• Journal of Acupuncture Research
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• v.27 no.2
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• pp.23-30
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• 2010

Objectives : The second derivative of photoplethysmogram waveform(SDPTG) is a simple, convenient and non-invasive technique for pulse wave analysis. This study was designed to investigate the differences in the SDPTG between the affected side and the unaffected side in hemiparetic patients after stroke, and the effects of acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : To evaluate the differences between the affected side and the unaffected side in hemiparetic patients after stroke, their SDPTG were recorded by using a Cardio Peri SA6000. To evaluate the effects of acupuncture at Palsa(BaXie) in 20 hemiparetic patients after stroke and 20 healthy subjects, their SDPTG were recorded 2 times(pre-acupuncture and post-acupuncture). The SDPTG consists of an a, b, c and d wave in systole and an e wave in diastole. Sano aging index was defined as (b-c-d)/a. Results : 1. The affected side in hemiparetic patients after stroke had higher average b/a ratio(p<0.05)and Sano aging index(p<0.05) than the unaffected side 2. In a comparison of pre-acupuncture and post-acupuncture at the Palsa(BaXie), b/a ratio(p<0.05) and Sano aging index(p<0.05) was decreased significantly in both hemiparetic patients and healthy subjects. Conclusions : These findings suggest that acupuncture at Palsa(BaXie) may be effective method of reverting some of the deleterious effects on vascular function produced by stroke.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.97-104
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• 2008

Objectives : Investigate the effectiveness of an acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : Acupuncture at Palsa(BaXie) applied to thirty one hemiparetic patients who had been by general treatment after stroke. The other thirty one hemiparetic patients had only general treatment. Outcomes were assessed by Medical research council scale motor grade(MRCSMG) of wrist, grip power, Fugl-Meyer Motor Scale(FMS) of hand, and Motricity Index(MI) of fingers. Results : The patients exhibited substantial improvements on grip power and Fugl-Meyer Motor Scale of hand, but Medical research council scale motor grade of wrist and Motricity Index of fingers have not significantly meaningful differences between sample and control group. Conclusions : Acupuncture at Palsa(BaXie) may be an effective method of improving hand function of hemiparetic patients after stroke.

• The Journal of Korean Physical Therapy
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• v.1 no.1
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• pp.15-25
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• 1989

The purpose of this study was to determine the factors influencing the standing balance of independent ambulatory hemiparetic patients. The subjects of this study were 30 hemiparetic patients (18 males, 12 females) being treated as admitted or out patients at Severance Hospital Medical Center, all of whom agreed to participate in the study. In order to assure the statistical significance of the results, the paired t-test aid a Pearson's correlation were applied at the .05 level of significance. The results were as follows. 1. The difference in maintenance time of standing balance on a stable and unstable support surface was significant at the .05 level. 2. The difference in maintenance time of standing balance according to the control of visual and acoustic stimuli was significant at the .05 level. 3. The presence or absence of passive joint motion sense influenced the standing balance maintenance time. 4. There was no significant difference in the maintenance standing balance of the sound tower leg standing conditions according to spasticity, but the paretic lower leg standing conditions were significantly different (p<.05). This type of evaluation should be more widely used in the field of evaluating standing balance with hemiparetic patients. However, more extensive study and reports on various factors of standing balance are needed.

• Physical Therapy Korea
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• v.19 no.1
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• pp.86-93
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• 2012

The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.

• Journal of Korean Physical Therapy Science
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• v.17 no.3_4
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• pp.29-39
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• 2010

Purpose: The purpose of this study was to examine the effect of foot position and lifting an object on muscle activity and foot pressure during sit to stand(STS) in hemiparetic patients. Methods: Fourteen patients participated in this study. Surface electromyography was used to collect muscle activity and foot pressure measurement system was used to analyze foot pressure in hemiparetic side. Three different foot position was assumed(anterior, neutral, posterior) in hemiparetic side. The repeated two-way analysis of variance and multiple comparisons were conducted to determine statistical significance with a significance level of 0.05. Results: The results were as follows. 1) Lower extremity muscle activity was significantly higher(p<0.05) in biceps femoris and tibialis anterior muscle during STS without holding an object. With changing positions of the affected foot, muscle activity was significantly increased (p<0.05) in vastus medialis and lateral gastrocnemius when the foot was positioned in posterior. 2) There was no significant difference(p>0.05) in foot pressure during STS with object holding and foot positioning. Conclusion: Muscle activity showed a significant increase when the foot was positioned in posterior in comparison to the muscle activity when the foot was in neutral or anterior position.

