• 한방재활의학과학회지
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• 제33권2호
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• pp.87-94
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• 2023

This study aims to demonstrate the effectiveness of facial chuna manual therapy in treating the sequelae of Bell's palsy. Four patients were treated with facial chuna manual therapy once a week for 4 weeks, consisting of facial muscle massage, acupoint pressure, contracture chuna, and synkinesis chuna. The changes in symptoms (contracture and sysnkinesis) were measured using the Sunnybrook Facial Grading Scale (SFGS), Synkinesis Assessment Questionnaire (SAQ), Facial Disability Index (FDI), Contracture/Synkinesis scale using a facial scanning system, Numeric Rating scale (NRS) for synkinesis or contracture, and Was It Worth It questionnaire. After treatments, SFGS, Contracture/Synkinesis scale, and NRS for synkinesis or contracture showed significant improvements. SFGS increased in three cases from 39~76 to 52~85 score. SAQ decreased in two cases from 53.33~57.78 to 40.00~55.56. FDI increased in three cases from 120~128 to 138~145. These results suggest that Korean medicine treatment, including facial chuna manual therapy can be effective in improving the sequelae of Bell's palsy.

• 한방안이비인후피부과학회지
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• 제32권3호
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• pp.202-211
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• 2019

Objectives : This study is to report 4 cases of the facial palsy sequelae synkinesis treated with Thread-Embedding Acupuncture(TEA) and Jung-An acupuncture(JAA). Methods : 4 patients received Korean medical treatment consists of TEA and JAA. Results : After treatment, relief of facial synkinesis and enhancement of facial symmetry were observed in all patients. Conclusions : This study suggests that TEA and JAA may be effective on facial palsy sequelae synkinesis. Therefore it seems that additional reporting about relevant studies is likely to be required.

• 한방안이비인후피부과학회지
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• 제25권4호
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• pp.1-11
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• 2012

Objective : The purpose of this study is to analyze research trends on facial synkinesis after bell's palsy in order to build stepping stone in the hope of further related study in Korean medicine society. Methods : We searched Pubmed with the title "facial synkinesis" only developed after bell's palsy for the last 10 years and analyzed their impact factors, interventions, types of study, published countries, journals and years. Results : We found 12 papers and interventions included in each studies turned out to be effective and showed meaningful outcomes, but, the number of papers is still inadequate though, constantly published annually. And we were unable to find any studies with oriental treatments. Conclusions : Further attention and studies are needed on this topic in Korean medicine society in order to search appropriate oriental clinical care for the bell's palsy patients suffering facial synkinesis.

• The Journal of Korean Physical Therapy
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• 제20권3호
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• pp.9-18
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• 2008

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.88-92
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• 2005

Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

• 국제물리치료학회지
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• 제10권3호
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• pp.1849-1855
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• 2019

Background: Stroke patients require arm movement exercising for various stimulations in standing position for various stimulations rather than in a sitting position because they require integrated skillful movements, such as stretching, holding, and controlling. Objective: This study was conducted to provide foundational clinical data about lower limb global synkinesis in stroke patients using arm movements in a standing position. Design: Randomized controlled trial. Methods: The subjects were divided into a control group (n = 10) and an experimental group (n = 10), and a pre-test was conducted to evaluate leg global synkinesis (GS) and balance. Intervention method is stretching an arm to hold a ball, repeating supination and pronation of the hand only while maintaining the arm extended as much as possible, repeating shoulder abduction and adduction while holding the pegboard. This was followed by a three-week intervention during which re-measurement was conducted in the same way as was done for the pre-test. Results: The control group showed a significant difference in GS and balance during plantar flexion (p<.05), and the experimental group showed a significant difference in GS and balance during all movements (p<.05, p<.01, respectively). There was a significant difference in GS and balance between the two groups during dorsiflexion (p<.05, p<.01, respectively). Conclusion: The findings demonstrate that human arm movements in a standing position can reduce GS in the affected limb, and balance can be improved by stimulating the surrounding tissues of the affected limb and changing them positively.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.5019-5026
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• 2011

본 연구는 만성 편마비 환자의 교감신경 활동 강화가 근 긴장도 및 중추신경 흥분성 변화에 미치는 영향을 알아보기 위해 시행하였다. 연구기간은 2009년 10월 12일부터 12월 4일까지 실시하였으며, 연구대상자는 발병 후 6개월 이상 된 만성 편마비 환자 30명을 대상으로 하였다. 실험은 교감신경 활동을 강화하는 세 가지 과제(암산, 정적인 상태에서 쥐기운동, 쥐기운동 후 허혈)를 실시하였으며 측정은 과제를 수행하기 전과 중의 global synkinesis 수준과 중추신경원 활동전위을 각각 측정하였다. 중추신경원 활동전위는 H/Mmax비, V/Mmax비를 측정하였고, global synkinesis 수준은 근전도 활동전위의 실효치 값을 측정하여 분석하였다. 본 연구에서, global synkinesis 수준은 정적인 상태에서 쥐기 과제를 제외한 나머지 과제(암산, 쥐기 후 허혈)에서 슬관절 굴곡, 신전 시 감소했다(p<.05). 또한 V/Mmax비에서는 세 가지 과제 모두에서 감소하였다(p<.05). 결론적으로, 교감신경 활동 강화는 만성 편마비 환자의 중추신경 흥분성과 근 긴장도를 감소시킴을 알 수 있었다.

