• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.1
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• pp.55-63
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• 2020

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

• PNF and Movement
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• v.15 no.1
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• pp.35-40
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• 2017

Purpose: The purpose of this study was to determine the immediate effects of using the proprioceptive neuromuscular facilitation (PNF) contract-relax technique in the close kinetic chain position on the gait ability and gastrocnemius muscle tone of stroke patients. Methods: The subjects were patients who had strokes due to cerebrum infarction and hemorrhage. The subjects participated in exercise with the PNF contract-relax technique in the standing-on-elbow position with a high table, and the affected lower leg was placed in the posterior position. The PNF contract-relax technique was applied at the position in which the ankle plantar-flexors were in a sufficiently elongated position. After performing twice in each range, while the muscle was elongated, the affected side was moved further back and a new range was set. In each session, the time of contraction was set to 8 seconds, and the resting time was set to 5 seconds; however, if the patient felt tired, they received more resting time during the intervention. The Myoton Pro and 10 m walking test were used to measure the muscle tone and gait ability both pre- and post-intervention. Results: After participating in the program, the muscle tone decreased and the gait ability improved in the ankle plantar-flexors, as determined by the Myoton Pro and 10 m walking test. Conclusion: The PNF contract-relax technique can help to decrease muscle tone in ankle plantar-flexors with hypertonus and increase the gait ability in stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1468-1474
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• 2018

The purpose of the study was to investigate the immediate effects of negative pressure soft tissue therapy on muscle tone, muscle stiffness and balance in patients with stroke. In total, 20 patients with stroke and assigned to the negative pressure soft tissue therapy group (NPST, n=10) or, placebo-negative pressure soft tissue therapy group(Placebo-NPST, n=10). Both groups underwent NPST or placebo-NPST once a day during the experimental period. MyotonPRO was used to assess the parameters for muscle tone and stiffness. Biorescue was used to assess the parameters for balance. Each group showed improvements in muscle tone, muscle stiffness, and balance ability (p<.05). Especially, Muscle tone, muscle stiffness, and anterior length in the limit of stability were the significant improvement on NPST group (p<.05). The results of the study suggest that the NPST is effective in improving muscle tone, muscle stiffness, and balance ability in patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.477-485
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• 2010

Purpose : The clinical scale to assess spasticity of muscle was wildly used the modified Ashworth scale (MAS). But reliability of the MAS has been controverted for ambiguity among the grades. The purpose of this study was to establish the inter-rater reliability of the modified MAS (MMAS) translated into Korean in stroke patients. Methods : Twenty-five patients (sixteen men and nine women) with hemiplegia (ten right and fifteen left) were measured by two raters who were physical therapist in the rehabilitation hospital. The raters assessed spasticity of shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor in the same patients according to ratings criteria of the MAS and the MMAS. Results : For the inter-rater reliability of the MAS, two raters agreed on 57.3% and the Kappa values were moderate ($\kappa$=0.41) between two rater. The inter-rater reliability of the MAS was fair for the wrist flexor and the hip adductor and moderate for the other muscles. The intra-rater reliability was good for the shoulder adductor and the knee extensor and moderate for the other muscles. For the inter-rater reliability of the MMAS, two raters agreed on 84.7% and the Kappa values were good ($\kappa$=0.78) between two rater. The inter-rater reliability of the MMAS was moderate for the hip adductor, and good for the shoulder adductor and the wrist flexor, and very good for the other muscles. The intra-rater reliability was good for the wrist flexor and the hip adductor and very good for the other muscles. Conclusion : This study suggests that the MMAS translated into Korean is reliable test scale for the spasticity with stroke patients in the clinical field.