• 한국산학기술학회논문지
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• 제14권2호
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• pp.737-743
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• 2013

본 연구는 시각 통제를 이용한 다중감각 훈련이 아급성 뇌졸중 환자의 균형 및 체간위치감각에 미치는 영향을 알아보고자 시행하였다. 뇌졸중 환자 30명을 대상으로, 다중감각 훈련군은 시각통제 후 훈련을 실시하였고, 대조군은 안대로 눈을 가린 것을 제외하고는 실험군과 동일한 훈련을 실행 하였다. 두 군 모두 훈련 과정은 4주간 주 5회 60분 동안 실시하였다. 대상자들은 사전, 사후 평가로 정적 균형, 동적 균형 및 체간위치감각을 검사하였다. 본 연구의 결과는 다중감각 훈련군에서 훈련 전, 후를 비교한 결과 정적 균형, 동적 균형, 체간위치감각에서 유의한 향상이 나타났고(p<.05), 두 그룹 사이에서는 동적 균형, 체간위치감각에서 유의한 차이가 나타났다(p<.05). 본 연구의 결과를 통하여 다중감각 훈련은 동적 균형 및 체간위치감각을 향상시키는데 효과적인 훈련방법으로 제시 할 수 있다.

• 재활치료과학
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• 제3권1호
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• pp.47-55
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• 2014

목적 : 본 연구는 에비안스-함베르크 스트레칭이 아급성 뇌졸중 환자의 환측 상지기능과 일상생활활동에 미치는 영향에 대해 알아보고자 단일 사례연구를 실시하였다. 연구방법 : 본 연구의 대상자는 대구광역시에 소재한 K재활병원에서 입원치료를 받고 있는 만 39세 남성 뇌졸중 환자이다. 에비안스-함베르크 스트레칭을 4주간 주 5회 1일 1회 30분간 적용하여 중재 전후 상지기능과 일상생활활동을 비교하였다. 상지기능의 평가는 뇌졸중상지기능평가(manual function test; MFT), 운동활동측정표(motor activity log; MAL)를 사용하였고, 일상생활활동 평가는 기능적 독립 척도(functional independence measure; FIM)를 사용하였다. 결과 : 대상자는 중재 후 평가에서 MFT는 향상 없이 유지되었으며, MAL에서는 사용빈도와 움직임의 질에서 각각 3점씩 향상되었다. FIM은 73점에서 94점으로 21점이 향상되었다. 결론 : 본 연구의 결과를 통해 에비안스-함베르크 스트레칭이 아급성 뇌졸중 환자의 상지기능과 일상생활활동을 증진시키는데 효과가 있음을 알 수 있었으며, 기존의 작업치료와 에비안스-함베르크 스트레칭을 적절히 활용한다면 환자의 기능 회복에 많은 도움이 될 것이라 사료된다.

• 재활치료과학
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• 제7권4호
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• pp.79-91
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• 2018

목적 : 본 연구에서는 상지 로봇 치료가 아급성기 뇌졸중 환자의 상지기능에 단기적으로 미치는 영향을 알아보는 것이었다. 연구방법 : 본 연구는 뇌졸중 편마비 진단을 받고 1회 1시간씩 상지 로봇 치료와 과제 지향적 훈련(task-oriented training)를 받았던 환자 20명의 의무기록을 이용한 후향적 연구로서, 중재 전/후의 3차원 동작분석검사 결과 값을 토대로 두 중재간의 변화량을 비교 하였다. 결과 분석은 기술 통계와 대응표본 t검정을 사용하여 결과 값을 파악 하였다. 결과 : 연구 결과 상지 로봇 치료를 한 경우 팔 뻗기를 하는 동안 팔굽관절 움직임의 순발력, 효율성, 부드러움에서 향상을 보였으며, 과제 지향적 훈련(task-oriented training)과 비교 하였을 때 팔굽관절의 부드러움에서 유의한 차이를 보였다(p<.05). 결론 : 단기적 상지 로봇 치료는 아급성기 뇌졸중 환자의 팔뻗기 시 팔굽관절 움직임에 효과를 보였으며, 추후 장기적인 연구를 통해 상지 기능의 움직임 개선에 대한 효과 입증이 필요하다.

• 한방재활의학과학회지
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• 제19권2호
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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.

