• Title/Summary/Keyword: Stroke Rehabilitation

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The effect of physical training on glutamate transporter expression in an experimental ischemic stroke rat model

  • Kim, Gye-Yeop;Kim, Eun-Jung
    • Physical Therapy Rehabilitation Science
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    • v.2 no.2
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    • pp.87-91
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    • 2013
  • Objective: The present study was aimed at determining the effect of physical training on glutamate transporter activity in a middle cerebral artery occlusion (MCAO)-induced ischemia injury rat model. Design: Randomized controlled trial. Methods: In this study, we randomly divided them into three groups. Group I included non-occlusion sham controls (n=10), Group II included non-physical training after MCAO (n=10), and Group III included rats that were subjected to physical training after MCAO (n=10). Rats in the physical training group underwent treadmill training, which began at 24 h after MCAO and continued for 14 consecutive days. The training intensity was gradually increased from 5 m/min on the first day to 12 m/min on day 3, and it was maintained until day 14. Focal cerebral ischemia was examined in adult male Sprague-Dawley rats by using the MCAO model. We determined the functional outcomes for each rat on days 1, 7, and 14. Glutamate transporter-1 (GLT-1) activity in the cortex of rats from all three groups was examined at the end of the experiment. Results: Out result show that MCAO rats exhibited severe neurological deficits on the 1 day, and there was no statistically significant in each groups. We observed that the functional outcomes were improved at days 7 and 14 after middle cerebral artery occlusion, and GLT-1 activity was increased in the physical training group (p<0.05). Conclusions: These results indicated that physical training after focal cerebral ischemia exerts neuroprotective effects against ischemic brain injury by improving motor performance and increasing the levels of GLT-1 activity.

Design and Evaluation of a Low-floor Care-bed for Elderly People (고령자용 저상 요양침대의 설계 및 평가)

  • Bae, Ju-Hwan;Moon, Inhyuk
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.1
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    • pp.29-35
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    • 2017
  • It was hard for a conventional care-bed to be realized to a low-floor position due to a complex actuation mechanism installed under the mattress support platform. In this paper a mechanism design to set a low-floor position as well as to adjust back- and leg-rest angles was proposed. A dual motor was applied to the back- and leg-rest mechanism of which design parameters were determined by an optimal method. An elevation mechanism was also designed to enlarge a limited stroke range up to two times of its original stroke using a pulley mechanism. An evaluation test was performed by five healthy subjects ($24.4{\pm}0.5yrs.$) when going up from a floor position to a preset best position which was set to the 240mm height for a prototype low-floor bed and to the 600mm height for a conventional bed. As a result, the moving distance was 38% lower than the conventional bed when the subject used the low-floor bed. It showed that the low-floor care-bed reduced physical burdens and was effective to assist activities of daily living of the elderly people.

The Effects of Repetitive Sit-to-Stand Training with a Paretic-side Asymmetrical Foot Position on the Balance of Chronic Stroke Subjects

  • Park, Jae Hyo;Kim, Young Mi;Lee, Na Kyung
    • The Journal of Korean Physical Therapy
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    • v.27 no.3
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    • pp.169-173
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    • 2015
  • 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.

Analyzing the Problem of the Caregiver Education System through a Research of the Caregiving Service Activity (요양보호 서비스 활동 조사를 통한 요양보호사 교육과정의 문제점 분석)

  • Suh, Tae-Soo;Kim, Kyong-Tae;Jun, Kyoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.20 no.4
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    • pp.61-69
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    • 2008
  • Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

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Change of Brain Activation due to Change of Viewpoint in Action during Action Observation: an EEG Analysis Study (동작관찰 중 동작 수행 시 시점의 변화에 따른 뇌 활성의 변화)

  • Kim, Oi-Jin;Sim, Ji-Young;Lee, Se-Young;Jin, Hyun-Jin
    • PNF and Movement
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    • v.14 no.3
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    • pp.209-217
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    • 2016
  • Purpose: Treatments using a mirror neuron system, such as 3D virtual reality therapy, are used in stroke rehabilitation, but they need to be constructed according to a detailed procedure. The aims of this study were to analyze electroencephalograms (EEG) during relaxation and action while observing first person perspective (1AE) and third person perspective (3AE) videos of the right hand for 20's. Methods: Thirty participants (Male=4, Female=26) were recruited for this study. Participants were selected by a vividness of movement imagery questionnaire (VMIQ). EEG was measured during relaxxation and during action with 1AE and 3AE videos, focusing on the supination and pronation actions of participants' right hands. An absolute mu rhythm, a relatively high alpha power, and a relative beta power were identified. In each group, one-way repeated measures ANOVA was used for statistical analysis. Results: Measurement of absolute mu rhythms was significantly suppressed for both 1AE and 3AE compared with relaxation in C3 and C4 regions. High alpha wave measurements were significantly suppressed for both 1AE and 3AE in all regions, while beta wave measurements were significantly increased only for 3AE in F3 and F4 regions. Conclusion: Based on this study, we suggest that the mirror neuron system is activated during actions accompanied by action observation, especially actions with 3AE video observation, which can be a great therapeutic mathod in stroke rehabilitation.

