• 대한통합의학회지
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• 제11권2호
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• pp.101-108
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• 2023

Purpose : To investigate effects of transcranial directed current stimulus (tDCS) combined with abdominal draw-in maneuver (ADIM) on balance ability and trunk impairment scale of chronic stroke patients. Methods : Twenty-six chronic stroke patients were recruited and twenty-four participated after excluding two patients who met the exclusion criteria. After screening tests, they were randomized through excel program into an experimental group (n = 12) to apply a tDCS combined with ADIM and a control group (n = 12) to apply a sham tDCS with ADIM. The intervention lasted three times a week for six weeks. To compare tDCS intervention effects, trunk impairment scale and balance ability were measured. Comparisons between experimental and control groups were statistically processed using an independent t-test and comparisons within groups were statistically processed using a paired t-test. Results : The experimental group showed significant increases of pre- and post-intervention medial lateral velocity, anterior posterior velocity and area of balance ability, and trunk impairment scale (p<.05). The control group showed significant increases in pre- and post-intervention medial lateral velocity of balance ability and trunk impairment scale (p< .05). The experimental group showed significant increases of medial lateral velocity of balance ability and trunk impairment scale compared to the control group (p<.05). Conclusion : Results of this study suggest that tDCS combined with ADIM for chronic stroke patients can be effective in improving medial lateral velocity of balance ability and trunk impairment scale. Thus, tDCS can be used as an effective treatment protocol for trunk rehabilitation of chronic stroke patients.

• 대한물리의학회지
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• 제6권3호
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• pp.361-368
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• 2011

Purpose : The aims of this study was to identify the activation of the mirror neuron system during action observation in people with stroke and the difference between left hemisphere and right hemisphere and to provide possibility of the use of action observation as a clinical method for improving motor function after stroke. Methods : Seventeen participants were asked to observe 3 different stimulation conditions for 80 seconds. A 30 second rest period was given between stimulations. Electroencephalogram(EEG) signals from electrodes on the participant's scalp were recorded during action observation. The activation of the mirror neuron system(MNS) between the picture observation condition and action observation condition was compared with a paired t-test. An independent t-test was used to compare difference between C3 and C4 on the activation of the mirror neuron system in the action observation condition. Results : Result of paired t-test showed a significantly decreased log ratio in the activation of the mirror neuron system in the action observation condition compared to the picture observation condition. Result of the independent t-test indicated no significant differences in the activation of the mirror neuron system in the right and left hemisphere. Conclusion : The mirror neuron system showed greater activation in the action observation condition than in the picture observation condition and activation in the both hemisphere during action observation. We conclude that these findings suggest that this may possibly be an efficient clinical intervention method for improving motor function.

• 재활치료과학
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• 제1권2호
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• pp.35-40
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• 2012

본 연구에서는 가상현실 치료가 뇌졸중 환자의 뇌 가소성을 동반한 상지기능 향상에 미치는 영향을 알아보고 강도 높은 가상현실 훈련이 뇌졸중 환자의 상지기능 향상을 위한 집중치료로써 임상적으로 유용한 훈련인지 알아보고자 하였다. 뇌졸중 환자에게 있어 사용-의존성 즉 운동 강도와 반복은 마비 측 사지의 운동 기능향상에 중요한 치료적 요소이다. 최근에는 상지의 지속적 사용을 통한 뇌-가소성에 기반한 변화를 유도할 수 있는 치료방법으로 가상현실 치료가 대두되었다. 가상현실 치료는 재활 임상환경에서 운동기능 향상을 위한 훈련강도와 반복을 제공할 수 있는 기술적 방법으로 채택되기 시작하였다. 특히 뇌졸중 환자의 상지 기능을 향상시키기 위한 치료적 유용성 측면에서는 강도 높은 반복적 훈련이 가능하다는 것과 게임 같은 형식으로 높은 동기부여가 가능하다는 것, 실제 수행을 통한 다중감각적 피드백 제공, 상호작용이 가능한 과제지향적 치료가 가능하다는 장점을 가지고 있다. 임상 환경에서 작업치료와 더불어 부가적으로 가상현실 치료를 실시하는 것은 뇌졸중 환자의 상지 기능회복을 더욱 촉진할 것이다.

• Physical Therapy Rehabilitation Science
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• 제5권3호
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• pp.125-131
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• 2016

Objective: The purpose of this study was to investigate the effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in stroke patients. Design: Randomized controlled pilot trial. Methods: Fifteen subjects were randomly divided into three groups where five subjects were in the visual feedback robotic device assist gait training (VRGT) group, five subjects in the auditory stimulation robotic device assist gait training (ARGT) group, and five subjects in the control group. Subjects received visual feedback and auditory stimulation while undergoing robotic gait training for 45 minutes, three times a week for 2 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 2 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test (10MWT) pre- and post-intervention. Results: All subjects showed that BBS, TUG test, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved post-treatment (p<0.05). The VRGT and the ARGT showed significant improvements in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). The VRGT group showed a significant improvement in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). In addition, it has been confirmed that VRGT had significantly improved in BBS, TUG test, and 10MWT scores compared with the auditory stimulation and control group (p<0.05). Conclusions: The results of this study showed improved balance and gait abilities after VRGT and ARGT groups compared with general physical therapy and was found to be effective in enhancing the functional activity of persons affected with stroke.

