• The Journal of Korean Physical Therapy
• /
• 제4권1호
• /
• pp.43-57
• /
• 1992

This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.

• 한국산학기술학회논문지
• /
• 제12권12호
• /
• pp.5715-5721
• /
• 2011

본 연구에서는 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인을 분석하여, 일상생활동작 향상에 기여하는 인지요소를 파악하고 이를 치료에 적용하고자 함에 있다. 본 연구는 뇌졸중으로 진단을 받고 A병원 재활의학과에 입원하여 포괄적인 재활치료를 받고 있는 환자 21명을 대상으로 전산화 신경인지기능검사(SCNT), MBI를 평가하였다. 뇌졸중 환자의 일상생활동작에 영향을 주는 인지요인에 대한 효과성을 평가하기 위해 일상생활동작 값을 종속변수로 하고 10개의 인지요인을 모형에 포함하여 다중회귀분석을 실시하였다. 연구 결과 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인으로는 주의력 배분과 운동조절, 선택적 주의력이 가장 영향을 주는 것으로 나타났다. 또한 뇌졸중 환자의 일상생활동작 수행도에 대하여 인지요인은 69.8%의 설명력을 나타내었다. 따라서 뇌졸중 환자의 재활치료 시 주의력 배분과 운동조절, 선택적 집중력을 우선적으로 고려하여 중점적인 훈련을 한다면 일상생활동작의 수행도 향상에 효율적일 것이다.

• 한국전문물리치료학회지
• /
• 제21권4호
• /
• pp.23-33
• /
• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• 디지털융복합연구
• /
• 제17권9호
• /
• pp.271-278
• /
• 2019

본 연구의 목적은 가상현실 훈련이 아급성 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 효과를 규명하는 것이다. 아급성기 뇌졸중 환자 18명이 본 연구에 참여하였다. 모든 대상자는 실험군 9명과 대조군 9명으로 배정되었다. 두 군은 하루 30분, 주 5회, 4주 동안 보편적인 작업치료를 받았다. 실험군은 가상현실 훈련을 회기 마다 30분 더 받았으며, 대조군은 보편적인 작업치료를 회기 마다 30분 더 받았다. 결과 측정은 중재 전과 후에 Fugl-Meyer 평가와 한국판 수정바델지수에 의해 수행되었다. 연구 결과, 실험군은 중재 후 Fugl-Meyer 평가 점수와 한국판 수정바델지수 점수에서 유의한 향상을 보였다(p<.05). 대조군은 Fugl-Meyer 평가의 어깨/팔꿈치/전완, 손목, 손 하위항목과 한국판 수정바델지수에서 유의한 향상을 보였다(p<.05). 중재 후 실험군은 대조군보다 Fugl-Meyer 평가의 총점, 손목과 손하위항목에서 유의하게 더 큰 향상을 보였다(p<.05). 이러한 결과들은 가상현실 훈련이 아급성기 뇌졸중 환자의 상지기능 향상에 긍정적인 효과를 나타낼 수 있음을 시사한다.

• 대한통합의학회지
• /
• 제7권2호
• /
• pp.19-29
• /
• 2019

Purpose : To determine whether an advanced rehabilitation therapy combined with conventional rehabilitation therapy consisting of sensorimotor exercises that would be superior to a usual treadmill training in gait ability and fall risk in subacute stroke patients. Methods : Thirty subjects randomly assigned to either multi-sensorimotor training group (n=19) or treadmill training group (n=18). Both groups first performed conventional physical therapy for 30 min, after which the multi-sensorimotor training group performed multi-sensorimotor training for 30 min, and the treadmill training group performed treadmill gait training for 30 min. Both groups performed the therapeutic interventions 5 days per week for 8 weeks. Gait ability was evaluated using the GAITRite system and Fall risk was measured using the Biodex Balance system before intervention and after 8 weeks. Results : There were no intergroup differences between demographic and clinical characteristics at baseline (p>.05). Both groups showed a significant improvement in gait ability (p<.05) and Fall risk (p<.05). In particular, the multi-sensorimotor training group showed more significant differences in gait velocity (p=.05), step length (p=.01) and stride length (p=.014) than the treadmill training group. Conclusion : The multi-sensorimotor training program performed on multiple types of sensory input had beneficial effect on gait ability. A large-scale randomized controlled study is needed to prove the effect of this training.

