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ABSTRACT: Therapeutic concept of interlimb transfer provides very important information relevant to patients with stroke because it can be applied to help these patients recover movement skills disrupted following unilateral damage to the brain.
The purpose of this study was to determine the transfer effects for both specialized training in each hemisphere and reversed training of a specialized task.
Twenty patients (ten women and ten men) with stroke and hemiparesis participated. All participants were in Brunnstrom recovery stage five or higher for arm and hand function and had Mini-Mental State Examination scores ≥25. We used a training task involving a modified static cone, modified box and block, and modified pegboard tasks. The specified-training group performed the reaching movements (based on grip, reach, and release movements) in a modified training setting in which left-handed participants began from a single starting location and proceeded to one of three target locations (1S3T condition), and the right-handed participants started form one of three starting locations and proceeded to a single target location (3S1T condition). The unspecified training group performed these movements starting under reverse-start and target conditions.
As a result of the left-to-right limb transfer in the specified-training group differed significantly in duration from that in the pre-training group. Also, the biceps brachii and triceps (lateral head) muscles were significantly more active after performing the specified training than before. On the other hand, the activity of the upper trapezius muscle did not significantly differ after specified training compared with before training.
Consequently, a symmetric transfer advantage was observed that depended on the characteristic resources of each hemisphere. The transfer of specified training from one arm to the other had a more positive influence on functional recovery than did unspecified training for patients with stroke and hemiparesis.
Neurorehabilitation 01/2013; 32(3):609-15. · 1.63 Impact Factor
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ABSTRACT: Objective: Meta-analysis was conducted to examine effects of OT interventions based on sensory stimulation, environmental modification and functional task activity on the behavioral problems and depression of individual with dementia. Search strategy: An extensive search in database such as MEDLINE, CINAHL, ProQuest Medical Library, and Cochrane and OT related 11 journals was performed. Selection criteria: Potential studies were identified through the keywords: dementia or Alzheimer, randomized controlled trials and occupational therapy or occupational therapist or ADL or sensory stimulation or Snoezelen or environmental modification or education for caregivers. Data collection and analysis: Two reviewers independently identified studies, extracted data, assessed methodological quality of the studies. Effect size was estimated using standardized mean difference with 95% confidence intervals. Significant heterogeneity and publication bias were investigated. Main results: Nine studies including 751 people were selected. Sensory stimulation was effective intervention in improving behavioral problems (0.32; 95% CI, 0.04 to 0.59). Conclusion: This review identified that OT intervention based on sensory stimulation was effective intervention to improve behavioral problems. However, the number of studies included in this review is limited. More research is needed to enable evidence-based OT for dementia patients.
Neurorehabilitation 01/2012; 31(2):107-15. · 1.63 Impact Factor
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ABSTRACT: Objectives: The aims of this study were to 1) investigate the effects of forced use combined with scheduled home exercise program compared to forced use only on increasing upper extremity functioning, 2) examine whether increased upper extremity functioning generalized to activities of daily living (ADL) functioning, and 3) explore participants' psychosocial functioning. Methods: A single-subject A-B-A'-C research design was employed in this study. The intervention consisted of two conditions: forced use only (intervention period B), and forced use in addtion to scheduled home exercise program (intervention period C). Results: The results were as follows: 1) Forced use combined with scheduled home exercise program compared to forced use only allowed individuals with stroke to take part in exercise programs on their own within their home setting, ultimately improving their upper extremity functioning. 2) The program's promotion of performance in ADL tasks have the advantage of keeping participants focused so that a number of exercises can be maintained throughout the intervention. 3) Finally, forced use combined with scheduled home exercise program showed partial effects on improving the participants' psychosocial functioning. Conclusion: The results of the present study suggest that forced use combined with scheduled home exercise program compared to forced use only has the potential to be a cost- and resource-efficient method for intensifying rehabilitation.
Neurorehabilitation 01/2012; 31(2):185-95. · 1.63 Impact Factor
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ABSTRACT: Meta analysis of studies was carried out to examine the effectiveness of functional task training with mental practice on functional performance following stroke.
An exhaustive search was conducted using computerized databases such as MEDLINE, PubMed, Cochrane, PsycINFO, and EBSCO (CINAHL).
The search was performed using the following keywords: stroke, functional task, mental practice, randomized controlled trial.
Two reviewers independently retrieved appropriate RCTs, extracted data, and assessed the methodological quality of each study. Selected studies needed to report the statistical values necessary for calculating the effect size, which was estimated using the standardized difference of the mean. Statistical heterogeneity and publication bias were also investigated.
The five studies included 146 participants. The overall effect size was moderate (0.51, p < 0.001). The 95% confidence interval was from 0.27 to 0.75. Significant heterogeneity and publications bias were not founded.
The present study is the first meta-analysis conducted on the effectiveness of functional task training with mental practice in stroke. The results indicate the clinical effectiveness of functional task training with mental practice provided by occupational and physical therapists in stroke rehabilitation.