• PNF and Movement
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• v.9 no.3
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• pp.25-29
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• 2011

Purpose : We investigated the effect of anti-flexion taping at the proximal interphalangeal joints on the gait in stroke patients with clawing toe. Methods : Nineteen patients (mean age $63.26{\pm}9.16$ years) with clawing toe were studied. Gait performance was measured under two different conditions : (1) non-tape (2) application of tape. Gait velocity, step time and stride length were examined with the GAITRite system Results : Compared to the non-tape control condition, step time of the hemiparetic side increased significantly after the application of tape(p=0.03). There was no significant mean differences between the taped and control conditions for stride length of the hemiparetic side and velocity. Conclusion : Whilst the anti-flexion tape at the proximal interphalangeal joints changed the walking by providing significant step time effect, positive changes were noted in stride length of the hemiparetic side after tape application. These findings indicate that anti-flexion tape procedures do not significantly alter stride length of the hemiparetic side and velocity.

• Physical Therapy Rehabilitation Science
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• v.7 no.1
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• pp.1-5
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• 2018

Objective: Setting therapeutic goals assist to identify patient priorities and predict problem that may arise in performing daily and functional activities. Goal setting is associated with improved rehabilitation outcomes in individuals with hemiparetic stroke. This study was conducted to assess the effects of having awareness and satisfaction of goals on the functional status of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Eighty-one people who had been diagnosed with stroke participated in this study. The study was conducted through a face-to-face surveys to identify participants' awareness and satisfaction of goals and standard assessment tools were used to evaluate patients' functional status. This study measured functional status through three clinical measures including the manual function test (MFT), Berg Balance scale (BBS), and modified Barthel index (MBI). Results: In participants with hemiparetic stroke, the MBI, BBS, and MFT scores were significantly higher in the participants who were aware of the therapeutic goal than in those who were unaware (p<0.05). The MBI, BBS, and MFT scores were not significant between the participants who were satisfied with the goal and those who were unsatisfied. Conclusions: This study suggests that having awareness in therapeutic goal-setting could lead to improvement of functional status in those with hemiparetic stroke. This study highlights how goal-setting can have a positive effect on persons with hemiparetic stroke.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Physical Therapy Korea
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• v.12 no.1
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• pp.91-99
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• 2005

We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

• Physical Therapy Korea
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• v.7 no.2
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• pp.1-19
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• 2000

Decreased equilibrium in standing and walking is a common problem associated with hemiparesis secondary to cerebral vascular accident. In patients with hemiplegia, postural sway is increased and often displaced laterally over the non-affected leg, reflecting asymmetry in lower extremity weight bearing during standing balance. Human balance is a complex motor control task, requiring integration of sensory information, neural processing, and biomechanical factors. Limits of stability (LOS) is a one of the biomechanical factors. The purposes of this study were to establish the influence of asymmetrical weight-bearing on the LOS of independent ambulatory hemiparetic patients. The subjects of this study were 29 hemiparetic patients (18 males, 11 females) being treated as admitted or out patients at Young-Nam University Hospital and Taegu Catholic University Hospital, all of whom agreed to participate in the study. Participants were asked to lean and displace their center of gravity (COG) as far as possible in directions to the sides and front of the body. The LOS and weight-bearing ratio were measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. In order to assure the statistical significance of the results, the independent t-test and a Pearson's correlation were applied at the .05 and .01 level of significance. The results of this study were as follows: 1) There were statistically significant differences in anteroposterior LOS according to the cause of brain demage (p<.01). 2) There were statistically significant differences in mediolateral LOS according to the hemiparetic side (p<.05). 3) There were statistically significant differences in anteroposterior and mediolateral LOS according to the brain operation (p<.01). 4) The mediolateral LOS significantly correlated with weight-bearing ratio (p<.01).