• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.41-51
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• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.126-135
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• 2018

This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.303-310
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• 2013

Purpose: The purposes of this study were to evaluate the correlation of clinical tools for assessment of balance and ability of gait, in order to discriminate the phases of sit-to-walk movement of patients with stroke using the motion analysis system, and to investigate the reliability of the phase of sit-to-walk movement according to functional ability of patients with stroke. Methods: Twenty -one patients participated (men 17, women 4) in this study. Sit-to-walk movement of all patients was recorded by the motion analysis system. Berg Balance Scale, Timed Up and Go test, Functional Reach Test, 10 meter Walk Timed Test, and Performance-Oriented Mobility Assessment were used as functional assessment tools. Results: The results of this study showed significant correlation between the phase I, II, IV and total phase duration of sit-to-walk movement and functional assessment tools. In addition, the intraclass correlation coefficient (ICC) showed high reliability in accordance with the functional ability of patients with stroke (Pearson's r 0.93 to 1.00). Conclusion: In conclusion, there is high reliability between measures of the phase of sit-to-walk movement of chronic stroke patients and the clinical assessment tool. Results of this study suggest that measurement of the phase of sit-to-walk movement can be used significantly as an intervention and a clinical tool for patients with stroke.

• Physical Therapy Korea
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• v.17 no.2
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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.

• Physical Therapy Korea
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• v.18 no.2
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• pp.43-51
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• 2011

Balance is a complex motor skill that depends on interactions between multiple sensorimotor processes and environmental and functional contexts. Many rehabilitation specialists believe that balance assessment under multitask conditions may be a more sensitive indicator of balance problems and falls than balance assessment in a single-task context. Functional Gait Assessment has many tasks that allow for testing under multitask conditions. The purpose of this study was to determine the concurrent validity between the Functional Gait Assessment (FGA), Berg Balance Scale (BBS), and Timed "Up & Go" Test (TUG) in patients with stroke. One hundred and five participants with at least 3 months post stroke and able to walk at least 6 m with or without a mono cane, participated in this study. Concurrent validity between the FGA, BBS, and TUG was assessed using Spearman rank order correlation. The FGA correlated with the BBS (r=.80, p<.01) and TUG (r=-.77, p<.01). The good and moderate correlation between the FGA, BBS, and TUG establishes the concurrent validity of the FGA in patients with stroke. These measures provide clinicians with valuable information about patients' functional balance capabilities.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.39-43
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• 2020

Purpose: This study examined whether the motivation for rehabilitation influences the functional performance of stroke patients. Methods: To elucidate the same, correlation analysis between the 'rehabilitation motivation level' and 'functional performance improvement' was performed. Thirty-three stroke patients, who were hospitalized in rehabilitation and nursing hospitals, were enrolled in this study. Functional performance was assessed using the 10MWT, FRT, and the BBS. Statistical analysis was performed to determine the correlation between the reactivation symptoms and rehabilitation therapy at four weeks, eight weeks, and 12 weeks. Results: The results showed a significant correlation between the reactivation symptoms and rehabilitation therapy, as evidenced by the 10MWT, FRT, and BBS (8-12 weeks 10M gait test, Berg balance scale for 4-8 weeks, and 8-12 weeks). The FRT did not reveal any significant correlation between the rehabilitation program and reactivation. Conclusion: The present study confirmed that a higher motivation for rehabilitation in stroke patients resulting in a higher likelihood of it acting as a factor in improving their functional ability. Based on the above-mentioned results, this study suggests that a rehabilitation program could be considered for the motivation of patients to participate in a rehabilitation program.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.39-45
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• 2009

Purpose: The purpose of this study was to determine correlations between the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up & Go (TUG), Motor-Free Visual Perception Reach Test Vertical format (MVPT-V), Functional Independence Measure (FIM). Methods: The subjects used in this study were 35 stroke patients from Cheongju ST. Mary's hospital. Balance was measured by BBS, FRT. Functional mobility was measured by TUG. Visual perception was measured by MVPT-V. FIM was used to evaluate the activities of daily living. Data was analyzed using pearson product correlation. The TUG and MVPT-V index were analyzed by linear regression. Results: There was a statistically significant difference between FRT and BBS (r=0.89, p<0.01), FIM (r=0.74, p<0.05), MVPT-V (r=0.40, p<0.05), and TUG (r=-0.36, p<0.05). There was significant statistical differences between TUG and MVPT-V (r=-0.64, p<.01). However, statistically significant differences were observed between BBS and FIM (r=0.79, p<0.01). The visual close item of the MVPT-V showed the strongest variance in predicting TUG. Conclusion: The use of both quantitative and qualitive scales was shown to be a good measuring instrument for the classification of general clinical performances of stroke patients. In particular, the results suggest that the visual perception test may be able to predict functional locomotion in stroke patients.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.23-39
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• 2022

Objective : To summarize clinical and demographic variables and machine learning uses for predicting functional outcomes of patients with stroke. Methods : We searched PubMed, CINAHL and Web of Science to identify published articles from 2010 to 2021. The search terms were "machine learning OR data mining AND stroke AND function OR prediction OR/AND rehabilitation". Articles exclusively using brain imaging techniques, deep learning method and articles without available full text were excluded in this study. Results : Nine articles were selected for this study. Support vector machines (19.05%) and random forests (19.05%) were two most frequently used machine learning models. Five articles (55.56%) demonstrated that the impact of patient initial and/or discharge assessment scores such as modified ranking scale (mRS) or functional independence measure (FIM) on stroke patients' functional outcomes was higher than their clinical characteristics. Conclusions : This study showed that patient initial and/or discharge assessment scores such as mRS or FIM could influence their functional outcomes more than their clinical characteristics. Evaluating and reviewing initial and or discharge functional outcomes of patients with stroke might be required to develop the optimal therapeutic interventions to enhance functional outcomes of patients with stroke.

• Physical Therapy Korea
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• v.12 no.4
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• pp.1-6
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• 2005

Community-based group exercise programs for people with chronic stroke are relatively uncommon in Korea. In addition, it is currently not known whether a community-based group exercise program is effective or not. The purpose of this study was to evaluate an 8 week community-based functional exercise program for its effects on balance performance and occupational performance in persons with chronic stroke. Twenty-five community-dwelling individuals with stroke participated in this program. Outcome of the program was assessed by the Berg Balance Scale and the Canadian Occupational Performance Measure (COPM). The functional exercise program lasted for eight weeks, with a 1-hour program twice per week and it consisted of mobility, stability, balance, functional strength, and gait training. The subjects were trained by one physical therapist but were under one-to-one supervision from students. The data of sixteen individuals who scored more than 24 on the Mini-Mental State Examination (MMSE) were analyzed. There was a significant effect both in terms of the COPM Performance Score & the Satisfaction Score (p=.002) and with the Berg Balance Score (p=.001). It was found that a short-term community-based exercise program could improve both performance of activities and balance. Further, all subjects reported that they were satisfied with this program.