Earticle

본 연구는 아급성뇌졸중환자의 상지기능과 일상생활수행능력에 대한 상상훈련의 효과를 알아보기 위해 시행되었다. 연구대상자들은 총 16 명으로 상상훈련군과 대조군에 8 명씩 무작위로 할당되었다. 상상훈련군은 4주 동안 주 5회, 매일 30의 상상훈련과 30분의 과제지향훈련을 시행하였고 대조군은 4주 동안 주 5회, 매일 30분간 과제지향훈련을 시행하였다. 측정은 상지기능의 변화를 알아보기 위해 울프운동 기능검사(Wolf motor function test, WMFT)와 Fugl-meyer 운동기능평가(Fugl-Meyer motor function assessment, FMA)를 측정하였고, 일상생활수행능력의 변화를 알아보기 위해 수정된 바델 지수(modified Barthel index, MBI)를 사용하여 측정하였다. 본 연구의 결과는 상상훈련이 대조군에 비해 모든 검사에서 더 유의한 향상을 보였다(p<.05). 그리고 훈련 전후의 효과크기는 상상훈련을 시행하였을 때 WMFT와 FMA는 각각 1.59, 2.02로 큰 효과를 나타냈으며, MBI는 0.37로 최소의 효과를 나타났다. 이러한 결과는 상상훈련이 상지기능과 일상생활수행능력 향상에 도움이 될 수 있으며, 상상훈련의 임상적용 가능성을 지지한다.

This study aimed to evaluate the effectiveness of imagery training on upper limb function and activities of daily living in subacute stroke patients. This study included 16 voluntary participants with subacute stroke. Subjects were randomly assigned to either experimental or control group, with 8 in each group. Imagery training group performed imagery training during 30 minutes and then task-oriented training 30 minutes a day, 5 times a week for 4 weeks. Control group performed task-oriented training during 30 minutes during a day, 5 times a week for 4 weeks. Assessments were made using the Wolf Motor Function Test (WMFT) and Fugl-Meyer motor function assessment (FMA) to evaluate the changes of upper function. And modified Barthel Index (MBI) was measured to evaluate the activities of daily living. The results showed that imagery training group was more significant increase than control group in WMFT, FMA, and MBI (p<.05). Small to huge effect sizes of 1.59, 2.02, 0.37 were observed for WMFT, FMA, and MBI, respectively. This study indicated that imagery training may be helpful in improving the upper limb function and activities of daily living for subacute stroke patients, and support the clinical feasibility of the imagery training.

본 연구는 만성 뇌졸중환자의 상지 기능과 일상생활동작에 대한 동작관찰훈련과 과제지향훈련의 효과를 비교하기 위하여 시행되었다. 연구대상자들은 총 12 명으로 1 집단과 2 집단에 6 명씩 무작위로 할당되었으며, 각 집단의 대상자들에게 동작관찰훈련(A)과 과제지향훈련(B)을 순차적으로 적용하였다. 본 연구는 교차연구 설계를 사용하여 1 집단은 A-B, 2 집단은 B-A의 순서로 중재가 적용되었다. 각 훈련은 2 주 동안 주 5회, 매일 30 분씩 시행되었으며, 총 실험기간은 4 주였다. 측정은 울프 운동 기능검사(Wolf motor function test, WMFT)와 수정된 바델 지수(modified Barthel index, MBI)를 사용하여 기초선, 2 주후, 4 주후에 시행되었다. 본 연구의 결과는 과제지향훈련과 동작관찰훈련 모두 만성 뇌졸중환자의 WMFT와 MBI 점수를 유의하게 향상시키는 것으로 나타났으나(p<.05), 두 훈련 방법의 차이는 없었다(p>.05). 훈련 전후의 효과크기는 두 집단 모두 동작관찰훈련을 시행하였을 때 더 높은 것으로 나타났다. 이러한 결과는 동작관찰훈련과 과제지향훈련 모두 뇌졸중 환자의 상지기능과 일상생활동작을 향상시키는데 도움이 된다는 것을 의미하는 것이며, 동작관찰훈련의 임상적용 가능성을 지지하는 것이다.

