• Physical Therapy Rehabilitation Science
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• v.6 no.4
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• pp.159-163
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• 2017

Objective: Persons with stroke have a tendency to exhibit asymmetric weight-bearing during sit-to-stand because due to the attempt to support themselves with the non-paretic foot. However, there are few devices that can assist with sit-to-stand (STS) performance. This study was designed to investigate the use of the elastic band with rings (EBR) in improving weight-bearing effectively in persons with stroke during STS training. Design: Cross-sectional study. Methods: Thirteen stroke survivors participated in the study. An EBR was applied onto the patient during STS activity. The foot pressure was measured before and after wearing the EBR, with a 5-minute rest period between measurements. Subjects were asked to perform each test twice with and without the EBR. Bilateral feet pressures were measured with standing posture being divided into the forward and backward aspects. The foot contact pressure during STS activity was measured with the CONFORMat System. Results: With EBR, the forward pressure of the affected foot significantly increased while the less-affected forward foot pressure significantly decreased (p=0.015 and p=0.023, respectively). The backward foot pressure did not differ significantly in the two limbs, and there was no difference with and without the EBR in terms of the total pressure of the affected foot. There was a significant difference with and without the EBR in the total pressure of the less-affected foot (p<0.05). Conclusions: STS training with the EBR has been shown to improve weight-bearing of both feet while decreasing the total pressure of the less-affected foot in stroke survivors. Therefore, we suggest that the EBR is a useful tool for STS training for persons with stroke in the clinic.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.134-138
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• 2018

Objective: The aim of this research was to investigate the effects of functional electrical stimulation (FES) applied to the gluteus medius (Gm) and tibialis anterior (TA) during stair climbing in persons with stroke compared to FES applied to the TA only during stair climbing, and during stair climbing without FES in persons with stroke. Design: Cross-sectional study. Methods: Twenty subjects with stroke participated in this study. Subjects were included if: 1) they were diagnosed as stroke at least 6 months before; 2) had Mini Mental State Examination- Korean score of 24 or higher; 3) were able to climb a flight of 10 stairs independently (with or without walking aid). The patients walked 10 stairs 3 times with FES applied to the Gm and TA, only TA, or no FES. There was a 1-minute rest period between each bout. The assessments were made using the Timed Up & Down Test and the Wii Balance Board. Results: Stair climbing with FES applied to the Gm and TA was significantly faster than stair climbing with FES applied to the TA only and without FES (p<0.05). Stair climbing with FES applied to the Gm and TA exhibited significantly greater sway velocity than stair climbing without FES (p<0.05). However, maximal sway distances were not significantly different between groups. Conclusions: Stair climbing with FES applied to the Gm and TA can be an important component of a rehabilitation program for improving stair climbing ability in persons with stroke.

• Physical Therapy Korea
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• v.17 no.2
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• pp.33-42
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• 2010

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

• Journal of Korean Physical Therapy Science
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• v.30 no.4
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• pp.29-43
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• 2023

Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.187-202
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• 2009

Objectives : The purpose of this study is to investigate the efficacy of adjusting leg length inequality(LLI) by chuna manual treatment for post-stroke hemiplegia. Methods : 39 patients with stroke-originated hemiplegia who had leg length inequality were included in this study. Chuna manual treatment at pelvic girdle was applied to 20 patients and they had been treated by general oriental rehabilitation therapy(test group). The other 19 patients had been treated by general oriental rehabilitation therapy only(control group). Outcomes were assessed by Modified Barthel Index(MBI), Berg Balance Scale(BBS), lower extremity Fugl-Meyer Assessment(FMA) at the point of beginning and end of the study. Results : 1. In terms of activity of daily living(ADL), test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group(onset had been past under 6 months), test group didn't showed statistically meaningful differences compared to control group. In chronic group(onset had been past over 6 months), test group didn't showed statistically meaningful differences compared to control group. 2. In terms of lower extremity function and balance, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.01). 3. In terms of lower extremity function of hemiplegic side, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.05). Coclusions : Adjusting LLI by chuna manual treatment is efficacious for rehabilitation of stroke-originated hemiplegia, in terms of ADL, balance and lower extremity function, and is especially efficacious for chronic patients.

• 재활복지
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• v.17 no.4
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• pp.401-420
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• 2013

This study was performed to investigate the impact of the Neurocognitive Rehabilitation Therapy on the upper limb function recovery of patients with stroke and their abilities to perform daily activities and to provide basic data for a long-term treatment. A total of 30 patients with hemiplegia that occurred due to stroke were recruited as subjects of the present study, and 15 patients were randomly assigned to a Neurocognitive Rehabilitation Therapy group and a conventional treatment group, respectively. And, tests were performed over four weeks, five times a week, and 30 minutes a session. Manual Function Test(MFT), Fugl-Meyer Assessment Scale(FMA), and Korean-Modified Bathel Index(K-MBI) were used to measure the degree of the functional recovery before and after the experiment. According to the data of this study, in the upper limb function test, the Neurocognitive Rehabilitation Therapy group showed significant increase of the measurement values of MFT and FMA(p <.05), and when the difference between the two groups were compared, the upper limb function showed a statistically significant difference. In the daily activity performance test, only the Neurocognitive Rehabilitation Therapy group showed a significant improvement of K-MBI value(p <.05). Based on the results of the present study, it was demonstrated that the Neurocognitive Rehabilitation Therapy was effective in enhancing the upper limb functions and daily activity performance of patients with stroke.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.1
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• pp.111-123
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• 2008

Objectives : The objective of this study was to investigate the outcomes of functional electrical stimulation (FES) which was applied twice a day in patients with dysphagia after stroke. Methods : Eleven patients with dysphagia after stroke were participated. The electrical stimulator with two channels was employed for forty minutes daily or forty minutes twice a day for fifteen days. Participants were divided into two groups by random method; The FES was performed twice a day for Twice-FES group (n=6), and once a day for Standard-FES group (n=5). For evaluation of dysphagia, the functional dysphagia scale by videofluoroscopic swallowing study, and swallow function scoring system by six clinical swallowing stage were assessed at pre- and post-treatment. Results : In both groups, there was a significant decrease of total functional dysphagia scales after FES treatment (p<0.05) and the results mainly affected the pharyngeal phase of deglutition. There was no significant difference between the two groups in total functional dysphagia scales, but the Twice-FES group had a decreased residue in oral cavity compared to the standard FES group. In both groups, there were significant improvements in swallow function scoring system (p<0.05). The twice-FES group had more high clinical swallowing stages. Conclusions : The results demonstrated that FES is a clinically effective intervention in treatment of stroke patients with dysphagia. Moreover, the treatment applied twice a day had relatively positive effects on the reduction of oral cavity residue and the improvement of clinical swallowing stage.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.102-108
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• 2018

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

• Korean Journal of Adult Nursing
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• v.16 no.1
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• pp.37-48
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• 2004

Purpose: The purpose of this preliminary study was to develop and evaluate the effects of East-West Self-help program for Rehabilitation of post-stroke clients. Method: This program is developed through literature review, survey and seminar. The program is consisted of six sessions twice a week for 6 weeks. This program is composed of health education on stroke, exercise, oriental nursing interventions, and therapeutic recreation. The outcomes have been evaluated on the basis of perceived health status, self-efficacy, U/E function, ADLs and subjective response. Result: 1) After the 6 week program, the perceived health status had improved and the score of rehabilitation self-efficacy increased significantly. 2) After the 6 week program, the score of BADL increased significantly, but, the score of IADL was not statistically significant. 3) After the 6 week program, the amount of use and quality of movement of the affected U/E were increased significantly. 4) All of the participants showed satisfaction with this program. Conclusion: Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be continuously developed and implemented as a community based self-helf group program for post-stroke clients.

• Journal of the Korean Society for Precision Engineering
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• v.30 no.4
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• pp.450-458
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• 2013

The aim of this study was to develop and verify gait training system for post-stroke hemiplegia patients with step length asymmetry. Most post-stroke hemiplegic patients show gait asymmetry and weight shifting training has been suggested as a useful method for improving the walking ability. However, verbal cue by physical therapist may be not effective. Therefore, our weight shift training system was designed to give a feedback to patients through precise plantar pressure and center of pressure (COP) measurement. This weight shifting biofeedback training system is composed of F-Scan plantar pressure measurement system and software development kit (SDK) for Windows operating system. Two post-stroke patients with step length asymmetry were enrolled in this study. After training for six weeks, the weight shift score and step length ratio of two all patients were improved and approached to them of non-disabled. This system developed in this study may improve the step length asymmetry, and therefore this system is also expected to improve a walking ability in hemiplegic patients.