• Physical Therapy Rehabilitation Science
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• 제8권3호
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• pp.146-151
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• 2019

Objective: The purpose of this study was to investigate the test-retest reliability and concurrent validity of the joint angle of the lower extremities during sit-to-stand movements with wearable sensors based on a portable gait analysis system (PGAS), and the results were compared with a analysis system (MAS) to predict the clinical potential of it. Design: Cross-sectional study. Methods: Sixteen persons with stroke (9 males, 7 females) participated in this study. All subjects had the MAS and designed PGS applied simultaneously and eight sensor units of designed PGAS were placed in a position to avoid overlap with the reflexive markers from MAS. The initial position of the subjects was 90º of hip, knee, and ankle joint flexion while sitting on a chair that was armless and backless. The height of the chair was adjusted to each individual. After each trial, the test administrator checked the quality of data from both systems that measured sit-to-stand for test-retest reliability and concurrent validity. Results: As a result, wearable sensor based designed PGAS and MAS demonstrated reasonable test-retest reliability for the assessment of joint angle in the lower extremities during sit-to-stand performance. The intra-class correlation coefficients (ICCs) for wearable sensor based designed PGAS showed an acceptable test-retest reliability, with ICCs ranging from 0.759 to 0.959. In contrast, the MAS showed good to excellent test-retest reliability, with ICCS ranging from 0.811 to 0.950. In concurrent validity, a significant positive relationship was observed between PGAS and MAS for variation of joint angle during sit-to-stand movements (p<0.01). A moderate to high relationship was found in the affected hip (r=0.665), unaffected hip (r=0.767), affected knee (r=0.876), unaffected knee (r=0.886), affected ankle (r=0.943) and unaffected ankle (r=0.823) respectively. Conclusions: The results of this study indicated that wearable sensor based designed PGAS showed acceptable test-retest reliability and concurrent validity in persons with stroke for sit-to-stand movements and wearable sensors based on developed PGAS may be a useful tool for clinical assessment of functional movement.

• 대한물리의학회지
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• 제18권3호
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• pp.39-45
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• 2023

PURPOSE: This study aimed to provide the basic data necessary for rehabilitation by identifying the effects of complex balance exercises combined with self-observation training on balance and gait improvement in stroke patients. METHODS: This study assigned 20 people randomly into two groups: the control and experimental groups. The experimental group (10 subjects) underwent self-observation training-combined complex balance exercise. The control group (10 subjects) underwent complex balance exercises. A pretest of the balance ability and walking ability of both groups was performed. The interventions were conducted for 30 minutes three times a week for four weeks, and post-tests were conducted four weeks after all interventions were completed. RESULTS: There was a significant difference between the experimental and control groups according to the increase in Berg Balance Sale within the group and a statistically significant difference by a decrease in 10MWT (p < .01). On the other hand, there was a significant difference only in the change in Berg Balance Sale between the two groups (p < .05). CONCLUSION: Combined balance exercise combined with self-observation training and combined balance exercise alone positively affected the Berg Balance Sale and 10MWT in both groups. On the other hand, in the results between groups, there was a statistically significant difference in Berg Balance Sale in complex balance exercise combined with self-observation training. Therefore, self-observation training should be used for the rapid social rehabilitation of stroke patients.

• Physical Therapy Rehabilitation Science
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• 제2권2호
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• pp.87-91
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• 2013

Objective: The present study was aimed at determining the effect of physical training on glutamate transporter activity in a middle cerebral artery occlusion (MCAO)-induced ischemia injury rat model. Design: Randomized controlled trial. Methods: In this study, we randomly divided them into three groups. Group I included non-occlusion sham controls (n=10), Group II included non-physical training after MCAO (n=10), and Group III included rats that were subjected to physical training after MCAO (n=10). Rats in the physical training group underwent treadmill training, which began at 24 h after MCAO and continued for 14 consecutive days. The training intensity was gradually increased from 5 m/min on the first day to 12 m/min on day 3, and it was maintained until day 14. Focal cerebral ischemia was examined in adult male Sprague-Dawley rats by using the MCAO model. We determined the functional outcomes for each rat on days 1, 7, and 14. Glutamate transporter-1 (GLT-1) activity in the cortex of rats from all three groups was examined at the end of the experiment. Results: Out result show that MCAO rats exhibited severe neurological deficits on the 1 day, and there was no statistically significant in each groups. We observed that the functional outcomes were improved at days 7 and 14 after middle cerebral artery occlusion, and GLT-1 activity was increased in the physical training group (p<0.05). Conclusions: These results indicated that physical training after focal cerebral ischemia exerts neuroprotective effects against ischemic brain injury by improving motor performance and increasing the levels of GLT-1 activity.