This study aimed to compare the effectiveness of action-observational training and task-oriented training on upper limb function and activities of daily living in patients with post-stroke hemiparesis. This study included 12 voluntary participants with post-stroke hemiparesis. Subjects were randomly assigned to either group 1 or group 2, with 6 in each group. Each subject completed the crossover experiment that comprised of action-observational training (A) and task-oriented training (B). The intervention sequence was A-B for the group 1 and B-A for the group 2. Each training was performed for 30 min a day, 5 times a week for 2 weeks (total experimental period of 4 weeks). Assessments were made using the Wolf Motor Function Test (WMFT) and Modified Barthel Index (MBI) thrice: at baseline, after 2 weeks of intervention, and after 4 weeks of intervention. The results showed that the WMFT and MBI scores significantly improved after the completion of each training (p<.05). Therefore, a determination of the superior training method was difficult. The effect sizes of both groups were greater when performed the action-observational training. The findings suggest that both the action-observational training and task-oriented training may be helpful in improving the upper limb function and activities of daily living for patients with post-stroke hemiparesis, and support the clinical feasibility of the action-observational training.

Objective To investigate the effects of adjuvant mental practice (MP) on affected upper limb function following a stroke using three-dimensional (3D) motion analysis.Methods In this AB/BA crossover study, we studied 10 hemiplegic patients who had a stroke within the past 6 months. The patients were randomly allocated to two groups: one group received MP combined with conventional rehabilitation therapy for the first 3 weeks followed by conventional rehabilitation therapy alone for the final 3 weeks; the other group received the same therapy but in reverse order. The MP tasks included drinking from a cup and opening a door. MP was individually administered for 20 minutes, 3 days a week for 3 weeks. To assess the tasks, we used 3D motion analysis and three additional tests: the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the motor activity logs for amount of use (MAL-AOU) and quality of movement (MAL-QOM). Assessments were performed immediately before treatment (T0), 3 weeks into treatment (T1), and 6 weeks into treatment (T2).Results Based on the results of the 3D motion analysis and the FMA-UE index (p=0.106), the MAL-AOU scale (p=0.092), and MAL-QOM scale (p=0.273), adjuvant MP did not result in significant improvements.Conclusion Adjuvant MP had no significant effect on upper limb function following a stroke, according to 3D motion analysis and three clinical assessment tools (the FMA-UE index and the two MAL scales). The importance of this study is its use of objective 3D motion analysis to evaluate the effects of MP. Further studies will be needed to validate these findings.

Objective: To examine the contribution of perceived upper limb function to participation and activity among community-dwelling people with chronic stroke.Methods: A cross-sectional study was conducted with eighty-one people with stroke aged ≥50 years. The outcome measures included the Oxford Participation and Activities Questionnaire (Ox-PAQ), Arm Activity Measure (ArmA), Wolf Motor Function Test (WMFT), Timed Up and Go Test (TUG), and Geriatric Depression Scale (GDS).Results: Correlation analyses revealed that perceived upper limb function, as measured using the ArmA, had the strongest and most significant correlations with the levels of participation and activity, as measured using the Ox-PAQ, among all of the tested variables (rs=0.35?0.59, p<0.01). Multiple linear regression analyses also showed that perceived upper limb function significantly associated the levels of participation and activity, accounting for 2.0% to 9.0% of the variance in the Ox-PAQ scores. The final model, which included TUG time, the GDS score, the WMFT score, and the ArmA score, could explain 54% and 28% of the variance in the routine activities and social engagement subscales of the Ox-PAQ, respectively. The model including the GDS score, the WMFT score, and the ArmA score explains 32% of the variance in the emotional well-being subscale of the Ox-PAQ. Conclusion: Perceived upper limb function is a crucial determinant of participation and activity among community-dwelling people with chronic stroke. It could thus be a target component of stroke rehabilitation interventions to facilitate participation and activity after stroke.

