• Title/Summary/Keyword: Motor recovery

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The Neurological Effect and Mechanism of Mirror Therapy in Adults With Stroke (뇌졸중 환자를 대상으로 한 거울치료의 효과와 신경학적 기전)

  • Kim, Yeong-Jo
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.24-35
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    • 2013
  • The Purpose of this study was to determine the clinical effectiveness of mirror therapy for stroke. Moreover, this paper was designed to summarize clarified information of neurological plasticity by mirror therapy to finally define the neurological mechanism. Mirror therapy improves the stroke patients' hand and arm motor function. It also has a positive influence on recovering performance of activities of daily living and relieving pain. However, it is not evident that mirror therapy restores visual neglect. There are various ways of recovering stroke. Fundamentally, all the theories are on a bases of restoration of premotor area. Premotor area which is associated with motor control increases the activation of primary motor area and finally improves patients' motor function. If primary motor area is completely damaged, premotor area and supplementary motor substitute for primary motor area. In summary of literature survey, there are not enough evidence to verify the effectiveness and neurological mechanism of mirror therapy. In future, more researches should be conducted to verify the neurological recovery through mirror therapy. Then, mirror therapy will be acknowledged as a clinically effective treatment.

Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study

  • Midha, Divya;Arumugam, Narkeesh
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.318-323
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    • 2020
  • Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

The Effect on Activity of Cerebral Cortex by Key-point Control of The Adult Hemiplegia with fMRI (fMRI를 이용한 성인 편마비의 항조절점 운동이 대뇌피질의 활성화에 미치는 효과)

  • Lee Won-Kil
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.295-345
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    • 2003
  • This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

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Normal data on axonal excitability in Koreans

  • Lee, Ju Young;Yu, Jin Hyeok;Pyun, So Young;Ryu, Sanghyo;Bae, Jong Seok
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.34-39
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    • 2017
  • Background: Automated nerve excitability testing is used to assess various peripheral neuropathies and motor neuron diseases. Comparing these excitability parameters with normal data provides information regarding the axonal excitability properties and ion biophysics in diseased axons. This study measured and compared normal values of axonal excitability parameters in both the distal motor and sensory axons of normal Koreans. Methods: The axonal excitability properties of 50 distal median motor axons and 30 distal median sensory axons were measured. An automated nerve excitability test was performed using the QTRACW threshold-tracking software (Institute of Neurology, University College London, London, UK) with the TRONDF multiple excitability recording protocol. Each parameter of stimulus-response curves, threshold electrotonus, current-voltage relationship, and recovery cycle was measured and calculated. Results: Our Korean normal data on axonal excitability showed ranges of values and characteristics similar to previous reports from other countries. We also reaffirmed that there exist characteristic differences in excitability properties between motor and sensory axons: compared to motor axons, sensory axons showed an increased strength-duration time constant, more prominent changes in threshold to hyperpolarizing threshold electrotonus (TE) and less prominent changes in threshold to depolarizing TE, and more prominent refractoriness and less prominent subexcitability and superexcitability. Conclusions: We report normal data on axonal excitability in Koreans. These data can be used to compare various pathological conditions in peripheral nerve axons such as peripheral neuropathies and motor neuron disease.

Kinematic analysis of rowing exercise using a motor-assisted rowing machine for rowers with spinal cord injury: a case report

  • Jeong, Ju Ri;Lee, Bum Suk;Park, Dae-Sung
    • Physical Therapy Rehabilitation Science
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    • v.3 no.1
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    • pp.69-75
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    • 2014
  • Objective: We developed a Motor-Assisted Rowing Machine (MARM) for Spinal Cord Injury (SCI), by modification of the Concept II rowing machine, so that the seats could be operated automatically in a backward and forward direction by a motor. Design: Case report. Methods: Motor rowing consisted of a chair with inclination control, a motor system, control button, monitor, program, leg supporter, safety belt, and seat. The patients were 2 men rowing athletes with SCI, classified as American Spinal Injury Association class B, participated in the study. Level of thoracic injury ranged from T8 to T10. The subjects rowed at a self-selected stroke rate with 50 watts. Two different rowing methods (static rowing without movement of the seat, dynamic rowing using MARM) were assigned to each participant during 10 minutes; 34 reflective markers were attached to their full bodies. Kinematic data were collected using the Vicon motion analysis system. Based on the full body model provided as a default by the equipment. In the rowing exercise, the rowing motions were divided into Drive Phase and Recovery Phase. Results: The two rowing methods differ in handle range, seat range, handle and seat ratio, handle velocity, and seat velocity during static and dynamic rowing. The rowing exercise using a rowing machine developed MARM increased tendency to the range of motion in the dynamic method compared to the static method. Conclusions: The newly developed MARM could be a useful whole body exercise for people with SCI.

