• Journal of Digital Convergence
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• v.11 no.8
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• pp.235-242
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• 2013

This study aimed to evaluate the effectiveness of imagery training on upper limb function and activities of daily living in subacute stroke patients. This study included 16 voluntary participants with subacute stroke. Subjects were randomly assigned to either experimental or control group, with 8 in each group. Imagery training group performed imagery training during 30 minutes and then task-oriented training 30 minutes a day, 5 times a week for 4 weeks. Control group performed task-oriented training during 30 minutes during a day, 5 times a week for 4 weeks. Assessments were made using the Wolf Motor Function Test (WMFT) and Fugl-Meyer motor function assessment (FMA) to evaluate the changes of upper function. And modified Barthel Index (MBI) was measured to evaluate the activities of daily living. The results showed that imagery training group was more significant increase than control group in WMFT, FMA, and MBI (p<.05). Small to huge effect sizes of 1.59, 2.02, 0.37 were observed for WMFT, FMA, and MBI, respectively. This study indicated that imagery training may be helpful in improving the upper limb function and activities of daily living for subacute stroke patients, and support the clinical feasibility of the imagery training.

• Journal of Magnetics
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• v.19 no.2
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• pp.192-196
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• 2014

The aim of the present study was to examine the effects of high and low frequency repetitive transcranial magnetic stimulation on motor cortical excitability and the balance function in subacute stroke patients. Twenty-four subjects were randomly assigned to either the high frequency (HF) rTMS group, or the low frequency (LF) rTMS group, with 12 subjects each. All subjects received routine physical therapy. In addition, both groups performed a total of 20 sessions of rTMS for 20 minutes, once a day, 5 times per week, for a 4-week period. In the HF rTMS group, 10 Hz rTMS was applied daily to the hotspot of the lesional hemisphere; and in the LF rTMS group, 1 Hz rTMS was applied daily to the hotspot of the nonlesional hemisphere. Motor cortex excitability was determined by motor evoked potentials, and the balance function was evaluated by use of the Balance Index (BI) and the Berg Balance Scale (BBS), before and after the intervention. The change rate in the value of each variable differed significantly between the two groups (p<0.05). Furthermore, significant differences were observed between all post-test variables of the two groups (p<0.05). In the HF rTMS, significant differences were found in all the pre- and post-test variables (p<0.05). On the other hand, in the LF rTMS, significant difference was observed only between the pre- and post-test results of BI and BBS (p<0.05). The findings demonstrate that HF rTMS can be more helpful in improving the motor cortical excitability and balance function of patients with subacute stroke treatment than LF rTMS, and that it may be used as a practical adjunct to routine rehabilitation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.459-466
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• 2016

This study examined the effects of robot-assisted therapy on the motor and functional recovery of the lower limbs in 53 subacute stroke patients. Robot-assisted therapy was performed using Lokomat? (Hocoma AG, Zurich, Switzerland) for thirty minutes per day, five times a week for four weeks. The outcome measures used were the Fugl-Meyer assessment, Motricity index(MI), Functional ambulation category(FAC), Berg balance scale(BBS) for gait function and balance ability, 10m walking test, K-Modified Barthel Index(K-MBI) for the activities of daily living and Mini mental state examination (MMSE), and Beck's depression inventory(BDI) for depression. All patients recruited underwent these evaluations before and after the four week robot-assisted therapy. For the evaluation, the somatosensory evoked potentials were used to assess the functional recovery. Robot-assisted therapy on the lower limb after subacute stroke showed improvement in motor strength, gait function, and the activities of daily living. All changes in terms of MI, FAC, BBS, and K-MBI exhibited a statistically significant difference after the four weeks robot-assisted therapy. The somatosensory evoked potential result showed a correlation with the MI and K-MBI. Robot-assisted therapy is believed to facilitate the motor and functional recovery of the lower limb in subacute stroke patients.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.1
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• pp.219-228
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• 2017

