• Title/Summary/Keyword: Stroke Rehabilitation

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An EEG-based Brain Mapping to Determine Mirror Neuron System in Patients with Chronic Stroke during Action Observation

  • Kuk, Eun-Ju;Kim, Jong-man
    • The Journal of Korean Physical Therapy
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    • v.27 no.3
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    • pp.135-139
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    • 2015
  • Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.

The Effects of TENS Applied to Affected Lower Extremities on Balance in Stroke Patients

  • Lee, Kyu-Ri;Jang, Sang-Hun
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.3
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    • pp.255-262
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    • 2014
  • PURPOSE: This study was to investigate the effectiveness of TENS on balance in stroke patients by analyzing some components such as foot pressure, limit of stability and velocity sway after providing somatosensroy input using TENS. METHODS: Twenty five subjects participated and were randomly divided into two groups, TENS group (n=13) and control group (n=12) by the computer program. Interventions were given to subjects 5 days a week for four weeks. TENS group were treated with TENS for 60 minutes in addition to the conventional therapy which included 30-minute exercise and rehabilitation ergometer training for 15 minutes. Control group performed only conventional therapy. TENS was applied on the skin of soleus, tibialis anterior, tensor fascia latae and vastus medialis in affected side. Foot pressure, limit of stability and velocity sway for balance test were measured using Biorescue. RESULTS: TENS group was significantly increased limit of stability and foot pressure in affected side more than control group. And in eye closed condition, TENS group was significantly decreased velocity sway more than control group. CONCLUSION: The application of TENS is effective to improve the somatosensory input of affected side and to increase the motor function and balance ability.

Change of activation of the supplementary motor area in motor learning: an fMRI case study (운동학습에 따른 대뇌 보조운동영역의 활성화 변화: fMRI 사례연구)

  • Park, Min-Chull;Bae, Sung-Soo;Lee, Mi-Young
    • The Journal of Korean Physical Therapy
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    • v.23 no.2
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    • pp.85-90
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    • 2011
  • Purpose: The contribution of the supplementary motor area (SMA) to the control of voluntary movement has been revealed. We investigated the changesin the SMA for motor learning of the reaching movement in stroke patient using functional MRI. Methods: The subject was a right-handed 55 year-old woman with left hemiparesis due to an intracerebral hemorrhage. She performed reaching movement during fMRI scanning before and after reaching training in four weeks. The motor assessment scale and surface EMG were used to evaluate the paretic upper limb function and muscle activation. Results: In the fMRI result, contralateral primary sensorimotor cortex (SM1) was activated before and after training. SMA was only activated after training. In addition, muscle activation of the paretic upper limb was similar to that of the unaffected upper limb after training. Conclusion: These findings suggest SMA is related to the execution of a novel movement pattern resulting in motor learning in stroke patients.

The Effect of Virtual Reality-based Sitting Balance Training Program on Ability of Sitting Balance and Activities of Daily Living in Hemiplegic Patients (앉기자세에서 실시한 가상현실 균형훈련이 뇌졸중 환자의 앉기 균형 및 일상생활활동 능력에 미치는 영향)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.3
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    • pp.11-19
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    • 2017
  • Purpose : This study examined the effects of balance training using virtual reality program on sitting balance ability and activities of daily living (ADL) in stroke patients. Method : In the study, 20 patients with hemiplegia were divided into two groups: experiment group (EG) of 10 patients and control group(CG) of 10 patients. The two groups received general occupational therapy for 30 minutes, per day, at a rate of 5 times per week for 6 weeks. The EG was additionally conducted which was performed virtual reality balance training and the CG was conducted general occupational therapy balance training for 30-minutes, once a day, 3 times a week for 6 weeks. Result : The evaluations of this study included: limit of stability(LOS), modified Functional Reach Test(mFRT), and modified Barthel Index(MBI). The patients were evaluated before and after their six week training programs. Significant differences in the LOS, mFRT, MBI were found between pretest and posttest scores in both the EG and CG groups(p<.05). Also, LOS, mFRT, MBI were significant different between the groups at post-test(p<.05). Conclusion : The study findings suggest that virtual reality balance training can improve sitting balance and ADL ability in stroke patients.

Effects of Using Scapular-Pelvic Patterns Simultaneously to Improve the Components of Gait in Patients with Stroke (견갑 - 골반 동시 사용 패턴이 뇌졸중 환자의 보행요소에 미치는 효과)

  • Kim, Seung-Ji;Choi, Jae-Won;Chung, Hyun-Ae
    • PNF and Movement
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    • v.14 no.2
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    • pp.75-81
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    • 2016
  • Purpose: This study used a comparative analysis to propose the effectiveness of using scapular and pelvic patterns of proprioceptive neuromuscular facilitation simultaneously (USPS) on the components of gait in patients with stroke. Methods: Subjects who signed a written consent form to participate in the experiment and attended voluntarily were divided randomly into two groups: the USPS group (12) and the control group (9). The USPS group received pattern training for 30 minutes a day, 3 days per week for 6 weeks. The control group received general physical exercise for the same duration. Gait ability was tested and analyzed before and after the 6 weeks of training with the GAITRite system. Results: The components of gait increased significantly in the USPS group after training (p < 0.05) and did not increase significantly in the control group. Conclusion: According to the results of this study, USPS training improves the components of gait more than general physical exercise. The USPS training method is effective for improving motor functions in patients with stroke, especially for gait rehabilitation.

