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Lee N.G.,Yonsei University | Kang S.K.,Yonsei University | Lee D.R.,Yonsei University | Hwang H.J.,Yonsei University | And 6 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2012

Objective: To investigate the feasibility and test-retest reliability of a novel electroencephalography (EEG)-based brain mapping system in healthy children and children with cerebral palsy (CP). Design: Correlation statistics. Setting: University brain mapping and neurorehabilitation laboratory. Participants: A convenience sample of children (N=12; 5 healthy children, mean ± SD, 12.6±0.89y; 7 children with CP, mean ± SD, 9.71±1.1y) participated in the study. Interventions: Not applicable. Main Outcome Measures: Mu band (8-12Hz) power values in event-related spectral perturbation maps during reach and grasp hand movements were repeatedly measured on 2 separate occasions (2h apart). Intraclass correlation coefficient (ICC 1,2) tests were computed to determine test-retest reliability at the standard level of significance (P<.004). In addition, the feasibility of the system was determined by evaluating potential differences in the cortical activation areas obtained from topographical maps during actual reach and grasp motor tasks between healthy children and children with CP. Results: The test-retest reliability results showed excellent reliability between the repeated measures, ranging from.93 (P=.000) to.99 (P=.000). Our EEG brain mapping system was capable of distinguishing differences in the cortical activity power (mu band power spectra) between healthy children and children with CP. Conclusions: To our knowledge, this study is the first evidence demonstrating the feasibility and reliability of the EEG brain mapping system. Clinically, this system provides important insights into neuroplasticity associated with motor recovery after treatment and can also be used as real-time neurofeedback or noninvasive neuromodulation in the course of neurologic rehabilitation. © 2012 American Congress of Rehabilitation Medicine. Source

Lee D.R.,Honam University | Kim Y.H.,Sungkyunkwan University | Kim D.A.,Korea National Rehabilitation Center | Lee J.A.,National Rehabilitation Research Institution | And 3 more authors.
NeuroRehabilitation | Year: 2014

BACKGROUND: In children with cerebral palsy (CP), the never-learned-to-use (NLTU) effect and underutilization suppress the normal development of cortical plasticity in the paretic limb, which further inhibits its functional use and increases associated muscle weakness.OBJECTIVE: To highlight the effects of a novel comprehensive hand repetitive intensive strengthening training system on neuroplastic changes associated with upper extremity (UE) muscle strength and motor performance in children with spastic hemiplegic CP.METHOD: Two children with spastic hemiplegic CP were recruited. Intervention with the comprehensive hand repetitive intensive strengthening training system was provided for 60 min a day, three times a week, for 10 weeks. Neuroplastic changes, muscle size, strength, and associated motor function were measured using functional magnetic resonance imaging (MRI), ultrasound imaging, and standardized motor tests, respectively.RESULTS: The functional MRI data showed that the comprehensive hand repetitive intensive strengthening training intervention produced measurable neuroplastic changes in the neural substrates associated with motor control and learning. These neuroplastic changes were associated with increased muscle size, strength and motor function.CONCLUSIONS: These results provide compelling evidence of neuroplastic changes and associated improvements in muscle size and motor function following innovative upper extremity strengthening exercise. Source

Son J.,Rehabilitation Institute of Chicago | Son J.,Northwestern University | Ryu J.,Yonsei University | Ahn S.,Yonsei University | And 3 more authors.
BioMed Research International | Year: 2016

This study aims to investigate the idea that an active-resistive training with an EMG-based exoskeleton robot could be beneficial to muscle strength and antagonist muscle cocontraction control after 4-week intensive elbow flexion/extension training. Three older people over 65 years participated the training for an hour per session and completed total 20 sessions during four weeks. Outcome measures were chosen as the maximum joint torque and cocontraction ratio between the biceps/triceps brachii muscles at pre-/post-training. The Wilcoxon signed-ranks test was performed to evaluate paired difference for the outcome measures. As a result, there was no significant difference in the maximum flexion or extension torque at pre- and post-training. However, the cocontraction ratio of the triceps brachii muscle as the antagonist was significantly decreased by 9.8% after the 4-week intensive training. The active-resistive training with the exoskeleton robot in the older people yielded a promising result, showing significant changes in the antagonist muscle cocontraction. © 2016 Jongsang Son et al. Source

