• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.69-79
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• 2024

PURPOSE: This study compared the effect of the muscle energy technique (MET) and stretching technique on ankle dorsiflexion passive range of motion, balance, and gait ability of stroke patients with limited ankle dorsiflexion. METHODS: Forty-four post-stroke patients participated. The participants were randomized into the MET group (METG; n = 22) and the stretching group (STG; n = 22). The METG was subjected to the MET to relax the dorsiflexion, while the STG was subjected to the dorsiflexion stretching technique. Both groups completed standard neurological physical therapy for 30 min per session. The intervention was conducted five times a week over 3 weeks for a total of 15 times. All participants underwent ankle dorsiflexion passive range of motion measurement and Berg Balance Scale score determination and completed a 10-m walking test and the timed up and go test before and after the intervention. RESULTS: After the 3-week intervention, both groups showed significant improvement after the intervention (p < .05). METG participants showed greater improvements in ankle dorsiflexion passive range of motion and 10-m walking test results compared to STG participants (p < .05). CONCLUSION: Both interventions improved ankle dorsiflexion passive range of motion, balance, and gait ability in stroke patients with limited ankle dorsiflexion. Moreover, the MET was superior to ankle dorsiflexion passive range of motion on the 10-m walking test.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.131-142
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• 2024

PURPOSE: This study was a systematic review and meta-analysis of the literature comparing the differences between task-oriented treadmill training and general treadmill training for stroke patients. METHODS: Literature published in the Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), and PubMed was reviewed. A total of 1,163 studies were initially retrieved, of which eight articles were included in the final review. A quality assessment of the included studies was conducted using the Risk of Bias (RoB) 2.0 tool, and Duval and Tweedie's trim and fill method was used to evaluate publication bias. Data analysis was performed using R studio 4.2.1. RESULTS: According to the quality assessment using RoB 2.0, three articles were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size of task-oriented tradmill training was .35. Regarding gait function, the values were .76, .25, and .40, respectively, for gait endurance, gait speed, and gait pattern. According to Duval and Tweedie's trim and fill method, no publication bias was observed. CONCLUSION: Study findings indicate that task-oriented treadmill training is the most effective intervention for improving gait endurance in patients with stroke. Therefore, applying this intervention to patients with stroke in the community is recommended.

• Journal of Korean Physical Therapy Science
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• v.31 no.1
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• pp.98-109
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• 2024

Background: The purpose of this study is to investigate changes in physical and cognitive function according to the level of independence in performing activities of daily living in stroke patients. Design: Retrospective study. Method: This study is a retrospective study analyzing medical records. This study utilized data collected from 123 stroke patients at admission in a local rehabilitation hospital between 2019 and 2022. Stroke patients were classified into 5 groups based on the scores of the Korean Modified Barthel index (K-MBI) evaluated at the time of hospitalization at a rehabilitation hospital, and investigated the change in physical (spasticity (modified Ashworth scale), muscle strength (manual muscle test), gait ability (functional ambulation category), upper extremity function (manual function test), and balance function (berg balance scale)) and cognitive function (Korean mini mental status examination) according to the level of independence in performing activities of daily living. Result:: As a results, significant differences were observed in the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive functions of stroke patients according to the level of independence in performing activities of daily living (p<0.05). However, there was no significant difference in upper and lower extremities spasticity. Conclusions: Through the results of this study, we found that the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive function were influenced by the level of independence in performing activities of daily living in stroke patients.

• Journal of Applied Biological Chemistry
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• v.66
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• pp.221-226
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• 2023

Proper activation and aggregation of platelets are necessary, but excessive or abnormal aggregation can lead to cardiovascular diseases such as stroke, thrombosis, and atherosclerosis. Therefore, identifying a substance that can regulate or inhibit platelet aggregation is important for preventing and treating these diseases. Several studies have shown that certain ginsenoside compounds in Panax ginseng can inhibit platelet aggregation. Among these compounds, Rk3 (G-Rk3) from Panax ginseng needs to be further explored in order to reveal the mechanisms of action during inhibition. G-Rk3 significantly increased amounts of cyclic adenosine monophosphate (cAMP) and led to significant phosphorylation of cAMP-dependent kinase substrates vasodilator-stimulated phosphoprotein and inositol 1,4,5-trisphosphate receptor. Furthermore, the effect of G-Rk3 extended to the inhibition of PI3K/Akt phosphorylation resulting in the reduced secretion of intracellular granules. Ultimately, G-Rk3 effectively inhibited platelet aggregation. Therefore, we suggest G-Rk3's potential as a prophylactic or therapeutic agent for cardiovascular diseases caused by faulty platelet aggregation.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.55-64
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• 2024

PURPOSE: This study evaluated the effects of robot-assisted gait training combined with virtual reality training on balance and gait ability in stroke patients. METHODS: Thirty-one stroke patients were allocated randomly into one of two groups: robot-assisted gait training combined virtual reality training group (RGVR group; n = 16) and control group (n = 15). The RGVR group received 30 minutes of robot-assisted gait training combined with virtual reality training. Robot-assisted gait training was conducted in parallel using a virtual reality device. In the Control group, neurodevelopmental therapy was performed according to the function of chronic stroke patients. Both groups underwent training for 30 minutes, three times per week for eight weeks. The balance assessment system (BioRescue, Marseille, France), BBS, and TUG were used to evaluate the balance ability. The OptoGait (Microgate Srl, Bolzano, Italy) and 10 mWT were measured to evaluate the gait ability. The measurements were performed before and after the eight-week intervention period. RESULTS: Both groups showed significant improvement in their balance and gait ability during the intervention. RGVR showed significant differences in balance and gait ability compared to the control group groups (p < .05). These results showed that RGVR was more effective on balance and gait ability in patients with chronic stroke. CONCLUSION: RGVR can improve balance and gait ability, highlighting the benefits of RGVR. This study provides intervention data for recovering the balance and gait ability of chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.91-98
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• 2024