Objective To prospectively investigate the long-term effects of botulinum toxin treatment on the upper limb function and performance of school age children with spastic bilateral cerebral palsy, who have limitations in performing activities of daily living and school activities, due to spasticity of the upper extremities.Methods Botulinum type A toxin (BoNT-A) was injected into 24 spastic upper limbs of 15 children. We used a Modified Ashworth Scale and a Modified Tardieu Scale for the evaluation of upper limb spasticity, and Quality of Upper Extremity Skills Test (QUEST), Canadian Occupational Performance Measure (COPM), and Test of Visual-Motor Skills-Revised (TVMS-R) for the evaluation of upper limb function and performance. Results Upper limb spasticity continuously decreased until the end of the one-year follow-up. Upper limb function on QUEST and COPM showed the best performance at 3 months and deteriorated slightly, but still showed a significantly better performance at 9 and 12 months than at pre-injection. In more functional nine subjects who could perform TVMS-R, the performance enhancement effects remained constant after 12 months, suggesting that the reduced spasticity led to the learning effect acquired by the repeated use of the affected upper limb. Conclusion For school age children with bilateral spastic cerebral palsy whose upper limb functions are important, BoNT-A injections seem to be of help in the performance of school activities and activities of daily living.

Objective To Investigate the synergic effects of short-term constraint-induced movement therapy (CIMT) and visual biofeedback training (VBT) in subacute stroke patients.Methods Thirty-two subacute stroke patients were enrolled and randomly assigned to one of three groups: short-term CIMT with VBT, VBT only, and control groups. We applied CIMT for an hour daily during VBT instead of the ordinary restraint time, referred to as ‘short-term’ CIMT. Short-term CIMT with VBT group received simultaneous VBT with CIMT, whereas the VBT the only group received VBT without CIMT for an hour a day for 2 weeks. The control group received conventional occupational therapy (OT) alone. Patients underwent the Purdue Pegboard Test, the JAMAR grip strength test, the Wolf Motor Function Test, the Fugl-Meyer Assessment (upper extremity), Motricity index and the Korean version of Modified Barthel Index test to evaluate motor functions of the hemiplegic upper limb at baseline, post-treatment, and 2 weeks after treatment.Results No significant differences were observed between short-term CIMT with VBT and VBT only groups. Both groups showed significantly higher scores compared to the control group in the WMFT and FMA tests. However, the short-term CIMT with VBT group showed significant improvement (p<0.05) compared with the control group in both grasp and pad pinch at post-treatment and 2 weeks after treatment while the VBT only group did not.Conclusion Short-term CIMT with VBT group did not show significant improvement of hemiplegic upper limb function of subacute stroke patients, compared to VBT only group. Larger sample sizes and different restraint times would be needed to clarify the effect.

Musculoskeletal disorders substantially impacts physical activity, men-tal state, and quality of life (QOL). Generally, comprehensive assessment of upper limb function requires measures of impairment or disability as well as health-related quality of life. A growing number of outcome in-strument have been introduced to evaluate upper limb function and dis-ability, and these measures can be categorized as patient- or clinician- based, and as condition specific or general health-related QOL evalua-tions. The upper limb outcome instruments reviewed in this article as-sess different aspect of upper limb conditions, and the measures are affected by differences in cultural, psychological, and gender aspect of illness perception and behavior. Therefore, physician should select/in-terpret the outcome instruments addressing their primary purpose of research. Information about regional instruments for upper limb condi-tion and health-related QOL in upper limb disorder may help us in deci-sion-making for treatment priority or in interpretation of the treatment outcomes.

