• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.242-247
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• 2022

Purpose: This study investigates the effect of 60° semi-squat exercises according to three different types of support surfaces. The effects were examined on joint position sense and balancing ability using stable and unstable surfaces in patients afflicted with post-stroke hemiplegia. Methods: Subjects were instructed to perform three sets of 60° semi-squat exercises according to the characteristics of the support surface conditions. The three ground states were bilateral stable surface (BSS), nonaffected side unstable surface (NUS), and bilateral unstable surface (BUS). The joint position sense, characteristics of body sway, and dynamic balance were analyzed according to floor conditions before and after the experiment. A balance-pad (50 cm W×41 cm L×6 cm H; Alcan Airex AG, Sins, Switzerland) was used for the unstable floor. Results: The 60° semi-squat exercises applied to hemiplegic patients showed the highest statistical significance in joint position sense in the NUS group, and Timed Up and Go test (TUG) in the BUS group (p<0.05). Conclusion: Functional training using an unstable surface can be applied as a meaningful intervention method for improving the balance and joint position sense of stroke patients.

• 대한물리치료과학회지
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• 제15권1호
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• pp.67-74
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• 2008

A decrease in the ability to maintain static and dynamic balance after stroke could be related to the inability to select reliable sensory information in producing relative motor action needed to maintain postural stability. The purpose of this study was to compare the effects of two different types of surface conditions on the balancing ability of subjects with stroke. Eighteen hemiparetic subjects were assigned to an experimental and control group participating in a six－week rehabilitative therapeutic exercise program focusing on balance and mobility. Exercises were performed 3 to 5 times per week in a stable surface condition by the control group, and in an unstable surface condition by the experimental group. Pre－ and post test assessments involved the measurement of the static balance and dynamic balance, respectively by 7－item Berg Balance Scale－3P and by Pro－3 Balance System. Results showed that under the unstable surface condition, static balance in the experimental group showed more improvement than that of the control group.(Statistically, not very significant.) All the aspects of dynamic balance and mediolateral sway(balance) improved significantly than those of the control group. However, there were no significant differences between two groups. Overall, it can be concluded that under the unstable surface condition, the rehabilitative therapeutic exercise programs are effective in improving the dynamic balance of stroke subjects. The results suggest that the adaptation of the unstable surface in the rehabilitative therapeutic exercises could be effective for the patients with hemiplegia in balance. Further studies are needed to confirm the effectiveness of the unstable surface on improving balance and postural stability of hemiplegics.

• 한국전자통신학회논문지
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• 제9권3호
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• pp.303-310
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• 2014

본 연구는 뇌졸중 환자를 대상으로 고유수용성신경근촉진법(PNF)를 이용한 중재프로그램이 조음기관의 기능에 미치는 효과를 알아보고자 하였다. 이를 위해 뇌졸중 환자 중에 PNF을 이용한 프로그램을 실시한 실험군 4명, 조음기관 훈련프로그램을 실시한 대조군 4명, 어떠한 중재도 하지 않은 통제군 4명을 대상으로 주 3회 30분~50분씩 총 24회기 동안 실시하였다. 각 집단별로 사전, 사후 최대발성시간(MPT), 교대운동속도(AMR), 연속운동속도(SMR)을 평가하여 비교하였다. 결과를 살펴보면, 실험군은 모든 항목에서 유의한 차이가 있었고, 대조군은 AMR의 /터/, /아/, /러/에서 유의한 차이를 보이지 않았으며. 통제군은 모든 항목에서 통계적으로 유의한 차이가 나타나지 않았다. 따라서 PNF를 이용한 프로그램이 뇌졸중 환자의 조음기관의 기능을 향상시키는데 가장 효과적이며, 특히 혀의 기능을 증진시키는데 효과적이라고 할 수 있다.

• 대한물리의학회지
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• 제9권4호
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• pp.363-373
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• 2014

PURPOSE: The purpose of this study was of scale using auditory biofeedback training and kinging training on walking speed and weight bearing ratio in patients hemiplegia with stroke to determine of the effects of such training would be maintained even after stopping the intervention. METHODS: The 30 subject were classified into three groups : 12 times, 3 times a week receiving the control, the experimental group scale using auditory and kicking training for 4 weeks. In addition, all subjects in the control group and experimental groups received the same general exercise treatment 12 times, 3 times a week for 4 weeks, and underwent follow-up tests. The significance of differences between the control group and the experimental groups was analysis by repeated-ANOVA, Interaction time and groups was analysis by repeated-ANOVA. In case where there were differences, post-hot tests were conducted using repeated measure ANOVA. RESULTS: There were significant differences in 10 m walking speed and weight bearing ratio between the control group and experimental group after the performance of the scale using auditory training and kicking training. Scale using auditory biofeedback training 4 weeks was more effective than kicking training. After 8 weeks weight bearing ratio maintained on scale using auditory training. CONCLUSION: These finding suggest that the scale using auditory biofeedback training and kicking training has positive effects on hemiplegia with stroke.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.321-327
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• 2015