PURPOSE: This study aimed to provide basic clinical data by investigating the impact of Activities of daily living-related dual-task intervention on lung function, balance, and Activities of daily living of stroke patients. METHODS: After sampling 40 stroke patients who met the selection criteria, this study randomly assigned 20 patients who received dual-task exercise intervention to the experimental group and 20 patients who received single exercise intervention to the control group by drawing lots. Next, the study pre-tested their lung function, balance, and activity of daily living. All interventions were conducted for 30 minutes, 3 times a week for 4 weeks, and when all interventions were completed after 4 weeks, lung function, balance, and activity of daily living were re-measured in the same way as the pre-test. RESULTS: In comparing changes in lung function, balance, and activity of daily living within each of the experimental and control groups, statistically significant improvement were found in the experimental group only (p < .01). Statistically significant improvement were also found in lung function, balance, and activities of daily living between the groups (p < .05) (p < .01). CONCLUSION: A statistically significant improvements were found in lung function, balance, and activities of daily living only in the experimental group and statistically significant differences were found between groups. Because they take arm exercises by maintaining balance in a standing position on a labile surface and through dual-task exercise such as folding a towel, moving a cup, and throwing and catching a ball, muscles related to lung function were stimulated and lung function and balance were improved. This helped activities of daily living to be improved. Thus, it is considered that dual-task exercise should be utilized for stroke patients' smooth everyday life.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.396-414
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• 2024

Objective: This study assessed the effectiveness of Gammaekdaejo-tang for post-stroke depression through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "Post-stroke Depression", "PSD", "Gammaekdaejo", and "Ganmai-dazao" on April 30, 2024. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), HDRS (Hamilton Depression Rating Scale), and NIHSS (National Institute of Health Stroke Scale), using the Review Manager website. Results: A total of 10 RCTs was selected. The treatment group ((Gammaekdaejo-tang) or (Gammaekdaejo-tang combined with other ingredients or decoction)+Western medicine) showed significant improvement effects in terms of TER, HDRS, and NIHSS compared to the control group (Western medicine). [TER] RR: 1.19, 95% CI: 1.11 to 1.27, P<0.00001, RR: 1.24, 95% CI: 1.11 to 1.38, P<0.00001; [HDRS] MD: -2.29, 95% CI: -2.58 to -2.00, P<0.00001), MD: -3.28, 95% CI: -4.21 to -2.35, P<0.00001) [NIHSS] MD: -7.70, 95% CI: -8.52 to -6.89, P<0.00001. Conclusion: This study suggests that Gammaekdaejo-tang is effective in treating PSD. However, there are limitations, such as the small number of included studies, inability to clearly determine the effect of Gammaekdaejo-tang, inability to use various evaluation tools, and risk of bias. This research must be supplemented through systematic research design and implementation.

• PNF and Movement
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• v.22 no.2
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• pp.191-199
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• 2024

Purpose: This study aimed to investigate the effects of ankle stretching with intrinsic muscles on ankle range of motion, static and dynamic balance, and gait speed in chronic stroke patients. Methods: The participants were 20 chronic stroke patients, divided into two groups, 10 in the ankle stretching with intrinsic muscles group and 10 in the slant board exercise group. Both groups performed their respective interventions once daily, with three sets per session, five times a week for four weeks. Ankle range of motion, dynamic and static balance, and gait speed were measured before and after the intervention. An independent t-test was used to compare the results between the two groups before and after the intervention. Results: Both groups showed significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention (p < .05). The ankle stretching with intrinsic muscles group showed more significant improvements in ankle range of motion, dynamic and static balance, and gait speed after the intervention compared to the slant board group (p < .05). These results suggest that ankle stretching with intrinsic muscles may be more effective than the slant board for certain outcomes. Conclusion: Ankle stretching with intrinsic muscles is effective in improving ankle range of motion, dynamic and static balance, and walking speed.

• PNF and Movement
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• v.22 no.2
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• pp.201-211
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• 2024

Purpose: This study aimed to evaluate the effects of trunk stabilization exercises using a Reformer on trunk control, balance ability, and gait function in chronic stroke patients. Methods: The participants were 24 chronic stroke patients, randomly divided into two groups: trunk stabilization exercise using the Reformer group (TS-R, n = 12) and general trunk stabilization exercise group (GT-E, n = 12). Assessment methods included the Trunk Impairment Scale for trunk control, the AMTI force platform for static balance, the Timed Up and Go test for dynamic balance, and the Dynamic Gait Index for gait function. Assessments were conducted before and after the intervention. The intervention for the TS-R group consisted of bridging exercises using a Reformer, while the GT-E group performed bridging exercises on a mat. All interventions were performed for 17 minutes per session, five times a week, for a total of 20 sessions over four weeks. Statistical analysis was performed using repeated-measures ANOVA to analyze the interaction between groups and time. Results: The results of the repeated measures ANOVA indicated a significant interaction between the groups and time. The TS-R group showed statistically significant differences in all variables before and after the intervention. In contrast, the GT-E group did not show statistically significant differences in any variables before and after the intervention. Conclusion: The findings of this study suggest that trunk stabilization exercises using a reformer are effective in improving trunk control, balance ability, and gait function in chronic stroke patients.

• Journal of Home Health Care Nursing
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• v.9 no.2
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• pp.114-128
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• 2002

In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.