• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.52-62
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• 2012

Object : The aim of this study was to examine the differences of symptom improvement between different diagnosis classification groups in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Oriental Medical Center from May 2011 to October 2012. We compared the improvement of Motricity Index and Scandinavian Stroke Scale score between Fire-heat group(n=20), Yin deficiency group(n=31), Dampness-phlegm group(n=30), and Qi deficiency group(n=13). Results : Yin deficiency group patients with cerebral infarction showed the most improvement in MI and SSS scores, and patients in Fire-heat group showed the poorest improvement in MI and SSS scores. There was a significant difference between the two groups, but there were no significant differences between all four diagnosis classification groups. Conclusions : This study provides evidence that diagnosis classification could be considered as an important factor in predicting the prognosis of acute cerebral infarction.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.423-427
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• 2012

Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.

• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.234-238
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• 2018

Purpose: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. Methods: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. Results: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. Conclusion: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.8-14
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• 2013

■ Objectives The goal of this study is to find the correlation between the motor function and gait pattern of stroke patients. ■ Methods We measured Manual muscle test(MMT), Motricity index(MI) and Spatiotemporal gait parameters of admitted hemiplegic patients with stroke. The gait parameters were measured using a Treadmill gait system. ■ Results There is a significant correlation between motor function and spatiotemporal parameters such as step length, stride length, step time, stride time, total double support or cadence, in stroke patients. ■ Conclusion The better motor function of stroke was, the more gait improved.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.118-124
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• 2017

Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.

• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.331-337
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• 2005

Objective : The purpose of this study is to identify correlations between diffusion tensor imaging[DTI] and motor improvement by quantifying and visualizing the corticospinal tract on DTI to predict motor impairment in patients with hypertensive intracerebral hemorrhage[ICH]. Methods : Fifteen normal subjects and 7 patients with hypertensive ICH were examined and the latter were treated surgically. DTI was performed with a 3.0 T MRI. The region of interest[ROI] from the posterior limbs of both internal capsules was measured on a fractional anisotropy[FA] map, and the ratios of ROIs were calculated. Tractography, 3-dimensional DTI was then constructed. Motor impairment was assessed on admission and 2weeks after stroke by the Motricity Index[MI]. The FA ratio, tractography and score on MI were analyzed for correlations. Results : The FA ratio from the initial DTI did not show a linear correlation with motor impairment. However, after 2weeks, patients with high FA ratios showed high degrees of motor recovery, regardless of the initial severity, and patients with low FA ratios showed low recovery rates. Otherwise, a relationship between the amount of hematoma and the degree of motor recovery could not be determined. On tractography, injury of the corticospinal tract could be visualized and estimated 3-dimensionally. Conclusion : FA ratio analysis and tractography constructed from DTI may be useful in understanding corticospinal tract injury and in predicting the recovery from motor impairment in patients.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.53-58
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• 2010

Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.36-41
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• 2013

Purpose: To investigate whether the long-term use of a cane induces pain in the unaffected lower limb of stroke patients. Methods: A total of 107 stroke patients with chronic hemiparesis were recruited in this study and classified into two groups; a cane-use group (n=49) and non-cane-use group (n=58). The existence of pain in the unaffected lower limb was assessed on a visual analog scale in the hip, knee, and ankle joint, and the University of Alabama pain behaviors scale (UAB pain behavior scale) used to measure the intensity of pain. In addition, the Motricity Index (MI) was tested in the upper and lower extremities. Results: The proportion of pain in each joint of the lower limb was significantly higher in the cane-use group, compared to the non-cane-use group (p<0.05). In addition, significant differences were observed on the UAB pain behavior scale between the two groups. The lower MI score was significantly lower in the cane-use group, compared with the control group. However, no difference was observed in MI scores of the upper limb between the two groups. Conclusion: These findings reveal that long-term cane usage can induce pain in the unaffected lower limb of stroke patients. We suggest careful consideration when prescribing a cane, depending on functional ability in hemiparetic patients, and recommend continuous evaluation for pain in the affected lower limb.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.51-59
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• 2019

Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.