• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.109-113
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• 2018

Objective: The purpose of this study was to investigate the effects of fall experience and task complexity on gait performance in community-dwelling persons with chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Thirty-three persons who had a history of stroke participated in this study. The participants included 18 persons (aged mean 54.0, mean score of 24.6 points on the Montreal Cognitive Assessment, MoCA) with fall experience (faller group) and 15 persons (aged mean 53.7, mean score of 24.7 points on the MoCA) without fall experience (non-faller group) in the previous six months. This study measured balance and gait performance at two different conditions (with/without 70% of water filled in a 200 cc cup). The participants were clinically assessed using the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Berg Balance scale (BBS), Dynamic Gait Index (DGI), and Timed Up-and-Go (TUG) test. Results: After analyzation, persons in the faller group performed significantly better on the 10MWT, 6MWT, BBS, DGI, and the TUG test in the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). The persons in the non-faller group also performed significantly better in all outcome measures with the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). However, there was no interaction between fall experience and task complexity in the two groups. Conclusions: Our results showed that balance and gait performance depended on fall experience and task complexity but fall experience did not interact with task complexity. Clinicians should consider fall prevention and task complexity during therapeutic approaches in persons with hemiparetic stroke.

• 대한한방내과학회지
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• 제35권1호
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• 재활치료과학
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• 제5권2호
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• pp.11-22
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• 2016

목적: 본 연구는 국외 뇌졸중 환자에게 적용한 한 말초감각신경자극의 효과에 대하여 고찰하기 위한 것으로 국외 학술지를 대상으로 체계적 문헌고찰 연구방법을 시행하였다. 연구방법: 2015년 10월 이전까지 국외 학술지에 게재된 논문을 Pubmed를 통하여 검색하였다. 주요 검색 용어로는 'peripheral nerve stimulation', 'electrical stimulation', 'sensory stimulation', 'somatosensory stimulation', 'stroke', 'hemiplegia', 'hemiparesis' 와 'hand', 'arm', 'upper limb'를 사용하였다. 최초 검색된 논문은 501편이었으나 선정 및 배제기준을 거쳐 10편의 연구가 선정되었다. 결과: 임상적으로 널리 사용되고 있는 말초감각신경자극은 뇌졸중 환자들에게 적용이 될 때에 보다 다양한 중재방법으로 연구에 적용이 되고 있었다. 말초감각신경자극치료는 뇌졸중 환자의 상지 기능에 효과를 나타냈으며, 대뇌피질의 활성화에도 긍정적인 영향을 나타냈다. 결론: 본 연구는 말초감각신경자극치료의 적용에 대한 근거를 제시하며, 향후 국내연구에서는 다양한 중재방법을 적용하여 말초감각신경자극의 효과를 더 정확하게 측정을 할 수 있는 방법에 대한 연구가 필요하다.

• 재활간호학회지
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• 제1권1호
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• pp.15-25
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• 1998

The purposes of this study was to determine the effect of beach ball play in stroke patients, and to define the strategy to promote their depression, powerlessness, self-esteem, activity of daily living. The experimental design was designed non-equivalent control group, non-synchroniged design. The study method had been done by investigating the experimental group and control group through the questionnaire on 57 patients who had been in patient department in D University hospital in Pusan from January 5th 1998 to the end of February 28th, 1998. Beach ball play was carried out experimental group once per day for 10 minute's for two weeks period from Jan 1998 to Feb 1998. Data was collected before and after the experimenation. Collected data was analyzed by means of frequency, percentage, chi-square test, mean, S.D, t-test with SPSS/PC. The results were summarized as follows : 1. The 1st hypothesis : "The experimental group which received the beach ball play should be higher in depression than the control group" was supported(t=3.11, p=.003). 2. The 2nd hypothesis : "The experimental group which received the beach hall play should be higher in powerlessness than the control group" was supported(t=3.32, p=.002). 3. The 3rd hypothesis : "The experimental group which received the beach ball play should be higher in self-esteem than the control group" was not supported(t=-1.90, p=.064). 4. The 4th hypothesis : "The experimental group which received the beach ball play should be higher in activity of daily living than the control group" was not supported(t=-.47, p=.637). In conclusion, the patients who received beach ball play showed the increase in the degree of depression and powerlessness of stroke patients. So the beach ball play had been judged the nursing intervention to improve their emotional problem in stroke patients.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.77-85
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• 2014

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

• PNF and Movement
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• 제16권3호
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• pp.307-315
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• 2018

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from $2482.13mm^2$ to $626mm^2$), and walking speed improved by 18.70% (from 0.75 m/s to 0.64 m/s). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.55-63
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• 2021

