• PNF and Movement
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• v.13 no.4
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• pp.181-188
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• 2015

Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.81-88
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• 2018

PURPOSE: The present study aims to determine the effect of lower extremity muscle strength exercise at the non-paralyzed side of patients of stroke using a mirror on gait and balance. METHODS: Subjects were assigned randomly to a group of lower extremity exercise without using a mirror (n=10), a group of lower extremity motion exercise using a mirror (n=10), and a group of lower extremity muscle strength exercise using a mirror (n=10). The exercise is added to a physiotherapy program conducted at the hospital and subjects conducted their designed lower extremity exercises 30 times a day (5 sets), five days per week for four weeks. RESULTS: The study result showed that BBS(Berg balance scale)(p<.05) and TUG(timed up and go test)(p<.05) had a significant difference. In the comparison on gait ability, stride length, step length, step width and single support was a significant difference within two groups using a mirror before and after the intervention(p<.05). CONCLUSION: Conclusively, low extremity motion exercise using a mirror and low extremity muscle strength exercise using a mirror conducted along with general physiotherapy exercises had a positive effect on functions of lower extremity in patients with stroke and the recovery of paralyzed side thereby incurring a significant difference in balance and gait abilities.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• 제어로봇시스템학회:학술대회논문집
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• 1992.10a
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• pp.90-94
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• 1992

A portable multichannel functional electrical stimulation(FES) system for the fine control of the paralyzed extremities in spinal cord injury patients is described. This system is composed of a stimulation data creating system, a serial communication device, a 16-bit microprocessor, D/A converter of 32 channels and a display device. Stimulation patterns are created from analytical results of integrated EMGs during motion in normal subjects and are stored in the stimulation data creating system as data files. And then the stimulation patterns are sent to the memory in the portable multichannel FES system through serial communication interfacing device. Sophisticated fine control of paralyzed extrimities was realized by transmitting multichannel stimulation patterns to percutaneous intramuscular electrodes, which stimulate the motor function of paralyzed muscle simultaneously. Advantages of this system are as follws: 1) It is possible to modify stimulation patterns in accordance with the patient's situation. 2) This system is small and light.

• Proceedings of the KOSOMBE Conference
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• v.1993 no.05
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• pp.120-122
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• 1993

This paper describes an improved FES system to restore paralyzed extremities in spinal cord injury patients. For composing stimulus pattern which is suitable for each muscle, electrical stimulus pattern creating system is also developed by using IBM-PC. In the improved portable FES system using V40 microprocessor, muscle fatigue can be decreased by selecting the stimulus frequency which is proper to the response characteristics of each muscle. Driving softwares for the portable FES system and the stimulus pattern creating system are programmed with assembler and C language. A multichnnel portable FES system is designed to minimize the sire and weight using a D/A converter and 32 channel multiplexer.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.53-62
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• 2022

PURPOSE: This study was conducted to investigate the effect of a real-time pressure feedback provided during gait training on the weight weight distribution of the inner part of mid-foot in paralyzed side and gait function in stroke patients. METHODS: A total of 24 patients with hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental and control group. All participants (n = 24) performed 15 min of comprehensive rehabilitation therapy 5 times a week for a period of 4 weeks. Additionally, the experimental group and control group underwent gait training with a real time feedback and general gait training, respectively, for 15 min five times a week for 4 weeks. Weight distribution and gait function were measured before and after the 4-week training. RESULTS: Significant increases in the weight distribution (WD), stance time (ST) and step length (SL) of the paralyzed side, and a significant decrease in the 10 m walking test (10 MWT) observed after training in the two groups (p < .05). The experimental group showed larger changes in the all variables than the control group (WD, +10.5 kg vs. +8.8 kg, p < .05; ST, 12.8 s vs. 4.9 s, p < .05; SL, 4.9 cm vs. 1.7 cm, p < .05; 10 MWT, -3.5 s vs. -1.0 s, p < .05, respectively). CONCLUSION: Gait training with a real-time feedback might be effective in improving the normalization of weight bearing of the paralyzed lower extremity and gait function of stroke patients, and be considered to be a more effective gait training for improving the abilities than the general gait training.

