• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.265-272
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• 2016

Objectives: This study presents two cases of patients with post-stroke global aphasia who were treated with scalp acupuncture with electrical stimulation.Method: The two patients were treated by scalp acupuncture with electrical stimulation six times a week. The degree of aphasia was measured via the Korean version of the western aphasia battery (K-WAB).Results: After treatment, aphasia was improved in both cases (autism-spectrum quotient [AQ] scores increased from 13.7 to 37.1 and from 4.1 to 18.4 in the two patients).Conclusion: Based on the results of these two cases, scalp acupuncture could be effective in treating post-stroke global aphasia.

• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.213-222
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• 2024

Objective: Stroke is a leading cause of disability worldwide, often leaving survivors with significant cognitive and motor impairments. Dual-task (DT), which involves performing cognitive and motor tasks simultaneously, can influence brain activation patterns and functional recovery in stroke patients. Design: A systematic review Methods: Following PRISMA guidelines, databases including MEDLINE, CINAHL, Embase, and Web of Science were searched for studies assessing cortical activation via functional near-infrared spectroscopy (fNIRS) during DT performance in stroke patients. Studies were selected based on predefined eligibility criteria, focusing on changes in hemodynamic responses and their correlation with task performance. Results: Eight studies met the inclusion criteria. Findings indicate that DT leads to increased activation in the prefrontal cortex (PFC), premotor cortex (PMC), and posterior parietal cortex (PPC), suggesting an integrated cortical response to managing concurrent cognitive and motor demands. However, increased activation did not consistently translate to improved functional outcomes, highlighting the complex relationship between brain activation and rehabilitation success. Conclusions: DT interventions may enhance cortical activation and neuroplasticity in post-stroke patients, but the relationship between increased brain activity and functional recovery remains complex and requires further investigation. Tailored DT programs that consider individual neurophysiological and functional capacities are recommended to optimize rehabilitation outcomes.

• Physical Therapy Korea
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• v.29 no.2
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• The Journal of Korean Physical Therapy
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• v.23 no.3
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• pp.43-47
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• 2011

Purpose: This study determined the best adjustable height supporter for stroke patients in wheelchairs for the maintenance of a symmetric sitting posture. Methods: Thirty-one stroke participants and 20 age-matched control participants were recruited. The enrolled participants were evaluated by the Force Sensitive Application (FSA) System that was used to assess weight shift and symmetry in wheelchair sitting and assess the symmetric index (SI) of subjects according to 1, 2 and 3 cm height supporters. Results: When a 1 cm height supporter was applied to the paretic side of stroke survivors, sitting postures of stroke patients were significantly more symmetrical (p<0.01). Cross tabulation between the SI of wheelchair sitting and that of the paretic side of stroke patients caused? by a 1 cm supporter showed that 21 SIs of 26 stroke patients were improved by a 1 cm supporter to the paretic side (k=0.26, p<0.01). Conclusion: The findings of the present study demonstrate that stroke patients can maintain a more symmetrical sitting posture (than is possible when simply sitting in a wheelchair seat) if a 1 cm supporter is applied to the paretic side of stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2370-2374
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• 2021

Background: Masticating is an activity that is free from temporal or spatial constraints, with an advantage that it can be combined easily with other treatment methods. While several studies have reported a positive effect of the intervention of chewing using the jaw on postural stability, only a few studies were conducted on stroke patients. Objectives: To investigated the effects of masticating chewing gum on the static and dynamic balancing of stroke patients. Design: Randomized cross-over study design. Methods: Nineteen stroke patients were randomly assigned to the chewing group or control group. BT4 was used to measure the static and dynamic balancing abilities. Pre-test measurements were taken before mastication of chewing gum, and post-test measurements were taken after 2 days. The stroke patients in the chewing group were guided to sit on a chair and chew gum for 3 min, and their balancing abilities were simultaneously measured. The balancing abilities of the control group patients were measured while they sat at rest without masticating chewing gum. Results: The chewing group showed significant increases in the measures of static balance (i.e., C90 area, trace length, X mean, and Y mean). In the between-group comparison, the measures of static balance were significantly higher in the chewing group than in the control group. Conclusion: These findings suggest that masticating chewing gum enhanced the static balancing ability of stroke patients. Thus, gum chewing should be considered a viable clinical intervention to control posture in stroke patients.

