Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.
Objective: Dual-task walking deficits impact functional daily life, which often requires walking while performing simultaneous tasks such as talking, thinking or carrying an object. This study is to find out the latest trend of dual-task training's influence on ambulatory abilities of a stroke patient. Design: Systematic review of randomized controlled trials. Methods: This literature review was conducted in Pubmed and Sciencedirect with the follwing key words:stroke, cerebro-vascular accident, hemiplegia, gait, rehabilitation, exercise. 7 studies were chosen in findings by search tool. 3 studies were case study, 3 studies were cross sectional observational study and 1 study was randomized controlled trial. Results: It was found that stroke patients have difficulties in doing 2 motor tasks simultaneously and when they do 2 tasks, one is done in a naturally preferred activity areas. Moreover, when simply applying dual-tasks, the walking speed decreased. Meanwhile, when applying them through training, the speed increased. This showed the improvement of effective task-implementation abilities after dual-task training using task-integration models. Conclusions: In the beginning of the 2000s, dual-tasks were implemented by simply combining walking and cognition or exercise task, and the results of this study suggest that subjects with stroke have difficulty performing dual task. However, the latest trend is to let patients do the dual-task training by combining it with virtual reality. Therefore, dual task training could be performed in a safe in the environment such as virtual reality or augment reality.
Journal of the Korean Society of Physical Medicine
/
v.13
no.3
/
pp.99-111
/
2018
PURPOSE: This study was conducted to identify the effects of sympathetic conversation on stress, anxiety and depression, and muscle tone in chronic stroke patients. METHODS: Patients were randomly assigned to either an experimental group (EG, n=7) or control group (CG, n=7). Both groups participated in a pretest before intervention. Subjects were asked to undergo: 1) electroencephalogram, 2) Stress Response Inventory, 3) Hospital Anxiety and Depression Scale, 4) muscle tone and stiffness testing. After the pretest, EG received sympathetic conversation and CG received a simple explanation about stroke recovery and rehabilitation. Following the intervention, both groups were immediately administered a post test. RESULTS: In EG, the electroencephalogram relative alpha power was significantly increased (p<.05), while the electroencephalogram relative gamma power was significantly decreased (p<.05). The Stress Response Inventory and Hospital Anxiety and Depression Scale scores decreased significantly in both groups (p<.05). In addition, muscle tone and stiffness decreased significantly in the EG (p<.05) CONCLUSION: The results of the present study indicate that sympathetic conversation had a positive effect on stress, anxiety and depression, and muscle tone in patients with chronic stroke. Therefore, sympathetic conversation could be used to improve not only psychological problems in chronic stroke patients including stress and anxiety, but also physical conditions including muscle tone.
Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.
Purpose: This study aimed to determine the effect of curved walking training on balance confidence and fall efficacy in early stroke patients. Methods: The study included 16 early stroke patients who were randomly allocated to a curved walking training group (experimental group, N=8) and a straight walking training group (control group, N=8). Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using the Activities-specific Balance Confidence (ABC) Scale, Fall Efficacy Scale (FES), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Results: After 3 weeks of training, both groups showed significantly improved ABC, FES, BBS, and TUG (p<.05 in both groups). However, the ABC, FES, BBS, and TUG scores in the experimental group were significantly better than those in the control group (p<.05). Conclusion: These findings indicate that curved walking training may be effective at improving balance confidence and decreasing fall risk in early stroke patients. Therefore, curved walking training can be used as a recommended walking method in early stroke patients.
Objective: Participation restrictions are serious problems that stroke survivors experience while reintegrating into family, work, community, and social situations after participating in rehabilitation programs. The purpose of this study was to explore the factors affecting participation in activities of daily living (ADL), as well as social and leisure activities of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: The study involved 96 participants who were diagnosed with a first stroke 6 months before the study (58 men, 38 women; $60.3{\pm}14.3years$). The Berg Balance Scale, Modified Barthel Index, Manual Function test, and Activity Card Sort were used to assess static and dynamic balance function, upper limb function, level of independence, and their level of participation within the community. A regression analysis was used to identify the influence of factors affecting participation in ADL, social and recreational activities. Results: The Activity Card Sort scores were significantly affected by the Manual Function test and Modified Barthel Index scores (p<0.05). Participation in leisure activities was affected by the level of independence. Participation in social activities was affected by the balance function and level of independence of the participants. Conclusions: The results of this study have shown that participation restrictions are affected by upper limb function, balance function, and the level of independence in individuals with hemiparetic stroke.
