• Journal of The Korean Society of Integrative Medicine
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• v.1 no.4
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• pp.15-24
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• 2013

Purpose : The purpose of this pilot study was to examine the effects of task-oriented training program on balance, activities of daily living(ADL) performance, and self-efficacy in stroke patients. Method : Two subjects with stroke in experimental group participated in the task-oriented training program, while two subjects with stroke in control group received traditional rehabilitation therapy for 4 weeks, 30 minutes per session, four times per week. The task-oriented training program consisted of four tasks with 4 difficulty levels. In two groups, balance was examined with using the Berg Balance Scale(BBS), ADL performance was examined with using the Modified Barthel Index(MBI), and Self Efficacy was evaluated with using the Self-Efficacy scale(SES) before and after 4-week training. Result : After 4 weeks training, all scores of measurement variables increased in both the experimental group and the control group, but the average rates of change differed between the two groups. After the training program, the scores of BBS, MBI, and SES in experimental group increased to 11.4%, 9.9%, 15.4%, respectively than pre-training. Conclusion : According to the results of this study, task-oriented training program might be proposed as a intervention to improve balance ability, ADL performance, and self-efficacy in stroke patients.

• Physical Therapy Korea
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• v.22 no.3
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• pp.81-90
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• 2015

This study aimed to determine the effects of Rhythmic Auditory Stimulation (RAS) using music and a metronome on the gait of stroke patients. 13 female and 15 male volunteers were randomly allocated to two groups: namely a group to receive RAS using music and a metronome group (the experimental group; $n_1=14$) and a group to receive RAS using a metronome only (the control group; $n_2=14$). The affected side was the left side in 15 subjects and the right side in 13 subjects. The mean age of the subjects was 56.6 years, and the mean onset duration of stroke was 8.6 months. Intervention was applied for 30 minutes per session, once a day, 5 times a week for 4 weeks. To measure the patients' gait improvement, we measured gait velocity, cadence, stride length, double limb support using GAITRite, body center sway angle using an accelerometer, and Timed Up-and-Go test. Functional Gait Assessment were conducted before and after the experiment. The paired t-test was used for comparisons before and after the interventions in each group. Analysis of covariance was used for comparisons between the groups after the interventions. Statistical significance was set at ${\alpha}=.05$. Within each of the two groups, significant differences in all of the dependent variables before and after the experiment (p<.05) were observed. However, in the comparison between the two groups, the experimental group showed more significant improvements in all dependent variables than the control group (p<.05). Our results also suggest that in applying RAS in stroke patients, the combination of music and a metronome is more effective than using a metronome alone in improving patients' gait.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.115-123
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• 2023

PURPOSE: This study examined the effects of combined conventional exercise therapy plus respiratory exercise program with combined conventional exercise therapy plus aqua exercise program in the pulmonary function of subacute stroke patients. METHODS: The respiratory exercise program group underwent inspiration and expiration training using the Threshold IMT and Threshold PEP three days per week for four weeks. The aquatic exercise program group had aquatic aerobics, halliwick, and bad ragaz ring training three days per week for four weeks. Before and after the experiment, Pony fx was used to examine the FVC, FEV1, FEV1/FVC, VC, and MVV. RESULTS: Significant improvement was found after the experiment in the FVC. FEV1, VC, MVV, excepting FEV1/FVC, of the pulmonary function in the aquatic exercise program group. After the experiment, significant improvement was found in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function in the respiratory rehabilitation therapy group. No significant difference in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function was observed in the inter-group comparison. CONCLUSION: Significant improvement was found after the experiment in both the aquatic exercise program group and the respiratory exercise program group. No difference in pulmonary function was noted in the inter-group comparison. Therefore, combining general exercise therapy and an aquatic or respiratory exercise program is expected to be effective for the pulmonary function of acute stroke patients. These results are expected to provide basic data to help research intervention of aquatic and respiratory exercise programs for subacute stroke patients.

