• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.1
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• pp.9-17
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• 2019

Purpose : This study assessed the effects of transcranial direct current stimulation (tDCS) on balance, fall efficacy, and fall-related fitness in stroke patients, using a cohort of 30 stroke patients divided into two groups. Methods : The experimental group (was given transcranial direct current stimulation in a virtual reality program) and the control group was given false tDCS in virtual reality. there were 15 patients in each group, receiving appropriate treatment over 30 sessions (30 minutes per session per week over a six-week period). In order to assess the change in balance before and after the intervention, the Berg Balance scale was utilized. Fall efficacy was evaluated using the Korean Falls Efficacy Scale for the Elderly (FES-K), The following exercises were performed by patients to assess fall-related fitness : sitting down in a chair and standing up : walking a 244 cm round= trip, and standing on one foot. Results : After the intervention, the experimental group exhibited significantly increased fall efficacy and fall-related fitness, while the control group exhibited no change. These findings suggest that tDCS has positive effects on balance, fall efficacy, and fall-related fitness in stroke patients. Conclusion : Using tDCS as an intervention would bring positive effects on balance, fall efficacy, and fall-related fitness in stroke patients undergoing rehabilitation.

• PNF and Movement
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• v.17 no.2
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• pp.167-175
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• 2019

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder's active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder's active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.117-125
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• 2019

Purpose : The purpose of this study was to determine the effects of simultaneous application of focal vibration stimulation and task-oriented training on the improvement in upper extremity motor function after stroke. Methods : The study period was from January to April 2019; 23 patients who fulfilled the study eligibility criteria were enrolled. The participants were divided into two groups: the experimental group with vibration stimulation and task-oriented training and the control group with only task-oriented training. Training was conducted in a total of 20 sessions, 5 times a week for 30 minutes a day for 4 weeks. The amount of use of the affected and unaffected side by accelerometers, and Box and Block test (BBT), Action Research Arm Test (ARAT) was measured with a pre-test, a post-test. Wilcoxon Signed Rank Test and Analysis of Covariance were used to compare and analyze the changes within and between the groups. Results : Both the groups showed statistically significant changes in the results of the BBT and the ARAT, as well as the amount of use of the affected and unaffected side. Regarding the use of the affected side, BBT results, and the grasp and gross movement item of the ARAT showed significant changes in the experimental group compared with the control group. Conclusion : We found that simultaneous application of focal vibration stimulation and task-oriented training was more effective than task-oriented training alone. A large-scale comparative study involving a group that is only given vibration stimulation should be conducted for more generalizable results.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.107-115
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• 2019

PURPOSE: This study examined the effects of the chopping pattern of proprioceptive neuromuscular facilitation (PNF) on the neglect, balance ability, and activities of daily living in stroke patients with hemi-spatial neglect. METHODS: Twenty stroke patients with neglect volunteered for this study. The subjects were assigned randomly to either the experimental group (EG, n=10) or control group (CG, n=10). The chopping pattern of PNF and exercise therapy were applied in the EG and CG, respectively, for four weeks. Neglect, balance, and activities of daily living were evaluated at the pre-and post-intervention. The assessment tools included a line-bisection test, balance test using Space balance 3D, and modified Barthel index. The pre-and post-intervention values were compared in each group using a paired t-test and the between-group differences were assessed using an independent t-test. Statistical significance was set to ${\alpha}=.05$ for all variables. RESULTS: Significant differences were observed between the EG and CG in terms of neglect, balance, and activities of daily living (p<.05). Both groups showed significant improvement in neglect, balance, and activities of daily living (p<.05). CONCLUSION: These results suggest that the chopping pattern of PNF is effective in improving the hemi-spatial neglect, balance, and activities of daily living in stroke patients with neglect.

• PNF and Movement
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• v.17 no.1
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• pp.47-56
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• 2019

Purpose: This study investigated the effects of neck pattern of proprioceptive neuromuscular facilitation (PNF) on balance and walking ability in patients with chronic stroke. Methods: Fourteen participants with chronic stroke were randomly assigned to vestibular rehabilitation and then divided into two groups: the neck pattern group or treadmill group. Each group underwent 20 sessions (20 minutes/day, five days/week, for four weeks). Patients were assessed with the Berg balance scale (BBS) and gait parameters (gait speed, cadence, step length, and double-limb support period) using a GAITRite system. Results: Vestibular rehabilitation for the neck pattern group and the treadmill group showed significant intragroup improvement on the BBS and in terms of gait speed, cadence, step length, and double-limb support period (p < 0.05). Vestibular rehabilitation was more effective for the neck pattern group than for the treadmill group in terms of the BBS (p = 0.00; 95% CI, 1.49-5.94), gait speed (p = 0.01; 95% CI, 0.05-0.16), cadence (p = 0.02; 95% CI, 0.54-4.99), and step length (p = 0.00, 95% CI, 1.55-4.62). Conclusion: This study used the neck pattern of PNF for vestibular rehabilitation in patients with chronic stroke. The results showed significant improvement in the patients' balance and walking ability. Therefore, the neck pattern of PNF for vestibular stimulation may be more effective than treadmill training to improve balance and walking ability in patients with chronic stroke.

