• 재활치료과학
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• 제5권2호
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• pp.71-80
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• 2016

목적: 본 연구는 뇌졸중으로 인한 편마비 환자를 대상으로 거울치료의 임상적용 가능성 및 효과를 제시하는 데에 목적이 있다. 연구방법: 2005년 1월부터 2016년 1월까지 국외 학술지에 게재된 논문을 PubMed를 통하여 검색하였다. 포함기준과 배재기준을 고려하여 최종적으로 9개의 논문을 대상으로 분석하였다. 결과: 거울치료의 효과를 알아보기 위한 중재방법으로는 손목과 손의 단순한 움직임과 과제기반 거울치료가 사용되었다. 중재효과를 알아보기 위해 상지기능, 일상생활동작, 신체적 상태, 삶의 질 평가도구가 사용되었다. 상지의 기능은 근위부보다 원위부에서 더욱 효과가 있고, 일상생활동작에서도 유의한 효과가 있는 것으로 나타났으나, 삶의 질에서는 실험군과 대조군 사이에 유의한 차이가 없는 것으로 나타났다. 결론: 연구를 통해 임상 치료사들은 대상자의 특성에 따라 거울치료를 적절하게 사용할 근거를 찾을 수 있을 것이라 생각된다. 하지만 다양한 거울치료의 프로토콜로 인해 효율적인 적용방법을 확인하는 데 어려움이 있었다. 앞으로는 거울치료의 효과를 극대화 할 수 있는 체계화된 치료 프로토콜이 개발되어야 할 것이다.

• 대한한방내과학회지
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• 제26권2호
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• pp.353-359
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• 2005

Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.

• 대한물리치료과학회지
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• 제4권4호
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• pp.539-548
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• 1997

The purpose of this study was to determine the effects of FES on the clinical test patients who had disturbance gait due to cereberal vascular accident. The subjects for study were 16 hemiplegic patients (9 Male and 7 Female) who can gait with or without device. Their average age was 55 and they received average of 20.19 month of treatment collected data analysis was completed by using one-way analysis variable(ANOVA), Pearson ($-1{\leq}r{\geq}1$). The results were as follows : 1) There was difference in four variable (stride length,gait speed,gait cadence) between at the biginning and at the end of the treatment of FES (p<0.01). 2) There was relationship in capacity of activity between MAS and stride length (r = 0.751), gait speed (r = 0.689) but no relationship gait cadence (r = 0.236). 3) Age revealed relationship of stride length (r = -0.727), gait speed (r = -0.725), gait cadenc (r = -0.362). 4) There was no relationship in months post-CVA with MAS (r = 0.171), stride length (r = -0.110), gait speed (r = -0.096), gait cacedce (r = -0.154).

• 한국전문물리치료학회지
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• 제13권3호
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• pp.10-17
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• 2006

The purpose of this study was to determine the consequence of resistance strengthening exercise on the hip flexor and extensor performed to improve functional mobility in stroke patients more than six months post stroke. Seventeen patients were randomized into two groups. Both groups received conventional physical therapy for six weeks. In addition, the experimental group performed eccentric resistance strengthening exercise in the hip flexor and extensor using an isokinetic dynamometer. The hip flexor and extensor strength, stair up and down mobility, timed get up and go (TUG), 10 m gait velocity, and functional reach were repeatedly measured at baseline, three weeks, and six weeks after treatment. The results were as follows: 1. The experimental group improved more remarkably in the hip flexor and extensor strength, stair up and down mobility, and the 10 m gait velocity after three weeks and six weeks of treatment (p<.05), 2. The control group improved significantly in the hip flexor and extensor strength, and 10 m gait velocity after three weeks of treatment (p<.05), 3. At each three and six week point, the experimental group made greater gains in hip flexor and extensor strength, stair up and down mobility, and 10 m gait velocity than the control group (p<.05). In conclusion, it is desirable to perform resistance strengthening exercises combined with conventional physical therapy to improve functional mobility in chronic stroke patients.