Objective: The purpose of this study was to examine the effects of balance training with Functional Electrical Stimulation (FES) on balance and gait in patients with chronic stroke. Design: A cross over design Methods: Nine patients with stroke were recruited into this study. They were measuring their balance ability and gait ability. The intervention "A" included 4 weeks of balance training with Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Intervention "B" included 4 weeks of balance training with placebo Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Of the 9 patients who completed the study, 5 were randomly assigned to" group A-B", and 4 to group B-A. The crossover occurred after 4 weeks. Results: Following are the specific results of balance training with Functional Electrical Stimulation (FES) on patients with chronic stroke. First, patients who received treatment A showed improvement compared with patients who received treatment B in static balance. There were significant decreases in anterioposterior, mediolateral postural sway extension and velocity moment (p<0.05) with their eyes opened and closed conditions. Second, they had significantly improved in dynamic balance (p<0.05). Lastly, there were also improvement in their gait velocity and cadence (p<0.05). Conclusions: These findings suggest that, the Functional Electrical Stimulation (FES) combined with balance training more effectively improves the balance and gait ability, I'm convinced that it could be actively used in clinics added to the conventional physical therapy in the future.

• 대한물리의학회지
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• 제17권4호
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• pp.123-132
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of cognitive orientation to daily occupational performance (CO-OP) interventions on the upper extremity function and occupational performance in subacute stroke patients. METHODS: A total of 30 eligible stroke patients were randomly distributed into the CO-OP experimental group (n = 15) and the traditional occupational therapy (OT) control group (n = 15). The CO-OP approach was applied for twelve 60-minute sessions. The Jebson Taylor Hand Function Test (JTHFT), the Korean version of the Modified Barthel Index (K-MBI), and the Performance Quality Rating Scale (PQRS) were used for outcome evaluations. RESULTS: There was a statistically significant difference in the paralytic upper extremity function before and after treatment (p < .01) between the group treated with the CO-OP approach and the group treated with traditional OT. The occupational performance of the CO-OP approach group showed a significant improvement (p < .01), and this group also showed a statistically significant improvement in quality of performance compared to the traditional OT group (p < .01). CONCLUSION: The CO-OP approach may be useful in clinical practice as a therapeutic intervention for improving the functional recovery and performance of subacute stroke patients. Future research should be carried out to investigate the persistence of this effect involving more participants and follow-up studies should also be undertaken.

• 대한물리의학회지
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• 제17권1호
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• pp.21-30
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• 2022

PURPOSE: This study examined the effects of treadmill training with taping on the affected ankle joint on the gait and balancing ability in patients with sub-acute stroke. METHODS: Nineteen patients with sub-acute hemiplegic stroke in a rehabilitation hospital were assigned randomly to either the experimental group (n = 10), who received treadmill training with taping on the affected ankle joint or the control group (n = 9), who received general treadmill training. All participants performed 60 min of comprehensive rehabilitation therapy (five sessions per week for four weeks). Each group received treadmill training with or without taping on the affected ankle joint for 20 min (three sessions per week for four weeks). The gait and balancing ability were measured before and after the four-week training. RESULTS: Post-training scores of 10-meter walk test (10 MWT), timed up and go (TUG) test, and center of pressure (COP) path length and velocity for the experimental group increased significantly compared to that pre-training (p < .05). The experimental group showed a larger decrease in the 10 MWT and TUG test than the control group (-3.5 s vs. -1.01 s, p < .05; -4.9 s vs. -1.7 s, p < .05; respectively) CONCLUSION: Treadmill training with taping on the affected ankle joint might improve the gait and balancing ability of stroke patients and is considered a more effective method for improving gait and balancing ability than the method of general treadmill training.

• Physical Therapy Rehabilitation Science
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• 제12권2호
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• pp.123-129
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• 2023

Objective: Kinesio tape has been applied to the ankle to improve balance and gait. Stroke patients show abnormal gait patterns due to foot drop. This study aimed to determine the effects of ankle balance taping which to support the ankle joint on balance and gait in patients with chronic stroke. Design: A randomized controlled trial. Methods: Twenty-four chronic stroke patients were selected and randomized into experimental group (n=12) and control group (n=12). The experimental group applied kinesio taping three times a week for three weeks, and the control group applied placebo taping for the same amount of time. To evaluate the effectiveness of the treatment, the subjects' walking ability, static balance, and dynamic balance were assessed before and after the experiment. Gait speed and spatiotemporal gait ability were measured to examine walking ability, postural sway velocity and velocity moment for static balance, and Timed-Up and Go test and Berg Balance Scale were conducted to check dynamic balance. Results: The experimental group showed a significant increase in walking ability, static balance, and dynamic balance in the within-group pre-post difference (p<0.05). In the between-group comparison, the experimental group had a significant difference in walking ability than the control group (p<0.05). Conclusions: Ankle balance taping can help improve gait, and this study can be used as a basis for future studies of ankle balance taping.