Constraint-induced movement therapy (CIMT/mCIMT) and task-oriented training (TOT) represent prominent interventions for upper-limb rehabilitation following stroke; however, their relative efficacy and consistency across outcome measures remain subjects of ongoing debate. This study aimed to synthesize evidence from randomized controlled trials (RCTs) comparing CIMT and TOT for upper-extremity recovery post-stroke and to quantify pooled effects on validated impairment and activity assessments. Fourteen peer-reviewed RCTs published between 1990 and 2025 (seven investigating CIMT/mCIMT and seven investigating TOT) involving adult stroke survivors and providing sufficient data for meta-analysis were included. Adhering to a pre-specified protocol consistent with PRISMA 2020 guidelines, two independent reviewers conducted study screening, data extraction, and risk of bias assessment using the RoB 2 tool. Random-effects meta-analyses were performed to estimate pooled effect sizes; heterogeneity was evaluated using the I² statistic, and funnel plots were examined when the number of studies per outcome permitted. Primary outcomes synthesized included the MAL–Quality of Movement (MAL-QOM; mean difference [MD]), Action Research Arm Test (ARAT; standardized mean difference [SMD], Hedges’ g, based on change scores), and Fugl-Meyer Assessment for Upper Extremity (FMA-UE; SMD, Hedges’ g). Across four studies, MAL-QOM scores favored experimental interventions, predominantly CIMT variants, with a pooled MD of 0.68 (95% CI, 0.39 to 0.97; I² = 71%), indicating moderate but variable improvements in perceived real-world arm use. For ARAT (k = 3), pooled effects favored experimental treatments with an SMD of 0.95 (95% CI, 0.58 to 1.31; I² = 0%), and for FMA-UE (k = 2), the pooled SMD was 1.47 (95% CI, 0.98 to 1.97; I² = 0%), demonstrating robust enhancements in activity and impairment, respectively. The overall risk of bias was low to moderate, with masked outcome assessment commonly employed. Tests for publication bias were underpowered due to the limited number of studies (k < 10). These findings support the efficacy of intensive, task-specific upper-limb rehabilitation post-stroke. CIMT/mCIMT exhibited the most consistent benefits across impairment and activity outcomes, whereas TOT demonstrated advantages that appeared contingent upon intervention dose, fidelity of implementation, and task relevance. Clinically, rehabilitation programs that provide sufficient, progressive, and meaningful practice (utilizing CIMT when feasible and dose-matched TOT when restraint is impractical) are most likely to yield clinically significant improvements.

This study aimed to determine the effects of progressive resistive exercise (PRE), including complex decongestive physical therapy (CDPT), on edema volume, hand-grip strength, upper extremity function, and quality of life (QoL) in patients with breast cancer-related lymphedema (BCRL). Twenty patients were randomized between the progressive resistance exercise group (PREG) and the self-home resistance exercise group (SREG). Two patients in each group dropped out of the study, leaving 16 patients: n= 8 in the exercise group and n= 8 in the SREG. First, the PREG and the SREG received CDPT. Subsequently, the patients in the PREG performed PRE, whereas the patients in the SREG performed selfhome resistance exercises. Interventions were performed for 50 min, 3 times a week, for 6 weeks. The results showed that, for the edema volume, a significant intergroup variation was absent, whereas the intragroup variation was significant. The inter- and intragroup variations were significant for both hand-grip strength and upper extremity function. Regarding QoL, a significant difference was observed in global health status/QoL and role function between the groups. Furthermore, significant differences were observed within the PREG in global health status/QoL; physical, role, and cognitive function; and dyspnea. No significant differences were observed within the SREG. The results collectively suggest that the exercise program was an intervention with a greater potential contribution to reducing edema and enhancing physical function in patients with BCRL.

