• Title/Summary/Keyword: rehabilitation after stroke

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The Effects of TENS Applied to Affected Lower Extremities on Balance in Stroke Patients

  • Lee, Kyu-Ri;Jang, Sang-Hun
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.3
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    • pp.255-262
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    • 2014
  • PURPOSE: This study was to investigate the effectiveness of TENS on balance in stroke patients by analyzing some components such as foot pressure, limit of stability and velocity sway after providing somatosensroy input using TENS. METHODS: Twenty five subjects participated and were randomly divided into two groups, TENS group (n=13) and control group (n=12) by the computer program. Interventions were given to subjects 5 days a week for four weeks. TENS group were treated with TENS for 60 minutes in addition to the conventional therapy which included 30-minute exercise and rehabilitation ergometer training for 15 minutes. Control group performed only conventional therapy. TENS was applied on the skin of soleus, tibialis anterior, tensor fascia latae and vastus medialis in affected side. Foot pressure, limit of stability and velocity sway for balance test were measured using Biorescue. RESULTS: TENS group was significantly increased limit of stability and foot pressure in affected side more than control group. And in eye closed condition, TENS group was significantly decreased velocity sway more than control group. CONCLUSION: The application of TENS is effective to improve the somatosensory input of affected side and to increase the motor function and balance ability.

The Effect of Virtual Reality-based Sitting Balance Training Program on Ability of Sitting Balance and Activities of Daily Living in Hemiplegic Patients (앉기자세에서 실시한 가상현실 균형훈련이 뇌졸중 환자의 앉기 균형 및 일상생활활동 능력에 미치는 영향)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.3
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    • pp.11-19
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    • 2017
  • Purpose : This study examined the effects of balance training using virtual reality program on sitting balance ability and activities of daily living (ADL) in stroke patients. Method : In the study, 20 patients with hemiplegia were divided into two groups: experiment group (EG) of 10 patients and control group(CG) of 10 patients. The two groups received general occupational therapy for 30 minutes, per day, at a rate of 5 times per week for 6 weeks. The EG was additionally conducted which was performed virtual reality balance training and the CG was conducted general occupational therapy balance training for 30-minutes, once a day, 3 times a week for 6 weeks. Result : The evaluations of this study included: limit of stability(LOS), modified Functional Reach Test(mFRT), and modified Barthel Index(MBI). The patients were evaluated before and after their six week training programs. Significant differences in the LOS, mFRT, MBI were found between pretest and posttest scores in both the EG and CG groups(p<.05). Also, LOS, mFRT, MBI were significant different between the groups at post-test(p<.05). Conclusion : The study findings suggest that virtual reality balance training can improve sitting balance and ADL ability in stroke patients.

Spatial and Temporal Features of Motor Modules in an individual with Hemiparesis During the Curvilinear Gait: A Pilot Single-Case Study

  • LEE, Jae-Hyuk
    • Journal of Wellbeing Management and Applied Psychology
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    • v.5 no.1
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    • pp.1-7
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    • 2022
  • Purpose: This study aimed to investigate spatial and temporal features of motor control in an individual with hemiparesis during the curvilinear gait (CG) and proposed an exercise guideline. Research design, data and methodology: An individual aged 63 with hemiparesis by stroke disease was participated in the study. Autoencoder (AE) was used to extract four motor modules from eight muscle activities of the paretic leg during CG. After extraction, each module of four modules was operationally defined by numbering from M1 to M4 according to spatial and temporal features and compared with results reported in a previous study. Results: As a result, an individual with hemiparesis had motor module problems related to difficulty of weight acceptance (module 1), compensation for the weakness of ankle plantar flexor (module 2), a spastic synergistic pattern (module 3) and difficulty with transition from the swing to stance phase (module 4) in terms of spatial features. Also, a delayed activation timing of temporal motor module (module 2) related to the forward propulsion during CG was observed. Conclusions: Gait rehabilitation for the stroke will need to consider clinical significances in respect of the deterioration of motor module and provide the tailored approaches for each gait phase.

Physiological Review of Weakness in Patients with Hemiparesis (편부전마비 환자에서의 근육약화에 대한 생리학적 고찰)

  • Kim, Jong-Man;Kim, Tack-Hoon
    • Physical Therapy Korea
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    • v.3 no.2
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    • pp.84-94
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    • 1996
  • This paper reviews physiological changes in the nervous system of patients with hemiparesis that may contribute to muscle weakness. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakeness. This role is compared with the lesser role that spasticity of the antagonist muscle group appears to play in determining the weakness of agonist muscles. The contribution of other factors that result in mechanical restraint of the agonist by the antagonist is discussed relative to muscle weakness in patients with hemiparesis. More studies on patients with hemiparesis are required to assess what role muscle strength training should play in rehabiliting patients after a stroke.

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Effect of the application of low-frequency rTMS on cognitive function in chronic stroke patients (저빈도 rTMS의 적용이 만성 뇌졸중환자의 인지기능에 미치는 영향)

  • Lee, Dong-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.12
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    • pp.7239-7247
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    • 2014
  • This study repeated low-frequency transcranial magnetic stimulation (rTMS) to evaluate the effects on cognitive function in chronic stroke patients. Among the chronic stroke patients, 30 patients selected by MMSE-K and BCRS-K were divided randomly into 3 groups. Group I (n=10) had only sound applied, group II (n=10) were applied 1 Hz rTMS on the damaged side and group III (n=10) were applied to 1 Hz rTMS on the opposite side for total 2 weeks, 20 minutes per a day, five times per a week. To examine the change in cognitive function, CREAD-K scores were measured before, 1 week, 2 weeks, and then 3 months after the intervention. The CREAD-K scores were measured before and 1 week, 2 weeks and 3 months after the interventions. The immediate recall memory showed a significant difference after 2 weeks and 3 months in groups II and III (p<.05), The recognition memory showed a significant difference after 2 weeks and 3 months in group III (p<.05). The delayed recall memory showed significant differences after 3 months in group III than in group I (p<.05). Therefore, the application of low-frequency rTMS has a positive influence on the cognitive rehabilitation of chronic stroke patients.