Lee J.A.,Korea National Rehabilitation Research Institute | Park S.-W.,Korea National Rehabilitation Center | Hwang P.W.,Korea National Rehabilitation Research Institute | Lim S.M.,Korea National Rehabilitation Research Institute | And 3 more authors.
Journal of Alternative and Complementary Medicine | Year: 2012

Objectives: Shoulder pain, for which acupuncture has been used, is a common complication after a stroke that interferes with the function of the upper extremities. The aim of this systematic review is to summarize and evaluate the effects of acupuncture for shoulder pain after stroke. Methods: Randomized controlled trials (RCTs) involving the effects of acupuncture for shoulder pain, published between January 1990 and August 2009, were obtained from the National Libraries of Medicine, MEDLINE®, CINAHL, AMED, Embase, Cochrane Controlled Trials Register 2009, Korean Medical Database (Korea Institute of Science Technology Information, DBPIA, KoreaMed, and Research Information Service System), and the Chinese Database (China Academic Journal). Results: Among the 453 studies that were obtained (300 written in English, 137 in Chinese, and 16 in Korean), 7 studies met the inclusion criteria for this review. All of them were RCTs published in China and reported positive effects of the treatment. The quality of the studies was assessed by the Modified Jadad Scores (MJS) and the Cochrane Back Review Group Criteria List for Methodologic Quality Assessment of RCTs (CBRG); the studies scored between 2 and 3 points on MJS, and between 4 and 7 points on CBRG. Conclusions: It is concluded from this systematic review that acupuncture combined with exercise is effective for shoulder pain after stroke. It is recommended that future trials be carefully conducted on this topic. © Copyright 2012, Mary Ann Liebert, Inc. 2012. Source

Kim K.,Korea National Rehabilitation Center | Song W.-K.,Korea National Rehabilitation Center | Lee J.,Korea National Rehabilitation Center | Lee H.-Y.,Korea National Rehabilitation Center | And 3 more authors.
Clinical Biomechanics | Year: 2014

Background It is necessary to analyze the kinematic properties of a paralyzed extremity to quantitatively determine the degree of impairment of hemiplegic people during functional activities of daily living (ADL) such as a drinking task. This study aimed to identify the kinematic differences between 16 hemiplegic and 32 able-bodied participants in relation to the task phases when drinking with a cup and the kinematic strategy used during motion with respect to the gravity direction. Methods The subjects performed a drinking task that was divided into five phases according to Murphy's phase definition: reaching, forward transport, drinking, backward transport, and returning. We found that the groups differed in terms of the movement times and the joint angles and angular velocities of the shoulder, elbow, and wrist joints. Findings Compared to the control group, the hemiplegic participants had a larger shoulder abduction angle of at most 17.1 during all the phases, a larger shoulder flexion angle of 7.6 during the reaching phase, and a smaller shoulder flexion angle of 6.4 during the backward transporting phase. Because of these shoulder joint patterns, a smaller elbow pronation peak angle of at most 13.1 and a larger wrist extension peak angle of 12.0 were found in the motions of the hemiplegic participants, as compensation to complete the drinking task. The movement in the gravity direction during the backward transporting phase resulted in a 15.9% larger peak angular velocity for elbow extension in the hemiplegic participants compared to that of the control group. Interpretation These quantitative kinematic patterns help provide an understanding of the movements of an affected extremity and can be useful in designing rehabilitation robots to assist hemiplegic people with ADL. © 2013 Elsevier Ltd. Source

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