목적: 본 연구의 목적은 외골격형 상지로봇을 활용한 상지로봇 재활프로그램이 뇌성마비 아동의 상지기능과 일상생활에 미치는 효과를 알아보는 것이다. 연구방법: 2024년 1월부터 2024년 6월까지 서울특별시 소재의 S 재활병원에서 외래로 내원하는 상지기능저하가 있는 만 6~15세(10.92 ± 2.82) 뇌성마비 아동 17명을 대상으로 연구를 진행하였다. 연구 설계는단일집단 사전-사후검사 설계(one-group pretest-posttest design)였다. 중재는 상지로봇 재활치료(ARMEO Spring Pediatric)를 회기당 30분, 주 1~2회, 총 20회 제공하였다. 상지로봇 재활치료 전⋅후아동의 상지기능 변화를 측정하기 위해 상지기능평가(Quality of Upper Extremity Skills Test; QUEST), 상자와 나무토막 검사(Box and Block Test; BBT)를 시행하였으며, 일상생활활동 수행 능력을 평가하기위해 한국형 수정바델지수(Korean Version of Modified Barthel Index; K-MBI)를 사용하였다. 결과: 대상자는 상지로봇 재활치료 후 유의미한 상지기능 향상을 보였다[QUEST (z = -3.62, p < .001), BBT (z = -3.42, p = .001)]. 또한, K-MBI로 확인한 일상생활활동 수행에서의 유의한 향상이 확인되었다(z = -2.53, p = .011). 결론: 본 연구를 통해 상지기능 저하를 보이는 뇌성마비 아동을 대상으로 한 상지로봇 재활치료가 대상자의 상지기능 및 일상생활활동 수행 능력 향상에 미치는 유의미한 효과를 확인하였다. 뇌성마비 아동의상지기능과 일상생활활동 수행 능력 증진을 위해 상지로봇 재활치료를 활용한 최신 재활 치료기법적용이 가능하다.

Objective: This study examined the effect of an upper limb robot rehabilitation program on upper limb and hand function, as well as activities of daily living (ADL) in children with cerebral palsy. Methods: Seventeen outpatients with cerebral palsy (aged 6~15 years) at S Rehabilitation Hospital in Seoul participated. They received 20 sessions of upper limb robot therapy (30 minutes per session, 1?2 times per week). The Quality of Upper Extremity Skills Test (QUEST) and the Box and Block Test (BBT) assessed limb and hand function, while the Korean version of the Modified Barthel Index (K-MBI) evaluated ADL. Results: After treatment, significant improvements were observed in upper limb and hand function (QUEST, z = -3.62, p < .001; BBT, z = -3.42, p = .001) and ADL (z = -2.53, p = .011). All QUEST subitems and personal hygiene component of the K-MBI improved. Conclusion: This study investigated the effect of an upper limb robot rehabilitation program in children with cerebral palsy who had decreased upper limb function. Upper limb robot rehabilitation is an effective method to improve upper limb function and activities of daily living in children with cerebral palsy.

This study aimed to investigate the associations between upper limb somatosensory evoked potential (SEP) and motor evoked potential (MEP) status and functional recovery in patients with subacute stroke. A total of 111 patients who underwent SEP and MEP testing within three months of stroke onset were retrospectively analyzed. Functional outcomes were assessed using the Fugl-Meyer Assessment for Upper Limb (FMA-U/L), Box and Block Test (BBT), Functional Independence Measure (FIM), and the Korean Modified Barthel Index (K-MBI). Correlation and multiple linear regression analyses were performed to examine the relationships between SEP and MEP status and changes in functional outcomes during inpatient rehabilitation. The results showed that MEP was significantly associated with improvements in BBT and K-MBI scores, while SEP significantly predicted changes in FIM and K-MBI scores. Neither SEP nor MEP showed significant predictive power for changes in FMA-U/L scores. Among all models, baseline scores were the strongest predictors of recovery in FMA-U/L and K-MBI, while treatment duration contributed significantly to BBT improvement. Scatterplot analysis further confirmed moderate correlations between predicted and actual changes, particularly in K-MBI and FMA-U/L outcomes. These findings suggest that SEP and MEP provide distinct and domain-specific prognostic information for upper limb recovery in subacute stroke. Specifically, MEP may be useful in predicting hand function and ADL performance, while SEP may better reflect the potential for overall functional independence. These results support the complementary use of neurophysiological assessments in developing individualized rehabilitation strategies.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

