The purpose of this study was to investigate the effect of balance training with upper extremity exercise on the improvement of balance performance in people who have had a stroke. Eighteen candidates who have all experienced a stroke, were living in Dong-Gu, Ulsan and were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 7 consecutive weeks. Subjects were tested with 7 m and 100 m Timed Gait Test (sec), Timed Get Up and Go Test (sec), Functional Reach Test (cm) and 5 items of Berg's Balance Test at pre-training and post-training. Total balance index and balance ratios were measured by K.A.T. 3000. The balance training program performed by sitting on a chair and gymnastic ball and standing on stable and unstable surfaces during upper extremity exercises such as Proprioceptive Neuromuscular Facilitation (PNF) upper extremity pattern, picking a ball up from floor, throwing and catching it. After seven weekends of balance training, subjects showed a significant difference in balance test results. The exceptions were three items of Berg's Balance Test (p<.05). Balance index score and affected and unaffected side balance ratio had a larger improvement than pre-training (p<.05). The result of this study showed that intervention of this balance training program could improve the balance performance in people who have had a stroke.
Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P<0.05). Significant differences between the PWBV and WBV groups were found (P<0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.
Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.
The Journal of Churna Manual Medicine for Spine and Nerves
/
v.14
no.2
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pp.15-28
/
2019
Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.
Kim, Tae-Won;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Tae-Sun;Kim, Jae-Hyoo;Kim, Soo-Han
Journal of Korean Neurosurgical Society
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v.39
no.2
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pp.130-135
/
2006
Objective : After ischemic stroke, partial recovery of function frequently occurs and may depend on the plasticity of axonal connections. Here, we examine whether blockade of the Nogo/NogoReceptor[NgR] pathway might enhance axonal sprouting and thereby recovery after focal brain infarction. Methods : Adult male Sprague Dawley rats weighing $250{\sim}350g$ were used. Left middle cerebral artery occlusion[MCAO] was induced with a intraluminal filament. An osmotic mini pump [Alzet 2ML4, Alza Scientific Products, Palo Alto, CA] for the infusion of NgR-Ecto[310]-Fc to block Nogo/NgR pathway was implanted 1 week after cerebral ischemia. Prior to induction of ischemia, all animals received training in the staircase and rotarod test. Two weeks after biotin dextran amine injection, animals were perfused transcardially with PBS, followed by 4% paraformadehyde/PBS solution. Brain and cervical spinal cord were dissected. Eight coronal sections spaced at 1mm intervals throughout the forebrain of each animal with cresyl violet acetate for determination of infarction size. Images of each section were digitized and the infarct area per section was measured with image analysis software. Results : Histological examination at 11 weeks post-MCAO demonstrates reproducible stroke lesions and no significant difference in the size of the stroke between the NgR[310]Ecto-Fc protein treated group and the control group. Behavioral recovery is significantly better and more rapid in the NgR-Ecto[310]-Fe treated group. Blockade of NgR enhances axonal sprouting from the uninjured cerebral cortex and improves the return of motor task performance. Conclusion : Pharmacological interruption of NgR allows a greater degree of axonal plasticity in response this is associated with improved functional recovery of complicated motor tasks.
Purpose: This study investigated the efficacy of task-related circuit training aimed at improving balance in individuals discharged from rehabilitation facilities following a stroke. Methods: We recruited 12 stroke patients (34-66 years of age) to participate in a task-related circuit training program. Baseline assessment included a history of stroke and an assessment using the Mini-Mental State Examination Korea (MMSE-K). After a baseline assessment, follow-up assessments were administered pre- and post-training. These included Berg Balance Scale (BBS), Functional Reach Test (FRT), and the Time Up & Go Test (TUG). Physiotherapists trained study subjects under the one-to-one supervision of students from the department of physical therapy. Circuit class study participants attended 90-minute treatment sessions, one day a week for 12 weeks (from September to December 2008). The program consisted of a light warm-up period (10 min), physical exercises for improving balance (20 min), tasks focused on improving balance (50 min) and a cool-down period (10 min). Results: Scores for the BBS assessment increased significantly (from 43.2 to 49.7) after the training (p<0.05). Reach distance on the FRT increased substantially (from 27.7 cm to 47.0 cm), although the improvement was not significant (p>0.05). The average time on the TUG test decreased significantly (from 23.7 sec to 19.5 sec) after the training (p<0.05). Conclusion: The task-related circuit training program improved the balance and mobility of subjects, indicating that such a group program is useful for stroke patients who are discharged from the hospital. More such task-related programs set in a community environment should be developed.
