• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.1-8
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• 2009

Purpose: This study examined the effect of EMG-stim related to the functional recovery of the upper extremity in chronic stroke patients with an intensive massed practice protocol. Methods: The subjects were assigned randomly to either the EMG-stim group (n=10) or sham treatment group (n=10). Both groups received conventional physical therapy, occupational therapy and FES, five times per week over a four week period. In the EMG-stim group, EMG-stim was applied to the hemiplegic wrist and finger extensors for 2 sessions for 30 minutes per day, 5 times per week over a 4 week period. As the pre- and the post-test, the following four motor tests were assessed as the function of the upper extremity clinical functional test: extensor digitorum strength test, Box and Block test, Fugl-Mayer Assessment, and Jebson-Taylor Hand Function Test. Results: In the Box and Block test and Fugl-Mayer Assessment, there were statistically significant differences between both groups as well as between pre- and post-test. The extensor digitorum and wrist extensor strength were similar in both groups. In the Jebson-Taylor Hand Function Test, there was a significant difference in simulated page turning but not in the other subtests. Conclusion: Intensive massed practice with EMG-stim intervention applied to the hemiplegic upper extremity is an effective therapeutic method for chronic stroke patients. However, a variety of intervention methods designed for stroke patients in clinical settings are needed.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.13-19
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• 2014

Objective: The purpose of this study was to determine the effects of Augmented Reality-based Postural Control (ARPC) training on balance and gait function in patients with stroke. Design: Single-blind randomized controlled trial. Methods: Twenty participants who experienced a stroke were enrolled in the study and randomly assigned to the ARPC (n=10) or control group (n=10). Subjects in both groups received conventional physical therapy for 60 min per session, 5 days per week, for 4 weeks. In addition, subjects in the ARPC group received ARPC training for 30 min per day, 3 days per week, for 4 weeks. The participants watched established normal postural control patterns on a head-mounted display and repeated the movements in ARPC training. Outcome measurements were assessed using the Berg Balance Scale (BBS) and 10-Meter Walk Test (10MWT) before and after 4 weeks of training. Results: Of the 20 randomized participants, only 18 completed the 4-week training program. The ARPC group showed significant improvement in the BBS and 10MWT after training (p<0.05). Meanwhile, the control group did not exhibit improvement in either variable. In addition, the ARPC group showed significantly greater improvement than the control group in the 10MWT (p<0.05), whereas no significant difference was observed between the groups for the BBS. Conclusions: The results of this study confirmed the benefits of ARPC training on dynamic balance and functional gait ability. Additionally, this study may provide evidence supporting the use of an ARPC training program for improving balance and gait ability in patients after a chronic stroke.

• PNF and Movement
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• v.17 no.1
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.75-82
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• 2022

PURPOSE: This study examined the correlation between the pulmonary function and respiratory muscle strengthening training on an unstable support surface and a stable support surface in stroke patients. METHODS: The study subjects were 22 stroke patients undergoing central nervous system developmental rehabilitation treatment. After excluding six dropouts, eight people in the experimental group and eight people in the control groups were classified by random sampling. Both groups performed central nervous system developmental rehabilitation therapy and were provided a 10-minute break. The experimental group was provided with an unstable support surface using Togu, and the control group was trained to strengthen the respiratory muscle in a stable support surface. Respiratory muscle strengthening training was conducted three times per week for 20 minutes. Before and after each group of experiments, a nonparametric test Wilcoxon signed rank test, and a Mann Whitney U-test analysis were used to analyze the variations between the two groups. All statistical significance levels (α) were set at 0.05. RESULTS: Both groups showed increases in the pulmonary function but showed significant differences only in the experimental group. There was a significant difference in the peak expiratory flow between the two groups. CONCLUSION: Central nervous system development rehabilitation treatment for patients with an impaired nervous system and respiratory muscle strengthening training on unstable support surfaces are effective in improving the pulmonary function of stroke patients. Therefore, they are expected to be applied to physical therapy programs to help various functional activities.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.83-90
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• 2017

PURPOSE: Central post-stroke pain (CPSP), a chronic pain condition of stroke patients, can impair activities of daily living and worsen the quality of life (QOL), thereby negatively influencing the rehabilitation process. However, CPSP remains an underestimated complication of stroke. This study aimed to describe the prevalence and types of new-onset chronic pain and to identify the relation between pain and QOL in stroke patients. METHODS: All patients hospitalized because of a diagnosis of stroke were included. Questionnaire was used. Pain intensity was measured using Numerical rating scale (NRS), and pain characteristics were assessed using DN4. QOL was measured using SF-36. Descriptive statistics were used to analyze the characteristics and pain data, and chi-square test was used to compare QOL categorical data between the nociceptive and neurological pain groups. RESULTS: CPSP development was reported by 34% of the post-stroke pain patients. Perceived QOL was low in both groups, especially with respect to the physical functioning, bodily pain, physical-role functioning, emotional-role functioning, and mental health domains. However, no significant difference was observed in QOL between the nociceptive and neurological pain groups (p<.05). CONCLUSION: Our results indicated that CPSP is a common and disabling complication that is difficult to treat, often decreases QOL, and may negatively affect rehabilitation treatment.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.163-168
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• 2014