The aim of this study was investigated the effect of cognitive training using tablet pc applications on cognitive function, daily living, and satisfaction in subacute stroke patients. This study participated in fourteen subacute stroke inpatients, in I general hospital, at located in Incheon. All subjects assigned that randomized each seven patients in experimental and control group. Two groups received to traditional cognitive therapy during half hour/day, 5 times per week, for 4 weeks. Experimental group performed additionally that cognitive training using tablet pc applications for 30 min/day. The outcome measures were the K-MMSE(: Korea-Mini Mental State Examination), MoCA-K(: Montreal Cognitive Assessments-Korea), MBI(: Modified Barthel Index), VAS(: Visual Analog Scale) for cognitive function, daily living, satisfaction. In results, Both group showed significant improvements after intervention in MoCA-K, MBI(p<.05). In comparison of change between two groups, experimental group showed significant improvements than control group in MoCA-K(p<.05). In comparison of satisfaction of two groups, both group was not significant difference(p>.05). we suggested that Cognitive training using tablet pc applications expected to positive effects the improvements of cognitive function in subacute stroke patients.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.727-732
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• 2007

Objectives : This study investigated using National Institutes of Health Strokes Scale in acute and subacute stroke patients and evaluated relativity of pulse pattern to NIHSS. Methods : 104 acute and subacute stroke patients were selected from 4 oriental medical hospitals from April 2007 to May 2007. The patients were admitted to hospital within 1 month after stroke. Pulse feeling diagnosis was done by oriental medical doctor and classified into 7 subtypes. Results : There were significant results statistically between slow/rapid pulse and NIHSS score in the male group; in the female group, there were no significant results statistically but the results showed that slow pulse has lower NIHSS score than rapid pulse. Patients with surging pulse had lower NIHSS score than the other patients. Another pulse pattern had no relativity to NIHSS score.

• Annals of Clinical Neurophysiology
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• v.14 no.2
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• pp.64-71
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• 2012

Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.19-29
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• 2019

Purpose : To determine whether an advanced rehabilitation therapy combined with conventional rehabilitation therapy consisting of sensorimotor exercises that would be superior to a usual treadmill training in gait ability and fall risk in subacute stroke patients. Methods : Thirty subjects randomly assigned to either multi-sensorimotor training group (n=19) or treadmill training group (n=18). Both groups first performed conventional physical therapy for 30 min, after which the multi-sensorimotor training group performed multi-sensorimotor training for 30 min, and the treadmill training group performed treadmill gait training for 30 min. Both groups performed the therapeutic interventions 5 days per week for 8 weeks. Gait ability was evaluated using the GAITRite system and Fall risk was measured using the Biodex Balance system before intervention and after 8 weeks. Results : There were no intergroup differences between demographic and clinical characteristics at baseline (p>.05). Both groups showed a significant improvement in gait ability (p<.05) and Fall risk (p<.05). In particular, the multi-sensorimotor training group showed more significant differences in gait velocity (p=.05), step length (p=.01) and stride length (p=.014) than the treadmill training group. Conclusion : The multi-sensorimotor training program performed on multiple types of sensory input had beneficial effect on gait ability. A large-scale randomized controlled study is needed to prove the effect of this training.

• Korean Journal of Radiology
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• v.2 no.4
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• pp.183-191
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• 2001

Objective: To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. Materials and Methods: In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2^* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. Results: DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. Conclusion: DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

• PNF and Movement
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• v.3 no.1
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• pp.35-45
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• 2005

Objectives : The purpose of this study was to understanding the constraint induced movement and Self-efficacy with arm training on upper motor function in Stroke Patients. Methods : Stroke, the leading cause of functional disability, causes a variety of impairments that compromise quality of life. Upper limb hemiparesis, a commonly seen impairment, is particularly problematic given its impact on activities of daily living. Because stroke was a disease to correspond to the first during domestic cause of death, and was accompanied by a lot of side aftereffects after a survival, stroke rehabilitation bought a patient and a family and a physical therapist, and it was main concern of. Results : Looks into upper extremity excrise of a subacute stroke patient estranged a acute convalescence later by a rehabilitation treatment in this consideration, and evaluates an effect to wind up constraint induced movement for an early treatment of stroke and Self efficacy, and help is one to an early rehabilitation of an stroke patient. Conclusions : Overuse sound tends after the stroke occurrence in the early stage in order to recompense for stroke, and at the time of a new aspect called learned nonuse syndrome by a movement of a paralysis part dusting off wealth with this step thing later. Constraint induced movement using self efficacy could be an effective for improving function of stroke.