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 purpose of this study was to investigate the relationship between three quantitative measures of the pendulum test for spasticity in strokes: The relaxation index, the number of oscillations, and the duration of oscillations. Twenty-six stroke subjects participated in the study. Correlations among these measures of spasticity used Pearson's correlation coefficient. There was a statistically significant positive correlation between the relaxation index and number of oscillations in strokes (r=.881, p<.01). In addition there was significant positive correlation between the relaxation index and duration of oscillations (r=.896, p<.01), and between the number of oscillations and duration of oscillations (r=.938, p<.01). Thus, it is possible to use the number of oscillations and duration of oscillations as quantitative measures of spasticity, rather than the relaxation index, which is more complicated to obtain. According to the result of this study, the use of the simple and objective measurements of the number of oscillations and the duration of oscillations are required clinically in the quantitative measures of spasticity in the future.
The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.
The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.
Kim, Kwang-Soo;Seo, Hyun-Du;Lee, Byoung-Hee;Kim, Seong-Yeol;Lee, Jong-Soo
Journal of Korean Medicine Rehabilitation
/
v.20
no.2
/
pp.79-87
/
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.
Objectives : This study was designed to investigate the effect of PC6 and SP4 on autonomic nerve system in healthy adults. Methods : 22 healthy adults were recruited and randomized into the study group or control group. The study group (real acupuncture group) was acupuncturcd on PC6 and SP4. The control group (sham acupuncture group) was acupunctured superficially near PC6 and SP4 but not the exact points. The subjects rested for 10 minutes, and were then acupunctured. After 15 minutes, acupuncture needles were removed and the subjects rested for another 15 minutes. Heart rate variability(HRV) was continuously measured during the study period by FM-150 (digital Holter ECG recorder). Results : In the real acupuncture group. LF(low frequency) significantly decreased during the acupuncture period(p<0.05). LF/HF ratio also had a significant decrease during acupuncture period and the decrease was maintained during the post-treatment period as compared with the pre-treatment period. In the sham acupuncture group. LF significantly increased during the acupuncture period but LF/HF ratio had no significant changes. Conclusions : The results suggest that acupuncture on PC6 and SP4 can increase parasympathetic activity and balance autonomic nervous system.
Kim, Bong Jun;Youn, Dong Hyuk;Chang, In Bok;Kang, Keunsoo;Jeon, Jin Pyeong
Journal of Korean Neurosurgical Society
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v.65
no.1
/
pp.4-12
/
2022
Objective : We reported the differentially methylated genes in patients with subarachnoid hemorrhage (SAH) using bioinformatics analyses to explore the biological characteristics of the development of delayed cerebral ischemia (DCI). Methods : DNA methylation profiles obtained from 40 SAH patients from an epigenome-wide association study were analyzed. Functional enrichment analysis, protein-protein interaction (PPI) network, and module analyses were carried out. Results : A total of 13 patients (32.5%) experienced DCI during the follow-up. In total, we categorized the genes into the two groups of hypermethylation (n=910) and hypomethylation (n=870). The hypermethylated genes referred to biological processes of organic cyclic compound biosynthesis, nucleobase-containing compound biosynthesis, heterocycle biosynthesis, aromatic compound biosynthesis and cellular nitrogen compound biosynthesis. The hypomethylated genes referred to biological processes of carbohydrate metabolism, the regulation of cell size, and the detection of a stimulus, and molecular functions of amylase activity, and hydrolase activity. Based on PPI network and module analysis, three hypermethylation modules were mainly associated with antigen-processing, Golgi-to-ER retrograde transport, and G alpha (i) signaling events, and two hypomethylation modules were associated with post-translational protein phosphorylation and the regulation of natural killer cell chemotaxis. VHL, KIF3A, KIFAP3, RACGAP1, and OPRM1 were identified as hub genes for hypermethylation, and ALB and IL5 as hub genes for hypomethylation. Conclusion : This study provided novel insights into DCI pathogenesis following SAH. Differently methylated hub genes can be useful biomarkers for the accurate DCI diagnosis.
