• Title/Summary/Keyword: Hemiplegic Patient

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A study on the immediate effects of weight distribution and gait patterns of hemiplegic patients through PLS on and off (편마비 환자의 단하지 보조기 착용유무에 따른 하지 체중지지율과 보행특성의 변화에 관한 연구)

  • Kim, Tack-Hoon;Current, Marion E.;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.3 no.2
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    • pp.55-76
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    • 1996
  • The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.

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Assessments of Isometric Trunk Extension Strength in Post Stroke Hemiplegic Patients (편마비 환자의 등척성 체간 신전 근력 평가)

  • Kim, Jae-Sook;Lee, Dae-Hee;Kim, Sang-Beom;Kwak, Hyun;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.21-27
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    • 2007
  • The purpose of this study was to evaluate isometric trunk extension strength in hemiplegic patients, and to compare that with normal subjects to find a correlation between trunk extension strength and the functional independent degree in hemiplegic patients. Fifteen hemiplegic male patients (mean age $55.2{\pm}10.2$ years) and twenty-five healthy male subjects (mean age $54.6{\pm}10.3$ years) completed isometric trunk extension. Strength was measured at 0, 12, 24, 36, 48, 60, and 72 degrees of trunk flexion. The functional independent degree was assessed by Functional Independence Measure (FIM). Mean isometric trunk extension strength was 91.2 ft-lbs, 120.7 ft-lbs, 142.3 ft-lbs, 156.4 ft-lbs, 173.5 ft-lbs, 184.1 ft-lbs, and 195.3 ft-lbs in the hemiplegic patients group, and 135.6 ft-lbs, 175.6 ft-lbs, 204.4 ft-lbs, 221.9 ft-lbs, 231.2 ft-lbs, 246.8 ft-lbs, and 259.7 ft-lbs in the normal subjects group. The values of isometric trunk extension strength had a descending linear correlation pattern from trunk flexion angle to extension angle. Trunk extension strength in hemiplegic patients was significantly lower than that of normal subjects (p<.05) but did not correlate with the FIM total score (p>.05). Therefore, the isometric trunk extension strength in hemiplegic patients was lower than that of normal subjects and did not correlate with the functional independent degree.

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Effects of Functional Electrical Stimulation on the Balance of Hemiplegic Patients (기능적 전기자극 치료가 편마비 환자의 균형에 미치는 영향)

  • Kim, Yong-Cheol;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.97-111
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    • 2004
  • This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

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Ultrasonographic Findings of Both Knee in Hemiplegic Ambulators with Recent Stroke (초기 편마비 보행 환자에서 양측 무릎의 초음파 검사 소견)

  • Park, Soon-Ah;Yang, Chung-Yong;Kim, Ji-Hee;Lee, Kang-Keun;Shin, Byung-Cheul;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.539-545
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    • 2012
  • To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

The Effect of Functional Electrical Stimulation on Shoulder Subluxation in Hemiplegic Patient (기능적 전기자극이 편마비환자의 견관절아탈구에 미치는 효과 - 단일 사례연구 -)

  • Kim, Yong-Kwon;Cha, Jung-Jin;Kim, Sang-Soo
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.859-867
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    • 2001
  • The purpose of this single subject care study was to evaluate the effectiveness of a functional electrical stimulation(FES) treatment program designed to prevent glenohumeral pint stretching and subsequent subluxation and shoulder pain in hemiplegic patients. The subject was a 43-year-old male who had left side hemiparesis with shoulder pain and subluxation on affected side. He received conventional physical therapy and additional FES therapy where two flaccid shoulder muscles, supraspinatus and posterior deltoid. were induced to contract repetitively up to 20 minutes for 2 weeks. As a result. the patient showed improvements in hemiplegic arm function, reduction in subluxation(as indicated by Jig test) and range of motion(SLROM). But it was difficult to generalize. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain. Further study must be evaluated its statistical significance.

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Torque Curves and Cardiovascular Response to Isometric Exercise at the Elbow Joint in Normal and Hemiplegic Subjects (정상인과 편마비 환자의 주관절 등척성 운동시 우력양상과 심혈관계에 미치는 영향)

  • Shin, Hyung-Soo;Hwang-Bo, Gak;Lim, Weon-Sik;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.537-549
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    • 2001
  • The isometric torque of the elbow flexor and extensor muscles were measured for 6 seconds at a joint angle of 90$^{\circ}$ , in 10 normal subjects (control group) and 10 hemiplegic subjects(patient group), using the Cybex NORMTM System. The peak torque, the time to peak torque were measured for each exercise. In addition, heart rate and blood pressure were recorded simultaneously at rest and immediately following exercise completion at 1 and 3m mutes. Statistical analysis was performed using SPSS 8.0 for Windows software and mean and standard deviations were calculated. The results are as follows. 1) In the patient involved group. the isometric values for flexors and extensors were significantly lower than in the normal nondominant group(p<.05). 2) The extensor to flexor strength ratio in the isometric mode was 121.0% in the patient involved group compared with 78.7%in the normal nondominant group, a significant difference(p<.05). 3) The mean increment ratio was increased 19.0% for systolic blood pressure and 25.2% for disatolic blood pressure in the patient group. 4) The mean increment ratio was increased 36.0% heart rate in the patient group.