Objective: The purpose of this study is to analyze the effects of virtual reality-based upper limb rehabilitation using smart gloves on the upper extremity function, muscle activation, daily activities, and quality of life in stroke patients. Methods: A total of 31 patients after a stroke were randomly assigned to a study group of 16 patients and a control group of 15 patients. For the experimental group, virtual reality-based upper limb rehabilitation using smart gloves was applied, and for the control group, occupational therapy was given. The experiment was conducted for 25 sessions, 5 times a week for 30 min. A Manual Function Test, surface electromyography, Korean version of the Modified Barthel Index, and Stroke Impact Scale 3.0 were applied as pre- and post-assessments. Results: Virtual reality-based upper limb rehabilitation using smart gloves showed significant differences in upper extremity function, muscle activation, daily activities, and quality of life. Conclusion: Virtual reality-based upper limb rehabilitation using smart gloves is an effective occupational therapy method for improving the upper limb function, muscle activation, activities of daily living, and quality of life in stroke patients.

Purpose: The purpose of this study was to identify cognitive function, upper limb function, and activity of daily living according to characteristics of stroke patients. Methods: The study was a cross-sectional and descriptive design. 102 hemiplegic patients less than 90 day after stroke were recruited from October 1, 2009 to April 30, 2010. The data were analyzed using descriptive statistics, t-test, and ANOVA. Results: Participants showed 21.04(SD=7.05) score of MMSE-K, 14.56(SD=9.42) score of upper limb function, and 53.87(SD=31.38) score of activities of daily livings. Participants with brainstem and cerebellum lesion had higher cognitive function than with right and left hemisphere lesion. An unaffected upper limb function among men and those under age 49 had higher score than other groups. There was shown higher score of affected upper limb function among those with cerebral infarction than cerebral hemorrhage. Conclusion: In early stage of rehabilitation, stroke patients had moderate cognitive dysfunction, severe affected upper limb dysfunction, and severely dependent state of activities of daily livings. For enhancing cognitive function and upper limb function, post stroke patients should be provided nursing care that considered not only cause of disease and location of brain lesion but also gender and age.

목적 : 본 연구는 뇌졸중 환자를 대상으로 가상현실 기반 프로그램 라파엘 스마트보드를 적용하여 시지각기능, 인지기능, 상지기능 및 일상생활수행 능력에 미치는 영향을 확인하고자 하였다. 연구방법 : 울산광역시에 소재한 S병원에 입원한 환자 36명을 무작위 배정하여 가상현실 기반 프로그램의 효과를 확인하고자 하였다. 실험군은 라파엘 스마트보드를 적용한 그룹과 대조군으로 과제지향훈련을 하는 그룹으로 나누었다. 하루 40분, 주 3회 8주 간 중재를 시행하였으며, 중재 전과 후에 MVPT-3, MoCA-K, Fugl-meyer assessment, K-MBI를 사용하여 평가하였다. 자료의 분석은 SPSS 22.0을 사용하였으며 통계학적 유의수준은 0.05로 하였다. 결과 : 실험군과 대조군 모두 MVPT-3, MoCA-K, Fugl-meyer assessment, K-MBI 점수에서 유의한 결과를 나타내었다. 그룹 간 결과 비교에서는 실험군에서 MVPT-3, MoCA-K, Fugl-meyer assessment, K-MBI 점수가 유의하게 향상되었다. 결론 : 가상현실 기반 프로그램 라파엘 스마트보드를 사용한 중재가 뇌졸중 환자의 시지각기능, 인지기능, 상지기능 및 일상생활수행 능력 증진에 효과적이다.

