• 한국전문물리치료학회지
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• 제18권2호
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• pp.27-34
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• 2011

The aim of this study was to determine the effect of action-observation training on arm function in people with stroke. Fourteen chronic stroke patients participated in action-observation training. Initially, they were asked to watch video that illustrated arm actions used in daily activities; this was followed by repetitive practice of the observed actions for 3 times a week for 3 weeks. Each training session lasted 30 min. All subject participated 12 training session on 9 consecutive training days. For the evaluation of the clinical status of standard functional scales, Wolf motor function test was carried out at before and after the training and at 2 weeks after the training. Friedman test and Wilcoxon signed rank test was used to analyze the results of the clinical test. There was a significant improvement in the upper arm functions after the 3-week action-observation training, as compared to that before training. The improvement was sustained even at two weeks after the training. This result suggest that action observation training has a positive additional impact on recovery of stroke-induced motor dysfunctions through the action observation-action execution matching system, which includes in the mirror neuron system.

• 한국전문물리치료학회지
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• 제15권3호
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• pp.17-25
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• 2008

This study aimed to evaluate the effect of a weekly circuit-group exercise program on functional performance, flexibility of the trunk and lower extremities, and balance in individuals with chronic stroke who are living in a community. Thirteen community-living individuals (eleven males and two females) with chronic stroke participated in this study. The group exercise program was set up as a weekly circuit application with four stations aiming to strengthen the muscles, increase endurance, improve flexibility, and enhance functional capacity. The average duration of a session was an hour, and the sessions were conducted once a week for six months for a total of 24 sessions. Assessments for functional performance, flexibility of the trunk and lower extremities and balance were conducted four times: before treatment, after one month of treatment, after four months of treatment, and after six months of treatment. There were significant improvements in functional performance and flexibility of the trunk and lower extremities in the given time frame. No significant improvement was observed in balance ability. The findings suggest that a weekly circuit-group exercise program has some benefits in terms of managing the physical symptoms of individuals with mobility problems after stroke. Therefore, this program can be adapted and employed as a community-based rehabilitation program for such patients. Further studies with various community-based treatments will be conducted to validate these findings.

• 대한물리의학회지
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• 제15권4호
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• pp.37-45
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• 2020

PURPOSE: The purpose of this study was to identify the effects of neck stabilization exercise combined with trunk stabilization exercise on balance and gait function in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The experimental group subjects (n = 11) performed neck stabilization (15 min) and trunk stabilization (15 min) exercises, while the control group subjects (n = 11) performed trunk stabilization exercise only for 30 min. Before and after the intervention, the subjects underwent static balance and gait testing. RESULTS: The 95% confidence ellipse area, center of pressure (COP) path length, and COP average velocity were significantly lower in both groups after the intervention compared to before intervention (p < .05). The average stance force on the affected side increased significantly in both groups after the intervention (p < .05). The changes in the static balance variables were larger in the experimental group than in the control group. The cadence, gait velocity, and single leg support increased significantly in both groups after intervention (p < .05). The changes in the gait variables were larger in the experimental group than in the control group. CONCLUSION: Trunk stabilization is a beneficial intervention, but the combination of neck stabilization with trunk stabilization is a more effective method to increase the gait and static balance in chronic stroke patients.

• 성인간호학회지
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• 제16권1호
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• pp.37-48
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• 2004

Purpose: The purpose of this preliminary study was to develop and evaluate the effects of East-West Self-help program for Rehabilitation of post-stroke clients. Method: This program is developed through literature review, survey and seminar. The program is consisted of six sessions twice a week for 6 weeks. This program is composed of health education on stroke, exercise, oriental nursing interventions, and therapeutic recreation. The outcomes have been evaluated on the basis of perceived health status, self-efficacy, U/E function, ADLs and subjective response. Result: 1) After the 6 week program, the perceived health status had improved and the score of rehabilitation self-efficacy increased significantly. 2) After the 6 week program, the score of BADL increased significantly, but, the score of IADL was not statistically significant. 3) After the 6 week program, the amount of use and quality of movement of the affected U/E were increased significantly. 4) All of the participants showed satisfaction with this program. Conclusion: Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be continuously developed and implemented as a community based self-helf group program for post-stroke clients.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.7-12
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• 2014

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

• Journal of Magnetics
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• 제20권2호
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• pp.129-132
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• 2015

The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.98-107
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• 2022

Background: Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient's information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language. Methods: We created a mini blockchain to store the medical information of patients using the Java programming language. Results: After generating a unique pair of public/private keys for identity verification, a patient's identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks. Conclusion: We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.

• PNF and Movement
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• 제17권1호
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• 대한물리의학회지
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• 제17권2호
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• pp.75-82
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• 2022

PURPOSE: This study examined the correlation between the pulmonary function and respiratory muscle strengthening training on an unstable support surface and a stable support surface in stroke patients. METHODS: The study subjects were 22 stroke patients undergoing central nervous system developmental rehabilitation treatment. After excluding six dropouts, eight people in the experimental group and eight people in the control groups were classified by random sampling. Both groups performed central nervous system developmental rehabilitation therapy and were provided a 10-minute break. The experimental group was provided with an unstable support surface using Togu, and the control group was trained to strengthen the respiratory muscle in a stable support surface. Respiratory muscle strengthening training was conducted three times per week for 20 minutes. Before and after each group of experiments, a nonparametric test Wilcoxon signed rank test, and a Mann Whitney U-test analysis were used to analyze the variations between the two groups. All statistical significance levels (α) were set at 0.05. RESULTS: Both groups showed increases in the pulmonary function but showed significant differences only in the experimental group. There was a significant difference in the peak expiratory flow between the two groups. CONCLUSION: Central nervous system development rehabilitation treatment for patients with an impaired nervous system and respiratory muscle strengthening training on unstable support surfaces are effective in improving the pulmonary function of stroke patients. Therefore, they are expected to be applied to physical therapy programs to help various functional activities.

• PNF and Movement
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• 제6권2호
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• pp.39-50
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• 2008

Purpose : This article reviewed the advances in the understanding of the effect of motor rehabilitation and brain plasticity on functional recovery after CNS damage. Methods : This is literature study with Pubmed, Medline and Science journal. Results : The inability of CNS neurons to regenerate is largely associated with nonneuronal aspects of the CNS environment. Especially, this neuronal growth inhibition is mediated by myelin associated glycoprotein, olygodendrocyte-myelin glycoprotein, and NOGO. Enriched environment, motor learning, forced limb use have been utilized in scientific studies to promote functional reorganization and brain plasticity. Especially, enriched environment and motor enrichment may prime the brain to respond more adaptively to injury, in part by expressed neurotrophic factors. Conclusions : These reviews suggest that activity-induced neural plasticity occur in damaged brain areas in order to functional reorganization, where it could contribute to motor recovery, and represent a target for stroke rehabilitation.