• 대한임상전기생리학회지
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• 제11권1호
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• pp.45-52
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• 2013

Purpose : The goal of this study is to estimate the effect of SSP electrical stimulation applied to acupoints as conducted in oriental medicine on the swallowing function of patients with swallowing difficulties caused by stroke. Methods : Twenty-two hemiplegic stroke patients with swallowing difficulties were divided into an intervention-only group (Group I; n=11) and an intervention-SSP electrical stimulation group (Group II; n=11). Therapeutic intervention was performed on participants in the intervention-only group and the intervention-SSP electrical stimulation group, for 20 minutes per session, three times per week, for four weeks. In this study, SSP electrical stimulation to the acupoints (Cheondol, Yomchon, Budol, Pungji, and Sanyinjian) of stroke patients with swallowing difficulties was applied, and to investigate the effects of SSP electrical stimulation, Clinical dysphagia scale (CDS) and ultrasonography assessment was used to measure pre and post-intervention scores. Results : In the clinical dysphagia scale assessment, the post-intervention score for group II had significant enhancement unlike group I. In the ultrasonography assessment, the hyolaryngeal movement in group II showed significant increase in the swallowing function unlike group I. Conclusion : From the above results, significant effects came from SSP electrical stimulation of 3Hz, biphasic wave, continuous current when applied to the acupoints as conducted in oriental medicine to improve the swallowing function of stroke patients.

• 한방재활의학과학회지
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• 제20권2호
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• pp.79-87
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• 2010

Objectives : The purpose of this study is to analyze and to compare the difference and the change between dynamic balance exercise group and dynamic balance exercise with core program exercise group. Also, based on this data, to prescribe effective exercises for hemiplegic patients and the pubis in order to achieve more effective dynamic balance exercise rehabilitation and better dynamic balance exercise in the field of therapeutical exercise. Methods : Twenty subjects(Core program exercise plus Dynamic balance exercise group, CP: 10, Dynamic balance exercise group, NCP: 10) were chosen among hemiplegic patients. Measurements of dynamic balance were evaluated at initial presentation(pretest) and after 4, 8, 12 weeks'. Paired t-test and Repeated measured ANOVA was utilized to detect the mean difference between the groups. Results : Firstly, after 4 weeks' and 8 weeks' and 12 weeks' CP exercise and NCP exercise, there were all significant difference to increase dynamic balance (p<0.05). secondly, after 4 weeks' and 8 weeks' and 12 weeks' CP and NCP exercise, there was significant difference to increase dynamic balance more CP group than NCP group. Lastly, among 4 weeks' and 8 weeks' and 12 weeks' CP exercise, there was progressively significant difference to increase dynamic balance(p<0.05). Conclusions : This study showed that dynamic balance exercise with core program exercise is an effective treatment strategy for hemiplegic patients than dynamic balance exercise rehabilitation.

• 재활치료과학
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• 제1권1호
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• pp.57-70
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• 2012

