• 한국운동역학회지
• /
• 제30권4호
• /
• pp.301-309
• /
• 2020

Objective: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke during walking. Method: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory stimulus used white noise, and all participants listened for 40 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated while all participants walked before and after listening to white noise. The variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle. Results: There is a significant increase in the antero-posterior (A-P) CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). Conclusion: Our findings confirmed the positive effect of using white noise as auditory stimulus through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

• Annals of Clinical Neurophysiology
• /
• 제14권2호
• /
• pp.64-71
• /
• 2012

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

• 한국융합학회논문지
• /
• 제11권4호
• /
• pp.63-69
• /
• 2020

본 연구는 복부압박벨트가 만성 뇌졸중 환자의 안정성한계와 보행 변수에 즉각적인 효과를 알아보기 위해 실시하였다. 뇌졸중 환자 30명을 모집하여 복부압박벨트 착용 전과 복부압박벨트 착용 후 변화를 확인하였다. 측정은 균형변수인 안정성한계(limited of stability), 시공간적 보행 변수(spatiotemporal gait parameter)를 측정하였다. 복부압박벨트 착용 후 마비측, 비마비측, 전방, 후방 이동면적이 유의하게 증가하였고(p<.05), 시간적 보행 변수인 분속수(cadence), 보행속도(gait velocity), 공간적 보행변수인 보폭(stride length)이 유의하게 증가하였다(p<.05). 본 연구를 통해 복부압박벨트 착용은 뇌졸중 환자에게 균형과 보행 기능 개선에 즉각적인 효과가 있다는 것을 확인할 수 있었다. 향후 연구에서는 뇌졸중 환자의 균형과 보행 기능 개선에 효율적인 복부압박 수준과 중재기간에 대한 연구가 필요하다.

• 한국전문물리치료학회지
• /
• 제10권3호
• /
• pp.71-79
• /
• 2003

Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of $-20^{\circ}$ to $20^{\circ}$ and $0^{\circ}$ to $60^{\circ}$. The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.

• The Journal of Korean Physical Therapy
• /
• 제21권4호
• /
• pp.31-36
• /
• 2009

Purpose: Pusher syndrome in stroke patients is the tendency to push strongly toward the paretic side with the non-affected limbs. The purpose of this study was to estimated inter-rater and intra-rater reliability of the Scale for Contraversive Pushing (SCP). Methods: Fourteen patients in the acute phase after stroke onset were diagnosed with pusher syndrome. Two physical therapists randomly assessed the same patients on different occasions on the same day. Almost all patients were assessed on more than one day. The inter-rater and intra-rater reliability of the SCP was estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of the SCP ranged from 0.87 to 0.97; the inter-rater reliability of the SCP ranged from 0.71 to 0.99 in sitting and standing positions. These results show good reliability for the calculated variables. Conclusion: The results provide support for the use of the SCP in assessing pusher syndrome based on its reliability in stroke patients. It may use the standardized clinical assessments in clinical implication.

• The Journal of Korean Physical Therapy
• /
• 제26권4호
• /
• pp.226-233
• /
• 2014

Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.