• 한방재활의학과학회지
• /
• 제21권2호
• /
• pp.227-238
• /
• 2011

Objectives : This study was to investigate the effects on using Virtual reality exercise program($Wii-Fit^{TM}$) for dynamic balance and walking ability in patients with stroke. Methods : The 22 subjects were randomly selected from the patients of the S hospital who met the study conditions. They were divided into a $Wii-Fit^{TM}$ balance game group of 12 patients and a conventional physical therapy group of 10 patients. The $Wii-Fit^{TM}$ balance game group received $Wii-Fit^{TM}$ balance game group general physiotherapy for 5 days a weeks, 30 minutes a day, for a 4 weeks and the conventional physical therapy group received general physiotherapy for the same period. The subjects were measured and compared for Brunel balance assessment, functional gait assessment, 6 minute walk test, GAITRite system before and after the program. Results : The experimental group tend to improve more than control group in shifting the weight to the affected side(p=0.040) and tap test(p<0.001). The experimental group tend to improve more than control group in FGA(p=0.016). The experimental group improved significantly more than control group in 6MWT(p=0.008). The experimental group improved significantly more than control group in gait speed, cadence, stride length. Conclusions : Virtual Reality program($Wii-Fit^{TM}$) with conventional physical therapy shows the benefits on dynamic balance and gait parameters in patients with stroke.

• 디지털융복합연구
• /
• 제17권11호
• /
• pp.349-355
• /
• 2019

가상현실 훈련은 신체 기능을 개선하기 위한 중재로 제안되었다. 그러나 급성 뇌졸중 환자의 ADL 개선에 초점을 둔 가상현실 훈련의 효과는 명확하지 않다. 본 연구의 목적은 급성 뇌졸중 환자의 손 기능 및 일상생활활동(ADL)에 대한 가상 현실 훈련의 효과를 조사하는 것이다. 급성 뇌졸중 환자 16명이 본 연구에 포함되었다. 실험 군(VRA군)은 각 세션마다 ADL에 중점을 둔 30분의 가상현실 훈련을 받았으며, 통제군은 30분의 보편적인 가상현실 훈련을 받았다. 피험자의 손기능과 ADL을 조사하기 위해 JTHFT(Jebsen-Tylor Hand Function Test)와 K-MBI (Korean Modified Barthel Index)를 각각 사용했다. 두 그룹 모두 중재 후 마비측과 비마비측의 손기능 및 K-MBI 총점에서 유의미한 개선을 보였다. 실험군은 통제군보다 중재 후 K-MBI의 자가관리 영역에서 유의하게 큰 향상을 보였다. 이러한 결과는 급성 뇌졸중 환자에서 ADL에 중점을 둔 가상 현실 훈련이 기존의 가상 현실 훈련보다 자기관리에 더 나은 영향을 줄 수 있음을 시사한다.

• 대한한방소아과학회지
• /
• 제20권3호
• /
• pp.87-95
• /
• 2006

Objectives : Cerebrovascular disease in children is more common than once recognized and the etiology. In stroke patient, dysphagia is a common. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of aspiration pneumonia and malnutrition. This is the clinical report about 1 case of patient with dysphagia who had a stroke developed after operation. Methods : The herb medicine, moxibustion and acupuncture therapies were applied for treating this patient's chief symptom. Results : This patient's dysphagia was improved by oriental medical therapy. Conclusions : The result suggests that the herb medicine and acupuncture therapies is efficacious against dysphagia associated with stroke. We though that more studies about the Oriental medical treatment on dysphagia associated with stroke are needed.

• The Journal of Korean Physical Therapy
• /
• 제31권5호
• /
• pp.311-316
• /
• 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.

• 대한물리치료과학회지
• /
• 제28권2호
• /
• pp.1-9
• /
• 2021

Background: The requirements for postural and motor control in backward walking training (BWT) may improve balance and walking speed in patients with acute stroke. The aim of this study was to analyze the effect of BWT on balance, balance confidence, and fall efficacy in this population. Design: Randomized controlled pilot trial. Methods: This study included 14 subjects with acute stroke (onset of illness less than one month). They were randomly allocated to a BWT (n=7) or forward walking training (n=7) group and observed five times in a week for a period of two weeks. Measurements were taken before and after the experiment using the Berg balance scale (BBS), Activities-specific balance confidence scale (ABC), and Fall efficacy scale (FES). Results: The BBS, ABC and FES scores obtained in both groups after the experiment were significantly higher than those before the experiment (p<0.05). In addition, the BBS, ABC, and FES scores in the experimental group were significantly higher than those in the control group (p<0.05). Conclusion: These findings indicate that BWT improved balance and balance confidence and decreased the risks of fall in patients with acute stroke. Further study is needed to better understand the effects of backward walking in acute stroke patients.