• Annals of Rehabilitation Medicine
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• v.41 no.6
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• pp.924-934
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• 2017

Objective To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. Methods We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. Results Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of $54.8{\pm}16.6$ years were assessed $8.8{\pm}9.2$ months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score <0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <-1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. Conclusion The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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• pp.333-352
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• 2000

The objective of this study was to identify the effects of the cognitive performance of stroke patients on their motor function recovery after comprehensive rehabilitation management. The subjects of this study were 41 stroke in-patients of the Rehabilitation Hospital, College of Medicine, Yonsei University, hospitalized during the period from September 1, 1997 to May 5, 1998. The cognitive performance was measured using a Mini-Mental State Examination(MMSE) and the motor function recovery using Motor Assessment Scale(MAS). The data were analyzed by the paired t-test, independent t-test, a one way ANOVA, and Pearson's correlation coefficiency. The findings were as follows: 1. There was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 2. There was no significant difference found in relation to sex, age, cause of stroke, laterality of paralysis and the level of spasticity. However, there was a big difference between pre- and post-treatment regarding the treatment period. 3. In line with the cognitive performance level, there was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 4. The correlation between the elements of the cognitive performance and the motor recovery was found to be high in orientation, attention, calculation, and language. Those elements were expected to give larger effects on motor recovery after the comprehensive rehabilitation management. Based on this study, the cognitive performance level was found to play an important role in bringing effects on motor recovery after the comprehensive rehabilitation management of stroke patients. And the evaluation on the motor recovery based on quality would be also expected to be examined, as well as the cognitive performance level test accompanied by Intelligence Quality(IQ) test.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.645-652
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• 2016

Objectives: To compare the effects of Eastern-Western integrative medical care (EWIM) and Western single rehabilitation therapy (WSRT) on the functional recovery of stroke patients.Methods: Seventy-six stroke patients were recruited retrospectively. The participants were divided into two groups: EWIM and WSRT. Data on age, sex, stroke-related risk factors, stroke type, neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS), elapsed time to the initiation of rehabilitation, duration from the onset to follow up, initial functional status, and function after therapy for 3 mon were obtained from a review of the patients’ medical records. Between-group differences in functional outcomes were analyzed before and after treatment using the functional ambulation category (FAC), Fugl-Meyer assessment (FMA), modified Barthel Index-Korean version (K-MBI), and Euro-Quality of Life-5 Dimension (EQ-5D).Results: At 3-mon poststroke, all the functional outcome measures had improved in both groups (P<0.05). However, the improvements were greater in the EWIM group, and the improvement was statistically significant in the K-MBI (P=0.048) and EQ-5D (P=0.042).Conclusions: With respect to activities of daily living and health-related quality of life, EWIM is a more effective stroke therapy than WSRT.

• Journal of the Korean Society of Manufacturing Technology Engineers
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• v.19 no.6
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• pp.819-825
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• 2010

For rehabilitation of stroke patients the repeat training is needed. However it is difficult to keep up the training for the patients because it is boring. Even if the patients continue the training there is no objective way to evaluate the remedial value. Recently there is a new attempt to apply the haptic system to the rehabilitation of the stroke patients. In this study a haptic system is applied to the rehabilitation of the stroke patients. Through the comparative analysis of the experimental data for the normal people and patients, the validity of the proposed rehabilitation was verified. In conclusion, the patient's condition at 8 days after the experiment has demonstrated the level of ADL.

• The Korean Journal of Rehabilitation Nursing
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• v.16 no.2
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• pp.90-99
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• 2013

Purpose: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. Methods: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. Results: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. Conclusion: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.33-40
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• 2019

Purpose : The purpose of this randomized controlled trial study was to examine the effect of transcranial direct current stimulation (tDCS) on cognitive function and depression in stroke patients. Methods : Thirty stroke patients were randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received tDCS while performing computerized cognitive rehabilitation programs, and the control group was provided with sham tDCS while operating the same programs. The 30-minute intervention was implemented five times per week for six weeks. To assess cognitive function before and after the intervention, the Neurobehavioral Cognitive Status Examination was conducted; the Beck Depression Inventory BDI was employed to assess depression. Results : The experimental group showed statistically significant increases in cognitive function and decreases in depression (p < .05 ). Comparing the amount of variation between the groups after arbitration also showed significant differences in cognitive function and depression between the two groups (p > .05). Conclusion : The application of tDCS and computerized cognitive rehabilitation programs for stroke patients may positively affect their cognitive function and depression. Therefore, tDCS used with computerized cognitive rehabilitation programs is positively applicable to the enhancement of cognitive function in stroke patients and reduction of depression.

• The Journal of Korean Physical Therapy
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• v.20 no.1
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.361-365
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• 2021

Stroke patients have reduced aerobic capacity. Therefore, intensive structured exercise programs are needed. We report the case of a patient with stroke and cardiac disease who underwent early inpatient cardiac rehabilitation (CR). A 38-year-old male patient with atrial fibrillation, heart failure, and cerebral infarction underwent a symptom-limited exercise tolerance test (ETT) without any problems on day 45 after admission. He completed a 2-week inpatient program and an 8-week home-based CR program. Follow-up ETT showed increased exercise capacity. The present case might be the first to report a safely performed CR program in a patient with stroke and cardiac comorbidity in Korea. Systematic guidance is needed for post-stroke patients to receive safe and effective CR for the secondary prevention of stroke and cardiovascular risk.

• PNF and Movement
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• v.15 no.3
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• pp.317-331
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• 2017

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.185-190
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• 2020

Purpose: Gait and cognitive impairment in stroke patients exacerbate fall risk and mobility difficulties during multi-task walking. Virtual reality can provide interesting and challenging training in a community setting. This study evaluated the effect of community-based virtual reality gait training (VRGT) using a 360-degree image on the gait ability of chronic stroke patients. Methods: Forty-five chronic stroke patients who were admitted to a rehabilitation hospital participated in this study. Patients meeting the selection criteria were randomly divided into a VRGT group (n=23) and a control group (n=22). Both these groups received general rehabilitation. The VRGT group was evaluated using a 360-degree image that was recorded for 50 minutes a day, 5 days per week for a total of 6 weeks after their training. The control group received general treadmill training for the same amount of time as that of the VRGT group. The improvement in the spatiotemporal parameters of gait was evaluated using a gait analyzer system before and after training. Results: The spatiotemporal gait parameters showed significant improvements in both groups compare with the baseline measurements (p<0.05), and the VRGT group showed more improvement than the control group (p<0.05). Conclusion: Community-based VRGT has been shown to improve the walking ability of chronic stroke patients and is expected to be used in rehabilitation of stroke patients in the future.