Shoulder pain is a common problem after stroke. This study was done to examine the effect of Cheongungkyeoji-tang for three stroke patients with shoulder pain. Cheongungkyeoji-tang was prescribed for these patients suffering from shoulder pain. In the morning, the grade of shoulder pain was evaluated by visual analogue scale (VAS). Results were taken as three cases of effective treatment of shoulder pain with Cheongungkyeoji-tang. This study suggests that Cheongungkyeoji-tang is an effective treatment for shoulder pain after stroke.
Journal of the Korean Society of Physical Medicine
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v.10
no.4
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pp.59-68
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2015
PURPOSE: The purpose of this study was to determine the comparison of visual and auditory biofeedback during sit-to-stand training in patients with stroke. METHODS: Thirty-five subjects with chronic stroke were divided into three groups: a visual feedback group (12 subjects), an auditory feedback group (12 subjects) and a control group (11 subjects). All Groups received neurodevelopmental treatment, and sit-to-stand training for 30minutes three times a week for four weeks. During the sit to stand training, the experimental groups received visual feedback and auditory feedback, whereas the control group performed sit-to-stand training without feedback. Five times sit-to-stand test (FTSST), motion analysis and postural sway during sit-to-stand were used to evaluate sit to stand performance ability. In addition, Berg balance scale (BBS) was performed for evaluation of balance function in participants. RESULTS: All groups showed significant increase on FTSST and BBS between pre- and post-intervention. The BBS scores in visual feedback group was significant increase than control group. The motion analysis and postural sway, more improvement was observed in the visual and auditory feedback groups compared with the control group. The only visual feedback group was a better performance of midline excursion during sit-to-stand than control group. CONCLUSION: These findings suggest that sit-to-stand training using a biofeedback may help to improve sit to stand performance and balance ability of stroke patients.
Purpose: The aim of this study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using sprinter and skater on balance and gait in the stroke patients. Methods: Twenty-two subjects were randomly assigned to the experimental group (n=11) and the control group (n=11). The experimental group performed PNF pattern exercise using sprinter and skater for 15 minutes with conventional physical therapy for 35 minutes (matt and gait training for 15 minutes + FES stimulation for 20 minutes), while the control group performed only conventional physical therapy for 50 minutes (matt and gait training for 30 minutes + FES stimulation for 20 minutes). Both groups performed therapeutic interventions for five days per week, for a period of four weeks. Functional Reach Test (FRT) and Berg Balance Scale (BBS) were used for assessment of balance, and Timed-Up and Go test (TUG) was used for testing of gait. Results: The experimental group showed significant improvements in the FRT and the BBS, while the control group did not show significant changes in two measurements. The experimental group also showed significant improvements, however, the control group did not show significant changes in the TUG. In post-values of three measurements, significant differences were observed between the two groups (p<0.05). Conclusion: This study demonstrated that PNF pattern exercise using sprinter and skater may be used to improve balance and gait function in stroke patients. Thus, we suggested that PNF pattern exercise using sprinter and skater would be a therapeutic intervention in stroke rehabilitation.
Purpose: This purpose of this study was to compare additionally applied weight underwater gait training and over-ground gait training to improve balance and lower extremity strength in stroke patients. Methods: Subjects were randomly allocated into two groups. Underwater gait training group (n=10) and Over-ground gait training group (n=9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 6 weeks. All subjects were assessed with the Berg balance scale test, the timed up and go test, and the medical research council test pre and post intervention. A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set at p<0.05. Results: The results showed that subjects in the underwater gait training group had a significantly increased Berg balance scale, timed up and go, and medical research council scores (p<0.05), and over-ground gait training group showed a significantly increased medical research council score (p<0.05) after intervention. The underwater gait training group showed a more significant improvement in medical research council, Berg balance scale and the timed up and go test scores compared to the over-ground gait training group (p<0.05). Conclusion: Findings of this study suggest that applying additional weight during underwater gait training improves lower extremity strength and balance in stroke patients. It' findings can contribute to the development of more efficient rehabilitation for stroke patients.
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