Neurorehabilitation 01/2012; 30(3):239-46. · 1.63 Impact Factor
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ABSTRACT: This study was performed to determine the changes in electromyographic activities in the shoulder and forearm muscles when using the bare hands, well-fitting gloves, and gloves that are one size smaller or one size larger for simulated assembly operations. Sixteen asymptomatic seated workers with normal hands and no obvious deformities, skin diseases, or allergies were recruited. The subjects were asked to simulate assembly operations using their bare hands, well-fitting gloves, and one size smaller or one size larger. This study showed that wearing the wrong glove size led to a decrease in forceful activation of the forearm muscle and a compensatory increase in shoulder movement. In contrast, use of the bare hands or wearing well-fitting gloves led to effective forearm muscle activation, which decreased inefficient shoulder movement. These data indicate that wearing the wrong glove size will lead to continuous inefficient use of the forearm and shoulder muscles, and result in overuse of the shoulder.
Industrial Health 08/2011; 49(5):575-81. · 0.94 Impact Factor
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ABSTRACT: The present study was performed to investigate the reliability of initial value and the rate of change of eight spike and turn variables in biceps brachii muscle of eleven subjects during sustained isometric voluntary contractions. Three levels of contraction were studied: 20%, 50% and 80% of the maximal voluntary contraction (MVC) level. Reliability was investigated using the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) of the estimates for each subject. The reliability of the spike and turn variables was compared with four classical variables (ARV: average rectified value, RMS: root mean square MDF: median frequency and MNF: mean frequency) for the same recorded signals. Tukey's HSD (honestly significant difference) test was applied to detect significant differences at the 95% confidence level (p<0.05) between the %MVC levels for each of the eight variables. The main findings of this study can be summarized as follows: (i) the initial value estimation with eight spike and turn variables showed good reliability but the estimation of rate of change showed poor reliability. (ii) The reliability of the classical variables for estimation of the initial value was slightly lower than that of the spike and turn variables, but the four classical variables showed better reliability than the spike and turn variables for estimation of the slope. (iii) The initial values of the amplitude variables (MTA: mean turn amplitude and MSA: mean spike amplitude) increased and the rate of changes of the frequency variables (MTF: mean turn frequency, MSF: mean spike frequency and ZC: zero-crossing) decreased significantly when the contraction level increased from 20% MVC to 80% MVC.
Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology 02/2011; 21(1):119-27. · 2.00 Impact Factor
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ABSTRACT: The purpose of this study was to detect any differences in electromyographic (EMG) activity in the neck and shoulder muscles while performing simulated orchard work with and without neck support.
Fourteen healthy orchard harvesters (eight men and six women) who had no functional disorder of the neck or upper limbs and had never received orthopedic surgery were recruited.
A repeated-measures design was used. The subjects were asked to perform simulated orchard work with and without neck support. The EMG activities of the anterior deltoid, middle deltoid, upper trapezius, and triceps brachii (lateral head) muscles during the two conditions were analyzed using paired t-tests.
The EMG activity of the anterior deltoid and middle deltoid muscles increased significantly and that of the upper trapezius muscles decreased significantly when the working with a neck support compared to without it (p < 0.05). Wearing a neck support may prevent overuse of the upper trapezius muscles by encouraging shoulder elevation and activating the deltoid muscles. The activation of these muscles decreases scapular movement and the results in greater stabilization of scapulohumeral rhythm.
The appropriate application of a neck support may be helpful in preventing disorders of the neck and shoulder muscles resulting from long-term intensive orchard work, however long term application of such support is necessary before definitive information is available.
Work 01/2011; 40(4):385-91. · 0.52 Impact Factor
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ABSTRACT: The purpose of this study was to observe changes in electromyographic activity appeared in shoulder and scapular muscles when one wears no wrist extension orthosis, short wrist extension orthosis and long wrist extension orthosis when performing two model assembling operations. The study subjects were 16 adults who use right hand and did not have any functional disorder on their wrist or the upper limbs without any orthopedic surgery. The study subjects were asked to do the two model assembling operations without wrist extension orthosis, with a short wrist extension orthosis and with a long wrist extension orthosis. As a result of repetitive assembling operation that requires shoulder movement, electromyographic activity in upper trapezius and serratus anterior increased significantly when the subjects wore the short and long wrist extension orthoses compared to none. When the subjects performed repetitive assembling operation that requires shoulder stability, electromyographic activity in upper trapezius, lower trapezius, serratus anterior, and anterior deltoid showed significant increase when they wore the short and long wrist extension orthoses compared to none. Especially, the upper trapezius showed significantly high electromyographic activity when they wore the long wrist extension orthosis compared to a short one.
Industrial Health 01/2010; 48(1):108-14. · 0.94 Impact Factor
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ABSTRACT: Background. Strokes frequently cause limitations of the upper extremity and in performance of activities of daily living (ADL). Constraint-induced movement therapy (CIMT) is designed to enhance the use of the hemiplegic arm. Purpose. To assess the effects of group CIMT on upper-extremity motor function and performance level of motor and process skills for instrumental activities in daily living (IADL) in community-dwelling individuals whose stroke occurred at least six months earlier. Methods. Eight adults with stroke participated in this study. Group-based CIMT was administered for two weeks, five times per week, with two-hour intensive daily training. Findings. The Fugl-Meyer Assessment (FMA) score and the Assessment of Motor and Process Skills (AMPS) scores improved after intervention. Implications. The results of this study suggest that relatively brief group-based CIMT may be an effective intervention for improving motor function of the affected upper-limb and the level of IADL in individuals who have had stroke.