• 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 Acupuncture Research
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• v.27 no.2
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• pp.23-30
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• 2010

Objectives : The second derivative of photoplethysmogram waveform(SDPTG) is a simple, convenient and non-invasive technique for pulse wave analysis. This study was designed to investigate the differences in the SDPTG between the affected side and the unaffected side in hemiparetic patients after stroke, and the effects of acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : To evaluate the differences between the affected side and the unaffected side in hemiparetic patients after stroke, their SDPTG were recorded by using a Cardio Peri SA6000. To evaluate the effects of acupuncture at Palsa(BaXie) in 20 hemiparetic patients after stroke and 20 healthy subjects, their SDPTG were recorded 2 times(pre-acupuncture and post-acupuncture). The SDPTG consists of an a, b, c and d wave in systole and an e wave in diastole. Sano aging index was defined as (b-c-d)/a. Results : 1. The affected side in hemiparetic patients after stroke had higher average b/a ratio(p<0.05)and Sano aging index(p<0.05) than the unaffected side 2. In a comparison of pre-acupuncture and post-acupuncture at the Palsa(BaXie), b/a ratio(p<0.05) and Sano aging index(p<0.05) was decreased significantly in both hemiparetic patients and healthy subjects. Conclusions : These findings suggest that acupuncture at Palsa(BaXie) may be effective method of reverting some of the deleterious effects on vascular function produced by stroke.

• PNF and Movement
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• v.16 no.1
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• pp.59-66
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• 2018

Purpose: This study aimed (1) to identify asymmetry observed in electromyography (EMG) activity patterns of lower limb muscles between affected and unaffected sides of stroke patients during sit to stand (STS) movement and (2) to identify the muscles of the paretic lower limb that affected STS performance in stroke patients. Methods: This study consisted of 27 patients (15 males and 12 females) with poststroke hemiparesis. The activation of the rectus femoris (RF), tibialis anterior (TA), and gastrocnemius (GCM) of the affected side and unaffected side during STS movement were recorded using surface EMG. In addition, EMG lower limb muscle activation patterns were measured in the all section, pre-thigh off (pre-TO), and post-thigh off (post-TO) section. All measurements were obtained during five repetitions of the STS (FTSTS) movement. An independent t-test was performed to compare the affected side and unaffected side of the lower limb during the STS movement. A stepwise linear regression analysis was conducted to identify the muscles that affected STS performance. Results: Activation of both the RF and TA significantly affected the lower limb during the STS movement (p<0.05). Two muscles showed a difference on the post-TO section. The results of the stepwise multiple regression analysis showed that the RF and TA muscles of the affected lower limb were affected in FTSTS. Conclusion: These results provide a basis for reinforcement training, focusing on the RF and TA muscles of the affected side of stroke patients to improve asymmetric movement and performance in STS movement.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.513-523
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• 2013

PURPOSE: The purpose of this study was to investigate characteristics of the forced pulmonary function test effect and abdominal muscles activation by combined complex exercise with abdominal drawing-in maneuver training of chronic stroke patients. METHODS: 14 post stroke patients(10 males and 4 females) involved voluntary this study and we divided two groups into CEG(complex exercise group) and CEAG (complex exercise and abdominal drawing-in maneuver group).(n=7, per goup). Each groups implicated the 2 times, 30minute exercises for 6 weeks a day. The CEAG performed the complex exercise 15 minutes and 15 minutes of abdominal drawing-in maneuver. For data analysis, the mean and standard deviation were estimated; non-parametric independent t-test was carried out. RESULTS: According to the study, in the combined complex exercise with abdominal drawing-in maneuver group, FVC and activation of transversus abdominis/internal oblique were statistically significant difference compared to the complex exercise group. CONCLUSION: These results indicate that the combined complex with abdominal drawing-in maneuver was efficient in enhancing abdominal muscles activation and pulmonary function of chronic stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.3
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• pp.1-9
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• 2017

Purpose: The purpose of this study was to investigate the effects of an immersive, virtual reality-based exercise program on range of motion and dexterity in the upper extremities of stroke patients. Methods: Fifteen patients with hemiparesis after stroke participated in this study. The participants participated in Rapael Semart GloveTM, an immersive, virtual reality-based exercise program, performed for 30 minutes-, 3 times per week for 4 weeks. The Rapael Smart GloveTM program and a Box and Block Test (BBT) were used to measure range of motion and to assess dexterity, respectively, pre-and post-intervention. Results: Range of motion in pronation and supination of the forearm and flexion, extension, and ulnar deviation of the wrist improved after the intervention. Dexterity measured by BBT also improved. However, range of motion in flexion and extension of the fingers and radial deviation of the wrist did not improve. Conclusion: This study presents the effects of an immersive, virtual reality-based exercise program on hand function. In the future, a study comparing an immersive, virtual reality- based exercise program to other upper-extremity interventions for stroke patients should be conducted. A study about the effects of an immersive virtual reality program on activities of daily living is also needed.