• 한국전문물리치료학회지
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• 제17권2호
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• pp.33-42
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• 2010

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

• 척추신경추나의학회지
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• 제14권2호
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• pp.29-42
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• 2019

Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

• 대한물리치료과학회지
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• 제13권2호
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• pp.85-98
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• 2006

This study was performed to examine the influences of the mental practice to the hemiplegic upper limb motor function improvement. 20 minute neurologic treatment based on the neurophysiological theory, 10 minute activities of daily living training, and 10 minute mental practice 5 times a week were given in turn to the experimental group(N=11). On the other hand 20 minute neurologic treatment, and 10 minute activities of daily living training 5 times a week were given in turn to the control group(N=11). Both Fugl-Meyer Assessment Scale and Manual Function Test were used to evaluate upper limb motor recovery, upper limb motor function and movement ability. And the Motor Activity Log; Amount of Use and Motor Activity Log; Quality of Movement before training, 2 weeks after training, and 4 weeks after training were measured to assess the upper limb motor quantitatively and qualitatively each. The results are as follows. 1) Considering the interactions of the rate of change on the upper limb motor recovery, motor function, movement ability improvement, and qualitative motor improvement in ADL of experimental group and control group, the change rates of experimental group were found to be greater than those of the control group. 2) In experimental group, the higher the achievements were, the better upper motor recovery was.

• 대한물리의학회지
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• 제8권2호
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• pp.245-252
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• 2013

PURPOSE: The aim of this study is to verify the effectiveness of modified constraint-induced movement therapy(mCIMT) on upper function and activities of daily living in people with subacute stroke patients. METHODS: Eighteen participants, with subacute stroke that were randomly assigned to either the experimental group(n=9) or the control group(n=9). For subjects from the experimental group modified Constraint-Induced Movement Therapy was performed. exercise program, the patient trained in affected side upper extremity with restricted non-affected side for 1 hour and using in activity daily living for 4 hours for five times per week, during 4 weeks. For subjects from the control group, conventional upper extremity training was performed. Outcomes such as the box and block test(BBT), Fugl-Meyer motor function assessment(FMA), and modified Barthel index(MBI) were measured before and after training. Between-group and within-group comparisons were analyzed by using Independent t-test and Paired t-test respectively. RESULTS: These finding suggest that experimental group was significant increase in BBT, FMA, MBI(p<.05). In comparison of two group, experimental group was high upper function and activity daily living than control group. CONCLUSION: This study showed experimental group can be used to improve upper function and activity daily living than control group. Thus it indicates that mCIMT will be more improved through the continued upper extremity exercise program.

• 대한통합의학회지
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• 제4권4호
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• pp.41-51
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• 2016

PURPOSE : The purpose of this study was to identify whether 3D motion input device based mirror therapy could improve on upper extremity function, quality of life and depression in chronic stroke patients METHOD : Thirty six patients with chronic stroke were enrolled and randomly divided into three groups: 3D leapmotion mirror therapy group, mirror therapy group, and sham therapy group. 3D leapmotion mirror therapy group performed 3D motion input device based mirror therapy, mirror therapy group performed general mirror therapy, control group performed sham therapy. All patients received a total of 15 exercise session over a 5 week period (three times per week). Fugl-Meyer Assessment-upper extremity(FMA-UE), Stroke Specific-Quality of Life(SS-QOL), Beck Depression Inventory(BDI) were performed prior to and five weeks after the treatment RESULT : Subjects in the 3D leapmotion mirror therapy group showed significant improvements in upper extremity function, quality of life and depression following training. The changes of upper extremity function, quality of life and depression in the 3D leapmotion mirror therapy group were significantly more than them of the control group. CONCLUSION : The result of this study suggest that 3D motion input device based mirror therapy is an intervention to improve on upper extremity function, quality of life and depression in chronic stroke patients.

• 대한통합의학회지
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• 제8권2호
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• 대한통합의학회지
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• 제8권3호
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• pp.143-151
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• 2020

Purpose: This study aimed to investigate the effect of single-leg stance training according to different support surfaces on walking speed and balance in patients with chronic hemiplegia. Methods: Twenty-two patients with chronic stroke were randomly categorized into an experimental group (11 patients) and a control group (11 patients). In the experimental group, single-leg stance training was performed on an unstable surface after 50 min of general physical therapy. In the control group, single-leg stance training was performed on a stable surface after 50 min of general physical therapy. All participants performed five sets of single-leg stance exercises per minute and rested for 3 min. The intervention was performed 5 times a week for 4 weeks, and each patient was evaluated using the Berg Balance Scale (BBS), Fugl-Meyer Assessment Scale (FMA), and difference in walking speed between the first and last day of the intervention. Results: Compared to baseline measurements, both study groups showed significant increases in FMA, BBS, and walking speed (p<.05) after the intervention. However, there was no statistically significant difference (p>.05) between the experimental and control groups. However, in the experimental group, the increases in FMA, BBS, and walking speed were 3.36 %, 9.50 %, and 7.71 %, respectively. In the control group, the increases in FMA, BBS, and walking speed were 2.39 %, 6.65 %, and 7.64 %. Conclusion: Single-leg stance training on different support surfaces could help improve walking ability and balance in patients with chronic hemiplegia.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.11-24
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• 2007

Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.38-46
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• 2006

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

• 대한물리의학회지
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• 제9권2호
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• pp.201-211
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• 2014

PURPOSE: The purpose of this study was to investigate the inter-rater absolute reliability and the concurrent validity of the Tinetti-gait scale that was translated into Korean for chronic stroke patients. METHODS: Fifty-two patients with post-stroke participated in this study. Inter-rater reliability was analyzed by Intraclass Correlation Coefficient ($ICC_{3,1}$) and Kappa coefficient, and absolute reliability was analyzed by the Standard Error of Measurement (SEM), and the Minimal Detectable Change (MDC). Concurrent validity was analyzed by correlating between the Tinetti-gait scale and physical functions. The physical functions were measured by using the Dynamic Gait Index(DGI), 10m walking test(10WT), One Leg Standing Test of affected/non-affected side(OLST), Sit to Stand test(STS), (Fugl Meyer assessment of Lower Extremity(FM-LE). RESULTS: The inter-rater reliability of the Tinetti-gait scale was high; $ICC_{(3,1)}=.91$ (95% CI=.85~.95) (very reliable), the range of Kappa coefficient were .73~.92 (substantial~good). The inter-rater agreement of the each item in Tinetti-gait scale ranged from .74 to .92 (95 % CI=.59~.95) (reliable~very reliable). The SEM and MDC were .56 and 1.55, respectively. In the results of concurrent validity, there were moderate positive correlation between Tinetti-gait scale and DGI (r=.78), 10WT (r=.74), OLST (r=.65~.73), FM-LE (r=67). And there was moderate negative correlation between Tinetti-gait scale and STS (r=-79) (p<.01). CONCLUSION: The Tinetti-gait scale(Korean version) was a reliable and valid tool to measure gait ability in patients with chronic stroke. Thus, it could be a useful tool for examining a gait ability of post-stroke patients. Further study should be conducted to investigate the usability to predict fall risk of post-stroke patients of the Tinetti-gait scale.