A case report of the intervention strategy & documentation in a patient with post stroke applied a International Classification of Functioning, Disability and Health (ICF를 적용한 뇌졸중 환자의 문서 기록과 중재 전략의 실례)

  • Lee, Sun-Ui;Kim, Tae-Yoon
    • PNF and Movement
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    • v.8 no.2
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    • pp.57-67
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    • 2010
  • Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

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Weight-bearing on Paretic in Patients with Acute Stroke (급성 뇌졸중환자의 마비측 체중지지 임상양상)

  • Seo, Kyung-Chul;Song, Kyo-Hyun;Lee, Jung-Soo;Jang, Dan-Bi
    • Journal of Korean Physical Therapy Science
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    • v.18 no.1
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    • pp.79-84
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    • 2011
  • Background: The purpose of this study was to investigate differences in balancing ability and weight bearing between paretic and non-paretic. Methods: Subjects of the study were consisted of 30 acute hemiplegia patients(paretic 15, non-paretic 15) who were receiving rehabilitation therapy in hospital. Weight shifting was quantitatively evaluated to determine the ability of patients to and during conscious weight shifting on the Gaitview. Independent t-test was utilized to detect the mean difference between the groups. Results: 15 patients with stroke were able to shift more weight onto the paretic leg. And pressure ratio of right hemiplegia was significantly difference on the nonparetic leg, pressure ratio of left hemiplegia was significantly difference onto the paretic leg. Conclusions: Patients with left hemiplegia who was cortical lesions in the right hemisphere were able to shift more body weight onto their paretic leg. These patients should be encouraged to practice shifting their weight towards their non-paretic leg to improve their balance.

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Effects of Proprioceptive Neuromuscular Facilitation Neck Flexion Exercise and the Shaker Exercise on the Activities of the Suprahyoid Muscles in Chronic Stroke Patients with Dysphagia

  • Hwangbo, Gak;Kim, Kyoung-Don
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.43-50
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    • 2018
  • PURPOSE: The purpose of this study is to examine the effect of proprioceptive neuromuscular facilitation (PNF) neck flexion exercise and the Shaker exercises on the activity of the suprahyoid muscles in chronic stroke patients with dysphagia and to show what exercise methods are effective for swallowing rehabilitation. METHODS: This study was conducted at F hospital in Daegu from August 2014 to February 2017 with 60 participants who understood the purpose of the study and desired to participate. The 60 participants were randomly divided into an experimental group (PNF neck flexion exercise) (n=30) and a control group (Shaker exercise) (n=30). PNF neck flexion exercise was performed in the experimental group and the Shaker exercise was performed in the control group for 30 minutes, 5 times a week for 6 weeks. The activity of the suprahyoid muscles was measured before and after treatment. RESULTS: Both the experimental group and the control group showed a statistically significant change in the activity of the suprahyoid muscles before and after the treatment. The changes were also statistically significant when compared by group. CONCLUSION: In conclusion, PNF neck flexion exercise should be used in addition to Shaker exercise when rehabilitating a patient with a swallowing disability.

Spatial and Temporal Features of Motor Modules in an individual with Hemiparesis During the Curvilinear Gait: A Pilot Single-Case Study

  • LEE, Jae-Hyuk
    • Journal of Wellbeing Management and Applied Psychology
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    • v.5 no.1
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    • pp.1-7
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    • 2022
  • Purpose: This study aimed to investigate spatial and temporal features of motor control in an individual with hemiparesis during the curvilinear gait (CG) and proposed an exercise guideline. Research design, data and methodology: An individual aged 63 with hemiparesis by stroke disease was participated in the study. Autoencoder (AE) was used to extract four motor modules from eight muscle activities of the paretic leg during CG. After extraction, each module of four modules was operationally defined by numbering from M1 to M4 according to spatial and temporal features and compared with results reported in a previous study. Results: As a result, an individual with hemiparesis had motor module problems related to difficulty of weight acceptance (module 1), compensation for the weakness of ankle plantar flexor (module 2), a spastic synergistic pattern (module 3) and difficulty with transition from the swing to stance phase (module 4) in terms of spatial features. Also, a delayed activation timing of temporal motor module (module 2) related to the forward propulsion during CG was observed. Conclusions: Gait rehabilitation for the stroke will need to consider clinical significances in respect of the deterioration of motor module and provide the tailored approaches for each gait phase.

The Effect Of Lower Limb Muscle Fatigue On Strength And Balance In Healthy Adults

  • Taewoong Jeong;Yijung Chung
    • Journal of Korean Physical Therapy Science
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    • v.31 no.3
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    • pp.23-30
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    • 2024
  • Background: Following lower limb strength training exercises, patients with stroke often experience muscle fatigue, which can frequently lead to falls. Therefore, this study aims to explore how lower limb muscle fatigue caused by squats affects the strength and balance of healthy individuals before extrapolating it to patients with stroke. Design: Cross-sectional study Methods: The study followed a cross-sectional design. The study was conducted on 30 healthy adults. Strength and balance were measured before and after performing wall squat exercises. Muscle strength was measured using a dynamometer, while balance was assessed with the S3 check system. A paired t-test was used for the analysis. Results: The knee extensor and hip extensor showed a significant decrease after wall squat (p < 0.05). However, there was no significant difference observed in knee flexor and hip abductor between before and after wall squat. Balance did not show a significant difference between before and after wall squat. Conclusion: Muscle fatigue caused by wall squats was found to reduce the strength of the knee and hip extensors, while having no impact on balance. The results of this study may serve as foundational data for future research targeting patients with stroke.