• 대한물리치료과학회지
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• 제30권1호
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• pp.62-71
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• 2023

Background: This study was performed to evaluate the effects of Thermal stimulation combined virtual reality training (TV) on improvement of upper extremity AROM and function in patient with chronic stroke. Design: Two groups pre-post randomized controlled design. Methods: A single-blind, randomized controlled trial was conducted with 30 chronic stroke patients. They were randomly allocated two groups; the TV group (n=15) and Virtual Reality training group (VT) (n=15). The TV group received treatment for 30 min - 15 min of Thermal stimulation, and 15 min of VR training. The VT group received 15 min of VR training. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome upper extremity AROM and function were measured by a active range of motion test, Manual Function Test (MFT) and Jebsen-Taylor hand function Test (JTT). The upper extremity active range of motion was evaluated using a digital dual inclinometer. MFT and JTT were used to evaluate the hand function. The measurement were performed before and after the 8 weeks intervention period. Results: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke. Conclusion: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic 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.

• Korean Chemical Engineering Research
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• 제62권2호
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• pp.133-141
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• 2024

전세계적으로 발병 및 사망률이 높은 동맥경화증은 뇌졸중, 심근경색 등 심혈관질환의 주요 병증의 원인인 만성 염증성 질환이다. 동맥경화증은 지질 침착으로 인해 죽종(atheroma)이 형성되고, 혈전증이 유발되면서 관련 증상이 발생한다. 동맥경화증의 합성 치료제의 부작용 우려로 인해 생물 유래 항동맥경화 소재 개발의 필요성이 강조되고 있다. 이에 따라 동맥경화증의 개선 및 치료를 위한 바이오소재의 발굴 및 기전 규명 등 관련 연구가 활발히 수행되고 있다. 주로 동맥경화증 발병 관련 인자들을 조절하여 증상을 억제하거나 지연시키는 바이오소재들이 연구되고 있으며, 대표적으로 다당류, 폴리페놀, 코엔자임 Q10이 해당된다. 우수한 활성을 가진 바이오소재의 경우에는 생체 내(동물 모델)에서의 항동맥경화증 활성이 확인되었다. 본고에서는 동맥경화증의 발병 기전을 살펴보고, 항동맥경화증 활성이 보고된 바이오소재의 연구 동향 및 활용 전망을 제시하고자 한다.

• PNF and Movement
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• 제22권1호
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• pp.113-128
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• 2024

Purpose: This study aimed to investigate the effects of eccentric training applied to the calf muscles on muscle tone, muscle strength, and gait variables in patients with chronic stroke. Methods: Twenty-two participants were divided into experimental (n=12; eccentric training) and control (n=10; static stretching and stretching board) groups. The participants completed 30-minute physical therapy sessions five times a week for three weeks. Calf muscle tone, muscle strength, and gait variables were measured using MyotonPRO, a hand-held dynamometer, and Optogait, respectively, before and after each intervention. Results: Two-way analysis of variance (ANOVA) indicated a significant interaction effect between measurement points and groups in frequency, stiffness, and decrement of the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05). Paired t-tests showed that the experimental group exhibited significantly decreased frequency and stiffness scores for the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05), as well as significantly increased decrement and muscle strength scores, gait speed, step length, and stride length (p<.05). Conclusion: The application of eccentric training to the calf effectively reduced muscle tone, increased muscle strength, and improved the gait speed, step length, and stride length of patients with chronic stroke.

• 대한물리의학회지
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• 제19권1호
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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.

• 대한물리의학회지
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• 제19권2호
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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.

• PNF and Movement
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• 제22권2호
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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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• 제22권2호
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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.

• 대한물리의학회지
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• 제19권3호
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• pp.55-63
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• 2024

PURPOSE: This study examined the test-retest reliability and clinical utility of the Modified Trunk Impairment Scale (mTIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke - Trunk Control (PASS-TC) in patients with chronic stroke. METHODS: Thirty-eight stroke patients were reassessed using the mTIS, TCT, and PASS-TC with a seven-day interval between assessments. The test-retest reliability was evaluated using the intraclass correlation coefficient (ICC_2,1), the standard error of measurement (SEM), the minimal detectable change (MDC), and MDC%, as well as Bland-Altman analysis. The relationship between the mTIS, TCT, PASS-TC scores, and the Barthel Index (BI) was also investigated. RESULTS: The test-retest reliability for the mTIS, TCT, and PASS-TC was high, with ICC values ranging from .91 to .94 (95% confidence interval: .83-.97). The MDCs for the mTIS and TCT were 2.35 and 13.9, respectively, while the MDC for the P ASS-TC was 2.54, all below 20% of the maximum possible score, indicating reliable measurement. The optimal mTIS cut-off score for distinguishing between mild (75-95 points) and severe (50-74 points) dependence on the BI was ≥ 9.5, with an accuracy of 79%. Patients with an mTIS score ≥ 9.5 (out of 15) showed an 18-fold higher likelihood of achieving a mild level of functional independence than those with a score < 9.5. CONCLUSION: The mTIS, TCT, and PASS-TC showed high test-retest reliability and no systematic errors in chronic stroke patients. The MDC values were reliable, indicating meaningful change. Among these, the mTIS is a sensitive and a useful tool for predicting functional independence in clinical practice and is straightforward to apply.

• Journal of Chest Surgery
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• 제39권9호
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• pp.681-691
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• 2006

배경: 본 연구에서는 류마티스성 승모판막질환과 동반된 만성 심방세동의 치료에서 냉동절제술을 이용한 변형 maze 술식들의 동율동 회복률 및 중기 결과에 대해 알아보고자 하였다. 대상 및 방법: 2000년 3월부터 2004년 2월까지 류마티스성 승모판막질환과 동반된 만성 심방세동 환자에서 승모판막수술과 동시에 냉동절제술을 이용하여 변형 maze술을 받은 177명의 환자를 대상으로 Cox-maze III (CM군, n=88), Kosakai-maze (KM군, n=63), 그리고 Left atrial maze (LA군, n=26) 세 군으로 분류하여 수술 전, 후 결과 및 동율동 회복률과 중기 결과에 대해 후향조사하였다. 결과: 술 후 병원 사망은 CM군 2명(2.3%)과 KM군 1명(1.6%)을 포함한 3명(1.7%)에서 있었으며 술 후 합병증 발생률에서 세군 간에 차이는 없었다. 총 체외순환 및 대동맥차단 시간은 CM군에서 다른 두 군에 비해 유의하게 길었다(p<0.0001). 생존자 174명에서 평균 $22.4{\pm}15.1$개월($1\sim52.6$개월)을 추적조사한 결과 만기 사망은 CM군 1명(0.6%)에서 있었다. 마지막 추적조사에서 동율동 회복률은 전체환자의 79.9%, CM군 77.9%, KM군 80.7% 그리고 LA군에서는 84.6%였다(p=0.743). 술 후 4년 동안 뇌졸중으로부터의 자유도는 CM군 $84.6{\pm}9.4%$, KM군 $95.0{\pm}:4.9%$ 그리고 LA군에서는 $92.9{\pm}6.9%$였다(p=0.916). 결론: 류마티스성 승모판막질환과 동반된 만성 심방세동 치료에서 승모판막수술과 동반하여 시행하는 냉동절제술을 이용한 변형 maze 술식들은 비교적 안전하게 시행될 수 있으며 심방세동 치료에 효과적이다.