• 재활치료과학
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• 제7권4호
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• pp.67-77
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• 2018

목적 : 본 연구는 수공예활동을 이용한 그룹 작업치료 중재프로그램이 뇌졸중 환자의 일상생활 수행능력과 삶의 질 향상에 미치는 효과를 알아보고자 한다. 연구방법 : 뇌졸중 환자 10명을 대상으로 진행하였으며, 두 집단 사전-사후 설계(Pretest-Posttest control group design)를 사용하였다. 실험은 사전검사 1회, 중재 10회, 사후 검사 1회로 총 12회기로 주 2회 6주간 실시하였다. 인지기능은 한국판 간이 정신상태검사 (Mini-Mental State Examinatin for Korean: MMSE-K)와 일상생활평가로 한글판 수정 바델 지수 (Korean Version of Modified Bathel Index: K-MBI)와 캐나다 작업수행 측정 (Canadian occupational performance measure: COPM)을 사용하였고, 삶의 질 평가는 한국판 세계 보건기구 삶의 질 간편형 척도(The World Health Organization Quality of life- BREF: WHOQOL-BREF)를 중재 전 후에 시행하였다. 기술통계와 비 모수 통계를 이용하여 결과분석을 하였다. 결과 : 실험군과 대조군의 사전 - 사후 결과를 비교한 결과 일상생활 활동 수행능력 부분에서 K-MBI의 점수 증진은 있었으나, 유의미한 차이는 없었다. COPM은 실험군에서만 수행도 전 후에 유의미한 차이가 있었으며, 실험군, 대조군 모두 만족도에 유의미한 차이가 있었다. WHOQOL-BREF에서 실험군에서 실험 전 후 및 집단 내에 유의미한 차이가 있었으며, 집단 간에도 유의미한 차이가 있었다. 결론 : 본 연구 결과를 통하여 뇌졸중 환자에게 수공예활동을 적용한 그룹 작업치료 중재프로그램이 작업수행능력과 삶의 질 증진에 효과가 있음을 확인 할 수 있었다.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.459-466
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• 2016

본 연구는 아급성기 뇌졸중 환자에서 로봇 보조치료법이 운동능력 및 기능적인 회복에 미치는 효과를 알아보고자 하였다. 환자 53명이 연구에 참여하였다. 로봇보조 보행치료군은 고식적인 치료에 추가로 Lokomat$^{(R)}$ 이용하여 하루에 삼십분씩, 일주일에 5회, 4주 동안 시행하였으며, 대조군은 고식적인 치료에 추가로 하루에 삼십분씩 고식적인 치료를 시행 받았다. 모든 환자들은 임상지표의 비교를 위해, 치료 전과 4주간의 치료 후 Fugl-Meyer assessment, Motricity index, functional ambulation category, Berg balance scale, 10m 보행검사, 한국판 수정 바델지수, 한국판 간이 정신 상태검사와 벡 우울증 척도를 평가 받았다. 환자들은 기능회복과 체성 감각 유발전위 검사 결과의 관계를 알아보기 위해 유발 전위 검사를 시행하였다. 아급성기 뇌졸중 환자에서 로봇 보조 보행치료군에서 대조군에 비해 하지의 운동기능, 보행 능력, 일상생활능력의 유의한 호전이 나타났다. 체성 감각 유발 전위 검사의 결과는 임상 지표들의 관련성 분석에서 Motricity index와 한국판 수정 바델지수와 관련이 있는 것으로 나타나 아급성기 뇌졸중 환자의 기능을 예측하는데 유용할 것으로 생각된다. 로봇 보조 보행치료는 아급성기 뇌졸중 환자의 운동기능과 보행기능의 회복을 촉진하는 것으로 생각된다.

• PNF and Movement
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• 제14권2호
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• pp.75-81
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• 2016

Purpose: This study used a comparative analysis to propose the effectiveness of using scapular and pelvic patterns of proprioceptive neuromuscular facilitation simultaneously (USPS) on the components of gait in patients with stroke. Methods: Subjects who signed a written consent form to participate in the experiment and attended voluntarily were divided randomly into two groups: the USPS group (12) and the control group (9). The USPS group received pattern training for 30 minutes a day, 3 days per week for 6 weeks. The control group received general physical exercise for the same duration. Gait ability was tested and analyzed before and after the 6 weeks of training with the GAITRite system. Results: The components of gait increased significantly in the USPS group after training (p < 0.05) and did not increase significantly in the control group. Conclusion: According to the results of this study, USPS training improves the components of gait more than general physical exercise. The USPS training method is effective for improving motor functions in patients with stroke, especially for gait rehabilitation.