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Effects of Functional Electrical Stimulation (FES) on the Temporal-spatial Gait Parameters and Activities of Daily Living in Hemiplegic Stroke Patients

  • Oh, Dong-Gun;Yoo, Kyung-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.3
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    • pp.37-44
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    • 2021
  • PURPOSE: This study examined the effects of functional electrical stimulation (FES) on temporal-spatial gait and the activities of daily living in hemiplegic stroke patients. METHODS: The subjects were 29 hemiplegic stroke patients (57.7 ± 10.3). The patients walked at a self-controlled speed in four states: (1) walking without FES (non-FES), (2) walking with FES on the gluteus medius in the stance phase (GM), (3) walking with FES on the common peroneal nerve and tibialis anterior in the swing phase (PT), (4) walking with both GM and PT. A GAITRite system, Timed-Functional Movements battery, and Timed UP and Go test were used to measure the variables. RESULTS: Significant improvements were observed in all variables of the GM+PT, GM, and PT states compared to the non-FES state (p < .05). There were significant improvements in the GM+PT state compared to GM and PT states (p < .05). Moreover, significant improvements were noted in the single support time on the affected side, backward walking 10ft, and side stepping 10ft on the affected side of the GM state compared to the PT state (p < .05). There were significant improvements in the stride length on the affected side and side stepping 10ft on the unaffected side of the PT state compared to the GM state (p < .05). CONCLUSION: FES is effective in improving the temporal-spatial gait and activities of daily living in hemiplegic stroke patients.

A Study of the Chewing Patterns in Patients with Temporomandibular Disorders by Electrognathography (Electrognathography를 이용한 측두하악장애환자의 저작양태에 관한 연구)

  • Moon-Gyu Kim;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.291-306
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    • 1995
  • Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

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A Preliminary Study on the Correlation Between ICF and Functions of Upper Limbs of Chronic Stroke Patients : ICF Activities, Participations, and Environmental Factors (만성 뇌졸중 환자의 상지 기능과 ICF와의 상관관계 예비 연구 : ICF 활동, 참여 및 환경영역 중심으로)

  • Im, Jong-Woo;Shin, Kyu-Hyun;Lee, Young-Min
    • PNF and Movement
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    • v.16 no.3
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    • pp.485-493
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    • 2018
  • Purpose: This study provides a treatment for central nervous system development in patients with chronic stroke by investigating changes in the upper limb function over time. The correlations among the activities, participation, and environmental factors of the international classification of functioning (ICF), disability and health are also examined. Methods: The subjects of this study are 18 patients with chronic stroke who were hospitalized and treated at 00 hospital in the Chungcheongbuk-do province. Their upper extremity functions are evaluated using the manual function test (MFT). The activities, participation, and environmental factors are evaluated using the ICF generic form. The correlations between the total scores of the affected and unaffected sides and the ICF items are analyzed using the Pearson correlation analysis. The significance level is p<0.05. Results: When the correlations between the activities and participation areas of ICF and the total score of the affected side of MFT were examined, significant correlations (p<0.05) were found in the following items: changing basic body position (D410), lifting and carrying objects (D430), moving around using equipment (D465), using transportation (D470), washing oneself (D510), caring for body parts (D520), and dressing (D540). When the correlations between the activities and participation areas of ICF and the total score of the unaffected side of MFT were examined, significant correlations (p<0.05) were found among writing (D170), speaking (D330), eating (D550), and drinking (D560). In addition, when the correlation between the environment area of ICF and the total score of the unaffected side of the MFT were examined, significant correlations (p<0.05) were found between products and technology for personal use in daily living (E115) and immediate family (E310). Conclusion: The MFT of patients with chronic stroke is closely correlated with the activities, participation, and environmental factors of ICF. This result suggests that ICF can be used as a useful tool to comprehensively evaluate the abilities of the patient, including the upper extremity function.

Unusual Lower Back Pain on the Non-Articulated Side in Patient with Bertolotti's Syndrome (가관절을 이루고 있지 않은 편측의 통증을 호소한 베르톨로티 증후군)

  • Kim, Inah;Lee, Jong In;Jang, Yongjun;Park, Hae-Yeon
    • Clinical Pain
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    • v.20 no.1
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    • pp.49-52
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    • 2021
  • Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.

The Effect of Visual Feedback on Postural Control During Sit-to-Stand Movements of Brain-Damaged Patients Under Different Support Conditions (지지조건에 따른 시각되먹임이 뇌손상환자의 일어서기 과정 동안 자세조절에 미치는 영향)

  • Shin, Jun-Beom;Lee, Jae-Sik
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.40-50
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    • 2012
  • The purpose of this study was to investigate the effect of visual feedback on the postural control of stroke patients, by systematically varying conditions of visual feedback [eye-open condition (EO) vs. eye-closed condition (EC)], and base-support (both-side support, affected-side support, and unaffected-side support). In this study, we allocated 41 stroke patients with no damage in the cerebellum and visual cortex who can walk at least 10 meters independently, and 35 normal adults who have no experience of stroke to the control group. Both groups were asked to perform a "sit-to-stand" task three to five times, and their postural control ability was measured and compared in terms of asymmetric dependence (AD) instead of the traditional symmetric index (SI) in the literature. The results showed that although both subject groups maintained better postural control in the EO condition than in the EC condition, the patient group appeared to be more stable in EC than in EO when they were required to perform the task of the support condition given on the affected side. These results implied that visual feedback can impair stroke patients' postural control when it is combined with a specific support condition.