Objective : This study was conducted to find out the impact of the virtual reality based rehabilitation program using RAPAEL Smartboard on visual perception, cognitive function, upper limb fuction, and Activities of Daily Living ability of stroke patients. Methods : A total of 36 patients admitted to S Hospital in Ulsan Metropolitan City were randomly assigned to a virtual reality-based rehabilitation program or task-oriented training. The experimental group performed virtual reality rehabilitation program and the control group performed task oriented training. Intervention The intervention was conducted 8 times for 8 weeks, 40 minutes per day, 3 times a week. SPSS 22.0 was used for data analysis, and the statistical significance level was set at 0.05. Results : Both groups showed a significant improvement in their visual perception, cognitive function, upper limb fuction and Activities of Daily Living ability. After the intervention, significant differences in the score of MVPT-3, Fugl-meyer assessment, MoCA-K, K-MBI were observe. Conclusion : In conclusion, it is desirable to implement a virtual conduction virtual reality-based rehabilitation program as a rehabilitation program to improve visual perception, cognitive function, upper limb function, and daily living ability in stroke ADL patients.

본 연구의 목적은 국소 진동 자극과 양측성 팔 훈련의 융합 중재를 뇌졸중 환자에게 적용했을 때, 팔 기능 개선에 미치는 영향을 알아보는 것이다. 20명의 뇌졸중 환자를 국소 진동 자극과 양측성 팔 훈련의 융합 중재를 실시한 실험군 과 양측성 팔 훈련만 실시한 대조군으로 나누어, 회기 당 30분씩 4주간, 총 20회 실시하였다. 진동자극은 실험군의 손상 측 팔에 훈련이 이루어지는 30분간 적용되었다. 평가는 손상 측 팔의 회복정도와 양측 팔 의 사용량, 양손 사용의 수행 의 질과 만족도를 측정하였으며, 대응표본 t-검정을 사용하여 그룹 내, 공분산 분석을 사용하여 그룹 간 비교를 하였다. 연구 결과, 실험군은 대조군보다 손상 측 팔의 기민성과 손상 측의 사용량에서 유의한 차이의 변화를 보였다. 효과 크기 는 모든 항목에서 작은 효과 크기 이상의 차이를 보였다. 본 연구를 통해, 국소 진동 자극과 양측성 팔 훈련의 융합 중재가 뇌졸중 환자의 팔 기능 회복을 위한 효율적 중재로써 임상에서 사용 될 수 있을 것으로 생각된다.

The purpose of this study was to investigate the convergence effect of focal vibration stimulation and bilateral upper limb training on the recovery of upper limb function when applied to stroke patients. For 20 stroke patients, divided into an experimental group that performed convergence intervention with focal vibration stimulation and bilateral upper limb training, and a control group who performed only bilateral upper limb training. It was conducted 20 times for 4 weeks, 30 minutes per session. Vibration stimulation was applied to the affected side of the experimental group for 30 minutes during training. Results were measured for the degree of recovery of the affected upper limb function, amount of use on the affected and unaffected sides, the quality and satisfaction in performance on use of both upper limbs. Comparisons were made within groups using a paired-sample t-test and between groups using covariance analysis. As a result of the study, the experimental group showed a significant difference in dexterity and the amount of use on the affected than the control group. The effect size was more than the small effect size in all evaluation items. Through this study, it is thought that the convergence intervention of focal vibration stimulation and bilateral upper limb trainingcan be used clinically as an effective intervention for the recovery of arm function in stroke patients.

Objective: To investigate whether transcranial direct current stimulation (tDCS) could improve the motor function of hemiparetic upper limb in chronic stroke patients through randomized double-blinded, sham-controlled study. Method: Twenty chronic post-stroke hemiparetic patients participated in this study. They were randomly assigned into either tDCS or sham group. Anodal tDCS was delivered on lesional primary motor cortex for 20 minutes in tDCS group and 30 seconds in sham group. Just after stimulation, both groups performed the shaping exercise for 30 minutes. Total 10 stimulation sessions (5 session/week for 2 weeks) were administered. Fugl-Meyer motor assessment, box and block test, grasp strength and FIM were assessed before stimulation, after 1 week of stimulation, after 2 weeks of stimulation, and 2 weeks after stimulation. Results: The upper extremity score of Fugl-Meyer motor assessment and box and block test improved significantly in tDCS group compared to sham group (p＜0.05). Their improvement lasted significantly for 2 week after stimulation. However, FIM, lower extremity score of Fugl-Meyer motor assessment and grasp power did not improved significantly in tDCS group compared to sham group. Conclusion: tDCS can improve the motor function of hemiparetic upper limb in chronic post-stroke patients, and the effects lasted after stimulation. tDCS may be used as an additional tool for stroke rehabilitation.

