• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.79-87
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• 2010

Objectives : The purpose of this study is to analyze and to compare the difference and the change between dynamic balance exercise group and dynamic balance exercise with core program exercise group. Also, based on this data, to prescribe effective exercises for hemiplegic patients and the pubis in order to achieve more effective dynamic balance exercise rehabilitation and better dynamic balance exercise in the field of therapeutical exercise. Methods : Twenty subjects(Core program exercise plus Dynamic balance exercise group, CP: 10, Dynamic balance exercise group, NCP: 10) were chosen among hemiplegic patients. Measurements of dynamic balance were evaluated at initial presentation(pretest) and after 4, 8, 12 weeks'. Paired t-test and Repeated measured ANOVA was utilized to detect the mean difference between the groups. Results : Firstly, after 4 weeks' and 8 weeks' and 12 weeks' CP exercise and NCP exercise, there were all significant difference to increase dynamic balance (p<0.05). secondly, after 4 weeks' and 8 weeks' and 12 weeks' CP and NCP exercise, there was significant difference to increase dynamic balance more CP group than NCP group. Lastly, among 4 weeks' and 8 weeks' and 12 weeks' CP exercise, there was progressively significant difference to increase dynamic balance(p<0.05). Conclusions : This study showed that dynamic balance exercise with core program exercise is an effective treatment strategy for hemiplegic patients than dynamic balance exercise rehabilitation.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.169-173
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• 2015

Purpose: This study aimed to improve the asymmetrical weight-bearing ratio, by applying different repetitive sit-to-stand training methods to the paretic-side foot of hemiplegic patients, as well as to provide the necessary information for applying balance training with hemiplegic patients. Methods: The subjects were divided into two groups: a spontaneous foot group and an asymmetrical foot group. They all performed repetitive sit-to-stand training five times a week for a total of six weeks. The sit-to-standing movement was studied using standardized clinical tests. The Biodex Balance System, Time up and go test (TUG), 5 times sit-to-stand test (5XSST), and functional reach test (FRT) were used to measure the static and dynamic standing balance of the patients. Results: In the balance system measurement, the results for the overall index, ant-post index, med-lat index, fall risk index, 5XSST, and FRT after the training differed significantly between the comparison groups (p<0.05). In the evaluation of dynamic balance, the differences in TUG did not differ significantly between the comparison groups after the training (p>0.05). Conclusion: The study found that the asymmetrical group showed significant increases in static and dynamic balance in comparison to the spontaneous group after repetitive sit-to-stand training. Based on this result, it is clear that training in an asymmetrical position with the paretic foot back can increase the left-right stability limit and the anterior-posterior stability limit, thus improving balance control.

• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.50-54
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• 2017

Purpose: This investigation aimed to determine the effects of treadmill training (TT) and high frequency chest wall oscillation (HFCWO) on pulmonary function and walking ability in stroke patients as well as propose an exercise program to improve cardiovascular function. Methods: Twenty hemiplegic stroke patients were randomized to either the control group (CG) (n=10) or the experimental group (EG), which received TT and HFCWO (n=10). Pulmonary function was quantitated using patient forced vital capacity (FVC) and forced expiratory volume at one second (FEV1) while walking speed was assessed by the 10m walking test (10MWT). Further, walking endurance was determined utilizing the 6-minute walk test (6MWT). Subjects of the EG performed the study protocol for 60 minutes, five times a week for six weeks; CG patients did not participate in regular exercise. To determine significance for the differences observed before and after exercise, within-group and between-group comparisons were conducted utilizing paired and independent t-tests, respectively, with the level of significance set at ${\alpha}=0.05$. Results: Within-groups, significant differences were observed in both FVC and FEV1 (p<0.01) following completion of the study protocol. Further, between-group comparisons demonstrated significant differences in both FVC (p<0.05) and FEV1 (p<0.01). Post-exercise, significant changes in the 10MWT and 6MWT score were observed between the EG and CG (p<0.01). Further, statistically significant differences were observed in 6MWT scores between-groups (p<0.05). Conclusion: The TT and HFCWO effectively improved pulmonary function and walking ability in subjects with stroke. The proposed program can be applied to stroke patients as a useful therapy.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.196-211
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• 2000