• 한방안이비인후피부과학회지
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• 제22권1호
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• pp.157-171
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• 2009

Objective : The face is very important for human communication. So facial palsy patients experience not only physical disturbances but also serious emotional stress. Therefore the focus of treatment must be to not only aid the recovery of objective symptoms but also the improvement of subjective quality of life. However there has not been enough Oriental Medical study in this field until now. Thus this study was begun to suggest a useful index for the treatment of facial palsy. Methods : Grade of paralysis, sequelas, and quality of life were used for evaluation. To evaluate Grade of paralysis, House-Brackman Grade was used as the Gross scale and Kim's Grade was used as the Regional scale. Sequelas were evaluated by muscle contraction, synkinesis, NA, and grade of philtrum tilt. Quality of life was evaluated by SF-36v2, Facial Disability Index, and Vas. Results & Conclusion : 1. The change of grade of paralysis between the early and the present time reveals remarkable improvement statistically. 2. There was a remarkable improvement in all parts of quality of life except several areas of SF-36(RP, RE, MH, VT) 3. In only PF(Physical Function) of FDI, quality of life increased remarkably according to the improvement of grade of paralysis. 4. There is the positive relationship among Kim's grade, HB grade and Synkinesis 2. 5. Synkinesis among sequelas has the greatest effect on quality of life. And muscle contraction, change of NA, and grade of philtrum tilt also affect quality to some extent. 6. There was no remarkable relationship between the period of illness and change of quality of life. 7. Change of NA is shown after 3 months of illness and synkinesis becomes worse after 6 months of illness.

• 국제물리치료학회지
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• 제11권3호
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• pp.2140-2146
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• 2020

Background: Stroke patients exhibit arm global synkinesis (GS), involuntary movement due to muscle weakness and irregular muscle tension. But currently there are few studies examined the effects of GS on activates of daily living in stroke patients. Objectives: To investigate the effects the effects of task-oriented bilateral movements, which promote brain plasticity and are based on neurological theory, using the unaffected arm and the affected arm. Design: Quasi-randomized trial. Methods: Twenty stroke patients were randomly assigned to experimental group I (n=10) and experimental group II (n=10). Before the intervention, arm GS was measured using surface electromyography, and the Motor Activity Log evaluated the quantitative and qualitative uses of the affected arm in daily life. The same items were measured four weeks later. Results: The changes in the GS of the arm of experimental group I showed statistically significant differences only in bending motions (P<.05). Both groups showed statistically significant differences in the amount of use (AOU) and the quality of movement (QOM) scores (P<.01). Comparing the groups, statistically significant differences in GS appeared during bending motions (P<.05), and in the AOU (P<.01) and the QOM scores (P<.05). Conclusion: The intervention in GS reduced the abnormal muscle tension of the affected side by increasing the use of the ipsilateral motor pathway, indicating its effectiveness in improving upper limb functions with smooth contraction and relaxation of the muscles.

• 대한물리의학회지
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• 제16권2호
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• pp.63-70
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• 2021

PURPOSE: This study aimed to analyze the factors influencing the improvement of global synkinesis (GS) and gait in stroke patients by the weight shift exercise. METHODS: Twenty stroke patients were randomly assigned to experimental group I (n = 10) and experimental group II (n = 10). In experimental group I, weight shift with upper extremity exercises in a standing position were mediated and in experimental group II, upper extremity exercises in a standing position were mediated. These interventions were conducted in both groups for three sessions per week, 30 minutes per session over four weeks. Before the interventions, leg GS was measured using surface electromyography and the 10m walk test (10MWT). The same parameters were measured four weeks later. RESULTS: The GS and 10MWT of the experimental group I showed that there was a statistically significant difference between dorsiflexion (p < .05) and plantarflexion (p < .01) and 10MWT (p < .01). In experimental group II, there was a statistically significant difference only in 10MWT (p < .01). The comparison between the changes in both groups showed that in the case of GS, there was a statistically significant difference in the dorsiflexion (p < .01) and plantarflexion (p < .05), and in the 10MWT too (p < .05). CONCLUSION: GS of the lower extremities was decreased by improving posture control and enlarging soft tissues due to the symmetrical weight shift in experimental group I, which turned out to be effective in improving the gait speed.