Objective : To determine whether the use of contrast enhancement (especially its extent) predicts malignant brain edema after intra-arterial thrombectomy (IAT) in patients with acute ischemic stroke. Methods : We reviewed the records of patients with acute ischemic stroke who underwent IAT for occlusion of the internal carotid artery or the middle cerebral artery between January 2012 and March 2015. To estimate the extent of contrast enhancement (CE), we used the contrast enhancement area ratio (CEAR)-i.e., the ratio of the CE to the area of the hemisphere, as noted on immediate non-enhanced brain computed tomography (NECT) post-IAT. Patients were categorized into two groups based on the CEAR values being either greater than or less than 0.2. Results : A total of 39 patients were included. Contrast enhancement was found in 26 patients (66.7%). In this subgroup, the CEAR was greater than 0.2 in 7 patients (18%) and less than 0.2 in the other 19 patients (48.7%). On univariate analysis, both CEAR ${\geq}0.2$ and the presence of subarachnoid hemorrhage were significantly associated with progression to malignant brain edema (p<0.001 and p=0.004), but on multivariate analysis, only CEAR ${\geq}0.2$ showed a statistically significant association (p=0.019). In the group with CEAR ${\geq}0.2$, the time to malignant brain edema was shorter (p=0.039) than in the group with CEAR <0.2. Clinical functional outcomes, based on the modified Rankin scale, were also significantly worse in patients with CEAR ${\geq}0.2$ (p=0.003) Conclusion : The extent of contrast enhancement as noted on NECT scans obtained immediately after IAT could be predictive of malignant brain edema and a poor clinical outcome.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.544-550
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• 2016

Objective : Cerebral endothelial cells have unique biological features and are fascinating candidate cells for stroke therapy. Methods : In order to understand the molecular mechanisms of human cerebral endothelial cell (hCMEC/D3) transplantation in a rat stroke model, we performed proteomic analysis using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Protein expression was confirmed by quantitative real-time PCR and Western blot. Results : Several protein spots were identified by gel electrophoresis in the sham, cerebral ischemia (CI), and CI with hCMEC/D3 treatment cerebral ischemia with cell transplantation (CT) groups, and we identified 14 differentially expressed proteins in the CT group. Proteins involved in mitochondrial dysfunction (paraplegin matrix AAA peptidase subunit, SPG7), neuroinflammation (peroxiredoxin 6, PRDX6), and neuronal death (zinc finger protein 90, ZFP90) were markedly reduced in the CT group compared with the CI group. The expression of chloride intracellular channel 4 proteins involved in post-ischemic vasculogenesis was significantly decreased in the CI group but comparable to sham in the CT group. Conclusion : These results contribute to our understanding of the early phase processes that follow cerebral endothelial cell treatment in CI. Moreover, some of the identified proteins may present promising new targets for stroke therapy.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.737-743
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• 2013

본 연구는 시각 통제를 이용한 다중감각 훈련이 아급성 뇌졸중 환자의 균형 및 체간위치감각에 미치는 영향을 알아보고자 시행하였다. 뇌졸중 환자 30명을 대상으로, 다중감각 훈련군은 시각통제 후 훈련을 실시하였고, 대조군은 안대로 눈을 가린 것을 제외하고는 실험군과 동일한 훈련을 실행 하였다. 두 군 모두 훈련 과정은 4주간 주 5회 60분 동안 실시하였다. 대상자들은 사전, 사후 평가로 정적 균형, 동적 균형 및 체간위치감각을 검사하였다. 본 연구의 결과는 다중감각 훈련군에서 훈련 전, 후를 비교한 결과 정적 균형, 동적 균형, 체간위치감각에서 유의한 향상이 나타났고(p<.05), 두 그룹 사이에서는 동적 균형, 체간위치감각에서 유의한 차이가 나타났다(p<.05). 본 연구의 결과를 통하여 다중감각 훈련은 동적 균형 및 체간위치감각을 향상시키는데 효과적인 훈련방법으로 제시 할 수 있다.