• Therapeutic Science for Rehabilitation
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• v.9 no.3
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• pp.63-75
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• 2020

Objective : The purpose of this study was to examine the changes in work performance and motor function of stroke patients in the Lee Silverman Voice Treatment-BIG (LSVT-BIG) program and to confirm its clinical applicability. Methods : Two stroke patients underwent the LSVT-BIG program for a total of 16 sessions (60 minutes per session and, four days a week for four weeks). To assess any changes between before and after the intervention, the Canadian Occupational Performance Measurement (COPM), Berg Balance Scale (BBS), Timed Up and Go (TUG), Functional Reaching Test (FRT), Manual Function Test (MFT) were used. Differences in scores between before and after the intervention were analyzed. Results : The performance and satisfaction of occupational performance increased after the intervention in both subjects. The performance time of the TUG decreased to 0.91, 8.42 seconds for each subject, increasing the walking speed. In FRT distance change, the subject increased in both the affected side and unaffected side. The BBS score increased by 3 points in one subject and by 6 points in the other, indicating improved balance. In addition, in the MFT score, subject A showed an improvement of 1 point on the unaffected side, and subject B showed an improvement of 1 point on the unaffected side and 3 points on the affected side. Conclusion : We confirmed the applicability of the LSVT-BIG program as a new intervention technique for stroke patients. Future, complementary research on the effects of the LSVT-BIG program on stroke patients will be needed.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.103-111
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• 2022

PURPOSE: This study was performed to investigate the effects of the whole-body vibration exercise combined with ankle joint mobilization on the gait and balancing ability in patients with hemiplegic stroke. METHODS: A total of 19 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (whole-body vibration exercise combined with ankle joint mobilization, n=10) or control group (whole-body vibration exercise, n=9). All participants underwent 30 min of comprehensive rehabilitation therapy (5 × /week for 6 weeks). Additionally, the experimental group performed the whole body vibration exercise and ankle joint mobilization (15 minutes each, 30 minutes total, 3 × / week for 6 weeks). In the control group, only the whole- body vibration exercise was performed in the same manner and not the ankle joint mobilization. The gait and balancing abilities were measured before and after the 6-week training. RESULTS: Significant improvements were observed in the 10-m walk test, timed up-and-go (TUG) test, center of pressure (COP) path length, and COP path velocity in the experimental group (p < .05). The experimental group showed a larger decrease in the COP path length and velocity than the control group (COP path length, -10.27 mm vs. -3.67 mm, p < .05; COP path velocity, -.33 cm/sec vs. -.13 cm/sec, p < .05, respectively). CONCLUSION: The whole-body vibration exercise combined with ankle joint mobilization could be effective in improving the gait and balancing ability of stroke patients and could also be more effective for improving the static balance ability than the general whole-body vibration exercise alone.

• International Journal of Contents
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• v.6 no.4
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• pp.8-13
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• 2010

Due to the expense of health care and the need to contain costs, many stroke patients are discharged from hospitals while still in an impaired condition. Using Tele-rehabilitation, these patients can receive rehabilitation services remotely. A pegboard is a conventional rehabilitation therapeutic device that integrates cognition, sensation and hand motor function. This study proposes a Tele-rehabilitation content with automated pegboard and shows its functional feasibility. The evaluation of the pegboard session was automated with RFID (radio frequency identification), and a 16-hole pegboard was rapid-prototyped. After a pegboard session is completed, the session result is uploaded to a server automatically for viewing on a web browser by a remote therapist. The therapist can also send messages to remote patients to encourage them or to manage the rehabilitation process.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.202-222
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• 2003

Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. The purpose of this study were to identify effects of a 6weeks repetitive bilateral arm training on upper motor function and the reorganization of motor network. Four chronic stroke patients participated in this study. They performed for 6 consecutive weeks, 3 days a week, 30 minutes a day. In the single group study, four 5-minute periods per session of bilateral arm training were performed with the use of a custom-designed arm training machine. The results of this study was as follows. 1. Following the 6weeks period of RBAT, patient exhibited a improvement in FMA and BBT. 2. Following the 6weeks period of RBAT, it showed improvement in reaching time, symbol digit substitution and finger tapping speed of KCNT. 3. fMRI activation after RBAT showed a focal map in lesional cortical area and perilesional motor areas. These fMRI data suggest that hemodynamics response to RBAT reflect sensorimotor reorganization in contralateral hemisphere. In conclusion, these date suggest that improved upper extremity function induced by repetitive bilateral arm training after stroke is associated with reorganization of motor network as a neural basis for the improvement of paratic upper extremity function.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.135-139
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• 2015

Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.