The Effects of Task oriented Training on Motor and Cognitive Function in Alzheimer's Dementia Rat (과제지향훈련이 알츠하이머성 치매 흰쥐의 운동 및 인지기능에 미치는 영향)

  • Lim, Gun-Hong;Lee, Hong gyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.119-126
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    • 2019
  • This study was conducted to investigate the effects of task oriented training on motor and cognitive function recovery in rats with induced Alzheimer's dementia. Thirty Sprague-Dawley rats were randomly assigned to a control group (n=15) and an experimental group (n=15). Training was given three times a week, for 20 minutes a session for 4 weeks. The cognitive and motor functions of the rats were evaluated by an eight arm radial maze test and ladder rung walk test. The eight arm radial maze test showed significant differences between groups according to the time of day 14 and 28 (p<.001). The difference in measured values according to the timing of the two groups was significant (p<.001). Additionally, there was a significant difference between the time and the group interaction (p<.001). The ladder rung walk test showed significant differences between groups according to the time of day 14 and 28 (p<.001). The difference in the measured values according to the timing of the two groups was significant (p<.001), and there was a significant difference between the time and the group interaction (p<.001). As a result, task oriented training for Alzheimer's dementia rats was found to have a positive effect on recovery of motor and cognitive function.

Water Workout Recovery Program on the Patient with Guillain-Barre Syndrome (부상회복 프로그램에 따라 실시한 Guillain-Barre 증후군 환자의 수중운동)

  • Park, No-Chul;Kim, Yong-Kwon
    • Journal of Korean Physical Therapy Science
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    • v.6 no.3
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    • pp.9-24
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    • 1999
  • Guillain-Barre syndrome(GBS) is one of the common motor unit diseases and defined as acute postinfectious polyneuropathy, It is not known most effective medical intervention for GBS, but generally benefits from an intensive physical therapy program. In this report, hydrotherapy was applied for a patient with GBS to improve muscle power and functional abilities. Two weeks later, the patient's functional abilities, muscle power, and physical endurance were improved without complications. Since the hydrotherapy does not load maximally to the patient with GBS, the patient can exercise himself actively for the maximal tolerance. It is the reason of fast recovery. In summary, the hydrotherapy is important to the patient with GBS and it must apply to these patients more frequently.

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A Relation between Functional Outcome and Changes of Tongue Inspection in Stroke Patients (중풍환자의 설상변화와 운동기능향상의 관련성 연구)

  • 최동준;김재관;문상관;조기호;김영석;배형섭;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.113-118
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    • 2000
  • Objectives : Stroke patients have continuously increased and many studies have been performed to predict their prognosis. Tongue Inspection is a diagnostic method that has been widely used in oriental medicine. The aim of this study was to examine if stroke patients' motor recovery might be related to tongue inspection. Methods : MBI(Modified Barthel Index) and tongue inspection of stroke patients within 3 days of onset were assessed on admission and at 10 days following admission. Results : Functional recovery was significantly better in those who showed favorable changes of tongue, especially in tongue coat color(P=0.030) and thick and thin tongue coat(P=0.092). Conclusions : The results suggest that tongue inspection can be used to predict a prognosis of early stage stroke patients.

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Cervical Disc Herniation as a Cause of Brown-S$\acute{e}$quard Syndrome

  • Choi, Kyeong-Bo;Lee, Choon-Dae;Chung, Dai-Jin;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.505-510
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    • 2009
  • The possible causes of Brown-S$\acute{e}$quard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and sensory deficits. On the basis of our cases, it is important to diagnose it early by cervical magnetic resonance imaging, especially in the absence of the typical symptoms of cervical disc herniation or other obvious etiology of extremity numbness. Immediate surgical treatment is also essential for a favorable functional neurological recovery.

Spinal Epidural Hematoma Occuring after Bloody Tap during Epidural Catheter for Cancer Pain Control -A case report- (암성통증치료를 위한 경막외카테테르 거치술중 혈성천자로 발생한 경막외혈종 -증례 보고-)

  • Woo, Sung-Chang;Cha, Dong-Suk;Kang, Keon;Kim, Young-Ki
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.160-164
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    • 1998
  • We report a case of epidural hematoma occuring after bloody tap during epi-dural catheter for cancer pain control in thrombocytopenic patient. Two hours after epidurl puncture, patient experienced severe back pain and numbness of both legs. Following day, patient complained of motor paralysis and urinary difficulty. Diagnosis utilizing magnetic reasonance imaging, showed epidural hematoma extending from $T_{11}$ to $T_{12}$. Thrombocytopenia prevented surgical intervention. Therefore we restored conservative therapy with packed red cell, platelet concentration, steroid and hemostatic, which provided complete neurologic recovery, spontaneously over several days without surgical intervention.

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