• 대한물리치료과학회지
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• 제17권1_2호
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• pp.1-9
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• 2010

Background: The objective of this study was to determine whether sensorimotor training using an unstable surface affects dynamic balance and gait function in patients with hemiparesis, and to compare the effect of sensorimotor training with that of cycling exercise. Methods: Two subjects with post-stroke hemiparesis volunteered to participate in this study. Single-subject A-B design with alternating treatment was used for this study. Baseline(A) and intervention(B) phases were performed for 7 and 8 sessions, respectively. Sensorimotor training and cycling exercise were performed for 20 minutes in randomized order. Assessment tools were made by using a step test, timed up and go(TUG) test, and 6-minute walk test(6MWT). Results: Each of the participants improved in all three tests after the two interventions. Participants 1 and 2 showed the improvement for their assessment score after sensorimotor training in the step test by 42.1%(p<.05) and 58%, in the TUG, 31% and 19.5%, and in the 6MWT test, 32.3% and 10.6%(p<.05), respectively. After cycling exercise, participants 1 and 2 also improved in the step test by 32.5% and 53.1%, in the TUG, 27.4% and 18%, and in the 6MWT test, 28.8% and 3%. In statistical analysis between the two interventions, sensorimotor training showed a significant increased values in the step test for participant 1 and the 6MWT for participant 2 as compared with those of cycling exercise. Conclusion: Sensorimotor training and cycling exercise are helpful for improving dynamic balance and gait capacity. Furthermore, sensorimotor training may be more helpful than cycling exercise.

• The Korean Journal of Physiology and Pharmacology
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• 제14권6호
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• pp.435-440
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• 2010

Valproic acid (VPA) is a well-known anti-epileptic and mood stabilizing drug. A growing number of reports demonstrate that VPA is neuroprotective against various insults. Despite intensive efforts to develop new therapeutics for stroke over the past two decades, all treatments have thus far failed to show clinical effect because of treatment-limiting side effects of the drugs. Therefore, a safety-validated drug like VPA would be an attractive candidate if it has neuroprotective effects against ischemic insults. The present study was undertaken to examine whether pre- and post-insult treatments with VPA protect against brain infarct and neurological deficits in mouse transient (tMCAO) and permanent middle cerebral artery occlusion (pMCAO) models. In the tMCAO (2 hr MCAO and 22 hr reperfusion) model, intraperitoneal injection of VPA (300 mg/kg, Lp.) 30 min prior to MCAO significantly reduced the infarct size and the neurological deficit. VPA treatment immediately after reperfusion significantly reduced the infarct size. The administration of VPA at 4 hr after reperfusion failed to reduce the infarct size and the neurological deficit. In the pM CAO model, treatment with VPA (300 mg/kg, i.p.) 30 min prior to MCAO significantly attenuated the infarct size, but did not affect the neurological deficit. Western blot analysis of acetylated H3 and H4 protein levels in extracts from the ischemic cortical area showed that treatment with VPA increased the expression of acetylated H3 and H4 at 2 hrs after MCAO. These results demonstrated that treatment with VPA prior to ischemia attenuated ischemic brain damage in both mice tMCAO and pMCAO models and treatment with VPA immediately after reperfusion reduced the infarct area in the tMCAO model. VPA could therefore be evaluated for clinical use in stroke patients.

• PNF and Movement
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• 제8권2호
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• pp.17-24
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• 2010

Purpose : The purpose of present study was to determine effects of a visual feedback training on balance ability in poststroke hemiparetic subjects. Methods : Fourteen chronic stroke patients participated. Participants were randomly divided into either visual feedback training group(7 experimental group, 7 control group). All of participated were inpatients at local rehabilitation center and had been receiving a traditional rehabilitation program, five days a week. Exprimental group have additionally undergone for four weeks, three days a week, the visual feedback training but control group was not received any additional program except the traditional rehabilitation program. The Berg Balance Scale(BBS), the FICSIT-4, the MTD-balance system to measure a balance ability were carried out twice before and after training. Results : After participation in the program, subjects of visual feedback training demonstrated a significant improvement in the scores of the BBS, the FICSIT-4, the MTD-Balance system. The control group had no change on the any tests. After the training, the result to improve significantly in visual feedback training group compared to post-test of control group were the score of BBS and the FICSIT-4 and the MTD-Balance system. Conclusions : The present study suggests that the visual feedback training program may become a useful strategy for enhancing balance ability in the rehabilitation of stroke patiens.