Objective: The purpose of this study was to investigate the effect of treadmill exercise on the posture and walking speed of chronic stroke survivors with an ankle-foot orthosis. Design: Randomized controlled trial. Methods: Twenty-four chronic persons with chronic stroke admitted to Bobath Memorial Hospital in Seongnam city were divided into two groups by random blind method. Treadmill exercise with an elastic ankle-foot orthosis was performed in the experimental group and treadmill exercise was performed in the control group. The experiment was carried out for 6 weeks, and the experiment was carried out three times a week for 20 minutes per session. To measure the effect, static balance was measured using the MTD system before and after training, and the Berg Balance Scale (BBS) was used to measure functional balance. Results: There was a statistically significant difference between the 2 groups in the BBS measurement results for confirming the functional balance (p<0.05). Also, there was a significant difference between the 2 groups in single limb support time, step time and step length (p<0.05). Conclusions: In this study, it was found that treadmill exercise with an elastic ankle-foot orthosis in persons with chronic stroke was effective in maintaining functional balance, walking ability, step length, and step time. Therefore, it is necessary to use a flexible ankle-foot orthosis with proper treadmill exercise as a method of improving balance and walking speed of chronic stroke survivors.
Objectives: To investigate the relationship between rehabilitation treatment, mental state and resilience of stroke patients undergoing rehabilitation by examining the correlation between The Core Seven Emotions Inventory-Short Form (CSEI-s) and the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). Methods: All 104 participants (44 diagnosed with stroke who were receiving rehabilitation and 60 without stroke or psychiatric history) completed the CSEI-s, K-CD-RISC, and Questionnaire for stroke symptoms. All data were analyzed using by Statistical Package for the Social Sciences (SPSS) ver. 27.0. Descriptive statistics, chi-square test, t-test, Mann-Whitney U test, Kruskal-Wallis H test, and Pearson correlation coefficient were used for data analysis. Results: As a result of the CSEI-s, compared to the control group, the stroke group showed significantly lower Joy (喜) scores and significantly higher scores for Depression (憂) and Sorrow (悲). With a morbidity period of 12 months or less, the Thought (思) score was significantly higher. The Fear (恐) score was significantly higher when the rehabilitation was initiation more than 4~8 weeks after than that when the treatment was started immediately. Meanwhile, the K-CD-RISC score was significantly higher when rehabilitation was started immediately. In the stroke group, the K-CD-RISC score was positively correlated with Joy (喜) but negatively correlated with Depression (憂) and Fear (恐). In the control group, K-CD-RSIC showed a positive correlation with Joy (喜) but negative correlations with Depression (憂), Sorrow (悲), and Fear (恐). Conclusions: In addition to early rehabilitation treatment, mental approach through Korean medicine psychotherapy is crucial for enhancing the resilience of stroke patients.
Purpose: This study compared the walking ability of chronic stroke patients following either treadmill training with knowledge of the result (KR group) or treadmill training with knowledge of the performance (KP group). Methods: Nineteen patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a KR group (10 patients) and a KP group (9 patients). They received 30 minutes of neuro-developmental therapy and treadmill training 30 minutes, five times a week for three weeks. The gait parameters were measured before and after training using the Optogait system. Results: After the training periods, the KR group showed significant improvement in gait speed, cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait assessment compared to the KP group (p<0.05). Conclusion: The results showed that treadmill training with KR was more effective in improving the gait speed and cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait ability than the treadmill training with KP. Therefore, to improve the walking ability of stroke patients, it is necessary to consider treadmill training with KR. If it can be combined with conventional neurological physiotherapy, it would be an effective rehabilitation for stroke patients.
The purpose of this study was introduce peer mentoring which is well used in various rehabilitation areas in overseas country to Korea academically and clinically and help psychological and physical recovery for stroke survivor. It was two group experimental design study, this protocol is designed for stroke survivor, 3-6 months after the onset. Peermentors were consisted of outpatients who is stroke survivor in different recovery levels, at least 2 year after the onset. Peermentors received education about how to support and mentor participants of the program emotionally, appraisally, and informationally and how to run the program. Geriatric Depression Scale Short Form-Korea Version(GDSSF-K) is used to measure psychological factor, Stroke Impact Scale(SIS) is used to measure recovery level of patient, and for physical factor Upper Extremity Function Test for the Elderly(TEMPA) was used. A researcher who is interested in the peer mentor program needs to find more effective applying method based on be offered method in this study for helping recovery after stroke.
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