• Title/Summary/Keyword: rehabilitation after stroke

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The Effects of Robot-Assisted Gait Training with Visual Feedback on Gait, Balance and Balance Confidence in Chronic Stroke Patients

  • Ham, Sin-Cheol;Lim, Chae-Gil
    • The Journal of Korean Physical Therapy
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    • v.28 no.2
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    • pp.71-76
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    • 2016
  • Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.

The Effect of Treadmill Gait Training in an Adjusted Position from Functional Training System on Chronic Stroke Patients' Walking and Balance Ability (기능적 훈련 시스템을 이용한 조절된 자세에서의 트레드밀 보행훈련이 만성 뇌졸중 환자의 보행 기능과 균형에 미치는 효과)

  • Park, Ji-Eung;Lee, Jun-Ho;Cha, Yong-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.1
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    • pp.35-42
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    • 2017
  • PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

The Effects of Modified Constraint-Induced Movement Therapy and Bilateral Arm Training on the Upper Extremity Performance of Individuals with Chronic Hemiparetic Stroke (수정된 강제-유도운동치료와 양측성 상지훈련이 만성 뇌졸중 환자의 상지 수행 능력에 미치는 영향)

  • Yang, Sung-Hwa;Lee, Wan-Hee;Lee, Kyoung-Suk
    • The Journal of Korean Physical Therapy
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    • v.23 no.5
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    • pp.65-72
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    • 2011
  • Purpose: The intention of this study was to investigate the effects of modified constraint-induced movement therapy (mCIMT) with bilateral arm training (BAT) on the motor performance and daily activity performance of individuals with chronic hemiparetic stroke. Methods: Sixteen subjects one year after stroke participated in this study with a control group; the pretest-posttest method was used. The subjects were randomly allocated into two groups: combination of bilateral arm training and modified constraint-induced movement therapy (n=8), and modified constraint-induced movement therapy (n=8). The mCIMT group received therapy for 90 minutes in 3 sessions per week over a period of 4 weeks. The patients receiving a combination of mCIMT and BAT were treated for the same period and frequency. The results were evaluated using the Fugl-Meyer Assessment, Action Research Arm Test (ARAT), and Motor Activity Log-Amount of Use, and Quality of Movement (MAL-AOU, QOM) assessment tools. Results: The Fugl-Meyer Assessment showed that hand and wrist performance improved significantly more in the mCIMT group than in the Combination group (p<0.05). Result from the ARAT assessment showed greater scores for gross movement in the combined group than in the mCIMT group (p<0.05). The MAL-AOU showed that there was greater improvement in the combined group than in the mCIMT group (p<0.05). Conclusion: The forced use of the more affected side can be important for the enhancement of upper extremity performance for chronic hemiparetic stroke patients during their daily activities.

Effects of Purposeful Activities Combined with Music on Upper Extremity Function, Therapeutic Motivation, and Mood in Acute Stroke Patients (음악을 병행한 목적있는 활동이 급성기 뇌졸중 환자의 상지기능, 치료동기와 기분에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Kye-Ho;Lee, Soon-Hyun;Won, Young-Sik
    • PNF and Movement
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    • v.15 no.3
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    • pp.267-279
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    • 2017
  • Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.

The effect of otago exercise-based fall prevention education activities on balance, fall efficacy and activities of daily living in the subacute stroke patients: A randomized controlled clinical trial (오타고운동 기반 낙상예방교육활동이 아급성 뇌졸중 환자의 균형, 낙상 효능감 및 일상생활동작능력에 미치는 영향: 무작위 대조군 임상 연구)

  • Yoon, Hyun Sik;Han, Kyu Bum;Oh, Seung In;Lee, Da Bee;Song, Ha Hee;Song, Jeong Eun;Cha, Young Joo
    • Journal of Korean Physical Therapy Science
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    • v.27 no.1
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    • pp.1-8
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    • 2020
  • Background: This study analysed the effect of the fall prevention education activities on balance, fall efficacy, activities of daily living (ADL) of sub-acute stroke patients. Design: Randomized controlled trial. Methods: The subjects of the study were 24 subacute patients, who have onset period of less than 6 months. They are randomly allocated in the conventional therapy group (n=12) and fall prevention education group (n=12) and observed with frequency for 5 times a week for four weeks. Measuring took place before and after the experiment leading to following results of the Fall efficacy scale (FES), Berg balance scale (BBS) and Functional Independence Measure (FIM). Results: FES, BBS and FIM score was significantly greater in the post-test than in the pre-test in both groups (p<0.01). Independent t-test confirmed that the fall prevention education group showed much greater improvement change in the FES, BBS and FIM score than conventional therapy group (p<0.05). Conclusion: The present study demonstrated the importance of clinical contribution of the fall prevention education in the individuals with subacute stroke patients to the balance, fall efficacy and ADL following the stroke rehabilitation.

