• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.65-74
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• 2004

Object : This is a study of acute stage stroke patients designed for comparison of combined Eastern and Western medical treatments and Oriental treatments alone. Methods : 51 patients were diagnosed by Brain-CT and Brain-MRI scan as having suffered stroke. They had entered Dong-eui hospital within seven days of attack, and remained over seven days, all between November 2002 and August 2003. Patients were divided into two groups: a group treated with both Eastern and Western medical treatments, and a group treated only with Oriental medical treatments (but examinations were done and medications were given in hypertension, Diabetes Mellitus and so on). Results : The Eastern-Western medical treatment group showed significant changes in NIHSS. A rate of improvement figure of 24.94% was obtained for the Eastern-Western medical treatment group, and for the Oriental medical group a figure of 7.84% was obtained. Conclusion : The East-West medical treatment group had significant rate of development that measure for NIHSS by treated comparatively dependent patients. And oriental medical treatment group had significant rate of development that measure for NIHSS by treated comparatively independent patients. The NIHSS measure for the Eastern-Western medical treatment group shows a significant rate of improvement for relatively dependent patients, and the NIHSS measure for the Oriental medical treatment group shows a significant rate of development for relatively independent patients.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.75-84
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• 2018

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke. METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment. RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05). CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

• PNF and Movement
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• v.16 no.3
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• pp.451-460
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• 2018

Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.35-44
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• 2020

Background: This study was to confirm the effect and feasibility of knee extension assist orthosis (KEAO) on balance and gait in subacute stroke patients. Design: Case study. Methods: The subjects of the study were 4 subacute stroke patients, who had an onset period of less than 6 months. The limit of stability (LOS) and berg balance scale (BBS), timed up and go test (TUG) were used to verify the dynamic balance ability, static balance ability, and gait ability pre and post and after wearing the knee extension assist orthosis (KEAO). In addition, the satisfaction survey was to confirm the feasibility of the knee extension assist orthosis (KEAO) through the to Korean quebec user evaluation of satisfaction assistive technology 2.0 (K-QUEST 2.0). Results: After the wearing on KEAO, the distance for the limit of stability decreased by mean 541.25±240.46 mm2, and the score on the berg balance scale improved by mean 5±2.71 point, and the time for the timed up and go test deceased by mean 3.75±1.71 second. The stability and durability were found to be full score, and the control, ease, effectiveness were some high score, and the size, weight, comfort were some low score in the satisfaction and feasibility. Conclusion: The knee extension assist orthosis (KEAO) produce in this study was improved the static balance ability, dynamic balance ability and gait ability of subacute stroke patients, and the satisfaction and feasibility were high in the stability, durability and effectiveness of the user.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.1-11
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• 2022

Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.167-175
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• 2023

Purpose : The study aim was to apply high-frequency repetitive transcranial magnetic stimulation to and investigate the effects on upper extremity function and activities of daily living. Methods : This study was conducted at Hospital D in U City from April to June 2018. Thirty-two patients diagnosed with stroke according to prior research criteria were selected and divided into two groups. Sixteen people in the experimental group received high-frequency repetitive transcranial magnetic stimulation and traditional occupational therapy, and sixteen people in the received sham stimulation and traditional occupational therapy. Both groups received 20 minutes of transcranial magnetic stimulation and 30 minutes of traditional occupational therapy per session, five times per week, for a total of 10 sessions over two weeks. Upper extremity functional evaluation, MFT and activities of daily living (Korean Version of the Modified Barthel Index, K-MBI) were conducted before and after the intervention, and an independent t test was used to confirm the effects of the intervention. Results : No statistically significant difference between the aforementioned groups' MFT and K-MBI scores was noted before the intervention. After the intervention, however, a statistically significant difference was found in K-MBI scores (p<.001). Additionally, after the intervention, a significant difference between the groups' MFT scores was found (p<.05). Conclusion : The results of this study showed that the combination of high-frequency repetitive transcranial magnetic stimulation and occupational therapy was effective in recovering upper extremity function and activities of daily living in patients diagnosed with acute stroke.

• Health Policy and Management
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• v.33 no.4
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• pp.440-449
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• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.