• Journal of Institute of Control, Robotics and Systems
• /
• v.16 no.9
• /
• pp.833-839
• /
• 2010

In this paper, a novel 1 DOF hand rehabilitation robot is proposed in consideration of ADL training for stroke patients. To perform several ADL trainings, the proposed robot can move the thumb part and the part of 4 fingers simultaneously and realize the full ROM (Range of Motion) in grasp. Based on these characteristics, the proposed robot realizes several types of grasp such as cylindrical grasp, lateral grasp, and pinch grasp by using a passive revolute joint that can change the thumb movement direction. The movement of the thumb is driven by a cable mechanism and the part of 4 fingers is moved by a four-bar linkage mechanism.

• Physical Therapy Korea
• /
• v.3 no.2
• /
• pp.42-48
• /
• 1996

Weight bearing training on the involved leg is impotant for ambulation and activities of daily living in ambulatory hemiplegic patients. Traditionally, physical therapists have relied on exercise therapy and subjective evaluation. The goal for this study was to measure lower extremity weight distribution in standing with ten hemiplegic pations(M:8, F:2) and to determine the traing effect on symmetrical standing posture using a "Limloader". The Limloader is a machine designed for training symmetrical weight bearing posture. The results showed that the ability to keep the center of gravity within the limits for balance was improved significantly but the ability to adjust weight bearing on the involved leg was not (p<0.05). This study demostrated that hemiplegics can improved their symmetrical weight bearing ability using sensory biofeedback.

• Physical Therapy Rehabilitation Science
• /
• v.11 no.4
• /
• pp.471-477
• /
• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• Physical Therapy Rehabilitation Science
• /
• v.12 no.2
• /
• pp.115-122
• /
• 2023

Objective: A previous study reported that cardiovascular training (CT) decreased interleukin-6 (IL-6), a pro-inflammatory cytokine with bidirectional effects. However, because of conflicting results of increasing and decreasing IL-6 levels in stroke patients, it is essential to clarify the effects of CT on IL-6 levels in this population. Therefore, this review aimed to investigate the effects of CT on IL-6 levels in stroke patients through a meta-analysis of randomized controlled trials (RCTs), synthesizing and analyzing the effects qualitatively and quantitatively. Design: A systematic review and meta-analysis of randomized controlled trials. Methods: In this review, conducted in April 2023, electronic databases (Web of Science, CINAHL, Embase, MEDLINE, Google Scholar) were searched to ascertain the effects of CT on IL-6 levels in stroke patients. For qualitative evaluation, ReVMan, provided by the Cochrane Group, was used, and for quantitative evaluation, a random-effects model and SMD (Standardized Mean Difference) were used. Results: Three RCTs measured IL-6 in 117 patients with stroke. The experimental group to which CT was applied showed no significant change compared to the control group.The result of analysis using the random effect model is SMD=-0.23; 95% confidence interval, -0.66 to 0.20. Conclusions: CT does not affect IL-6 levels in stroke patients. These results suggest that CT can be applied regardless of its positive or negative effect on IL-6 levels in stroke patients.

• Physical Therapy Rehabilitation Science
• /
• v.12 no.3
• /
• pp.300-309
• /
• 2023

Objective: The purpose of this study was to investigate the effects of gastrocnemius neuromuscular electrical stimulation training on ankle mobility and gait in patients with stroke. Design: A randomized controlled trial. Methods: 31 patients with stroke were selected and classified into an experimental group (n=16) and a control group (n=15). Both groups were assessed for ankle mobility using the Knee to Wall Test and gait parameters using G-walk before and after the intervention. The intervention was applied five times a week for four weeks. The experimental group performed gastrocnemius neuromuscular electrical stimulation followed by ankle control exercises, while the control group only applied NMES to the tibialis anterior muscle of the paretic side for 30 min per session five times a week for 4 weeks. Results: Experimental group showed significant improvements in Knee to wall test. and lumbar flexibility after the intervention. both group showed significant improvements in gait parameters after the intervention. However, when comparing between the two groups, the experimental group showed a more significant effect than the control group. Conclusions: Gastrocnemius neuromuscular electrical stimulation training can be considered an effective approach to improve ankle mobility and gait ability in patients with stroke.

