• Physical Therapy Rehabilitation Science
• /
• v.8 no.4
• /
• pp.187-193
• /
• 2019

Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.

• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.4
• /
• pp.163-174
• /
• 2020

PURPOSE: This study examined the effects of Robot Tilt-table Training (RTT) on the lower extremity strength, balance, gait, and satisfaction with rehabilitation, in patients with subacute stroke (less than six months after stroke onset), and requiring intensive rehabilitation. METHODS: A total of 29 subacute stroke patients were divided into an RTT group (n = 14) and a Body Weight Support Treadmill Training (BWSTT) group (n = 15). The mean age of patients was 62 years. RTT and BWSTT were performed for four weeks, three times a week, for 30 minutes. Isometric strength of the lower extremities before and after intervention was compared by measuring the maximal voluntary isometric contraction of the lower extremity muscles. To compare the balance function, the center of pressure (COP) path-length and COP velocity were measured. Timed Up & Go test (TUG) and 10 Meter Walking Test (10 MWT) were evaluated to compare the gait function. A satisfaction with rehabilitation survey was conducted for subjective evaluation of the subject's satisfaction with the rehabilitation training imparted. RESULTS: In the intra-group comparison, both groups showed significant improvement in lower extremity strength, balance, gait, and satisfaction with rehabilitation, by comparing the parameters before and after the intervention (p < .05). Comparison of the amount of change between groups revealed significant improvement for all parameters in the RTT group, except for the 10 MWT (p < .05). CONCLUSION: Both groups are effective for all variables, but the RTT group showed enhanced efficacy for variables such as lower extremity strength, balance, gait, and satisfaction with rehabilitation, as compared to the BWSTT group.

• Annals of Rehabilitation Medicine
• /
• v.42 no.6
• /
• pp.788-797
• /
• 2018

Objective To investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Patients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment. Results For each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups. Conclusion Treatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Results of this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

• The Korean Journal of Health Service Management
• /
• v.11 no.1
• /
• pp.91-105
• /
• 2017

Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

• Journal of the Korean Society of Physical Medicine
• /
• v.5 no.1
• /
• pp.25-34
• /
• 2010

Purpose : The purpose of this study is to assess the effect for gait, balance, and depression for stroke patients by group task-related program training based motor learning theory. Methods : The subjects of this study were administrated to the 11 stroke patients (9 male, 2 female) by 5 weeks, 3 times per week, 15 times. The group task-related program training were performed gait, balance, treadmill, muscle strengthening, and game program. Each program took 7~10 minutes and total time took 60 minutes including moving time. The difference of program training were compared using the paired t-test. Results : The results of this study revealed that Fugl-Meyer motor assessment, Chedoke-McMaster Stroke assessment of lower extremity and Berg balance scale were significantly correlated. However, impairment item of Chedoke-McMaster Stroke assessment, spatio-temporal gait parameters, Timed up and go test, and depression item of Minnesota Multiphasic Personality Inventory were not significantly correlated. Conclusion : These results support that group task-related program could be a useful treatment to improve the balance skills and motor function of lower extremity for the chronic stroke patients.

• The Korean Journal of Rehabilitation Nursing
• /
• v.16 no.2
• /
• pp.90-99
• /
• 2013

Purpose: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. Methods: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. Results: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. Conclusion: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.

• Journal of Magnetics
• /
• v.20 no.2
• /
• pp.129-132
• /
• 2015

The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

• Journal of the Korean Society of Physical Medicine
• /
• v.12 no.3
• /
• pp.11-21
• /
• 2017

PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p<.05). Post hoc test results differed significantly in the 10-meter walk test after intervention (p<.05). However, there were no significant differences in limits of stability test after intervention (p>.05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

• The Journal of Korean Physical Therapy
• /
• v.20 no.1
• /
• pp.41-47
• /
• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• Journal of Yeungnam Medical Science
• /
• v.39 no.2
• /
• pp.98-107
• /
• 2022

Background: Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient's information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language. Methods: We created a mini blockchain to store the medical information of patients using the Java programming language. Results: After generating a unique pair of public/private keys for identity verification, a patient's identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks. Conclusion: We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.