• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.187-194
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• 2013

Purpose: The aim of this study was to investigate the effects of interferential current therapy (ICT) on spasticity, ROM, and the balance function in patients with stroke. Methods: 30 inpatients with stroke were randomly divided into 2 groups: the ICT group (n=15) and the placebo-ICT group (n=15). Two groups have got the traditional rehabilitation for 30 minutes before applying either ICT or placebo-ICT stimulation. The stimulus of ICT has been applied to gastrocnemius at the level of 100 Hz, two times of sensation threshold, while the placebo-ICT group has put on the electrode without electrical stimulus. To assess spasticity in ankle, the modified Ashworth scale (MAS) was used, and goniometer was applied to measure the passive range of motion (PROM). Also, the Berg Balance Scale (BBS), the Timed-up and go (TUG), and the Functional Reach Test (FRT) were carried out to examine the balance ability. Results: The ICT group showed a significant reduction of spasticity and significantly increased PROM than the placebo-ICT group (p<0.05). The placebo-ICT group did not show significant changes in the BBS, the TUG, and the FRT, while the ICT group significantly improved the BBS, the TUG, and the FRT (p<0.05). Conclusion: Our results demonstrated that ICT applied to gastrocnemius effectively decreased spasticity and improved range of motion and balance function in patients with stroke.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.39-47
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• 2000

The purpose of this study was to evaluate the relationship between shoulder pain and hand edema in stroke patient with shoulder hand syndrome. In this study, 26 hemiplegic patients with the clinical symptom and sign of shoulder hand syndrome were evaluated. Hand volume was measured by hand volumeter, and hand edema was calculated by volume difference of both hands. Shoulder pain was evaluated using VAS (visual analog scale). and spasticity of shoulder was graded by modified Ashworth scale. The relationship among three factors such as shoulder pain. hand edema and shoulder spasticity was evaluated using correlation analysis. Results through correlation analysis among three factors are as follows : 1. Correlation between shoulder pain and hand edema was not significant$(\gamma=-.028)$. 2. Correlation between shoulder spasticity and hand edema was not significant $(\gamma=-.027)$. 3. Correlation between shoulder spasticity and shoulder pain was not significant $(\gamma=-.093)$. As the result of correlation analysis. this study shows that there was no statistically significant difference between shoulder pain and hand edema.

• 대한물리치료과학회지
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• 제27권1호
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• pp.56-65
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• 2020

Purpose: Individuals affected by stroke present with changes in motor function, balance, and cognition. The purpose of this study was to the correlation between motor function, balance, and cognition in patients with stroke. Design: cross-sectional study design. Methods: 67 stroke patients in the experiment were included. For evaluation of motor function which is Manual Muscle Test, Range of Motion, Modified Ashworth Scale for spasticity, grasping power, and balance was measured using the Berg Balance Scale and Functional reach test. For evaluating Cognition which is Korean-Mini Mental State Examination. Results: The results of this study's motor function, balance, and cognition showed a significant positive correlation (p<0.05). Conclusion: The results indicated that motor function, balance, and cognition were significantly correlated with each other. Therefore, it is suggested that to improve the motor function and balance of patients with stoke, it needs to evaluate the cognition and the motor function, balance, and cognitive training should be combined.

• 대한약침학회지
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• 제3권2호
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• pp.213-232
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• 2000

Hemiplegic shoulder pain(HSP) is one of the most frequent and difficult problems affecting poststroke hemiplegic patients. Honeybee venom acupuncture therapy(BVAT) is known for its pain relieving effects in arthralgia. To evaluate the effectiveness of BVAT on HSP, 24 patients were sequential1y allocated into BVA T treatment group and control group and monitored for 4 weeks at time interval of initial(T0), 1 week(T1), 2 weeks(T2) and 4 weeks(T4). In treatment group, 1:10000 honeybee venom solution 0.2㎖ was injected into acupoint(s) following Deqi three times a week. Kyonu(LI15) was used in the first week. Thereafter Kyonu(LI15) and Nosu(SI10) were used. Visual analogue scale of pain severity showed significant decrease in treatment group compared to control group at T2 and T4 evaluation. Painless passive range of motion of shoulder external rotation showed significant increase in treatment group compared to control group at T4 evaluation. Fugl-Meyer Motor Assessment of upper limb motor function and Modified Ashworth scale of the spasticity of upper limb showed no difference between two groups. BVAT showed as an effective therapy in HSP and further extensive clinical studies are expected.

• PNF and Movement
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• 제15권1호
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.181-188
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• 2022

Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

• 한국산학기술학회논문지
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• 제13권9호
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• pp.3991-3998
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• 2012