The effect of arm sling during hemiplegic gait (팔걸이가 편마비 환자의 보행에 미치는 영향)

  • Lee, Ilsuk;Lim, Hyungmoon;Choi, Sanho;Oh, Jaegun;Sung, Kang-keyng;Lee, Sangkwan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.80-89
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    • 2013
  • ■ Objectives The aim of study is to analyze the change of gait pattern by arm sling in a hemiplegic patient. ■ Methods We analyzed the change of gait pattern under three conditions using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) First, the patient didn't have arm sling on her upper limb, second, the patient have arm sling on her affected upper limb, third, patient have arm sling on her unaffected upper limb. ■ Results In terms of spatiotemporal gait values, swing phase, step time, step length of unaffected lower limb increased. Furthermore, stride time and stride length also increased when the patient had arm sling on her unaffected upper limb. In terms of displacement of Center of pressure(CoP), anterior/posterior position and lateral symmetry of CoP increased. Furthermore, lateral symmetry of decreased when the patient had arm sling on her affected upper limb. ■ Conclusion Arm sling applied on affected side would be advantage to gait improvement in hemiplegic patients.

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Infrared Thermal Imaging in Patients with Medial Collateral Ligament Injury of the Knee - A Retrospective Study

  • Yang, HyunJung;Park, HaeIn;Lim, Chungsan;Park, SangKyun;Lee, KwangHo
    • Journal of Pharmacopuncture
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    • v.17 no.4
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    • pp.50-54
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    • 2014
  • Objectives: Digital infrared thermographic imaging (DITI) has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient's with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient's who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient's knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient's were composed of 14 women (70%) and 6 men (30%), with a mean age of $62.15{\pm}15.71$ (mean${\pm}$standard deviation (SD)) years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05). The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury.

Growth observation and orthodontic treatment of a hemifacial microsomia patient treated with distraction osteogenesis

  • Chung, Nam Hyung;Yang, So Jin;Kang, Jae Yoen;Jeon, Young-Mi;Kim, Jong Ghee
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.136-144
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    • 2020
  • Hemifacial microsomia (HFM) patients may experience emotional withdrawal during their growth period due to their abnormal facial appearance. Distraction osteogenesis at an early age to improve their appearance can encourage these patients. Some abnormalities of the affected side can be overcome by distraction osteogenesis at an early age. However, differences in the growth rate between the affected and unaffected sides during the rest of the growth period are inevitable due to the characteristics of HFM. Therefore, re-evaluation should be performed after completion of growth in order to achieve stable occlusion through either orthognathic surgery or camouflage orthodontic treatment. An eight-year-old patient visited the clinic exhibiting features of HFM with slight mandibular involvement. He received phase I treatment with distraction osteogenesis and a functional appliance. Distraction osteogenesis was performed at the right ramus, which resulted in an open bite at the right posterior dentition. After distraction osteogenesis, a functional appliance and partial fixed appliance were used to achieve extrusion of the affected posterior dentition and settlement of the occlusion adjustment on the unaffected posterior dentition. The patient visited the clinic regularly for follow-up assessments, and at the age of 20 years, he showed facial asymmetry of the mandible, which had deviated to the right side. He received orthodontic treatment to improve the occlusion of his posterior dentition after the growth period. Without orthognathic surgery, stable occlusion and a satisfactory facial appearance were obtained through camouflage orthodontic treatment.

The Influence of Sensory and Upper limb function on Activities of Daily Living of Patients with Chronic Cerebrovascular Accident (만성 뇌졸중 환자의 감각기능과 상지기능에 따른 일상생활활동 수행능력)

  • Song, Won-Il;Cha, Tae-Hyun;Woo, Hee-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5731-5740
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    • 2011
  • The aim of this study is to evaluate the relationship between sensory function and performances in the activities of daily living in chronic CVA patients. One-hundred and thirty-eight CVA patients, who experienced their CVA more than 6 months ago, were recruited. Their sensory, motor and cognitive functions, as well as performances in activities of daily living were assessed and analysed. The results indicated that Graphesthesia and proprioception of the affected hand of patients with right hemiplegia showed statistically significant correlation with personal hygiene. The motor functions of the unaffected side in patients with left hemiplegia showed statistically meaningful correlation with ADL performances. The correlation between the motor function of upper limb of the unaffected side and the activities of daily living showed statistical significance in both right and left hemiplegia.

Clinical validation of the 3-dimensional double-echo steady-state with water excitation sequence of MR neurography for preoperative facial and lingual nerve identification

  • Kwon, Dohyun;Lee, Chena;Chae, YeonSu;Kwon, Ik Jae;Kim, Soung Min;Lee, Jong-Ho
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.259-266
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    • 2022
  • Purpose: This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves. Materials and Methods: Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor was identified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described. Results: Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side. Conclusion: This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.