• PNF and Movement
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• v.16 no.1
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• pp.143-150
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• 2018

Purpose: The purpose of this study was to investigate the influence of opposite lower extremity lateral muscle activation by proprioceptive neuromuscular facilitation (PNF) exercise targeting the lower extremities. Methods: Nineteen patients with chronic hemiplegia volunteered to participate in this study. PNF flexion, abduction, and internal rotation patterns; initial, end range, and extension patterns; abduction and internal rotation patterns; and initial and end range patterns were applied to the dominant lower extremity. Activation of lateral muscles (multifidus, gluteus medius, tensor fascia lata, and peroneous longus) of the paralyzed leg was then measured by electromyography (EMG). Results: There were significant differences in lateral muscle activation, depending on the PNF pattern applied, with the differences more significant in flexion, abduction, internal rotation, and end range patterns. Conclusion: PNF flexion, abduction, and internal rotation patterns can improve lateral muscle activation of one leg in the standing position in the gait cycle.

• PNF and Movement
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• v.17 no.1
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• pp.93-101
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• 2019

Purpose: This study aimed to investigate lower extremity muscle activation to the variable weight shift on the affected side of patients with hemiplegia. Methods: Eighteen patients with chronic hemiplegia volunteered to participate in this study. All participants performed three types of weight shift (sideways, forward, and backward) in limits of stability on the affected side. Muscle activation in a paralyzed leg was measured with electromyography on the gluteus medius, tensor fasciae latae, rectus femoris, and biceps femoris; furthermore, the attached area was recommended by SENIAM projects. Each weight shift was performed three times, and then the mean value of the three measurements was analyzed. The data were analyzed by measuring the symmetrically standing position with the reference voluntary contraction (RVC) and was standardized with the percentage of RVC method. Results: No significant difference in lower extremity muscle activation occurred according to the three types of variable weight shift. However, significant differences in lower extremity muscle activation did occur with each weight shift position. In addition, activation increased at the rectus femoris and decreased at the gluteus medius and tensor fasciae latae. Conclusion: Hip abductor muscle strength training and variable weight shifts on the affected side must increase to improve patients'balance and limits of stability.

• Journal of Industrial Convergence
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• v.18 no.4
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• pp.51-59
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• 2020

The purpose of this study was to investigate the improvement of muscle strength and gait ability of paralyzed lower extremity through convergent stimulation of tDCS(transcranial direct current stimulation) during mirror therapy with resistance exercise in chronic stroke patients. 12 patients with stroke were randomly assigned and divided into groupI(n=6) and groupII(n=6). GroupI provided NDT(neurodevelopmental treatment) and mirror therapy with sham tDCS, and groupII provided NDT and mirror therapy with tDCS. Each convergent stimulation was conducted 5 times a week, 30 minutes per session for a total of 4 weeks. All evaluation was conducted before intervention and performed after 4 weeks. Lower extremity strength showed a significant improvement in groupII compared to groupI(p<.05), and in comparison between groups by variance, significant difference in the quadriceps(p<.01) and tibialis anterior(p<.01). Gait ability showed a significant improvement in both groupI(p<.05) and groupII(p<.05), and significant difference in comparison between groups by variance(p<.01). In conclusion, mirror therapy with tDCS convergent stimulation had a positive improvement effect on paralyzed lower extremity to strength and gait ability through the overlapping interaction.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.103-108
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• 1990

A method to roll-over the paralyzed body by means of Functional Electrical Stimulation(FES) is considered. It is demonstrated that individual joint motions necessary for the rolling-over are realized by electrical stimulation. EMG measurements are also performed to analyze the cooperative activities of the muscles during rolling over motion in a case where an upper extremity was used. These results of two experiments using normal subjects verifies the fundamental feasibility of body control by FES.