목적 : 본 연구는 지역사회 만성 뇌졸중 환자를 대상으로 원격동작관찰훈련이 상지 기능과 근 활성도에 미치는 영향을 알아보고자 실시하였다. 연구방법 : 2023년 8월부터 2024년 2월까지 대전광역시 소재의 재활병원에서 외래재활을 받지 않고 다른 기관에서도 치료를 계획하지 않은 대상자 6명을 실험군으로, 병원 내에서 외래재활치료를 받는 대상자 5명을 대조군으로 선정하였다. 실험군은 원격재활을 기반으로 한 원격동작관찰훈련을 하였고, 대조군은 실험군과 동일한 과제를 수행하는 외래재활치료를 진행하였다. 치료에 대한 중재는 1일 1회 30분, 주 3회, 총 4주간 실시하였고, 치료 중재 전과 후의 상지 기능을 측정하기 위해 ARAT 평가척도(Action Research Arm Test)와 MFT 평가척도(Manual Function Test)를 사용하였고, 근 활성도를 평가하기 위해 표면 근활성도 평가척도인 sEMG (Surface Electromyography)를 사용하였다. 결과 : 두 집단 각각의 중재 전과 후 결과 상지기능과 근 활성도 일부 항목에서 유의한 차이를 보였으며(p < 0.05), 중재 후 두 집단 간에서는 상지기능과 근 활성도에서 유의한 차이를 보이지 않았다(p < 0.05). 결론 : 본 연구에서의 결과로 원격동작관찰훈련이 지역사회 만성 뇌졸중 환자에게 외래재활치료와 유사하게 기능 향상을 시킬 수 있는 중재방법이자, 접근성과 경제적인 이점이 있어 지역사회 만성 뇌졸중 환자에게는 효율적인 방법으로 제시될 수 있다.

Objective: This study aimed to investigate the effects of remote motion observation training on upper limb function and muscle activity in community-based patients with chronic stroke. Methods: Six participants who did not receive outpatient rehabilitation were selected as the experimental group, and five participants who received outpatient rehabilitation were included in the control group. The intervention was conducted for 30 min a day, three times a week, for four weeks. Upper limb function was measured using the Action Research Arm Test (ARAT) and Manual Function Test (MFT) scales, and muscle activity was assessed using surface electromyography (sEMG). Results: Both groups showed significant differences in upper limb function and muscle activity (p < .05). However, after the intervention, no significant differences were observed between the two groups (p < .05). Conclusion: Remote action observation training can be an effective intervention for improving function in community-based patients with chronic stroke, similar to outpatient rehabilitation therapy. Additionally, it offers accessibility and economic benefits to patients.

Objective: To investigate the effect of mirror therapy on recovery of upper limb function and strength in subacute hemiplegia after stroke. Method: Fourty subacute hemiplegic stroke patients (onset ＜6 months) were enrolled and randomly assigned to either the mirror therapy (MT, n=19), or control group (n=21). MT group received mirror therapy for 30 minutes after each treatment, additionally with the traditional rehabilitation programs, 5 days per week for 4 weeks; 2 hours or more per day, 3 days or more per week. To measure the outcome, we performed the manual muscle test (MMT), manual function test (MFT) and Jarmar grip strength test. Results: MT group showed significant improvements in MMT, grasp and lateral pinch force of grip strength test (p＜0.05), compared to control group. Improvement in MFT was more evident in MT group (p＜0.05). Conclusion: Mirror therapy can be used as an adjuvant therapeutic technique for improving upper limb function and strength for subacute hemiplegia. (J Korean Acad Rehab Med 2010; 34: 508-512)