• Physical Therapy Korea
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• v.28 no.1
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• pp.47-52
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• 2021

Background: Compared with normal people, stroke patients have decreased voluntary craniocervical motion, which affects their balance. Objects: This study was conducted in order to examine the effects of active craniocervical movement training using a cognitive game on stroke patient's cervical movement control ability, balance, and functional mobility. Methods: The subject of this study were 29chronic stroke patients who were randomly allocated to either an experimental, cognitive game group (n = 15), or control group (n = 14), to which only neuro-developmental treatment (NDT) was applied. The intervention was conducted 5 times per week, 30 minutes per each time, for a total of 4 weeks. Active angle reproduction test, static stability test, limits of stability test, and Time up and Go (TUG) test, respectively, were carried out in order to evaluate cervical movement control ability, static balance, dynamic balance, and functional mobility. Paired t-test was used in order to compare differences between prior to after the intervention, along with an independent-test in order to compare prior to and after-intervention differences between the two groups. Results: After the craniocervical training with a body-driven cognitive game, the experimental group showed significant differences in flexion, extension, and lateral flexion on the affected side, and rotation on the affected side in the active angle reproduction test. The experimental group indicated significant differences in sway length both with eyes-open and with eyesclosed in the static stability test and in limits of stability test and TUG test. The control group to which NDT was applied had significant differences in flexion in the active angle reproduction test and in limits of stability test and TUG test. Conclusion: The above results mean that craniocervical training using a body-driven cognitive game positively influences stroke patient's cervical movement control ability and as a result their balance and functional mobility.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.1-9
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• 2022

Purpose : The purpose of this research is to propose a more efficient exercising method by measuring and comparing the movement of center of pressure (COP) while hemiplegic stroke patients perform kneeling squat exercise and squat exercise. Methods : 17 hemiplegic stroke patients were instructed to perform kneeling squat exercises and squat exercises, and the research was designed as a cross-over study. For data collection, a pressure distribution measurement platform (PDM) was used to measure the movement area, length, speed, and distance from the center of the X-axis of center of pressure. The data was then analyzed through a paired t-test. Results : Kneeling squat exercises have been found to have a significantly smaller center of pressure movement area compared to that of squat exercise(p<.001), and the center of pressure movement length of kneeing squat exercise has also been found to be relatively shorter (p<.001). Moreover, kneeling squat exercises have been found to have a significantly slower center of pressure movement speed than squat exercise (p<.001), and kneeing squat exercise center of pressure movement distance from the center of the X-axis has been found to be significantly small (p<.001). Conclusion : Kneeling squat exercises have significantly decreased amounts of center of pressure movement area, distance, and speed compared to squat exercises. Also, the center of pressure movement distance from the center of the X-axis was relatively closer. This result seems to derive from patients performing their motions with wide base surfaces while being refrained from using unstable ankle joints during kneeing squat exercise. Therefore, it can be concluded that kneeing squat exercises show relatively balanced center of pressure movements between the paralyzed and non-paralyzed sides because kneeling squats show smaller shakes in the center of pressure.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.57-65
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• 2022

Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.87-95
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• 2022

PURPOSE: This study examined the impact of functional group cooking activities on the depression and interpersonal relationships of stroke patients with psychological impairments. METHODS: Ten stroke patients were divided into an experimental group and a control group and participated in this study from October 2015 to January 2016. The experimental group and control group each comprised five stroke patients. Traditional occupational therapy was given to the control group and the experimental group undertook the cooking activity. Depression changes were measured using the Beck depression inventory (BDI), and the interpersonal relationships were evaluated using the relationship change scale. RESULTS: The findings indicate that, first, there was a significant difference in the depression changes in both groups before and after the intervention. Second, after the intervention, the interpersonal relationships of the experimental group showed a higher mean change value and were significantly higher than the control (experimental: 22.4, control: 4, p < .05). In contrast, there was no change in the depression status between the two groups. CONCLUSION: Functional group cooking activities appear to be more effective in improving interpersonal relationships than traditional occupational therapy. However, to establish that functional group cooking activities are linked to improvements in the depression status and interpersonal relationships of the participants, further studies would be needed with more extensive group activities and larger sample sizes.