• PNF and Movement
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• 제6권2호
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• pp.1-10
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• 2008

Purpose : The purpose of this study was to investigate the effect of aquatic exercise applied PNF patterns on body composition and balance performance in people who have had a stroke. Methods : Forteen candidates who have all experienced a stroke were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 10 consecutive weeks. Subjects were tested with body composition and 5 items of Berg's balance test at pre-training and post-training. Total balance indexes in 3 conditions were measured by K.A.T. 3000. The aquatic exercise applied PNF patterns was consisted of PNF patterns and various aquatic activities. Results : After ten weekends of aquatic exercise training, there were not significant difference in body composition(p>.05) except of muscular weight of affected lower extremity(p<.05). But edema index increased more than pre-training (p<.05). Subjects showed significant difference in Berg's balance test results except of 2 items of Berg's balance test (p<.05). Total balance index score when subjects opened their eyes and didn't hold the handle was decreased less than pre-training(p<.05). Conclusion : The results of this study showed that intervention of this aquatic exercise program applied PNF patterns could increase edema index and muscular weight of affected lower extremity and improve the balance performance in people who have had a stroke.

• 대한지역사회작업치료학회지
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• 제2권2호
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• pp.37-49
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• 2012

목적 : 본 연구의 목적은 상상연습이 뇌졸중 환자의 균형능력과 낙상 위험도 및 낙상 효능감에 미치는 영향을 알아보기 위한 것이다. 연구방법 : 뇌졸중 진단을 받은 4명의 성인을 대상으로 개별대상자 실험연구 방법 중 대상자간 다중기초선(multiple baseline across individuals)으로 설계되었다. 기초선 과정과 중재 과정을 포함해 총 20회를 4주 동안 진행하며, 기능적 손 뻗기 검사를 이용해 균형능력의 변화를 측정했다. 그리고 낙상 위험도(Tetrax) 프로그램과 낙상 효능감으로 중재 전 후를 비교했다. 시각적 분석과 2 표준편차 밴드 분석방법을 통해 나타냈다. 결과 : 상상연습 중재기간 동안, 기능적 손 뻗기 검사를 사용한 결과 대상자들의 균형능력의 향상이 나타났다. 이러한 변화로 낙상 위험도가 감소하였고, 낙상 효능감이 증가했다. 결론 : 본 연구 결과, 상상연습이 뇌졸중 환자의 균형능력 향상에 효과적임을 알 수 있었다. 향후 연구에서 더 많은 연구 대상을 통해 다양한 방법으로 균형능력을 측정하여 확인이 이루어졌으면 한다.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.71-76
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• 2016

Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.

• 대한물리의학회지
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• 제12권1호
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• pp.35-42
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• 2017

PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

• PNF and Movement
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• 제15권3호
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• pp.267-279
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• 2017

Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.23-30
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• 2009

Purpose: This study investigated the efficacy of task-related circuit training aimed at improving balance in individuals discharged from rehabilitation facilities following a stroke. Methods: We recruited 12 stroke patients (34-66 years of age) to participate in a task-related circuit training program. Baseline assessment included a history of stroke and an assessment using the Mini-Mental State Examination Korea (MMSE-K). After a baseline assessment, follow-up assessments were administered pre- and post-training. These included Berg Balance Scale (BBS), Functional Reach Test (FRT), and the Time Up & Go Test (TUG). Physiotherapists trained study subjects under the one-to-one supervision of students from the department of physical therapy. Circuit class study participants attended 90-minute treatment sessions, one day a week for 12 weeks (from September to December 2008). The program consisted of a light warm-up period (10 min), physical exercises for improving balance (20 min), tasks focused on improving balance (50 min) and a cool-down period (10 min). Results: Scores for the BBS assessment increased significantly (from 43.2 to 49.7) after the training (p<0.05). Reach distance on the FRT increased substantially (from 27.7 cm to 47.0 cm), although the improvement was not significant (p>0.05). The average time on the TUG test decreased significantly (from 23.7 sec to 19.5 sec) after the training (p<0.05). Conclusion: The task-related circuit training program improved the balance and mobility of subjects, indicating that such a group program is useful for stroke patients who are discharged from the hospital. More such task-related programs set in a community environment should be developed.