral palsy.

• The Journal of Korean Physical Therapy
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• 제29권3호
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• pp.135-141
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• 2017

Purpose: This study was to identify the anticipatory postural adjustment (APA) mechanism which is represented by the onset time of trunk muscles and the displacement of the center of pressure (COP) according to the different base of support (BOS) during upper extremity movement. Methods: Thirty healthy subjects (14 males, 16 females) participated in this study. The movement was performed for 10 trials during each of various BOS (shoulder - width double leg stance, narrow base double leg stance, tandem stance, non-dominant single leg stance) at the 1.2 Hz frequency. Electromyography was used to measure muscle onset time and biorescue was used to measure characteristics of the displacement of COP. Surface bipolar electrodes were applied over the right deltoid anterior, right latissimus dorsi, both rectus abdominis, both internal oblique and both erector spinae. The data were analyzed by repeated one-way ANOVA and Duncan's post hoc test. Results: The study has revealed following. There were significant differences with muscle onset time in each BOS (p<0.01). There were significant differences in characteristics of the COP in each BOS (p<0.01). Conclusion: The study found that the more narrowed the basis requires the more rapid anticipatory postural control in contralateral postural muscle when the upper extremity movement is performed.

• Physical Therapy Rehabilitation Science
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• 제2권1호
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• pp.1-6
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• 2013

Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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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.

• Journal of Korean Neurosurgical Society
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• 제43권4호
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• pp.182-185
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• 2008

Objective : The purpose of the present study is to assess the long-term results of microsurgical dorsal root entry zonotomy (MDT) for the treatment of medically intractable upper-extremity spasticity. Methods : The records of nine adult patients who underwent MDT by one operating neurosurgeon from March 1999 to June 2004 were retrospectively reviewed by another investigator who had no role in the management of these patients. In all patients, MDT was performed on all roots of the upper limb (from C5 to T1) for spasticity of the upper extremity. The degree of spasticity was measured by the Modified Ashworth Scale (grade 0-4). Severity of the pain level was determined using the Numeric Rating Scale (NRS, score 0-10). Also, patient satisfaction of the post-operative outcome was assessed. Results : Comparing the preoperative and postoperative spasticity using the Modified Ashworth Scale, we observed improvement in all patients, particularly in five of the nine patients (55.6%) who improved by three grades over an average of 66.4 months (range, 40-96). Regarding patient satisfaction, seven patients (77.8%) had affirmative results. None of the patients experienced severe, life-threatening, postoperative complications. We observed a decrease in the intensity of painful spasms to less than three scores as measured by NRS in all four patients with associated pain. Conclusion : This study shows that MDT provides significant, long-term reduction of harmful spasticity and associated pain in the upper limbs.

• 대한물리의학회지
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• 제9권4호
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• pp.347-354
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• 2014

PURPOSE: This study was to examine changes in muscle activity of lower extremity shoes sole form (high heels, shoes with curved out sole, house shoes). METHODS: The subjects of this study were 12 women in their twenties. They put three kinds of shoes (high heels, shoes with curved out sole, house shoes) and walked 5m. The muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) were measured using a wireless electromyogram (EMG). Rectus femoris was attached to 1/2 position at the distance between ASIS and knee bone and vastus medials was attached to 2cm from upper inside of knee bone. Tibialis anterior was attached to 75% position above line connecting knee joint and ankle joint and gastrocnemius medial part was attached to 3 5% position above knee joint and ankle. RESULTS: It was found that there were significant differences in changes of muscles activities of lower extremity muscles (rectus femoris, vastus medialis, tibialis anterior, gastrocnemius medial part) on shoes sole forms (p<.05). All lower extremity muscles were showed high muscles activities, when high heels wear (p<.05). Wearing shoes with curved out sole was showed high muscle activity of tibialis anterior and lower muscle activity of gastrocnemius medial part compared with wearing house shoes (p<.05). CONCLUSION: Shoes sole form should be considered when patients with knee and ankle joint problems choose shoes because muscles were showed different activities according to shoes sole forms.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• 국제물리치료학회지
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• 제11권4호
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• pp.2203-2211
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• 2020