The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.1-8
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• 2011

Purpose : The purpose of this study was to find out the effect of closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius on gait in stroke. Methods : 30 hemiplegic patients voluntarily participated in this study. Subjects were divided into experimental group(n=15) and control group(n=15). Experimental group was given closed kinetic chain exercise with FES of the gluteus medius and control group was given only closed kinetic chain exercise for 4 weeks. All subjects were measured 10m-walking speed, cadence, functional walking category(FAC) and modified motor assessment scale(MMAS) before and after intervention. Results : In experimental group, gait velocity, cadence, FAC and MMAS showed significant difference between pre and post test(p<.05). In control group, gait velocity, cadence and FAC showed significant difference between pre and post test(p<.05). Before intervention, gait velocity, cadence, FAC and MMAS were not significant difference between experimental group and control group(p>.05), but after intervention, gait velocity, FAC and MMAS were significant difference(p<.05). Conclusion : This study show that closed kinetic chain exercise with functional electrical stimulation(FES) of the gluteus medius is beneficial intervention for increase the wlking ability in stroke.

• The Journal of Korean Physical Therapy
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• v.16 no.3
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• pp.97-111
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• 2004

This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

• Journal of Korean Physical Therapy Science
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• v.4 no.4
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• pp.539-548
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• 1997

The purpose of this study was to determine the effects of FES on the clinical test patients who had disturbance gait due to cereberal vascular accident. The subjects for study were 16 hemiplegic patients (9 Male and 7 Female) who can gait with or without device. Their average age was 55 and they received average of 20.19 month of treatment collected data analysis was completed by using one-way analysis variable(ANOVA), Pearson ($-1{\leq}r{\geq}1$). The results were as follows : 1) There was difference in four variable (stride length,gait speed,gait cadence) between at the biginning and at the end of the treatment of FES (p<0.01). 2) There was relationship in capacity of activity between MAS and stride length (r = 0.751), gait speed (r = 0.689) but no relationship gait cadence (r = 0.236). 3) Age revealed relationship of stride length (r = -0.727), gait speed (r = -0.725), gait cadenc (r = -0.362). 4) There was no relationship in months post-CVA with MAS (r = 0.171), stride length (r = -0.110), gait speed (r = -0.096), gait cacedce (r = -0.154).

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.59-79
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• 2004

The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• Journal of Korea Entertainment Industry Association
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• v.13 no.1
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• pp.207-215
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• 2019

This study examines the effect of the height of cane that hemiplegic patients due to stroke use on their plantar pressure in standing position, gait speed. The study suggests a new standard for appropriate cane height that considers the change of average height of population. Research subjects included 12 patients hospitalized in S Medical Care Hospital located in Gwangju Metropolitan City in South Korea who were diagnosed with stroke. Group A uses a cane of the height of the greater trochanter of femur, group B uses a cane of 5cm above the height of the greater trochanter of femur, and group C is a cane of 10cm above the height of the greater trochanter of femur. In the study result, non-affected side plantar pressure and affected side plantar pressure showed a significant difference among the cases where the cane height was the same as the A group, B group, C group. In the post-hoc analysis result, a significant difference was observed between the case of A group and C group. Gait speed showed no significant difference among the case of the A group, B group, C group. The asymmetry of the stroke affects not only the posture but also the walking that is related to daily life. Changes in the height of the cane did not affect walking speed. The change in the height of the cane showed a change in the weight support ratio, which is thought to have a positive effect on the asymmetry. In future clinical setting, this study result will be able to provide fundamental data regarding the cane height in the standing or walking therapy for hemiplegic patients due to stroke with cane application.