• Journal of the Korean Society of Physical Medicine
• /
• v.12 no.3
• /
• pp.33-42
• /
• 2017

PURPOSE: To compare postural vertical training with and without visual feedback for improving functional recovery in post-stroke hemiparesis patients with pusher syndrome. METHODS: This study used a single-subject research with alternating design with multiple baselines. Three patients with hemiparetic post-stroke diagnosed with pusher syndrome were selected from the inpatients at the department of physical therapy of a local rehabilitation hospital. For subjective postural vertical (SPV) training with and without visual feedback, an alternating treatment was used. The subjects were randomly selected using the sequence of the two training methods upon starting the intervention, and then the training was alternated. SPV training was performed twice a day, once in the morning and again in the afternoon. Scale for contraversive pushing (SCP), postural assessment scale for stroke, and Barthel index score were used to determine the intervention-related changes. RESULTS: Compared to the average score at baseline, the average SCP score for the SPV training without visual feedback decreased from 5.3 to 2.8, from 4.6 to 3, and from 3.5 to 2.7 for subjects 1, 2, and 3, respectively. However, the average score for the SPV training with visual feedback decreased from 5.3 to 3.1, from 4.6 to 3.5, and from 3.5 to 3.3 for subjects 1, 2, and 3, respectively. CONCLUSION: Postural vertical training without visual feedback may be more beneficial than postural vertical training with visual feedback for improving pushing behavior and functional activity in stroke patients with pusher syndrome.

• Physical Therapy Rehabilitation Science
• /
• v.6 no.3
• /
• pp.106-112
• /
• 2017

Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions: The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.

• The Korean Journal of Rehabilitation Nursing
• /
• v.5 no.1
• /
• pp.60-70
• /
• 2002

This study was a quasi-experimental study to confirm the effects of a memory training program. The purpose was to develop an effective memory training program for elderly people and to identify the effects of the memory training program. This study was carried out between February 25 and July 20, 1999 and the subjects of the study were 102 elderly people who were participants at a welfare institute in Seoul. The experimental group (51) and the control group (51) were assigned by means of participation order. The control group was matched to the experimental group and was selected considering age, sex, and religion. The experimental group participated in the memory training program. The memory training program was based on the literature of Fogler & Stern (1994), Wang & Lee (1990), Lee (1991) and Lee (1993). The memory training program was given twice a week for two weeks with each program lasting two hours. Depression was measured using the Geriatric Depession Scale developed by Sheikh & Yesavage(1986) and memory self-Efficacy was measured using the Memory Self-Efficacy Scale developed by Berry & Dennehey (1989). Data were analyzed by SPSS PC and the results are described below. 1. The experimental group which participated in the Memory Training Program showed lower depression scores as compared to the control group(t=-4.310, P=.000). 2. The experimental group which participated in the Memory Training Program showed higher higher memory self-efficacy scores as compared to the control group(t=4.354, P=.000). 3. In the experimental group, there was significant negative correlation between the depression scores and memory self-efficacy scores. The results showed that the Memory Training Program is an effective nursing intervention for the elderly with depression and memory problems.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.4
• /
• pp.71-78
• /
• 2016

PURPOSE: The purpose of this study was to investigate which treadmill walking training mode is more effective strategy for improving pulmonary function of persons with chronic stroke. METHODS: Twenty-one chronic stroke patients were allocated and randomly to an experimental group (treadmill training with randomized speed control, n=11) and a control group (treadmill training without speed change, n=10). All participants received 30 minutes of neurodevelopmental treatment. In addition, the two groups performed treadmill training for 20 minutes each time with or without speed change. Speed change was applied 40%, 50%, 60%, 70% of Heart Rate Reserve. All the exercise programs lasted six weeks, with five times per week. Pulmonary function was assessed before and after exercise program by using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV). RESULTS: In the both groups, FEV1 was significantly increased after training (p<.05). Compared to the control group, the experimental group showed 11.9% larger amount of change (p<.05). In the experimental group, FVC and MVV were significantly increased after training (9.9%, 7.6%, respectively) (p<.05). But in the control group, there was no significant difference in the FVC and MVV after training. CONCLUSION: Treadmill training with randomized speed control will be a better positive rehabilitation program than treadmill training without speed change to improve pulmonary function in persons with chronic stroke.

• The Journal of Korean Physical Therapy
• /
• v.29 no.2
• /
• pp.101-107
• /
• 2017

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.