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Development and Evaluation of the Auditory Feedback Gait Training System Induced Symmetrical Weight-Bearing in Hemiplegic Patients (편마비 환자의 대칭적 체중부하 유도를 위한 청각적 피드백 보행훈련 시스템 개발 및 평가)

  • Kwon, Y.C.;Lee, H.J.;Tae, K.S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.6 no.2
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    • pp.23-30
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    • 2012
  • In this study, we developed a wireless rehabilitation auditory feedback gait training system for symmetrical weight-bearing in patient with CVA. The device consists of an instantaneous shoe equipped with two load-cell sensors. Auditory feedback can be applied according to the weight-bearing. For gait patterns analysis, cadence, walking velocity, stance/swing phase ratio and gait cycle were examined. The clinical test with six healthy volunteers and two hemiplegic patients was performed applying the auditory feedback system. Both normal subjects and hemiplegic patients were increased strength on weight-bearing in affected limb, walking velocity, and cadence after biofeedback device. Also, the stance time with weight-bearing was increased while the swing time was decreased in gait phase. It can be expected that by using the feedback system, the patient with lower limb disorder will be able to reach a better quality of weight-bearing during gait.

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EMG Signal Analysis of Upper Extremity Motor Function using Balance-handle Device (밸런스 핸들 장치를 이용한 상지 운동 기능의 근전도 신호 분석)

  • Lee, Choong-Keun;Song, Ki-Ho;An, Jae-Yong;Shin, Sung-Wook;Chung, Sung-Taek
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.4
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    • pp.295-303
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    • 2016
  • Rehabilitation of upper limb motor function of hemiplegic patient must maintain interest and demand a device for a quantitative evaluation of rehabilitation training. In this paper, we developed the device that is composed of arm cradle, handle, and balance ball for rehabilitation exercise. We have performed experiment for validity as to whether to use the rehabilitation device when tilting the upper extremity training device developed to measure changes in the EMG signal to the main upper limb muscles for 7 healthy volunteers. We have analyzed muscle activation signals on agonist and antagonist as a reference in the muscle contraction and relaxation in the upper limb extension and flexion when the balance-handle device is tilted to front-rear and left-right. The experimental results showed that a tendency of muscle activation of biceps, triceps, and deltoid used in upper limb motor function of hemiplegic patients from extension and flexion evaluation items of Fugl-Meyer Assessment(FMA). These results may be helpful for rehabilitation training for upper limb motor function of hemiplegic patients by utilizing a developed unit.

Physiotherapy For Pusher Behaviour in A Patient With Post-Stroke Hemiplegia - Case Report (밀기 증후군이 있는 편마비환자의 물리치료 - 사례연구)

  • Kim, Yong-Seon
    • Journal of Korean Physical Therapy Science
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    • v.14 no.1_4
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    • pp.55-60
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    • 2007
  • The purpose of this case report is to investigate whether an attempt to hold the repeated upright posture under blocking the patient's vision affects the deficits to push away from the paralytic side and the relapse time from down to stand up position without push away in patients with hemiplegia with pusher syndrome. Two hemiplegic patients with pusher syndrome were assessed. The task was performed 4 times per day for 6 weeks. The modified barthel index (MBI) was performed to assess activities of daily living (ADL). For assessing balance, the "balanced sitting" and "sit to stand" are analyzed using by modified motor assessment scale (MMAS). The scale for contraversive pushing (SCP) was used for determination of push away from paralyzed side. MBI, MMAS and SCP were assessed before and after trial of the task. In patient 1, total score of the scale is 0 in sitting posture and standing posture within 3 weeks and 4 weeks, respectively, In patient 2, total score of the scale is 0 in sitting posture and standing posture within 4 weeks and 6 weeks, respectively. These results demonstrated that pusher syndrome was completely resolved in at least 6 weeks. Our findings indicate that this physical therapy seems to be relevant for the hemiplegic patients with pusher syndrome.

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