• Journal of Biomedical Engineering Research
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• v.29 no.3
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• pp.179-186
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• 2008

This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

• PNF and Movement
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• v.13 no.3
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• pp.163-168
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• 2015

Purpose: The current study seeks to identify the effect of neck muscle strengthening exercise using proprioceptive neuromuscular facilitation (PNF) on the swallowing ability of patients diagnosed with dysphagia due to stroke. Methods: As a single case study, the current research conducted neck muscle strengthening exercise using PNF on the patient with dysphagia for 40 minutes, four times per week for a six-week period. At the same time, typical rehabilitation therapy for dysphagia was provided. This type of therapy included food-swallowing and the relation of the muscles surrounding the neck. The functional dysphagia scale and the penetration-aspiration scale were used to assess swallowing ability. Results: After the therapy, the functional dysphagia scale and the penetration-aspiration scale decreased by 18 points and 3 points, respectively, which proves the effectiveness of this type of therapy for dysphagia. Conclusion: The results of the current study indicate that neck muscle strengthening exercise using PNF reduces penetration-aspiration in patients with dysphagia, and that PNF can be clinically utilized to improve the swallowing ability of dysphagic patients.

• Therapeutic Science for Rehabilitation
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• v.6 no.2
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• pp.47-58
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• 2017

Objective : The purpose of this study is to observe effects of Occupation-Based bilateral UE training for chronic stroke. Methods : 4 patients with hemiplegic stroke were divided into two groups: experimental group and control group. From May to August 2016, we conducted a occupation - based bilateral UE training and a traditional bilateral UE training for 5 weeks, 3 times a week, and 60 minutes per session for each subject. EMG, accelerometer, ARAT, Y-BAT, SIS, and COPM were performed before and after the intervention. Results : The experimental group showed a large changes before and after intervention in ECR, DA and all items except for hand function and memory of SIS, compared with the control group. Also, the experimental group showed a large change before and after the intervention compared to the control group in the accelerometer measuring the amount used of bilateral hand and grasp, pinch, and gross movement items of ARAT and COPM, Y-BIT. Conclusions : Occupation-based bilateral upper extremity training was effective in the recovery of upper limb function and social participation through neurological changes. Future research will be required development studies to ensure a high content validity of the Occupation-based bilateral upper extremity training protocol.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.295-345
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• 2003

This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.1
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• pp.22-31
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• 2009

Purpose The purpose of this study was to compare the effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Methods Ten patients with stroke were randomly allocated to either a closed kinetic chain exercise (CKC) group(n=5) or an open kinetic chain exercise(OKC) group(n=5). The subjects of each group followed the exercise regimen of their respective groups, and each exercise was performed for 50 mins per day, 3 days per week, for 4 weeks. Assessment was made using Berg Balance Scale (BBS), One Leg Standing(OLS) test, and Timed up and go(TUG) test. The 2 groups were assessed twice: before and after the intervention. Results The TUG test score was significantly different in the CKC group between before and after intervention (p<.05); however, there was no such deference in the OKC group (p>.05). Further, the scores of the BBS and OLS tests were not significantly different for the 2 groups between before and after intervention (p>.05). The hanges in these BBS and OLS score were not significantly different(p>.05); however, there was a significant difference in the change in the TUG scores (p<.05). Conclusion On the basis of the results of this study, we found that the closed kinetic chain exercise is more effective in improving the walking ability and dynamic balance in patients with stroke. Future studies are warranted in this regard.

• Physical Therapy Korea
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• v.13 no.2
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• pp.52-60
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• 2006

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

• PNF and Movement
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• v.21 no.2
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• pp.213-222
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• 2023

Purpose: The purpose of this study was to investigate the effects of heel-raise-lower with Kinesio Taping (HKT) on spasticity and balance ability in patients with chronic strokes. Methods: The participants were divided randomly into the HKT group and heel-raise-lower with sham (control group), with 38 participants assigned to each group. Both groups received heel-raise-lower lifting 100 times, 5 times/week for 4 weeks. The HKT group applied Kinesio Taping to the calf muscles. The control group applied Kinesio Taping transversely to the ankle joint and tibialis anterior muscle. The composite spasticity score was used to evaluate the ankle plantar flexors. The center of pressure with the eyes open and closed and limited stability was measured using BioRescue equipment. Both groups evaluated spasticity and balance ability before the experiment and after 4 weeks. Statistical methods before and after working around spasticity and balance ability were independent t-tests. Results: After training, spasticity showed significant improvement in the HKT group and in the control group (p < 0.05). Similarly, balance ability was significantly more improved in the HKT group after 4 weeks of training compared to the control group (p < 0.05). Conclusion: We confirmed the effects of heel-raise-lower with Kinesio Taping (HKT) on spasticity and balance ability in patients with chronic strokes.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.291-299
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• 2012

Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

• Korean Journal of Adult Nursing
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• v.16 no.3
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• pp.432-441
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• 2004

Purpose: This descriptive survey was conducted to investigate out the utilization of alternative complementary remedies for stroke patients. Method: The subject for this study were 194 patients, selected from inpatients department of 11 major medical center at Busan and Ulsan. Data were collected from August 19th to November 12th, 2002 through interview schedule designed by the investigator. Data was analyzed with frequency, percentage, and ${\chi}^2$-test by using SPSS Win 10.0. Results: 71.6% of objects has used alternative complementary remedies. The use of alternative complementary remedies according to disease-related features was statistically significant in concurrent diseases(${\chi}^2=15.03$, p=0.001), rehabilitation treatment(${\chi}^2=6.341$, p=0.012) and the level of ADL(${\chi}^2=19.63$, p=0.000). The most frequently used therapies were diet and nutrition(31.8%). The patients with less than 3month onset and in the mid-period of treatment frequently used remedies. The reason for using remedies were the belief in it's effects on treatment, but most patients responded was not effective(30.9%) or not much improvement after using remedies. Most of the patients were recommended to use remedies by their neighbors(27.3%) and family members(25.2%). The family members were most supportive in therapy(56.1%). The 28.1% of patients responded that the remedies were effective in promoting blood circulation and 95% of the patients had not experienced side effects. Conclusion: These results could be the basic material in developing nursing intervention for cerebral apoplexy patients.

• The Journal of Internal Korean Medicine
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• v.37 no.6
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• pp.1042-1050
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• 2016

This case study reports on the effect of Korean medicine on a catheter-associated urinary tract infection (CAUTI) caused by multidrug-resistant Pseudomonas aeruginosa. An 83-year-old man diagnosed with stroke had dysuria, and it was found that an indwelling urinary catheter led to CAUTI. From laboratory tests, we identified multidrug-resistant Pseudomonas aeruginosa and applied Korean medicine to him. After herbal medication with acupuncture and moxibustion, we studied a urinalysis and urine culture again for follow-up. We found meaningful improvement in bacteriuria and bacterial identification. This case suggests that Korean medicine could have a beneficial effect on urinary tract infections caused by multidrug-resistant Pseudomonas aeruginosa.