Purpose: The purpose of this study was to investigate whether ipsilateral shoulder pain affects the sensorimotor function of the same side shoulder in patients with stroke. Methods: Thirty stroke patients, who were divided into the ipsilateral shoulder pain group (n=15) and the ipsilateral shoulder non-pain group (n=15). Subjects were evaluated on performance of a tracking task, joint reposition test and 9-Hole pegboard test for sensorimotor functions, and Fugl-Meyer test and Motricity Index for functional ability of the contralateral side. Results: In comparison of the two groups, significant differences in performance on functional ability, including the Fugl-Meyer test(both upper and lower limb) and Motricity Index(only lower limb) were observed (p<0.05). With regard to sensorimotor functions, the ipsilateral shoulder pain group were observed significantly poor scores on the Accuracy Index, joint reposition score and 9-Hole pegboard test, when compared with the ipsilateral shoulder non-pain group (p<0.05). Conclusion: We found that ipsilateral shoulder pain could impede accurate performance of a movement and result in deteriorated proprioception of the ipsilateral shoulder. Therefore, careful evaluation and appropriate therapeutic intervention are essential for stroke patients who suffer from ipsilateral shoulder pain.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.1-7
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• 2008

Purpose: Implicit motor learning is the capacity to acquire skill through physical practice without conscious awareness of what elements of performance improved. This study investigated whether subacute stroke patients can implicitly learn a perceptual-motor task. Methods: We recruited 12 patients with subacute stroke and 12 age-matched controls. All participants performed a perceptual-motor task that involved pressing a button corresponding with colored circles (blue, green, yellow, red) on a computer screen. The task consists of 7 blocks composed of 10 repetitions for a repeating 12-element sequence (total 120 responses). Results: Both groups demonstrated significant improvement in acquisition performance. Reaction times deceased in both groups at similar rate within the sequential block trials (2-5 blocks), and reaction times increased at a similar rate when the task paradigm was transferred from the sequential block trial to the random block trial (5-6-7 blocks). Conclusion: The results of this study suggest that patients with sub-actue stroke can implicitly learn a perceptual motor skill. Although explicit instructions should be used to focus the learner's attention rather than provide information about the task, the application of implicit motor learning strategies in the rehabilitation setting may be beneficial.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.2
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• pp.237-246
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• 2011

Purpose: Family-caregivers of stroke patients usually go through hardship and life style changes during the protracted course of a family member's rehabilitation. There is need for programs to educate family-caregivers to better manage the medical crisis. In this study an evaluation was done of the degrees of burden and well-being experienced by primary family-caregivers following video-guided education (VGE) on rehabilitation and family lifestyle changes. Method: Fifty-eight primary family-caregivers of stroke patients on a neurological ward were divided into VGE (29) and control (29) groups. VGE was started within 7 days of patient admission. Interventions included VGE, counseling, and demonstration - re-demonstration. The control group received standard education but not VGE. Data were analyzed using Chi-square test, t-test, ANCOVA, and Pearson correlation coefficients with the SAS program. Results: The VGE group had a significantly lower score for total burden (F=7.19, p=.010) and for sub-scale of time-dependent burden (F=8.44, p=.005) than the control group. There was a negative correlation between primary family-caregiver burden and well-being (r=-.7151, p<.001). Conclusion: Results suggest that the rehabilitation program using VGE was an effective nursing intervention to reduce the burden of primary family-caregivers of stroke patients.

• The Journal of Korea Robotics Society
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• v.8 no.4
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• pp.273-282
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• 2013

The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(Amadeo(R)) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in Amadeo(R), and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of Amadeo(R), finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.

• The Korean Journal of Rehabilitation Nursing
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• v.18 no.2
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• pp.67-74
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• 2015

Purpose: The purpose of this study was to identify the effects of auricular acupressure therapy on the upper extremity function, perceived health status and Activities of Daily Living for rehabilitation among stroke patients at home. Methods: As a quasi-experimental study, non-equivalent control group pretest-posttest design was used. Data were collected from August 1st to September 31st, 2012. Participants were 28 (Experimental 17, Control 11) stroke patients at home. Using the SPSS/WIN 12.0 program, data were analysed by the $x^2$-test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed rank test. Results: Upper extremity function (U=28.00, p=.001) and activities of daily living (U=47.50, p=.029) were significantly higher in the experimental group compared to the control group. However, perceived health status was not significantly different between the two group. Conclusion: This study proved that auricular acupressure therapy was effective for upper extremity function and activities of daily living among stroke patients at home.