목적 : 본 연구는 뇌졸중 환자를 대상으로 신경되먹임(Neurofeedback; NFB)을 통한 뇌파 훈련과 컴퓨터보조 인지 재활(Computer-Assisted Cognitive Rehabilitation; CACR) 훈련이 뇌졸중 환자의 인지, 상지기능에 미치는 영향을 알아보고자 한다. 연구방법 : 뇌졸중 후 3개월에서 1년 이내이며, 경기도 소재 병원에서 입원치료중인 환자 44명을 NFB군(14명)과 CACR군(14명), 대조군(16명)의 세 그룹으로 배치시켰다. NFB 훈련과 CACR 훈련은 6주간에 걸쳐 실시하였으며 사전, 사후 평가기간을 포함하여 총 9주간 연구를 진행하였다. 측정은 인지, 상지 기능을 측정하였으며 훈련 전후와 그룹간의 인지, 상지 기능의 변화를 분석하였다. 결과 : 연구대상자들의 훈련방법에 따른 인지기능의 차이를 알아보기 위해 한국형 간이정신상태 검사(Mini-Mental State Examination-Kore; MMSE-K) 총점의 변화를 분석한 결과 NFB군은 실험전 16.92 점에서 실험 후 20.50 점으로 유의한 차이를 보였고 CACR군은 실험 전 17.85 점에서 실험 후 22.14 점으로 유의한 차이를 보였으며 대조군도 실험 전 18.62 점에서 실험 후 19.25 점으로 유의한 차이를 보였다. 그러나 사후검정 결과 실험방법 간 차이는 보이지 않았다. 상지기능의 차이를 알아보기 위해 뇌졸중 상지 기능인 뇌졸중 상지 기능 검사(Manual Function Test; MFT) 총점을 분석한 결과 상지운동 영역에서 NFB군은 실험 전 4.64 점에서 실험 후 5.50 점으로 유의한 차이를 보였고 CACR군은 실험 전 3.92 점에서 실험 후 5.35 점으로 유의한 차이를 보였으며 대조군도 실험 전 3.68 점에서 실험 후 4.75 점으로 유의한 차이를 보였다. 그러나 사후검정 결과 실험방법 간 차이는 보이지 않았다. 결론 : 본 연구는 NFB 훈련과 CACR 훈련, 전통적 재활훈련 이후 인지기능과 상지 기능의 향상을 제시하였으며 앞으로 각 개인에게 적절한 훈련방법을 적용한 NFB 훈련과 CACR 훈련 프로그램 개발 및 프로토콜이 제시되어야 할 것이다.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.493-494
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• 2002

• 재활간호학회지
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• 제4권2호
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• pp.146-154
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• 2001

The purposes of this study was to determine the effect of exercise in stroke patients and to define to strategy to promote their activity of daily living, decrease to their depression. The experiemental design was designed nonequivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionaire on 60 patients who had been in patient department in D University hospital and K University hospital in Busan from November 5th, 2000 to the end of February 28th, 2001. Exercise was conducted by the researcher and was carried out experimental group once per day for 20 minutes for daily fourteen days. ADL check List tool by Kang and Center of Epideilogic Studies-Depression (CES-D) were used for measurement in this study. The data was analyzed by means of freqency, percentage, $mean{\pm}SD$, t-test, chi-square test and ANOVA with SPSS/PC. The results were summarized as follow; 1. The experimental group which received exercise should be higher in activity of daily living than the control group was supported (t=2.70, P=.009). 2. The experimental group which received exercise should be lower in depression than the control group was not support(t=-1.120, P=.267) but experimental group post-pre depression score support(t=7.247, P=.000). 3. Factors influencing the activity of daily living measured are payer of medical expenses (F=3.98, P=.018) and complications(t=3.97, P=.056). 4. Factors influencing the depression measured are economic status(F=5.71, P=.009) and caregivers (F=3.09, P=.045). In conclusion, the exercise incresed the activity of daily living and effect on depression of stroke patiens. Based upon these results, it is recommended that the nurses who take care of stroke patients such as exercise.

• 재활치료과학
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• 제1권2호
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• pp.35-40
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• 2012

본 연구에서는 가상현실 치료가 뇌졸중 환자의 뇌 가소성을 동반한 상지기능 향상에 미치는 영향을 알아보고 강도 높은 가상현실 훈련이 뇌졸중 환자의 상지기능 향상을 위한 집중치료로써 임상적으로 유용한 훈련인지 알아보고자 하였다. 뇌졸중 환자에게 있어 사용-의존성 즉 운동 강도와 반복은 마비 측 사지의 운동 기능향상에 중요한 치료적 요소이다. 최근에는 상지의 지속적 사용을 통한 뇌-가소성에 기반한 변화를 유도할 수 있는 치료방법으로 가상현실 치료가 대두되었다. 가상현실 치료는 재활 임상환경에서 운동기능 향상을 위한 훈련강도와 반복을 제공할 수 있는 기술적 방법으로 채택되기 시작하였다. 특히 뇌졸중 환자의 상지 기능을 향상시키기 위한 치료적 유용성 측면에서는 강도 높은 반복적 훈련이 가능하다는 것과 게임 같은 형식으로 높은 동기부여가 가능하다는 것, 실제 수행을 통한 다중감각적 피드백 제공, 상호작용이 가능한 과제지향적 치료가 가능하다는 장점을 가지고 있다. 임상 환경에서 작업치료와 더불어 부가적으로 가상현실 치료를 실시하는 것은 뇌졸중 환자의 상지 기능회복을 더욱 촉진할 것이다.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 한국산학기술학회논문지
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• 제14권1호
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• pp.294-300
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• 2013

