• The Journal of Korean Medicine
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• v.23 no.2
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

• Physical Therapy Korea
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• v.27 no.3
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.359-364
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• 2020

Purpose: This study was undertaken to compare the efficacy of instrument assisted soft tissue mobilization (IASTM) and a neural dynamic technique (NDYT). As an intervention to treat spastic lower limb muscle tone, stiffness, and static balance in stroke patients. Methods: Totally, 26 participants were assigned randomly to two groups: the IASTM (n=13) and NDYT (n=13) groups. Both groups were subjected to their respective technique for 15 minutes, 5 times a week, for 6 weeks. Muscle tone, stiffness, and static balance were evaluated before and after training, to compare both group changes. Results: IASTM group showed significant decrease in the gastrocnemius medial region and semitendinosus muscle tone and stiffness (p<0.05) compare to NDYT group; however, no significant different was observed in static balance between groups (p>0.05). Conclusion: The results suggest that IASTM is an effective method for decreasing the muscle tone and stiffness in acute stroke patients.

• The Journal of Korean Physical Therapy
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• v.24 no.4
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• pp.253-261
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• 2012

Purpose: In this study, the following experiment was conducted to see how to apply the sprinter pattern in proprioceptive neuromuscular facilitation (PNF) and functional weight bearing exercise affected balance capabilities and weight bearing among chronic stroke patients. Methods: The subjects included 27 subjects who had been diagnosed with hemiplegia due to stroke. A total of 12 sessions was held, 3 sessions a week over 4 weeks, were provided to the groups. The control group received general rehabilitation program, and the experimental group performed sprinter pattern in PNF or functional weight bearing exercise. The weight bearing capability and static balance capability test was implemented by using Good-Balance System and Frailty and Injuries Cooperative Studies of Intervention Techniques, while the dynamic balance capability test was carried out by using Four Square Step Test and Timed "Up and Go". Results: The paretic/nonparetic side weight bearing by application of each exercise showed that there were no significant differences in variation among each groups on before exercise, after exercise, 2 weeks after exercise. Static balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Dynamic balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Conclusion: To put the results together, the application of sprinter pattern and functional weight bearing exercise was effective in improving static and dynamic balance capabilities. Therefore, these exercises are helpful to improve balance in patients with stroke.

• Physical Therapy Korea
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• v.25 no.1
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• pp.31-38
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• 2018

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.5-14
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• 2000

Stroke patients have increased with the overall aging of our population, 60 years and older. Recently the number of stroke patients has been on the increase even among younger people in their thirties. The family support is frequently mentioned as a major variable which plays an important role in helping the patients adapt themselves to their hemiplegic situations. The purpose of the study was to examine between family support and activities of daily living(ADLs)abilities for the hemiplegic patients, and to provide the basic data to help the patients carry out their ADLs on their own. The sample for the study included 106 hemiplegic patients and their family members. The data were collected using a focused, structured interviews. The major findings of the study were as follows: 1. The hemiplegic patients perceived that their family supports were very high(Mean, 49.00). 2. The degree of family support was significantly higher in female. high economic status, and non-use of brace patients than in male, poor economic status, use of brace patients. 3. The ADL abilities of the hemiplegic patients were significantly higher in ambulatory, younger, and longer-period-of-illness patients and patients who used a cane as a assistive device. 4. The family support for the hemiplegic patients showed a statistically significant Cor relationship with their performance of ADL(r=.30809. p=0.0013). 5. The performance of ADL for the ambulatory patients were mainly affected by the degree of family support, the period of the hemiplegic illness, the use of brace, informal care giving, and the age. These variables explained 50% of variance. 6. The length of illness was a statistically significant affecting variable for ADL performance in OPD and assistive device in IPD. In conclusion, the higher the hemiplegic patients perceived the degree of family support, the better they performed ADL. We should develop nursing methods which enhance the family support for the hemiplegic patients in order to increase their performance of ADL.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.475-483
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• 2014