Change of Plantar Fascia Thickness in Hemiplegic Patients (편마비 환자에서 족저근막의 두께 변화)

  • Park, Ji-Won;Park, Sung-Hee;Ko, Myoung-Hwan
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.41-46
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    • 2009
  • Purpose: This study investigated the change in plantar fascia thickness in hemiplegic and non-hemiplegic feet in stroke patients using an ultrasonographic evaluation. Methods: Sixteen hemiplegic and non-hemiplegic feet from 16 hemiplegic patients (patient group) and 16 feet from 8 healthy subjects (control group) were evaluated by ultrasonography. The sagittal sonograms were obtained in the prone position, and the plantar fascia thickness was measured at its insertion into the calcaneus. Results: The mean plantar fascia thickness was measured to be $4.5\pm0.8$mm in hemiplegic feet of the patient group, $3.4\pm1.0$mm for the contralateral non-hemiplegic feet and $2.8\pm0.3$mm for the control group. There was a statistically significant difference in plantar fascia between the hemiplegic feet and contralateral non-hemiplegic feet as well as between the contralateral non-hemiplegic feet and control group (p<0.01 and p<0.05, respectively). The plantar fascia thickness according to the Brunnstrom stage and modified Ashworth scale was increased significantly in the hemiplegic feet (p<0.01). Conclusion: These results show that the plantar fascia is overloaded in the hemiplegic and non-hemiplegic feet of stroke patients. A therapeutic approach should be considered for these patients.

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Comparison of EMG and Muscle Reaction Force to Detect Exercise Intention (운동의도 검출을 위한 근육반력과 근전도의 비교)

  • Heo, J.H.;Kim, J.W.;Kwon, Y.R.;Eom, Gwang-Moon;Jeong, K.Y.;Kwon, D.K.
    • Journal of Biomedical Engineering Research
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    • v.34 no.2
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    • pp.63-68
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    • 2013
  • Activeness of exercise is critical for stroke rehabilitation so that application of stimulation in response to patient's intention would be effective in FES cycling. The purpose of this study was to investigate the relationship between muscle reaction force (MRF) and electromyogram (EMG) during cycling exercise, for the future usage of MRF as patients' intention signal. Seven young men ($24{\pm}1.63$ yrs) participated in this study. Cycling speed was set to 20 RPM and 60 RPM. MRF and EMG were measured in the vastus lateralis muscle of right leg. Active cycling was performed at the maximal load (16 Nm) of an ergometer. Angle dependent artifact in MRF was measured from passive cycling and was subtracted from the MRF of active cycling. The delay of MRF with respect to EMG envelope and their correlation coefficients were derived from the best of cross correlation. MRF was significantly correlated with EMG amplitude in all subjects (p<0.01). Their mean correlations were 0.84 and 0.91 for 20 RPM and 60 RPM, respectively. Mean delay in MRF was 59.14 ms and 53.14 ms for 20 RPM and 60 RPM, respectively. The result suggests that MRF can be used to assess patient's intention for exercise as a substitute to EMG. The method may be applied to FES cycling to encourage patient's effort which is critical for stroke rehabilitation.

Effect of Korea Red Ginseng Extract on PC12 Cell Death Induced by Serum Deprivation (홍삼 수용성 추출물이 PC12 세포사멸에 미치는 영향)

  • Lee, Sang-Hyun;Yun, Young-Gab
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.2
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    • pp.103-112
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    • 2009
  • Objectives : This study was to evaluate the pharmacological effect of Korea Red Ginseng aqueous extract (KRGE) on serum-deprived apoptosis of neuronal-like pheochromocytoma PC12 cells and to investigate its underlying action mechanism. Methods : KRGE was prepared by extracting Korea Red Ginseng with hot water and concentrating using a vacuum evaporator. Cell viability was determined after incubation of cells with KRGE or chemical inhibitor in serum-deprived medium for 60 h by counting intact nuclei following lysing of the cell membrane. Caspase activities were measured using chromogenic substrates and signal-associated protein phosphorylation and cytochrome c release were determined by Western blot analyses using their specific antibodies. Results : Serum deprivation induced PC12 cell death, which was accompanied by typical morphological features of apoptotic cell, such as nuclear fragmentation, caspase-3 activation, and cytochrome c release. This apoptotic cell death was significantly inhibited by KRGE and caspase-3 inhibitor, but not by the addition of NMA, ODQ, and PD98059. KRGE promoted phosphorylation of Akt and Bad, and this phosphorylation was inhibited by the PI3K inhibitor LY92004. In addition, this inhibitor also reversed KRGE-mediated protection of PC 12 cells from serum deprivation. These results suggested that KRGE protects PC12 cells from serum deprivation-induced apoptosis through the activation of PI3K/Akt-dependent Bad phosphorylation and cytochrome c release, resulting in caspase-3 activation. Conclusions : KRGE should be considered as a potential therapeutic drug for brain diseases including stroke induced by apoptosis of neuronal cells.

The Effect of Rehabilitation Training Programs on the Kinetic and Kinematic Parameters During Sit-To-Stand in Chronic Stroke Patients (만성편마비 환자의 재활 운동 유형이 일어서기 동작의 운동학 및 운동역학적 변인에 미치는 영향)

  • Yu, Yeon-Joo;Yoon, Te-Jin;Eun, Seon-Deok
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.121-134
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    • 2006
  • 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.

Translation and Content Validity of the Korean Version of the Motor Activity Log (한국어판 운동활동일지(Korean Version-Motor Activity Log) 번안과 내용타당도 연구)

  • Kim, Sujin;Hwang, Sujin
    • PNF and Movement
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    • v.20 no.2
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    • pp.263-273
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    • 2022
  • 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.