The Effect of Upper Exterimity Weight-Bearing Exercise on Bone Mineral Density and Upper Exterimity Fuction in Female Stroke Patients (상지 체중부하운동이 여성 뇌졸중 환자의 골밀도와 상지기능에 미치는 영향)

  • Lee, Sung-Eun;Kim, Shin-Gyun;Kim, Kyoung;Lee, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.257-264
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    • 2013
  • The purpose of this study was to examine the weight bearing exercise effect on bone mineral density(BMD) and upper extremity function in the female stroke patients. The subject were 24 female stroke patients, randomly assigned to a weight-bearing group(n=12, WBG) and a control group(n=12, CG). The experiments were conducted for three times per week for eight weeks, radial BMD and MFT(Manual Function Test) of both groups were measured before the experiments and eight weeks after the beginning of the experiments. In conclusion, it was found that there was a significant increase of the weight-bearing group radial BMD and MFT score, The results suggest that weight bearing exercise is effective in improving BMD and upper extremity function, thus, can be utilized in stroke rehabilitation.

Effects of Electro-acupuncture and Therapeutic Exercise on Nervous system in the Ischemic Stroke Rats (전침자극과 운동치료가 허혈성 뇌졸중 백서모델의 신경계에 미치는 영향)

  • Yoo, Young-Dae;Kim, Gi-Do;Chun, Jin-Sung;Jeong, Hyun-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.1014-1020
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    • 2006
  • This study was intended to examine the effects of electroacupuncture(EA) and therapeutic exercise on the improvement of exercise function, BNDF, and HSP70 protein expression in an ischemic stroke model induced by MCA occlusion. Experiments were conducted for 1, 3 days, 1, 8 weeks respectively. Group I was a group of EA and therapeutic exercise; Group II was a group of therapeutic exercise; Group III was a group of EA; Group IV was a sham group of EA; Group V was a control group; and Group VI was a sham group without ischemic stroke. In each group, neurologic motor behavior test, histologic observations, BDNF, and HSP70 expression were observed and analyzed. The following results were obtained. The results of behavior test suggest that 8 weeks after ischemic stroke was induced, Group I improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, indicating a similar state of muscle fiber and brain to Group VI. In immunohistochemical observations, Group I showed increase in BDNF and decrease in HSP70. Based on these results, EA and therapeutic exercise may improve muscle atrophy and change in BDNF and HSP70 expression of ischemic stroke rats and contribute to the improvement of exercise function.

The Effect of Dual-Task Exercise on an Unstable Surface on Involuntary Arm and Leg Movement and Balance in Stroke Patients (불안정한 지지면에서 과제운동이 뇌졸중 환자의 팔과 다리의 불수의적 움직임과 균형에 미치는 영향)

  • Kang, Jeong-Il;Baek, Seung-Yun;Jeong, Dae-Keun
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.1
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    • pp.85-92
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    • 2022
  • PURPOSE: This study aimed to analyze the effects of task exercise on an unstable surface on the involuntary arm and leg movement and balance in stroke patients. METHODS: 20 stroke patients were clinically sampled and randomly assigned to two groups of 10 patients each. Experimental group I received task exercise intervention on an unstable surface and experimental group II received task exercise intervention. The interventions were carried out 3 times a week for 4 weeks (30 minutes per session). The global synkinesis (GS) and Berg Balance Scale (BBS) of the patients were evaluated as pre-tests prior to intervention, and then the post-tests were re-measured in the same manner as the pre-tests after a 4-week intervention period. RESULTS: In the experimental group I, there were statistically significant differences in the changes in the arm and leg GS (p < .01) and in the BBS (p < .05). On the other hand, in the experimental group II, there were statistically significant differences in the changes only in the arm GS (p < .01) and in the BBS (p < .05). Also, in the comparison of the changes between the two groups, there was a statistically significant difference in the changes in the leg GS only (p < .05). CONCLUSION: In the experimental group I, the arm and leg GS were statistically significantly reduced, but the balance ability was statistically significantly improved. The reason was that in the experimental group I, similar movements of the paralyzed arm were promoted due to the double-task exercise on the unstable surface, and sensory feedback and posture strategies were well utilized in the legs, which was found to be effective in reducing the GS and improving the balance ability. Therefore, based on these results, the double-task exercise on an unstable surface should be fully utilized for the rapid rehabilitation of stroke patients.

Long-term Effect of Robot-assisted Step Training on the Strength of the Lower Extremity and Gait Speed in a Chronic Stroke Patient: A Preliminary Study (장기간의 로봇 보조 스텝훈련이 만성 뇌졸중 환자의 하지 근력과 보행속도에 미치는 영향: 예비 연구)

  • Se-Jung, Oh;Yong-Jun, Cha;Jongseok, Hwang
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.4
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    • pp.65-73
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    • 2022
  • PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

Effects of task-oriented training for Gross Motor Function Measure, balance and gait function in persons with cerebral palsy

  • Han, Hyun-Kyung;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.9-14
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    • 2016
  • Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.