• 대한물리의학회지
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• 제9권2호
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• pp.223-231
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• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• The Journal of Korean Physical Therapy
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• 제33권2호
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• pp.53-61
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• 2021

Purpose: This study examined the impacts of action observational physical training related to stair walking on the stair walking ability and self-efficacy of chronic stroke patients. Methods: This study was conducted on 24 chronic stroke patients, who were assigned randomly to an action observational physical training group (12 persons) and a landscape observation physical training group (12 persons). To the action-observational physical training group, five videos related to stair walking were presented, and after observing them, physical training was carried out. The landscape observation physical training group observed the videos consisting of landscape, where there were no humans and animals, and then underwent physical training. This study measured the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius to examine the muscle activity of the lower limb. A timed up and go and step test was performed to examine the balance ability, and a timed stair test was conducted to examine their stair walking ability. A self-efficacy scale was measured to examine the degree of their confidence of performing stair walking. The assessment was conducted three times in total: pre-, post-, and follow-up surveys. Results: As a result of this study, the action observational physical training group significant improvement after the intervention than in the landscape observation physical training group. Moreover, the follow-up study four weeks after the intervention showed significant improvements in the action observational physical training group (p<0.05). Conclusion: These results show that the action observational physical training had a positive impact on the stair walking ability and self-efficacy of chronic stroke patients.

• 대한치료과학회지
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• 제10권2호
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• pp.31-37
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• 2018

Objective: The purpose of this study was to evaluate the effects of closed chain lower limb exercise with abdominal breathing exercise on stroke patients and their effects on trunk control ability and balance. Method: The subjects were 40 stroke patients, 19 patients in the experimental group and 18 patients in the control group. The period was 5 weeks, 5 times a week, 30 minutes per session. The experimental group was subjected to a closed chain lower limb exercise with abdominal breathing exercise and the control group was subjected to a closed chain lower limb exercise. The posture assessment scale for stroke(PASS), trunk impairment scale(TIS) were used for trunk adjustment ability, and the balance ability was measured as center of pressure(COP) and limit of stability(LOS). Results: Results of this study showed that the PASS and TIS test significantly increased the experimental group compared to the control group. As a result of comparing the changes of pre and post intervention intervals between the two groups, the TIS test was significantly lower in the experimental group than in the control group, but the LOS test was not significantly increased in the experimental group. Conclusion: Closed chain lower limb exercise with abdominal breathing exercise showed a significant improvement in the trunk control and balance ability of the stroke patients compared to the closed chain lower limb exercise without the abdominal breathing exercise.

• PNF and Movement
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• 제16권3호
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• pp.307-315
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• 2018

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from $2482.13mm^2$ to $626mm^2$), and walking speed improved by 18.70% (from 0.75 m/s to 0.64 m/s). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

• 대한물리의학회지
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• 제14권1호
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• pp.151-161
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• 2019

PURPOSE: To investigate the validity of a smartphone application for post-stroke daily living activity management based on an evaluation by users and experts. METHODS: The study design adhered to the analysis, design, development, implementation, and evaluation ADDIE (Analysis-Design-Development-Implement-Evaluation) model. We downloaded the application onto the smartphones of 33 users and 30 experts, taught them how to use it, and asked them to use the application for four weeks. The users' daily lives before and after using the application were compared based on the K-MBI (Korean Version of Modified Barthel Index) to evaluate the usability of the application. For the expert group, we investigated the content validity and reliability of the application and evaluated the usability of the application. Data were analyzed using the SPSS 21.0 software. Users' general characteristics and experts' evaluation scores were analyzed using descriptive statistics. Content validity was tested using the content validity index (CVI), and reliability was tested with Cronbach's alpha. Users' K-MBI scores before and after using the application were compared with the paired sample t-test. RESULTS: Users gave an average rating of 2.93 out of 4 for the application for managing the daily lives of stroke patients, while experts gave an average score of 3.14. With regard to the K-MBI scores, only the dressing score improved significantly (p<.005) after using the application, and scores for other categories slightly improved but not to significant levels. CONCLUSION: The results of this study suggest that the STROKECARE application is usable and could help stroke patients manage their daily lives.