본 연구의 목적은 만성 뇌졸중 환자에서 발목관절 각도에 따른 근 수축이 내측 비복근의 근 구조에 미치는 영향에 대해 알아보고자 하였다. 연구대상은 MAS(modified Ashworth scale) 2등급인 만성 뇌졸중 환자 10명을 대상으로 하였다. 근육 두께, 우모각, 근섬유속 길이, 최대 수의적 등척성 수축력(MVIC) 측정은 초음파 영상 촬영장치와 동력계로 이완 시(resting)와 최대 수의적 등척성 수축 시를 측정하였다. 측정결과, 근육 두께는 마비측이 정상측에 비해 유의하게 얇은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 얇아짐을 알 수 있었다. MVIC에서는 이완 시보다 근육 두께가 유의하게 얇아지는 것을 알 수 있었다(p<.001). 우모각은 마비측이 정상측에 비해 유의하게 작은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 커짐을 알 수 있었다. MVIC에는 이완 시보다 우모각이 유의하게 커짐을 알 수 있었다(p<.001). 근섬유속 길이는 마비측이 정상측보다 유의하게 짧은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 짧아짐을 알 수 있었다. MVIC에는 이완 시보다 근섬유속 길이가 유의하게 짧아지는 것을 알 수 있었다(p<.001). 본 연구를 통해 만성 뇌졸중 환자에서 발목 각도에 따른 근 수축이 내측 비복근의 근 구조에 영향을 미치는 것을 알 수 있었다. 따라서, 만성 뇌졸중 환자의 영상구조적 특성을 평가하는 것은 임상적 진단과 치료에 매우 유용한 자료라 생각된다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5867-5874
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• 2012

본 연구의 목적은 뇌졸중 환자에서 주관절 각도 변화에 따른 상완이두근(biceps brachii)의 근구조 및 탄성 변화에 관하여 알아보고자 하였다. 연구대상은 주관절 수동 ROM범위가 $10^{\circ}{\sim}90^{\circ}$ 가능하며 MAS(modified Ashworth scale) 1~3등급인 뇌졸중 환자 12명을 대상으로 하였다. 이완(resting) 상태의 건측과 환측 상완이두근의 우모각, 근섬유속길이, 근탄성의 측정은 초음파 영상 촬영장치와 근긴장도 측정기(myotonometer)를 이용하여 주관절을 $10^{\circ}{\sim}90^{\circ}$로 변화시키면서 측정하였다. 본 연구 결과, 환측 상완이두근을 건측과 비교 시 우모각은 신전위치($<40^{\circ}$)에서 큰 값을 나타냈으며(p<.05), 근섬유속길이는 굴곡위치($>20^{\circ}$)에서 짧은 길이를 나타냈으며(p<.05), 근긴장은 신전위치($<50^{\circ}$)에서 전위 값이 낮게 나타나 근긴장이 높아짐을 나타냈다(p<.05). 이렇듯 이완 시 상완이두근의 근구조 및 탄성은 주관절 각도에 의해 영향을 받는다는 것을 알 수 있었다. 본 결과를 뇌졸중 환자의 근구조 변화 및 임상치료의 연구 자료로 사용할 수 있을 것으로 생각된다.

• 대한한방내과학회지
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• 제28권3호
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• pp.492-501
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• 2007

Objectives : This study was executed in order to evaluate the effects of electroacupuncture on upper-extremity spasticity control in stroke patients. Methods : Eighteen patients with stroke were enrolled and classified into two groups, the study and control group. The control group did not receive any oriental medical treatment. In the study group, the electroacupuncture points were applied to Kokt'aek (PC3) and $Ch'{\u{o}}ch'{\u{o}}n$ (PC2), Naegwan (PC6) and $Ch'{\u{o}}kt'aek$(LU5) of the affected limb. H-reflexl M-response ratio (HIM ratio), modified Ashworth scale (MAS) and Fugl-Meyer motor function assessment (FMA) were used for evaluation of spasticity control before electroacupuncture, within two hours after electroacupuncture, and at two weeks. Results : In MAS, the study group declined more than the control group. but there was no statisticallysignificant consideration. In H/M ratio. the study group was more efficient than the control group. and spasticity decreased successively during the series in the study group. In FMA, motor function in the study group improved more than in the control group and motor function in the study group increased successively during the series. Conclusions : These results showed that electro acupuncture was a useful method to decrease upper-extremity spasticity in patients with stroke. Further studies are needed to explore more cases and the long-lasting carryover effects on upper-extremity spasticity in electroacupuncture.

• 한국산학기술학회논문지
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• 제12권7호
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• pp.3109-3116
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• 2011

본 연구는 뇌병변으로 상지경직이 관찰되는 환자를 대상으로 자극방식에 따른 진동자극이 경직에 미치는 영향에 대하여 알아보고자 하였다. 뇌병변으로 인해 상지경직이 있는 21명의 환자가 연구에 참여하였고, 실험군 I: 길항근(상완삼두근)자극, 실험군II: 주동근(상완이두근)자극, 실험군III: 동시(상완삼두근 및 상완이두근)자극에 각 7명씩을 배정하여 진동자극을 실시하였다. 척수운동신경원 흥분성을 알아보기 위해 Neuro-EMG_Micro를 이용한 F파를 자극전, 자극 직후, 자극 10분 후, 자극 20분 후에 측정하였고, 임상적 평가로는 MAS(Modified Ashworth Scale)와 MFT(Manual Function Test)를 자극 전, 자극 20분 후에 평가하였다. 본 연구의 결과, MAS는 세군 모두 유의한 감소를 나타냈고, F파 진폭 및 F/M비에서는 세군 모두에서 자극 직후에서부터 유의한 감소를 나타냈으며, 실험군III에서 시간 경과상 변화량이 가장 크게 나타났다. MFT에서는 실험군II와 III에서 유의한 증가를 나타냈으며 특히, 실험군III에서 기능적 변화량이 가장 크게 나타났다. 이러한 결과는 경직근에 대한 진동자극시 경직 주동근이나 길항근에 대한 단일 자극 방식보다는 동시자극 방식이 척수운동신경원의 흥분성 감소 및 상지 운동 기능 향상에 더 효과적임을 확인할 수 있었다.