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Description. Les accidents vasculaires cérébraux (AVC) occasionnent souvent une limitation fonctionnelle d'un membre supérieur, ce qui affecte le rendement dans les activités de la vie quotidienne (AVQ). La thérapie par contrainte induite (TCI) a pour but d'améliorer l'usage fonctionnel du bras hémiplégique. But. Évaluer les répercussions de la TCI de groupe sur la fonction motrice des membres supérieurs ainsi que sur le niveau de rendement des habiletés motrices et de planification dans les activités instrumentales de la vie quotidienne (AIVQ), chez des individus vivant dans la collectivité et ayant subi un AVC dans les six derniers mois. Méthodologie. Huit adultes victimes d'un ACV ont participé à cette étude. En prenant part à la TCI, ils devaient se présenter à une formation intensive de deux heures, cinq jours par semaine, pendant deux semaines. Résultats. Après l'intervention, les scores obtenus lors de l'Évaluation de Fugl-Meyer (EFM) et de l'Assessment of Motor and Process Skills (AMPS) étaient nettement supérieurs. Conséquences. Les résultats de l'étude révèlent qu'une TCI de groupe relativement brève constitue une intervention efficace pour améliorer la fonction motrice du membre supérieur affecté et le rendement aux AIVQ chez les personnes ayant subi un AVC.
Canadian Journal of Occupational Therapy 11/2009; 76(5):335-341.
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ABSTRACT: The aim of this paper was to investigate the effectiveness of client-centred occupational therapy using the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Eight girls and 23 boys from Korea, with developmental disabilities and from 3 to 10 years of age participated in this study. Each child participated in 20 to 24 sessions of client-centred occupational therapy. Both the COPM and the AMPS change scores demonstrated statistically significant improvement (p < 0.01) in occupational performance. Significant correlations were found between COPM - Performance and AMPS - Motor skills (r(s) = 0.64, p < 0.05), and COPM - Satisfaction and AMPS - Process skills (r(s) = 0.62, p < 0.05) in a group positive towards client-centred occupational therapy. The COPM was a valuable tool in guiding and measuring the client-centred occupational therapy for children with developmental disabilities. The small sample size of 31 children limits the generalizability of the study's results. Future research needs to use a larger and more diverse sample of children to further validate the effectiveness of client-centred occupational therapy.
Occupational Therapy International 10/2008; 15(4):253-68. · 0.53 Impact Factor
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ABSTRACT: Introduction: Despite the important contribution of multifaceted risk factors on low back pain (LBP), only few studies have attempted to examine the impact of functional level and environmental factors on LBP in mothers of children with disabilities. Moreover, there has been no previous study investigating the risk factors associated with LBP in mothers of children with cerebral palsy. Hence, the present study was to investigate the risk factors associated with LBP in mothers of children with cerebral palsy.Patients and methods: A sample of 94 mothers of children attending three pediatric physical medicine and rehabilitation clinics at three major medical centers and local community rehabilitation centers for their rehabilitation services were recruited for this study. They were divided into two groups: group 1 (mothers of children with the Functional Independent Measure for Children [WeeFIM] score ? 5); and group 2 (mothers of children with WeeFIM score < 5). The independent variables included demographic characteristics of mothers and children, and functional independence levels in children with cerebral palsy as determined by the WeeFIM measurement. The dependent variables entailed level of pain and disability, which were determined by the Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI), respectively. Multiple regression analysis, one-way analysis of variance (ANOVA), independent t-test, and frequency analysis statistics were performed at P < 0.05.Results: The most important risk factors associated with LBP in the care-giving mothers were type of housing, weight, and locomotion of the children in this order (P < 0.05). The regression equation for locomotion measure was significant (R2 = 0.22; F [3, 94] = 7.43; P = 0.002). The regression equation for weight measure was significant (R2 = 0.22; F [3, 94] = 7.43; P = 0.0 06). The regression equation for the type of housing measure was significant (R2 = 0.22; F [3, 94] = 7.43; p = 0.025). ANOVA revealed that mothers living in multi-unit villas complained of significantly greater pain when compared to the other types of housing (P = 0.037). Independent t-test showed that the group of children who required physical assistance from their mothers for transfer (P = 0.000), locomotion (P = 0.005) and overall WeeFIM score (P = 0.029) showed greater pain in NRS when compared with the controls who did not require physical assistance. Pearson correlation showed that LBP pain in NRS was correlated with the children's transfer (r = ?0.23; P < 0.05), locomotion (r = ?0.24; P < 0.01), and weight (r = 0.27; P < 0.01) variables, respectively. Frequency analysis of the home environmental factors showed that mothers' care and independence of children in the home were affected by access to the bathroom, entrance, kitchen, and corridors. Adaptive devices that influenced children's independence were in self-care, sphincter control, and locomotion, followed by transfer.
The Pain Clinic 05/2007; 19(3):93-98.
