• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.155-164
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• 2020

Objective: This study aimed to compare muscle structure, balance, and gait parameters between healthy adults and persons with stroke and to analyze the correlation among these variables. Design: Cross-sectional study. Methods: Twenty persons with stroke (11 male, 9 female) and twenty healthy participants (9 male, 11 female) were included. Ultrasound images of the triceps surae and the tibialis anterior were acquired in sitting resting, sitting co-contraction, and standing resting positions and also during the functional reach test (FRT) and single leg anterior reaching test (SLART). Muscle thickness and fascicle length were measured. Spatiotemporal parameters of gait were measured using a pressure walkway. Gait speed, cadence, step length, stride length, stance time, and swing time were measured. Results: Changes in percent fascicle length were significantly greater in the gastrocnemius and soleus (SOL) muscles of healthy adults in the sitting co-contraction position (p<0.05). The percent fascicle length of the SOL in FRT and SLART were significantly greater in healthy adults (p<0.05). The mid-stance phase of stroke patients was shorter than healthy adults (p<0.05). A negative correlation was observed between percent fascicle length of the SOL in the sitting co-contraction position and the proportion of the mid-stance phase (p<0.05). Conclusions: The function of the triceps surae is affected in persons with stroke when compared with healthy adults. This can lead to difficulty in performing tasks that involve forward transfer of weight. If the triceps surae is not sufficiently secured, the possibility of compensation in the stance phase increases during gait.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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• pp.1007-1017
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• 1999

The purpose of this study was to evaluate the factors influencing the ambulatory status in hemiplegia with intracerebral hemorrhage after rehabilitation. Thirty patients with stroke who was admitted in the Chosun University Hospital, between from January 1st' 1998 and December 31st' 1998, were included in this study. The following variables as a potential predictors for ambulation were evaluated at treatment of the stroke onset; 1) general characteristics including age and sex, and 2) clinical characteristics including frequency and onset time of the stroke, affected side, duration of the treatment, time interval between onset and rehabilitation, manual muscle test of paretic limb, sitting and standing balance, proprioception, perception, cognitive function. We compared and analyzed the these variables to the two type of ambulatory status at the time of the discharge by Modified Barthel Index, independent, dependent. The data were analyzed by student t-test, Fisher-exact test, Mann Whitney-U test, $X^{2}$-test, correlation analysis(spearman's). The results were as follows; 1. Were no significantly inflenced independent ambulatory status among general characteristics. 2. Frequency of the stroke and proprioception (p<0.05), muscle strength of the lower limb, cognitive function and standing balance (p<0.01), perception and sitting balance (p<0.001) were significantly inflenced independent ambulatory status among clinical characteristics. 3. Independent Variable correlated with the ambulatory status were muscle strength of the lower limb, proprioception and sitting balance (p<0.05), standing balance, frequency of the stroke, perception and cognitive function (p<0.01). Therefore the muscle strength of the lower limb, proprioception, sitting balance, standing balance, frequency of the stroke, perception, cognitive function were the most significant influencing factors of ambulatory status after rehabilitation.

• Physical Therapy Korea
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• v.26 no.1
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• pp.37-50
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• 2019

Background: Stroke is one of the most common diseases responsible for physical disabilities. In addition to their physical and occupational therapy, the self-exercise programs were developed for patients with hemiplegia to increase the intensity of their therapeutic exercise. Objects: The purpose of this study was to assess the effect of a customized self-exercise program (CSP) to walking function on improving stroke survivors' muscle strength and ambulation function. Method: To test the effect of the self-exercise program, the following tests were conducted: The functional ambulation category (FAC), Tinetti performance-oriented mobility assessment gait part (POMA-G), timed up and go (TUG), 10-meter walk, and 2-minute walk. The study included 161 consenting stroke patients (FAC score>1) from a randomized, screened sample of 217. The CSP group participated in a 30-minute CSP each day for 10 weeks in addition to completing a routine rehabilitation program. The control group received only a routine rehabilitation program. All the subjects were monitored by a therapist once a week and had to submit an exercise checklist at the end of each session. Result: The strength of the participants' upper and lower extremity muscles showed no significant differences between the CSP group and the control group. The FAC score and POMA-G also showed no significant differences. However, there were significant differences in the TUG, 10-meter walk test, and 2-minute walk test (p<.05). Conclusion: The findings of this study suggest that a CSP may improve gait-related function in stroke survivors.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.37-46
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• 2018

Objective : The aims of this study is to investigate the research trends of driver rehabilitation in stroke patients through systematic consideration and suggests future research directions. Method : This study was conducted on a total of 6 subjects selected from 2008 to 2017. The analysis criteria were classified into qualitative level, published journal, evaluation tool, and keyword. Result : The study on the driving rehabilitation of stroke patients was the highest in IV and V levels at 33.32% each, and the most studies were published in 2014. The keywords of the study were 33.32% each related to driving and stroke. Conclusion : This study investigated the driving rehabilitation of stroke patients. Based on the results, it is necessary to continuously study the effects of various programs for driving rehabilitation in the future.