Effects of Mechanical Horseback Riding Training on Trunk Control and Balance function in Stroke patients (뇌졸중 환자의 체간조절, 균형능력에 기계적 승마치료가 미치는 영향)

  • Song, Myung-Soo;Kang, Tae-Woo;Kim, Su-Mi;Noh, Hyeon-Jeong
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.487-494
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    • 2013
  • The purpose of this study was to determine the effect of mechanical horseback riding training on trunk control, balance function in stroke patients. 15 stroke patients were recruited for this study. The subjects were randomly assigned to two groups: experimental(n=7) and control(n=8). All subjects received a routine physical therapy. The mechanical horseback riding training was for 30 min in the case of the EG subjects. This study was carried out approximately 8 weeks from March 4 to May 3. The assessment tools of this study involved the trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test. The measurements were recorded before the intervention and after the intervention. In the cases of the EG subjects and CG subjects, the variables measured after the intervention significantly differed from trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test before the intervention (p<.05). Also, there were significant differences in trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test at post test between the 2 groups (p<.05). The findings indicate that mechanical horseback riding training exerts a positive effect on trunk control, balance function in stroke patients. Further studies are required to generalize the result of this study.

A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient (ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례)

  • Yun, Tae-Won;Kim, Tae-Yoon
    • Journal of Korean Physical Therapy Science
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    • v.18 no.1
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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Efficacy of PNF Group Exercise Program in Chronic Stroke (만성 뇌졸중 환자에 대한 PNF 집단 운동프로그램의 효과)

  • Kim, Soo-Min;Bae, Sung-Soo
    • PNF and Movement
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    • v.3 no.1
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    • pp.1-15
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    • 2005
  • Objective : The purpose of this study was to evaluate the influence of a community based group exercise intervention on motor functional capacity. To evaluate the immediate(post-treatment) effects after 6-weeks exercise program on the group exercise intervention(PNF and Circuit exercise). Methods : Subjects-Included persons with stroke who were living in the community. Thirty-seven subjects were randomly assigned to the PNF, Circuit exercise and control group participated in a repeated measures design that evaluated the subjects with pre-treatment, post-treatment(6 weeks). Functional ability outcome measures assessed the motor assessment scale(MAS) and EMG. Both treatment groups participated in exercise cJass three times a week for 6 weeks. Group programs focused on balance, functional motor capacity and walking ability. The PNF program was modified PNF pattem and techniques with emphasis on functional tasks when possible, as well as stretching of the more affected limb particularly in the more affected shoulder. The Circuit program with subjects completing practice at a selies of work station as well as participating in walking races and relay with other members of the group. Results : Compared with the control group, the treatment group had larger improvements in the motor function ability after 6 weeks treatment and Post-treatment test scores were more significant than the pre-treatment score. 1. Motor function were assessed by using MAS, sit to stand, walking and upper function were assessed pre-treatment versus post-treatment measures revealed a statically significant(p<.05). There were significant differences between the groups. Compared with the control group, the treatment group had larger improvements. 2. In the treatment groups, demonstrated difference in the electromyographic activation of biceps, triceps, quadriceps and tibialis anterior muscles on the paretic side in the response to the reaching arm movement and stepping motion in stance. The difference in muscle activation improvement were not statically significant. Conclusion : The results of this study showed that the PNF and Circuit group exercise intervention can improve motor functional ability. This study suggests that the PNF and Circuit exercise programs is appropriate for community-based group exercise principles. It leads to gain and maintain potential function for disabled persons after stroke in the community.

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Recovery of an Injured Corticospinal Tract in a Patient With Infarction on the Corona Radiata

  • Lee, Sook;Lim, Hyoung-Won;Yeo, Sang-Seok
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.78-80
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    • 2015
  • Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.

The Effect of Aquatic Exercise Applied PNF Patterns on Body Composition and Balance Performance in Stroke Patients (PNF 패턴을 응용한 수중운동이 뇌졸중 장애인의 신체조성과 균형수행력에 미치는 영향)

  • Song, Ju-Min;Kim, Soo-Min
    • PNF and Movement
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    • v.6 no.2
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    • pp.1-10
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    • 2008
  • Purpose : The purpose of this study was to investigate the effect of aquatic exercise applied PNF patterns on body composition and balance performance in people who have had a stroke. Methods : Forteen candidates who have all experienced a stroke were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 10 consecutive weeks. Subjects were tested with body composition and 5 items of Berg's balance test at pre-training and post-training. Total balance indexes in 3 conditions were measured by K.A.T. 3000. The aquatic exercise applied PNF patterns was consisted of PNF patterns and various aquatic activities. Results : After ten weekends of aquatic exercise training, there were not significant difference in body composition(p>.05) except of muscular weight of affected lower extremity(p<.05). But edema index increased more than pre-training (p<.05). Subjects showed significant difference in Berg's balance test results except of 2 items of Berg's balance test (p<.05). Total balance index score when subjects opened their eyes and didn't hold the handle was decreased less than pre-training(p<.05). Conclusion : The results of this study showed that intervention of this aquatic exercise program applied PNF patterns could increase edema index and muscular weight of affected lower extremity and improve the balance performance in people who have had a stroke.

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