• 대한물리의학회지
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• 제17권4호
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• pp.123-132
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of cognitive orientation to daily occupational performance (CO-OP) interventions on the upper extremity function and occupational performance in subacute stroke patients. METHODS: A total of 30 eligible stroke patients were randomly distributed into the CO-OP experimental group (n = 15) and the traditional occupational therapy (OT) control group (n = 15). The CO-OP approach was applied for twelve 60-minute sessions. The Jebson Taylor Hand Function Test (JTHFT), the Korean version of the Modified Barthel Index (K-MBI), and the Performance Quality Rating Scale (PQRS) were used for outcome evaluations. RESULTS: There was a statistically significant difference in the paralytic upper extremity function before and after treatment (p < .01) between the group treated with the CO-OP approach and the group treated with traditional OT. The occupational performance of the CO-OP approach group showed a significant improvement (p < .01), and this group also showed a statistically significant improvement in quality of performance compared to the traditional OT group (p < .01). CONCLUSION: The CO-OP approach may be useful in clinical practice as a therapeutic intervention for improving the functional recovery and performance of subacute stroke patients. Future research should be carried out to investigate the persistence of this effect involving more participants and follow-up studies should also be undertaken.

• 대한물리의학회지
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• 제18권2호
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• pp.115-123
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• 2023

PURPOSE: This study examined the effects of combined conventional exercise therapy plus respiratory exercise program with combined conventional exercise therapy plus aqua exercise program in the pulmonary function of subacute stroke patients. METHODS: The respiratory exercise program group underwent inspiration and expiration training using the Threshold IMT and Threshold PEP three days per week for four weeks. The aquatic exercise program group had aquatic aerobics, halliwick, and bad ragaz ring training three days per week for four weeks. Before and after the experiment, Pony fx was used to examine the FVC, FEV1, FEV1/FVC, VC, and MVV. RESULTS: Significant improvement was found after the experiment in the FVC. FEV1, VC, MVV, excepting FEV1/FVC, of the pulmonary function in the aquatic exercise program group. After the experiment, significant improvement was found in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function in the respiratory rehabilitation therapy group. No significant difference in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function was observed in the inter-group comparison. CONCLUSION: Significant improvement was found after the experiment in both the aquatic exercise program group and the respiratory exercise program group. No difference in pulmonary function was noted in the inter-group comparison. Therefore, combining general exercise therapy and an aquatic or respiratory exercise program is expected to be effective for the pulmonary function of acute stroke patients. These results are expected to provide basic data to help research intervention of aquatic and respiratory exercise programs for subacute stroke patients.

• 대한물리의학회지
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• 제3권2호
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• pp.135-144
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• 2008

Purpose : The purpose of this study was to identify the effect of body weight support treadmill training (BWSTT) and parallel bar gait training(P-bar) on gait and balance ability of subacute stroke patients. The subjects were consisted of 27 patients with subacute stroke, and they were randomly devided into two groups which were BWSTT group and P-bar group. Method : The timed up and go(TUG), 10m gait speed were used to measure gait speed, Bergs balance scale(BBS) was used to measure dynamic balance ability, and balance performance monitor(BPM) was used to measure sway area, sway path, max velocity. Result : 1. The TUG and 10m gait speed of BWSTT group and P-bar group were significantly decreased (p<.05). The TUG and 10m gait speed were different significantly between BWSTT group and P-bar group(p<.05). 2. The BBS and sway area of BWSTT group and P-bar group were significantly decreased (p<.05). The BBS and sway area were not different significantly between BWSTT group and P-bar group(p>.05). 3. The sway path and max velocity of BWSTT group and P-bar group were significantly decreased (p<.05). The sway path and max velocity were not different significantly between BWSTI group and P-bar group(p>.05). Conclusion : The outcomes suggest that patient with subacute stroke can improve their gait and balance through body weight support treadmill training.

• 인간행동과 음악연구
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• 제10권1호
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• pp.1-23
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• 2013

상지의 운동기능 장애는 뇌졸중 환자에게서 빈번히 보고되는 증상 중의 하나이다. 뇌졸중의 원인인 신경학적 손상의 회복은 발병 초기인 6개월 동안 가장 활발히 일어나며, 이 시기의 회복은 이후 기능회복에 결정적 영향을 미친다. 독립적인 일상생활 수행과 상지 운동기능의 재활을 위하여 다양한 재활치료 접근이 적용되어 왔으나 그 효과성에 있어서 일관성이 결여된 결과가 보고되어 왔다. 따라서 뇌졸중 환자의 신경학적, 기능적 상지 운동 기능의 재활을 촉진할 수 있는 보다 효과적인 치료 방안 마련이 시급하다고 할 수 있다. 재활의학 분야의 연구에서 음악은 운동기능의 향상에 긍정적인 영향을 미치고 있으며, 특히 하지 운동기능 향상에 있어서 리듬 적용의 근거 및 그 효과성이 입증되고 있다. 하지만, 음악연주를 활용한 뇌졸중 환자의 상지 운동기능 재활에 대한 근거는 아직 확립되어 있지 않으며, 적용 대상 또한 만성 뇌졸중 환자에 제한 되어 있는 실정이다. 본 연구에서는 운동기능을 촉진하는 음악의 역할을 근거로, 뇌졸중 환자의 상지 운동기능 재활을 위하여 다양한 음악활동을 사용한 선행 연구를 고찰 및 분석하였다. 이를 바탕으로 아급성 뇌졸중 환자의 상지 운동기능의 재활을 도모하기 위한 악기연주 활용 방안에 대한 근거를 마련하고자 하였다.

• 대한통합의학회지
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• 제12권3호
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• pp.189-199
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• 2024

Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

• 대한물리의학회지
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• 제8권2호
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• pp.245-252
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• 2013

PURPOSE: The aim of this study is to verify the effectiveness of modified constraint-induced movement therapy(mCIMT) on upper function and activities of daily living in people with subacute stroke patients. METHODS: Eighteen participants, with subacute stroke that were randomly assigned to either the experimental group(n=9) or the control group(n=9). For subjects from the experimental group modified Constraint-Induced Movement Therapy was performed. exercise program, the patient trained in affected side upper extremity with restricted non-affected side for 1 hour and using in activity daily living for 4 hours for five times per week, during 4 weeks. For subjects from the control group, conventional upper extremity training was performed. Outcomes such as the box and block test(BBT), Fugl-Meyer motor function assessment(FMA), and modified Barthel index(MBI) were measured before and after training. Between-group and within-group comparisons were analyzed by using Independent t-test and Paired t-test respectively. RESULTS: These finding suggest that experimental group was significant increase in BBT, FMA, MBI(p<.05). In comparison of two group, experimental group was high upper function and activity daily living than control group. CONCLUSION: This study showed experimental group can be used to improve upper function and activity daily living than control group. Thus it indicates that mCIMT will be more improved through the continued upper extremity exercise program.

• 대한물리의학회지
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• 제15권4호
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• pp.101-109
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• 2020

PURPOSE: This study investigates the therapeutic effect of a prototype of a hand rehabilitation device based on magnetic forces. METHODS: Using an electromagnet and permanent magnets, we developed an end effector type device that induces various movements of the finger in accordance with the magnetic field direction. A total of 26 subacute stroke patients were enrolled and assigned to two groups in this randomized controlled trial. The intervention group received 30 minutes hand rehabilitation therapy per day for 4 weeks, using the device developed by us. Conventional physical therapies were conducted equally twice a day, 30 minutes per session, during the same period in both groups. RESULTS: After 4 weeks, rate of the Wolf Motor Function Test as a primary outcome measure showed significant improvement in the intervention group as compared to control group(p = .036). Scores of the Manual Function Test and Fugl-Meyer Assessment of upper limb were also significantly increased in the intervention group as compared to control group(p = .038 and p = .042, respectively). Moreover, the Korean version of Modified Barthel Index tended to improve after subjecting to physical therapy in both groups. CONCLUSION: Our results indicate that the novel hand rehabilitation device developed using a magnetic force, improves the hand motor functions and activities of daily life in subacute stroke patients.

• International Journal of Advanced Culture Technology
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• 제7권4호
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• pp.1-13
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• 2019

Purpose: Rehabilitation nursing requires an interdisciplinary comprehensive team approach that allows for enough time to promote patients' functional recovery. We identified the effects of a nurse-led rehabilitation intervention program on subacute stroke patients' activities of daily living, anger, and muscle strength, as well as their chief caregivers' satisfaction. Methods: Intervention group participants (n = 20) completed a rehabilitation intervention program, which integrated physical activities with psychological and social approaches. Results: The program did not significantly improve patients' activities of daily living or anger management; however, it significantly affected both anger-in (t = 3.384, p = .002) and anger-out (t = 2.167, p = .037) attitudes. Caregivers' satisfaction among the intervention group (t = 6.935, p < .001) decreased more significantly than that of the comparison group (t = 0.224, p = .825). Conclusion: Rehabilitation intervention program should enlist nurses' participation and promote a team-based approach during the rehabilitation program. Further, patients and their caregivers should be encouraged to express their emotions during counseling.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.31-38
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• 2018

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

• Physical Therapy Rehabilitation Science
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• 제4권2호
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• pp.73-78
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• 2015

Objective: This study focused on subacute stroke patients who were asked to kick a ball while walking on a treadmill. The aim of the study was to determine the effect of a body weight-supported treadmill training (BWSTT) combined with ball-kicking on muscle strength, balance, and gait. Design: Single blind, randomized controlled trial. Methods: Twenty stroke patients who volunteered to participate in this study were randomly assigned to either the BWSTT combined with ball-kicking (BWSTT-BK; 10 participants) group or the BWSTT group (10 participants). Participants in the BWSTTBK group performed treadmill walking combined with simultaneous ball-kicking for 30 minutes daily for 5 weeks. Participants from the BWSTT group performed only treadmill walking. The muscular strength, balance, and gait ability were measured before and after the 5-week training. To assess for muscular strength, a digital muscle tester was used to measure hip flexor, knee extensor, and dorsiflexor strength. To assess for balance, the Berg Balance Scale (BBS) and Timed Up and Go Test (TUG) was used. To assess for gait, the 10 meter walk test (10MWT) and Functional Gait Assessment (FGA) was used. Results: The BWSTT-BK group showed significantly improved muscular strength, balance, and gait according to BBS, TUG, 10MWT, FGA, and digital muscle testing scores compared to the BWSTT group (p<0.05). In addition, within-group comparison showed significant improvement in all variables (p<0.05). Conclusions: These findings suggest that BWSTT-BK results in more favourable outcomes for stroke patients. Therefore, BWSTT-BK may be useful for the recovery of gait ability of stroke patients.