Purpose: Translation and adaptation involve cross-cultural and conceptual aspects; they are not simply based on linguistic equivalence. This study aimed to produce a conceptually equivalent Korean version of the motor activity log (K-MAL) for the upper extremities that can be applied across the Korean population and its cultures. Methods: Following the procedures used in the translation of other cross-cultural evaluation tools, and the five steps of the translation process, the motor activity log (MAL) was translated into Korean (K-MAL). We then examined the content validity of the K-MAL. Twenty-two rehabilitation professionals (11 males and 11 females, mean length of clinical career = 101.54 months) assessed the content validity of the K-MAL. The content validity ratio and content validity index were used to verify the content validity. Results: There were inconsistencies found in three sub-items in the MAL during the forward translation process. These inconsistencies were corrected, and the complete K-MAL was produced. The exact critical values of the content validity ratio and the content validity index of the K-MAL were 0.45-0.95 and 0.77-1.00, respectively. Conclusion: The K-MAL was successfully developed using a systematic methodology, which included translation, adaptation, and evaluation of the content validity. We expect that stroke rehabilitation professionals working in both clinical and research settings will apply the K-MAL when evaluating the amount and quality of use of the upper extremities in post-stroke patients in Korea.
Journal of the Korean Society of Physical Medicine
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v.18
no.1
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pp.1-8
/
2023
PURPOSE: This study analyzed how proprioceptive neuromuscular facilitation (PNF) combined with auricular acupuncture affected the activation of the leg muscles of stroke patients and measured the effects of this combination to provide clinical data. METHODS: The subjects were divided randomly into experimental group I, which received PNF combined with auricular acupuncture, and experimental group II, which received PNF alone. Each group had ten members. A 30-minute intervention was performed four days a week for six weeks. Before the six weeks of intervention, pre-tests were conducted to measure muscle activation in the legs. After six weeks, post-tests were also conducted to measure muscle activation in the legs. RESULTS: Experimental group I showed a statistically significant difference in muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus. Experimental group II also showed a statistically significant difference in the muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus (p < .05). In a between-group comparison of the changes, a statistically significant difference was observed between the two groups in terms of muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus (p < .05). CONCLUSION: Intervention in experimental group I increased the activation of the leg muscles more effectively because auricular acupuncture was applied to various spots on the ear corresponding to the spleen, liver, kidney, pelvis, knee, ankle, and toe. Auricular acupuncture is expected to be used more widely in the future because it is a safe way of stimulating muscle activation.
Purpose : The purpose of this study was to find out useful radiological projection of shoulder subluxation in patients with post-stroke hemiplegia. Methods : A total of 33 patients with post-stroke hemiplegia were included(20 men and 13 women, mean age 62.3 years) and having the subluxed shoulder over one finger breath. The shoulder subluxation was determined as the ratio of the radiographic vertical and horizontal distance. The vertical distance was determined by measuring the distance between the most inferolateral point of the acromion and the central point of the humeral head. The horizontal distance was determined by measuring the distance between the central point of the glenoid fossa and the central point of the humeral head. To measure of the shoulder subluxation, the shoulder AP, axial and transthoracic lateral projections were taken on both affected and unaffected shoulders. We analyzed the difference of subluxation distance by t-test. Results : When patients was in sitting position, the average time of being shoulder subluxation was 123 second. There was significant difference between supine($49.90{\pm}13.6\;mm$) and sitting position($60.72{\pm}16.3\;mm$) in the vertical distance of shoulder anterior-posterior projection. Also, there was significant difference on transthoracic lateral projections, Affected $35.92{\pm}6.2\;mm$, Unaffected $28.76{\pm}5.4\;mm$. But in case of shoulder axial projection(supine position), there was no significant difference (Unaffected and affected was $23.01{\pm}9.0\;mm$, $22.45{\pm}8.2\;mm$ each). Conclusion : Radiological projection of shoulder subluxation has diagnostic value when it goes after check out the process of subluxation through finger breadth test. For this, patients must be in sitting and shoulder neutral position about 2 minutes. In addition, Shoulder anterior-posterior and transthoracic projection were significant to diagnose subluxation. But in axial projection, there wasn't meaningful differences.
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