• Physical Therapy Korea
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• v.13 no.1
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• pp.32-37
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• 2006

The purpose of this study was to investigate the effects of clinical characteristics of chronic stroke patients on physiological cost index (PCI) during walking. Fourteen stroke patients participated in this study. To investigate the clinical characteristics, Fugl-Meyer score (FMS), gait velocity (GV), muscle strength of the knee extensor, modified Ashworth scale (MAS) of ankle plantar flexor, devices, and gait patterns during walking were measured and analyzed. The results were as follows: Firstly, use of devices and high MAS of the ankle plantar flexor significantly increased PCI. Secondly, PCI was significantly correlated with the FMS and MAS of the ankle plantar flexor. In conclusion, inhibition of spasticity of the ankle plantar flexor is considered to reduce PCI during walking for chronic stroke patients.

• Physical Therapy Korea
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• v.13 no.2
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• pp.52-60
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• 2006

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5723-5729
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• 2013

The purpose of this study was to investigate the imbalance of muscle tone and frequent exposure to excessive gait training in patients with chronic spasticity due to stroke, the thickness of the plantar fascia to change and to evaluate. The subjects of this study was in 54 patients with chronic stroke from 18 patients Group I(MAS G0), 18 patients Group II(MAS G1), and 18 patients Group III(MAS G2) were selected. Measurement of clinical symptoms and physical examination, MAS(Modified Ashworth Scale), ultrasonographic, ROM(Range of Motion), VAS(Visual Analogue Scale), TUG(Timed Up and Go test) was measured. The study results were each group between the unaffected side and the affected side on plantar fascia thickness was statistically significantly thicker(p<.001). Each group between the unaffected side and the affected side on ankle dorsiflexion ROM was statistically significantly decrease(p<.001), VAS(p<.001), TUG(p<.001) statistically significantly increase(p<.001). In this study, the plantar fascia pathokinesiology ever presented by the contents of gait training in stroke patients is one of the information that you need to consider when presented.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.2
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• pp.111-118
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• 2012

Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.

• Journal of Korean Physical Therapy Science
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• v.12 no.4
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• pp.25-31
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• 2005

이 사례연구는 2002년 10월 15일 칼에 의한 좌상으로 경추 3-4번의 불완전 척수손상을 입은 25세의 남자 환자가 최초 병원에서 2002년 12월 한달 간의 치료를 마친 후, 2003년 1월 3일부터 4월 28일까지 태릉에 위치한 N 재활센터에서 주 5회 2시간의 자세조절 훈련, 심폐지구력 훈련, 웨이트 훈련, 스포츠(축구, 소프트 볼), 여가활동(등산)의 프로그램을 적용하여 척추손상 환자의 사회적응을 돕기위한 재활 프로그램의 다양화를 꾀하기 위한 기초 선행 작업으로 시작되었다. 신체능력을 평가하기 위한 측정도구는 관절가동범위(Range of Motion), 수동근력검사(Muscle Manual Test), 경직(Spasticity), 신체체력(Physical Fitness), 발란스(Balance: one leg stand), 상대적인 등속성 하지근력(Isokinetic Muscle Strength) 그리고 신체조성(Body Composition)로 하였다. 재활기간을 통해 처음 시작 일자에서 45일 간격으로 3차례의 측정을(1월 3일부터 4월 28일까지 실시하였다) 실시하였다. 최초 환자의 상태는 부분적으로 일상생활의 도움을 받아야 하는 상태로 동작을 시작하려 할 때 경직이 발생되어 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요했으며, 작은 물건 잡기와 글씨쓰기, 타이핑 작업은 불가능 한 상태였다. 또한 스포츠 활동과 여가활동 역시 불가능 한 상태였다. 3달 15일간의 기간 동안 환자는 복학을 준비하기 위해 적극적으로 치료에 임했으며, 결과는 다음과 같았다. 신체조성은 재활 훈련을 통해 체중, 체지방율(%), 복부지방율(WHR)의 많은 감소를 가져왔다. 경직을 측정하는 Ashworth Scale은 정상에 가깝게 감소하였다. 관절가동범위는 고관절, 무릎, 발목에서 모두 증가하였다. 수동근력검사(0-9)는 많은 향상을 가져왔다. 신체체력능력 항목에서 근지구력의 윗몸일으키기와 팔굽히기, 악근력, 유연성으로 앉아 체간 숙이기, 민첩성으로 사이드 스텝, 순발력의 서전트는 모두 크게 향상되었다. 환자의 일상능력에서도 옷을 입고 벗기, 신발 신고 벗기, 운전, 식사, 보행과 계단보행, 경사보행에서 보조자의 도움이 필요없었으며, 타이핑 작업은 5손가락을 모두 사용하지는 않았지만, 1분에 80타로 큰 향상을 가져왔다. 또한 축구와 소프트볼, 등산을 달에 1회 정도 실시하여 약간의 도움만으로 가능하게 되었다.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.59-64
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• 2017

Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

• The Journal of Pediatrics of Korean Medicine
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• v.19 no.2
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• pp.255-269
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• 2005

Objective : To evaluate the effect of Oriental Medical Treatment on a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation Method : We applied various methodology of Oriental Medical Treatment including Acupuncture, Electroacupuncture, Physical treatment, Herbal Medicine, Moxibustion treatment and Western medication as well. Result: Herbal medicine was applied on the basis of the patient's history. We applied formular to remove phelgm as a pathogenic factor after Hypoxic Ischemic Encephalopathy. At the same time, considering the patient spent more than a month in ICU lacking appropriate nutrition, we used formuli on the basis of 'Deficiency of Spleen' focusing to vitalize the function of digestive system. As the condition of the patient changed, we also adapted formular accordingly. We prescribed Herbal medication to strengthen Yin and Yang equally as she got hospitalized for long time. Also we applied Acupuncture treatment and Moxibustion treatment to control Qi flow. The general condition of the patient got better with successful removal of Foley catheter and elevated Glasgow Coma scale. We used Electroacupuncture, Physical treatment and Western medication at the same to get maximized effect on relaxing the contracted muscle. According to the Modified Ashworth Scale (MAS), we have some changes in muscle spasticity but later, the effect was not that significant. Conclusion : We had a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation. In the management of Hypoxic Ischemic Encephalopathy, Conservative treatments are the mainstream but there are not many alternatives. Therefore, We suggest that Oriental medical approach may contribute to the management of Hypoxic Ischemic Encephalopathy.

• CELLMED
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• v.13 no.14
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• pp.16.1-16.14
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• 2023

Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.3
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• pp.24-36
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• 2017

Objectives The purpose of this study is to provide clinical evidence of herbal medicine treatment for cerebral palsy by reviewing randomized controlled trials conducted in China. Methods We searched literatures dated up to 17 May, 2017 in China National Knowledge Infrastructure (CNKI), and evaluated methodological quality of those studies using 'Risk of Bias' tool. Results Sixteen studies were selected for analysis. These studies indicated that the total effective rate, motor function, self-care, muscle spasticity were significantly improved in the herbal medicine treatment group, as compared to the control group. The most-commonly-used herbs were Poria (茯?), Astragali Radix (黃?), Glycyrrhizae Radix (甘草), and Atractylodis Rhizoma Alba (白朮). There were no serious adverse events found that were associated with herbal medicine treatment. The methodological quality of included studies was generally unclear or low. Conclusions This study shows that the herbal medicine treatment can be effective and safe in treating cerebral palsy. Further well-designed clinical trials with high methodological quality and appropriate assessment tools need to be performed to solidify these findings.

• Journal of Korean Physical Therapy Science
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• v.27 no.1
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• pp.56-65
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• 2020

Purpose: Individuals affected by stroke present with changes in motor function, balance, and cognition. The purpose of this study was to the correlation between motor function, balance, and cognition in patients with stroke. Design: cross-sectional study design. Methods: 67 stroke patients in the experiment were included. For evaluation of motor function which is Manual Muscle Test, Range of Motion, Modified Ashworth Scale for spasticity, grasping power, and balance was measured using the Berg Balance Scale and Functional reach test. For evaluating Cognition which is Korean-Mini Mental State Examination. Results: The results of this study's motor function, balance, and cognition showed a significant positive correlation (p<0.05). Conclusion: The results indicated that motor function, balance, and cognition were significantly correlated with each other. Therefore, it is suggested that to improve the motor function and balance of patients with stoke, it needs to evaluate the cognition and the motor function, balance, and cognitive training should be combined.