Purpose: Functional recovery of the paretic upper extremity post stroke continues to be one the greatest challenges faced by rehabilitation professionals. Although many tasks require the coordinated participation of both hands, rehabilitation strategies for the most part have focused on the paretic limb. This study investigated whether coupled bilateral coordinated movements and repetitive high frequency TMS enhanced upper limb corticomotor excitability and motor function poststroke. Methods: For this study, we compared the neurophysiological and behavioral changes associated with two such rehabilitation protocols: coupled bilateral training and coupled unilateral training. Twenty chronic stroke patients were randomly assigned to the two training group over 8-week period. For this experiment, transcranial magnetic stumulation, EMG, Ag/AgCI suface electrode, rehabilitation training equipment, jebsen-talyer hand function kit, box & block, and pinch & power grip test kit were used. Results: First, in the box & block and JTT task, coupled bimanual group showed a reduction in movement time in comparision to receiving coupled unilateral group. Second, in the cortical excitability within affected hemisphere, using TMS, an increased in map volume, and map number following coupled bilateral group. Overall, these finding suggest that a coupled bilateral movement and high frequency repetitive TMS protocol effective in recovering upper limb motor function and cortical excitability in chronic stroke patients.

Purpose: The purpose of this study was to investigate the influence of body perception image training on functional recovery of upper limb in stroke patients, not image training with visual stimulation for specific task. Methods: Thirty inpatients(15males, 15females) who were diagnosed as stroke participated with agreement in this study, also they were divided randomly by experimental and control groups. Before traditional therapeutic exercise, body perception image training was performed in experimental group, as well as control group took a rest, respectively. Body perception image training program was modified using body scan part of Mindfulness Based on Stress Reduction(MBSR) for present study, then it was spplied individually for 4weeks, 5days a week for 10 min. To determine the effects of this training program, data of muscle activities were collected and analyzed from biceps brachii, upper trapezius and deltoid muscles through electromyogram(EMG). Results: By comparison of changes in muscle activities, both experimental and control groups showed significant increase of muscle activities from all theree of muscles after therapeutic intervention(p<.001). In particular, increment of upper trapezius muscle activity in experimental group was markedly higher than control group(p<.05). Conclusion: These results may indicate that traditional therapeutic exercise combined with body perception image training result in increase of muscle activity of upper limb, suggesting it is beneficial for functional recovery in stroke patients.

The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(AmadeoⓇ) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in AmadeoⓇ, and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of AmadeoⓇ, finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.