• 대한물리치료과학회지
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• 제27권3호
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• pp.35-44
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• 2020

Background: This study was to confirm the effect and feasibility of knee extension assist orthosis (KEAO) on balance and gait in subacute stroke patients. Design: Case study. Methods: The subjects of the study were 4 subacute stroke patients, who had an onset period of less than 6 months. The limit of stability (LOS) and berg balance scale (BBS), timed up and go test (TUG) were used to verify the dynamic balance ability, static balance ability, and gait ability pre and post and after wearing the knee extension assist orthosis (KEAO). In addition, the satisfaction survey was to confirm the feasibility of the knee extension assist orthosis (KEAO) through the to Korean quebec user evaluation of satisfaction assistive technology 2.0 (K-QUEST 2.0). Results: After the wearing on KEAO, the distance for the limit of stability decreased by mean 541.25±240.46 mm2, and the score on the berg balance scale improved by mean 5±2.71 point, and the time for the timed up and go test deceased by mean 3.75±1.71 second. The stability and durability were found to be full score, and the control, ease, effectiveness were some high score, and the size, weight, comfort were some low score in the satisfaction and feasibility. Conclusion: The knee extension assist orthosis (KEAO) produce in this study was improved the static balance ability, dynamic balance ability and gait ability of subacute stroke patients, and the satisfaction and feasibility were high in the stability, durability and effectiveness of the user.

• 대한물리의학회지
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• 제17권1호
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to investigate the effect of the resistance respiratory muscle exercise with transcutaneous electrical nerve stimulation (TENS) on the respiratory muscle tone and pulmonary function of stroke patients. METHODS: Twenty stroke patients were divided into the TENS group (n = 7), placebo TENS group (n = 7), and control group (n = 6), and each intervention was performed on the three groups 5 times a week for 4 weeks. The assessment was carried out by measuring changes in the muscle tone of the latissimus dorsi and abdominal external obliques, and pulmonary function. RESULTS: In this study, the TENS group and the placebo TENS group had significant increases in the paretic side latissimus dorsi muscle tone, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). There was no significant difference in changes in respiratory muscle tone between the three groups. The pulmonary function was significantly different between the three groups, and it was observed from the results of the post-hoc test that FVC showed a significant increase in the TENS group and the placebo TENS group compared to the control group. CONCLUSION: Through this study, it was found that the respiratory muscle resistance exercise was more effective as a method to increase respiratory muscle tone and pulmonary function in stroke patients than combined transcutaneous electrical nerve stimulation.

• 대한물리의학회지
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• 제17권1호
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• pp.85-92
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• 2022

PURPOSE: This study aimed to analyze the effects of task exercise on an unstable surface on the involuntary arm and leg movement and balance in stroke patients. METHODS: 20 stroke patients were clinically sampled and randomly assigned to two groups of 10 patients each. Experimental group I received task exercise intervention on an unstable surface and experimental group II received task exercise intervention. The interventions were carried out 3 times a week for 4 weeks (30 minutes per session). The global synkinesis (GS) and Berg Balance Scale (BBS) of the patients were evaluated as pre-tests prior to intervention, and then the post-tests were re-measured in the same manner as the pre-tests after a 4-week intervention period. RESULTS: In the experimental group I, there were statistically significant differences in the changes in the arm and leg GS (p < .01) and in the BBS (p < .05). On the other hand, in the experimental group II, there were statistically significant differences in the changes only in the arm GS (p < .01) and in the BBS (p < .05). Also, in the comparison of the changes between the two groups, there was a statistically significant difference in the changes in the leg GS only (p < .05). CONCLUSION: In the experimental group I, the arm and leg GS were statistically significantly reduced, but the balance ability was statistically significantly improved. The reason was that in the experimental group I, similar movements of the paralyzed arm were promoted due to the double-task exercise on the unstable surface, and sensory feedback and posture strategies were well utilized in the legs, which was found to be effective in reducing the GS and improving the balance ability. Therefore, based on these results, the double-task exercise on an unstable surface should be fully utilized for the rapid rehabilitation of stroke patients.

• 대한물리의학회지
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• 제16권4호
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• pp.13-21
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• 2021

PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.