• PNF and Movement
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• v.17 no.1
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• pp.47-56
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• 2019

Purpose: This study investigated the effects of neck pattern of proprioceptive neuromuscular facilitation (PNF) on balance and walking ability in patients with chronic stroke. Methods: Fourteen participants with chronic stroke were randomly assigned to vestibular rehabilitation and then divided into two groups: the neck pattern group or treadmill group. Each group underwent 20 sessions (20 minutes/day, five days/week, for four weeks). Patients were assessed with the Berg balance scale (BBS) and gait parameters (gait speed, cadence, step length, and double-limb support period) using a GAITRite system. Results: Vestibular rehabilitation for the neck pattern group and the treadmill group showed significant intragroup improvement on the BBS and in terms of gait speed, cadence, step length, and double-limb support period (p < 0.05). Vestibular rehabilitation was more effective for the neck pattern group than for the treadmill group in terms of the BBS (p = 0.00; 95% CI, 1.49-5.94), gait speed (p = 0.01; 95% CI, 0.05-0.16), cadence (p = 0.02; 95% CI, 0.54-4.99), and step length (p = 0.00, 95% CI, 1.55-4.62). Conclusion: This study used the neck pattern of PNF for vestibular rehabilitation in patients with chronic stroke. The results showed significant improvement in the patients' balance and walking ability. Therefore, the neck pattern of PNF for vestibular stimulation may be more effective than treadmill training to improve balance and walking ability in patients with chronic stroke.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.1-11
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• 2022

Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

• Advances in robotics research
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• v.1 no.2
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• pp.155-169
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• 2014

Study results in the last decades show that amount and quality of physical exercises, then the active participation, and now the cognitive involvement of patient in rehabilitation training are known of crux to enhance recovery outcome of motor dysfunction patients after stroke. Rehabilitation robots mainly have been developing along this direction to satisfy requirements of recovery therapy, or focusing on one or more of the above three points. Therefore, neuro-machine interaction based active rehabilitation robot has been proposed for assisting paralyzed limb performing designed tasks, which utilizes motor related EEG, UCSDI (Ultrasound Current Source Density Imaging), EMG for rehabilitation robot control and feeds back the multi-sensory interaction information such as visual, auditory, force, haptic sensation to the patient simultaneously. This neuro-controlled and perceptual rehabilitation robot will bring great benefits to post-stroke patients. In order to develop such kind of robot, some key technologies such as noninvasive precise detection of neural signal and realistic sensation feedback need to be solved. There are still some grand challenges in solving the fundamental questions to develop and optimize such kind of neuro-machine interaction based active rehabilitation robot.

• PNF and Movement
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• v.15 no.3
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• pp.317-331
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• 2017

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.7
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• pp.3057-3064
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• 2012

In this study, we have tried to identify the relationship between the patient's health belief and the implementation of functional movement rehabilitation and ability to perform ADL in stroke patient, and have done this study to use this as evidence in treating stroke patients in clinical trials by providing a basis data of stroke patients' successful rehabilitation program. We targeted stroke patients who were diagnosed with stroke and are hospitalized in D hospital in J City, Jeollabuk-do, South Korea. More over, we distributed a total of 150 questionnaires to patients who understand the purpose of the research and agreed to participate. We were able to collect 132questionnaires at the end. However, 11 had insufficient data so we only analyzed and evaluated 121 of the said questionnaires. We did frequency analysis to understand the general characteristics by using SPSS for Windows(ver.12.0) program and we used Pearson's Correlation Coefficient and regression analysis to know the relationship between the patient's health beliefs and the implementation of rehabilitation and ability to perform ADL in stroke patients. The results of this study shows that patients with higher perceived sensitivity, perceived benefit and perceived severity equates to an implementation of the rehabilitation better, however patients with a lower perceived disability equates an implementation of functional movement rehabilitation better than those with a higher perceived disability.

• Journal of Institute of Control, Robotics and Systems
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• v.16 no.10
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• pp.919-926
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• 2010

This paper proposes a wearable hand rehabilitation device, DULEX, for persons with functional paralysis of upper-limbs after stoke. DULEX has three degrees of freedom for rehabilitation exercises for wrist and fingers except the thumb. The main function of DULEX is to extend the range of motions of finger and wrist being contracture. DULEX is designed by using a parallel mechanism, and its parameters such as length and location of links are determined by kinematic analysis. The motion trajectory of the designed DULEX is aligned to human hand to prevent a slip. To reduce total weight of DULEX, artificial air muscles are used for actuating each joint motion. In feedback control, each joint angle is indirectly estimated from the relations of the input air pressure and the output muscle length. Experimental results show that DULEX is feasible in hand rehabilitation for stroke survivals.