• 대한물리의학회지
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• 제11권1호
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• PNF and Movement
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• 제15권1호
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• pp.105-113
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• 2017

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.379-386
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• 2021

Objective: The purpose of this study was to systematically review the trunk impairment scale that are used to assess the trunk control of stroke patients. Design: A systematic review Methods: Stroke subjects were categorized as acute, subacute, chronic. In this systematic review, the studies published between 2000 and 2020 were selected. A literature search using the keywords 'QUADAS', 'stroke', 'trunk impairment scale'. Data sources included RISS, GOOGLE Scholar and DBpia. We assessed the quality of assessment tools using Quality Assessment of Diagnostic Accuracy Studies tool. Results: We reviewed 18 studies. 7 of the 18 studies reported reliability results, 10 reported validity results. The QUADAS tool quality evaluation of 17 literatures extracted except for one randomized control test among 18 literatures showed a range of 3 to 13 points. 5 of the 18 studies are presented with the Cronbach alpha coefficient indicating reliability using internal consistency, all of which are more than 0.8. All studies that presented test-retest reliability, intra-rater reliability, and inter-rater reliability showed high agreement with an intra-class correlation coefficient of 0.75 or more. Conclusions: A systematic review of the study of the application of the trunk impairment scale for stroke patients will help provide criteria for future studies and application of the trunk impairment scale in clinical practice.

• 대한통합의학회지
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• 제7권3호
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• pp.11-19
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• 2019

Purpose : The purpose of this study is to examine the effect of instrumental-activity of daily living program on a patient with subacute stroke in the view of self-efficiency, motivation for rehabilitation, social support. Methods : Eight stroke patients who attended instrumental-activity of daily living program at P hospital in Busan Metropolitan City from march 2018 to January 2019 were recruited. Instrumental-activity of daily living program was offered to 8 stroke patients 1 session (at least 1 hours) a day, 5 times a week, for 4~5 weeks. The instrumental-activity of daily living program was based on occupational therapy practice framework (OTPF) and international classification of functioning, disability and health (ICF). We evaluated self-efficacy, rehabilitation motivation, social support before and after intervention. Self-efficacy was evaluated using the general self-efficacy scale. The collected data was processed using SPSS 20.0 and were analyzed using descriptive statistics, Wilcoxon signed rank test, Pearson's correlation coefficient. Results : There were statistically significant differences in self-efficiency, rehabilitation motivation, social support between before and after instrumental-activity of daily living program (p<.05). Examining the correlation between the self-efficiency, rehabilitation motivation and social support of the stroke patient, there was a correlation between the self-efficiency and social support (p<.05). Conclusion : This study showed that the instrumental-activity of daily living program have positive effects on self-efficacy, rehabilitation motivation, social support. When considering the instrumental-activity of daily living program with improved self-efficacy, rehabilitation motivation, social support of the participants, we suggest that further studies will be needed to examine more extensive instrumental-activity of daily living and rehabilitation to the society with a larger sample size.

• 한국콘텐츠학회논문지
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• 제12권8호
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• pp.264-273
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• 2012

본 연구는 아급성 뇌졸중 환자를 대상으로 컴퓨터화된 시각적 되먹임 균형 훈련 및 평가 장비인 space balance 3D와 기능적 검사인 tinetti mobility test (TMT)의 신뢰도 및 버그균형척도와의 동시타당도를 분석하기 위해 실시하였다. 아급성 뇌졸중 환자 총 23명을 대상으로 하였고 대상자에게 space balance 3D, TMT, 버그균형척도를 이용해 균형 능력 평가를 실시하였다. 검사-재검사간 신뢰도에서 space balance 3D의 정적균형과 동적균형은 중등도의 신뢰도를 보인반면, TMT의 세가지 점수와 버그균형척도는 높은 신뢰도를 보였다. 동시타당도에서 TMT의 세가지 점수, 버그균형척도, space balance 3D의 정적균형간에 각각 중등도의 유의한 (p<.01) 양의 상관관계를 보였다. TMT의 세가지 점수와 버그균형척도는 space balance 3D의 동적균형의 후좌측, 전좌측 방향과는 각각 유의한 (p<.05) 낮은 양의 상관관계를 보였지만 나머지 방향과는 유의한 상관관계를 보이지 않았다. 따라서 space balance 3D와 TMT의 균형 능력 평가는 아급성 뇌졸중 환자의 균형 능력을 평가하는데 유용하게 쓰일 수 있을 것으로 보이나 space balance 3D의 동적균형 평가는 한계점이 있었다.

• 대한물리의학회지
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• 제1권1호
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• pp.1-12
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• 2006

Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.