이 연구는 요가운동이 뇌졸중 환자에게 자가 운동 프로그램으로의 가능성을 확인하고자 요가운동을 적용하여 정적균형, 동적균형, 보행속도를 측정하였다. 뇌졸중으로 편마비 진단을 받은 입원 환자 18명을 대상으로 대조군과 요가운동군에 각각 9명씩 배정하여 주 3회 60분씩 8주간 요가운동을 실시하였다. 정적균형은 Tetrax를 사용하여 안정성지수(무게중심의 이동)와 체중분포지수를, 동적균형은 functional reach test(FRT)와 dynamic gait index(DGI)를, 보행속도는 10미터 보행 검사를 실시하였다. 그 결과 요가운동군에서 무게중심의 이동과 체중분포의 안정성, FRT와 DGI의 유의한 향상을 보였다. 대조군에서는 유의한 차이를 보이지 않았다. 보행속도에는 두 군 모두 유의한 차이를 보이지 않았다. 이는 요가운동이 뇌졸중 후 균형능력이 상실된 환자에게 체계적인 자가 운동 프로그램으로 적용 가능하다고 사료된다.

• 대한물리의학회지
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• 제18권3호
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• pp.39-45
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• 2023

PURPOSE: This study aimed to provide the basic data necessary for rehabilitation by identifying the effects of complex balance exercises combined with self-observation training on balance and gait improvement in stroke patients. METHODS: This study assigned 20 people randomly into two groups: the control and experimental groups. The experimental group (10 subjects) underwent self-observation training-combined complex balance exercise. The control group (10 subjects) underwent complex balance exercises. A pretest of the balance ability and walking ability of both groups was performed. The interventions were conducted for 30 minutes three times a week for four weeks, and post-tests were conducted four weeks after all interventions were completed. RESULTS: There was a significant difference between the experimental and control groups according to the increase in Berg Balance Sale within the group and a statistically significant difference by a decrease in 10MWT (p < .01). On the other hand, there was a significant difference only in the change in Berg Balance Sale between the two groups (p < .05). CONCLUSION: Combined balance exercise combined with self-observation training and combined balance exercise alone positively affected the Berg Balance Sale and 10MWT in both groups. On the other hand, in the results between groups, there was a statistically significant difference in Berg Balance Sale in complex balance exercise combined with self-observation training. Therefore, self-observation training should be used for the rapid social rehabilitation of stroke patients.

• 한국전문물리치료학회지
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• 제18권2호
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• pp.43-51
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• 2011

Balance is a complex motor skill that depends on interactions between multiple sensorimotor processes and environmental and functional contexts. Many rehabilitation specialists believe that balance assessment under multitask conditions may be a more sensitive indicator of balance problems and falls than balance assessment in a single-task context. Functional Gait Assessment has many tasks that allow for testing under multitask conditions. The purpose of this study was to determine the concurrent validity between the Functional Gait Assessment (FGA), Berg Balance Scale (BBS), and Timed "Up & Go" Test (TUG) in patients with stroke. One hundred and five participants with at least 3 months post stroke and able to walk at least 6 m with or without a mono cane, participated in this study. Concurrent validity between the FGA, BBS, and TUG was assessed using Spearman rank order correlation. The FGA correlated with the BBS (r=.80, p<.01) and TUG (r=-.77, p<.01). The good and moderate correlation between the FGA, BBS, and TUG establishes the concurrent validity of the FGA in patients with stroke. These measures provide clinicians with valuable information about patients' functional balance capabilities.