PURPOSE: The purpose of the study was to determine the effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke patients. METHODS: The subjects were 50 patients who were diagnosed with cerebrovascular accident. They were randomly assigned either to a close kinetic chain resistant exercise of lower extremity group (study group)(n=25) or open kinetic chain resistant exercise of lower extremity exercise group (control group)(n=25). Gait abilities were measured by using Timed Up & Go (TUG) test, Functional Gait Assessment (FGA) and spatio-temporal gait variable that were velocity, cadence, stride length, double limb support by 3 axises wireless accelerometer and sway angle of center of mass by same instrument. RESULTS: Study group and control group before and after the intervention there were significantly difference in TUG, FGA, spatio-temporal gait variables and sway angle of center of mass (p<.05). There were significantly different between study group and control group for all variables at post-exercise. CONCLUSION: When all is said and done it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with stroke. In its final analysis when applying resistant exercise of lower extremity to stroke patients' gait, close kinetic chain is more effective than open kinetic chain.

• The Journal of Korean Physical Therapy
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• v.19 no.5
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• pp.87-96
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• 2007

Purpose: It remains controversial for the effect of daily functioning and quality of life on therapeutic exercise after stroke. The purpose of this study was to describe the effects on daily functioning and QOL. Methods: Outcome measures of daily functioning included, such as the Functional Independence Measure (FIM), Barthel index. Outcome measures of QOL included, such as Stroke Impact Scale(SIS) and the Medical Outcomes Study short-form 36-item questionnaire(SF-36). Results: 125 stroke patients were recruited, who were in or outpatients. The average age was 55.4 years. 64.8% were male. The mean Bathel index and FIM score was 63.7 and 87.5. The mean SIS score were higher in communication and mean SF-36 score were higher in physical pain. In/out patients are associated with SIS (communication, emotion) and SF-36(social function, energy or fatigue). Sex are associated with SF-36 (physical function). Other disease state are associated with SIS(hand function) and SF-36 (physical function). Paralysis portion are associated with SIS(communication, daily activity). Barthel index are associated with SIS(communication, mobility) and SF-36(social function, physical function, role limits due to emotional problems). Conclusion: These findings may provide the useful with rehabilitation professionals, who specilalized in the importance of QOL in designing treatment modalities.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.45-52
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• 2016

PURPOSE: The purpose of this study was to determine the effects of balance training on balance pad and sand on balance and gait ability in stroke patients. METHODS: Sixty stroke patients were divided into a Balance Pad group(BPG, N = 20), a Sand group (SG, N = 20) and a Hard Ground group (HGG, N = 20) randomly. The subjects in the Hard Ground group stood in a comfortable position, faced a therapist, then threw a Swiss ball back and forth. They then performed balance training in which they raised and lowered their ankles while facing forward or moved objects from one table to another. The BPG performed same tasks in HGG, on an unstable surface using a balance pad. The SG performed same tasks on sand ground. All groups received training 30min per day, five times per week, for eight weeks. RESULTS: After intervention, all groups showed significant increases balance and gait components. And the BPG and the SG showed significant increase in weight distribution rate, Sway length and BBS compared with the HGG, but there was no significant difference in Cadence, Stride length among three groups. CONCLUSION: According to the results of this study, balance training on unstable surface using balance pad and sand was more effective in improving balance in stroke patients.

• International Journal of Contents
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• v.9 no.1
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• pp.65-70
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• 2013

The purpose in the present study was to examine the effects of weight-bearing exercises on stroke patients' ability to perform upper extremity activities. Experiments were conducted with 24 female stroke patients who were randomly assigned to either a control group (CG) that performed general exercise or an experimental group that performed weight-bearing exercise (WBG). The experiments were conducted for 30 minutes per time, three times per week for six weeks. The upper extremity functions, grasping power, and the ability to manipulate the fingers were measured for both groups before the experiments and again six weeks after the beginning of the experiments. Although the scores for upper extremity functions relating to raising the arms that correspond to proximal upper extremity functions increased in both groups, the WBG showed more significant improvement. The WBG showed significant changes in grasping power compared to the CG. Based on these results, weight-bearing exercise can be effective in improving the ability to perform upper extremity movements and grasping power and thus can be used in stroke rehabilitation.