Background: Backpacks are one of the most widely used accessories in modern society. However, previous studies have shown that carrying a backpack can cause various musculoskeletal problems. Objectives: To investigate the effects of a body-adhesive backpack on craniovertebral angle, sagittal shoulder angle and the muscle fatigue in the upper extremity. Design: Randomized cross-over design. Methods: For this study, 36 healthy university students participated in this study. The experiment was conducted three times using common backpack, and body-adhesive backpack condition. The angles of the cervical spine and shoulder joints of the subjects were calculated without the backpack. Electrodes were placed at upper trapezius, lower trapezius, rectus abdominis and erector spinae to check for muscle fatigue. Subjects carried a backpack and walked on a treadmill for 15 minutes at 4 km/h. The muscle fatigue signal was also measured while walking. After walking, the craniovertebral and sagittal shoulder angles were measured again while subjects carried backpack. Results: As a result of this study, body-adhesive backpack condition showed significant decrease and significant increase in craniovertebral angle and sagittal shoulder angle than common backpack (P<.05). Body-adhesive backpack condition showed significant decrease in upper trapezius, lower trapezius, erector spinae, and rectus abdominis when compared to a common backpack (P<.05). Conclusion: This study suggests that a body-adhesive backpack is more beneficial in correcting body posture than a common backpack.

• 문화기술의 융합
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• 제9권2호
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• pp.519-524
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• 2023

이 연구는 경기상황과 유사한 점프 동작이 포함된 배드민턴 기술 동작 시 근육의 활성도의 차이를 조사함으로써 효율적인 기술훈련을 위한 기초자료를 구성하기 위한 목적이다. 남자 배드민턴 선수 7명을 대상으로 하여 스매시, 드롭, 클리어 기술을 무선배정으로 실시하였으며, 3가지 기술 동작 시행 중 근전도를 측정하였다. 측정된 근전도는 RMS로 산출하였으며 일원분산분석을 실시하였다. 스매싱 동작의 근활성도는 부위에 따른 유의한 차이를 보이지 않았다. 드롭 동작에서 상지 근육 중 PM의 활성도는 BC, ECR보다 낮았으며, FCR의 활성도는 EC보다 낮았다. ECR의 활성도는 PM, FCR보다 높았다. 몸통 근육 중 ES의 활성도는 RF, GM보다 낮았다. 하지 근육 중 RF의 활성도는 ES, BF보다 높았다. 클리어 동작에서 상지 근육 중 TC의 활성도는 FCR보다 높았다. 몸통 근육 중 ES의 활성도는 BF보다 낮았다. 하지 근육 중 RF의 활성도는 BF보다 높았으며, BF의 활성도는 RF, GM보다 낮았다. GM의 활성도는 BF보다 높았다. 배드민턴 기술에 따른 근활성도는 FCR에서 스매시와 드롭 동작이 클리어 동작보다 높았으며, RA에서 클리어가 스매시, 드롭 동작보다 높았다. 종합하면, 배드민턴 경기 중 근육활동은 기술별 특성에 따라 다르게 나타나고 노쪽손목굽힘근은 스매시와 드롭, 배곧은근은 클리어 동작에 영향을 미칠 수 있을 것으로 사료된다.

• 대한인간공학회지
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• 제32권3호
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• pp.273-278
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• 2013

Objective: This study aims to analyze and evaluate fatigue in upper trapezius muscles of adults when inputting text on a smart phone, thereby examining the risk of cumulative trauma disorders in the musculoskeletal system of the upper extremity. Method: Forty-five healthy adults were divided equally into three groups: a smartphone group, a notebook group, and a desktop group. A surface electromyogram was placed on the upper trapezius muscle of each participant, after which they inputted text for ten minutes within an ergonomic setting; their side posture was recorded on video and analyzed. Results: The spectral edge frequency values for the smartphone group, as recorded from the upper right trapezius muscles on the surface electromyogram, showed a significant decrease(p<.05). Regarding the RULA, all three groups had results indicating "action level 2". Conclusion: All three groups had results indicating "action level 2" according to the RULA, which means that additional research on the posture of the participants while performing tasks is necessary, and their posture needs to be corrected. In particular, the smartphone group has the highest levels of fatigue in the upper trapezius muscles, suggesting that the task of inputting text on a smartphone is a high risk for causing cumulative trauma disorders.