• Journal of The Korean Society of Integrative Medicine
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• v.6 no.3
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• pp.123-130
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• 2018

Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.447-454
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• 2014

PURPOSE: The aim of this study was to determine the effect of inclination treadmill training with dynamic stretching on the spasticity and gait of chronic stroke patients. METHODS: Twenty two subjects were randomly assigned to either an experimental group (EG, n=11) or a control group (CG, n=11). Both groups participated in a standard rehabilitation program; in addition, the EG participated in inclination treadmill training for 20 min per day, five times per week, for 4 weeks, and the CG participated in treadmill walking training for 20 min per day, five times per week, for 4 weeks. Outcome measurements, recorded before and post intervention. Walking ability was measured using the 10m walking test (10MWT) and Timed up and go (TUG) test. Spasticity of the medialis gastrocnemius was measured using a myotonometer. RESULTS: Significant differences were observed the both groups for walking ability and spasticity after the training program. The results of the study were follows: 10MWT and TUG was significantly increased in both groups (p<0.05) and it was also found to be significant between groups after intervention (p<0.05). Spasticity was significantly increased in both groups (p<0.05) and it was also found to be significant between the groups after intervention (p<0.05). CONCLUSION: These findings indicate that inclination treadmill training improves gait ability and reduces spasticity of the medialis gastrocnemius. Inclination treadmill training may be used as an easy, effective and accessible way to improve the walking ability and decrease spasticity in stroke patients. Further studies are necessary to generalize the findings of this study.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.484-488
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• 2013

Objective : To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. Methods : The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. Results : Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. Conclusion : Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.487-498
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• 2010

Purpose : To investigate the immediate effects of transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in the stroke patients. Methods : 26 subjects with spasticity over lower limbs were allocated randomly into two groups : (1) TENS group, (2) placebo-TENS group. TENS was applied on the both gastrocnemius for 60 minutes(100 Hz, 0.25 ms, 2 times sensory threshold). The modified Ashworth Scale(MAS) and Manual Muscle Tester were used to assess the spasticity of the ankle plantar flexors. Static balance under three conditions was measured by force-plate; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Results : When compared with the pre and post TENS application, TENS showed significant reduction of ankle spasticity in MAS and MMT measurement. Also, Application of high-frequency TENS improved the balance under three conditions. Conclusion : A single session of TENS to stroke patients could reduce spasticity and improve the balance.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.2
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• pp.146-154
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• 2001

The purposes of this study was to determine the effect of exercise in stroke patients and to define to strategy to promote their activity of daily living, decrease to their depression. The experiemental design was designed nonequivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionaire on 60 patients who had been in patient department in D University hospital and K University hospital in Busan from November 5th, 2000 to the end of February 28th, 2001. Exercise was conducted by the researcher and was carried out experimental group once per day for 20 minutes for daily fourteen days. ADL check List tool by Kang and Center of Epideilogic Studies-Depression (CES-D) were used for measurement in this study. The data was analyzed by means of freqency, percentage, $mean{\pm}SD$, t-test, chi-square test and ANOVA with SPSS/PC. The results were summarized as follow; 1. The experimental group which received exercise should be higher in activity of daily living than the control group was supported (t=2.70, P=.009). 2. The experimental group which received exercise should be lower in depression than the control group was not support(t=-1.120, P=.267) but experimental group post-pre depression score support(t=7.247, P=.000). 3. Factors influencing the activity of daily living measured are payer of medical expenses (F=3.98, P=.018) and complications(t=3.97, P=.056). 4. Factors influencing the depression measured are economic status(F=5.71, P=.009) and caregivers (F=3.09, P=.045). In conclusion, the exercise incresed the activity of daily living and effect on depression of stroke patiens. Based upon these results, it is recommended that the nurses who take care of stroke patients such as exercise.

• Therapeutic Science for Rehabilitation
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• v.1 no.2
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• pp.35-40
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• 2012

The purpose of this review was to investigate feasibility of intensive virtual reality training to improve upper extremity function with brain plasticity of individuals with stroke through the literature. The recovery of the paretic upper extremity depends on regularity and intensity of training as use-dependent plasticity. In resent, virtual reality program has been widely used in the occupational therapy field of augmented stroke rehabilitation. There is a growing body of evidence that virtual reality training of the paretic extremity induces brain plasticity associated with motor improvement. In terms of therapeutic feasibility to improve paretic upper extremity, recent research has explored several important factors of virtual reality training for recovery of upper extremity motor function. These factors include high repetition intensity, high motivation like type of game, enhanced multisensory feedback regarding performance, and interactive task-oriented training. Therefore, occupational therapy combined with intensive and repetitive virtual reality training will enhance recovery of upper extremity motor function after stroke.

• 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 The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.291-300
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• 2019

Purpose : This study focuses on the influence of bridge exercise combined with whole body vibration on muscle activity and balance. Methods : 30 stroke patients were recruited for subjects. The subjects were divided to bridge exercise combined stable surface (Group I), bridge exercise combined unstable surface (Group II), and bridge exercise combined bridge exercise (Group III), of which 10 subjects were randomly allocated. The subjects were given 30 minutes of neurologic physical therapy which included gait training and muscular strength training, and additionally given 30 minutes of bridge exercise combined stable surface, bridge exercise combined unstable surface, and bridge exercise combined whole body vibration for each group, five times a week, for 8 weeks. Their muscle activity and balance were analyzed before the intervention. After 8 weeks of the intervention, the mentioned parameters were measured once more for between-group analysis. Results : Comparative analysis of the muscle activity and balance between the groups showed statistically significant difference, and post-hoc analysis showed the Group III had greater changes in muscle activity and balance than Group Iand Group II. Conclusion : Such results revealed that bridge exercise combined with whole body vibration is effective in muscle activity and balance. Based on the current study, more effective program is to be proposed for elite athletes as well as stroke patients. Based on the current study, studies that incorporates various frequencies of vibration is required for development of effective whole body vibration exercise program.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.3
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• pp.57-65
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• 2015

PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.

• Physical Therapy Korea
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• v.21 no.4
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• pp.34-39
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• 2014

The purpose of this study was to examine the effect of three cognitive tasks on gait at a preferred walking speed, and at a fast speed, using dual-task methodology. A total of 29 stroke patients participated in the study. All 29 subjects performed 2 motor tasks (10-meter walk task and timed up and go task each at a preferred and a fast speed) and three cognitive tasks [Stroop, word list generation (WLG), serial subtraction (SS)] under dual-task conditions [cognitive-motor interference (CMI)] in a randomized order. Gait speeds were measured in six different conditions. A repeated-measure analysis of variance was employed to compare the results of the Stroop training, WLG, and SS tasks during preferred and fast walking. A Bonferroni adjustment use for post hoc analysis. The level of statistical significance was set at ${\alpha}=.05$. A CMI effect occurred for performance of a 10-meter walking task at two different speed and a cognitive task (p<.05). Stroop had a significantly greater effect than SS and WLG (p<.05). The timed up and go task was affected when performed with fast walking speed during Stroop cognitive task (p<.05), but was not affected if performed with preferred walking speed during a cognitive task (p>.05). This study showed that CMI of Stroop can be used as a rehabilitation program for stroke patients.