• PNF and Movement
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• 제7권1호
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• pp.1-8
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• 2009

Purpose : The aim of this study was to determine the effect of Proprioceptive Neuromuscular Facilitation (PNF) on gait ability in hemiplegic patients. Method : The subjects of this study were 11 hemiplegic patients. Each subject was taken PNF exercise with 3 times per week for 4 weeks. Pre- and post-intervention change in gait ability were measured using an 6m walking test, stride length, and step length. The data were analyzed using the paired t-test. Results : The results of this study showed significantly improvement in 6m walking test, stride length, and step length after intervention. Conclusion : These results suggest that the PNF coordination exercise is an effective way of improving gait ability for hemiplegic patients.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• PNF and Movement
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• 제12권1호
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• pp.19-25
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• 2014

Purpose: To investigate the effect of action observation training on the muscle onset time and symmetrical use of rectus femoris(RF) and gastrocnemius medialis(GCM) during sit-to-stand (STS). Methods: Sixteen patients with stroke entered a single-blind trial and were randomly assigned to the experimental(Action) or control(Landscape) groups. Those in the Action observation group watched video clips showing specific movement and strategies to STS, wheas those in the control group watched video clips of static pictures showing differnet landscapes. All patients was measured the EMG data in the STS on the affected side and unaffected side. The EMG data were collected from RF and GCM while performing the STS task. The EMG onset time and onset time ratio for the RF and GCM were calculated by dividing the EMG onset time of RF and GCM action on the affected side by these on the unaffected side. Results: Onset time of affected side RF, GCM was significantly faster action observation training group than control group(p<.05). But interventions before and after the symmetry did not show a significant increase. Conclusion: There findings suggest that action observation training has a positive effect on the muscle onset time shortened during STS tasks.

• 대한중풍순환신경학회지
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• 제7권1호
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• pp.34-39
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• 2006

Objectives and methods : The Euibujipsung is the one of the huge-scale encyclopedias about Oriental Medicine. To investigate the most frequently used acupoints for hemiparesis after stroke, we used Euibujipsung CR-ROM database with several key words concerned with motor weakness (半身不遂 不遂不隨 癱瘓 中臟 中腑 風痱, etc.). Results : In the result, we found five popular acupoints (GV20, LI11, LI15, ST36 and GB39), and four meridians (Stomach, Gall bladder, Large intestine and Small intestine). We also found that the Yang meridians were cited more frequently than the Yin. Conclusion : Therefore we think that these findings can give further ideas to clinical practice and research fields for stroke rehabilitation in Oriental medicine.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.135-140
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• 2018

Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.

• 대한간호학회지
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• 제36권3호
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• pp.514-522
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• 2006

Purpose: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. Method: The subjects were 60'stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, $\chi^2-test$, and t-test using the SPSS/Win 10.0 computerized program. Result: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. Conclusion: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.37-47
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• 2014

Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

• The Journal of Korean Physical Therapy
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• 제23권2호
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• pp.69-76
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• 2011

Purpose: The aim of this study was to investigate the prevalence of depressive symptoms in stroke patients and to compare characteristics of different rating scales - Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale-Depression (HAD.D)- with regard to diagnosis and severity assessment for post-stroke depression. Methods: Participants included 44 stroke patients who could communicate. At admission, all study participants received a semi-structured interview using the HDRS and a self-completed questionnaire using the BDI and the HAD-D. Pearson's correlation method was used to examine associations among the three depression scales. The BDI and HAD-D were compared based on HDRS criteria, and the sensitivity and specificity using cut-off values were analyzed. Results: The HDRS showed that 52.30% of stroke patients had depressive symptoms on the BDI and HAD-D it was 59.10%. The HDRS correlated significantly with the BDI (r=0.81, p<0.01) and HAD-D (r=0.55, p<0.01). The BDI correlated significantly with HADS (r=0.50, p<0.01). After calculating the area under the ROC curve to decide on HDRS criteria, the BDI (AUC=0.91, 95% CI: 0.83.0.99) showed a significantly larger area compared to the HAD.D (AUC=0.82, 95% CI: 0.69-0.94). The cut-off value of the BDI was 12.50 points with a sensitivity of 81.00% and a specificity of 76.20%. Conclusion: These findings show that the BDI is a useful screening test for depression that most closely predicts the HRDS score.

• 대한통합의학회지
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• 제9권1호
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• pp.41-48
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• 2021

Purpose : The purpose of this study is to find out if it helps to improve static balance ability and weight bearing rate for chronic stroke patients with poor balance in clinical intervention through a method of correcting movement errors while performing a task by vibrotactile bio-feedback providing pressure information. Methods : Fifteen chronic stroke patients (12 male and 3 female) were participated in this study. To examine the effects of vibrotactile bio-feedback and general standing without bio-feedback on static balance ability and weight distribution symmetric index in all subjects randomized with R Studio. The static balance ability and weight distribution symmetric index of the participants was evaluated using a force plate. A paired t-test was used for comparison of each conditions. Statistical significance was set at α=0.05. Results : The comparisons of static balance ability and weight distribution symmetric index in chronic stroke patients after two different condition are as follows. In the static balance ability and weight distribution symmetric index, the vibrotactile feedback providing pressure information showed a significant difference compared to none feedback (p<.001). Conclusion : The vibrotactile bio-feedback providing pressure information in real time can support an improve in static balance ability, uniform weight bearing rehabilitation in chronic stroke patients. In the future, it is hoped that a follow-up study that provides a better direction of intervention compared to various feedback interventions commonly used in clinical practice.

• 대한물리치료과학회지
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• 제30권1호
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• pp.62-71
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• 2023

Background: This study was performed to evaluate the effects of Thermal stimulation combined virtual reality training (TV) on improvement of upper extremity AROM and function in patient with chronic stroke. Design: Two groups pre-post randomized controlled design. Methods: A single-blind, randomized controlled trial was conducted with 30 chronic stroke patients. They were randomly allocated two groups; the TV group (n=15) and Virtual Reality training group (VT) (n=15). The TV group received treatment for 30 min - 15 min of Thermal stimulation, and 15 min of VR training. The VT group received 15 min of VR training. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome upper extremity AROM and function were measured by a active range of motion test, Manual Function Test (MFT) and Jebsen-Taylor hand function Test (JTT). The upper extremity active range of motion was evaluated using a digital dual inclinometer. MFT and JTT were used to evaluate the hand function. The measurement were performed before and after the 8 weeks intervention period. Results: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke. Conclusion: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke.