• Therapeutic Science for Rehabilitation
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• v.1 no.2
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• pp.14-22
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• 2012

Introduction : The purpose of scholarly paper is to review of motor learning concepts and to examine in integration of motor learning research finding in occupational therapy services for adults with hemiplegia. Body : The principles of motor learning is stage of learning, type of task, practice and feedback. Depending on stage of learning, therapist need to apply of the principles. In early stage of learning, therapists should be promote patient's awareness about therapeutic goals, task performance environment and how to perform. Whole practice, blocked practice and constant practice improve performance skill. In the latter stage of learning, therapists have to design a intervention protocol for patient to use the implicit feedback. Random practice and open task facilitates performance skills. Conclusion : When establishing the a intervention plan for adults with hemiplegia, therapists should systematically developed the principles of motor learning. Intervention program must be established by applying the principles of motor learning in accordance with the learner's level of task performance, and modified depending on the therapeutic progress.

• Physical Therapy Korea
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• v.14 no.4
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• pp.50-57
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• 2007

The purpose of this study was to investigate the relationship between delays in initiation and termination of tibialis anterior contraction through surface electromyographic (sEMG) analysis in adults with hemiplegia and healthy subjects and clinical assessment of lower-limb mobility. EMG activity of 6 long-term survivors of stroke and 5 healthy subjects was recorded during maximal isometric ankle dorsiflexion in 3 seconds beeper signals. It must be done as fast and forcefully as possible. Lower limb mobility was assessed with Modified Emory Functional Ambulation Profile (mEFAP). Delay in initiation and termination of muscle contraction was significantly prolonged in the affected lower limb relative to the unaffected limb. Termination of muscle contraction in the hemiplegic lower limb was significantly delayed than the initiation on the affected sides. Delay in initiation and termination of muscle contraction correlated significantly with a few range of mEFAP. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in hemiparetic patients. Consequently, this study showed that abnormal delay of initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in adults with hemiplegia. Further studies are needed to demonstrate a treatment effect.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.145-153
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• 2022

Objective: The purpose of this study was to evaluate the Electromyography (EMG) of the upper limb during reaching tasks according to two heights in the sitting position. Design: Cross sectional design Methods: Fifteen hemiplegia, fifteen elderly, and fifteen healthy subjects have participated in this study. The targets (90% length of the subject's arm) were located at the two heights (the eye and xiphoid process). We have recorded EMG signals of seven upper limb muscles (anterior deltoid (AD), posterior deltoid (PD), pectoralis major (Pec), infraspinatus (Inf), supraspinatus (Sup), biceps brachii (Bi), triceps brachii (Tri)). The dependent variables were movement time(s), modulation ratio, working ratio, and the co-contraction ratio of the hemiplegia, elderly, and healthy at the reaching task. Two-way repeated-measures ANOVA (2-heights) was analyzed with the LSD post hoc test. Results: The study results were as follows: (1) The movement time to the target during reaching movement was significantly longer for the hemiplegia and elderly groups compared to the healthy group. (2) The modulation rate was significantly higher at eye height than the xiphoid height in AD, PD, Pec, Inf, Bi muscles, and the hemiplegia group and elderly group were significantly lower than the healthy group. Additionally, the modulation ratio showed a significant interaction between heights and groups. Conclusions: It is expected that the variables using the muscle contraction characteristics, the evaluation method of this study, can be used as an electromyography-based feedback method that can be objectively evaluated and quantified in clinical practice.

• Physical Therapy Korea
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• v.17 no.3
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• pp.77-86
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• 2010

The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

• Physical Therapy Korea
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• v.14 no.4
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• pp.84-90
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• 2007

The purpose of this study was to assess the test-retest reliability of heart rate (HR) and velocity measurements during peak effort and free treadmill walking tests in older patients with gait-impaired chronic hemiparetic stroke and control group. Twenty-two adults (13 men, 9 women; mean age, $73.7{\pm}5.2$ yrs) with chronic hemiparetic stroke are the experimental group. Nineteen elderly people (5 men, 14 women; mean age, $72.3{\pm}3.5$ yrs) were recruited as control group. Patients had mild to moderate chronic hemiparetic gait deficits, making handrail support necessary during treadmill walking. Free and peak effort treadmill walking tests were measured and then repeated at least two days later. Reliability was calculated from HR and walking velocity during free and peak effort treadmill walking test. Among the people who had strokes, HR [ICC(2,1)=.85, r=.86] and velocity [ICC(2,1)=.93, r=.93] were good parameters during free testing. Maximal testing generated good results for HR [ICC(2,1)=.81, r=.82] and velocity [ICC(2,1)=.96, r=.96] with the chronic hemiparetic stroke. In elderly people, HR [ICC(2,1)=.59, r=.62] and velocity [ICC(2,1)=.77, r=.76] were moderately reliable during free testing. Maximal testing produced moderate parameters for HR [ICC(2,1)=.74, r=.74] and velocity [ICC(2,1)=.66, r=.66] in the elderly. This study provides that free and maximal treadmill testing produce highly reliable HR and velocity measurements in adults with chronic hemiplegia using minimal handrail support.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.3 no.1
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• pp.1-12
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• 2005

This study aimed at examining the maximal isometric contraction caused by voluntary exercise and at comparing its aspects of decrease and restoration in their different repeated application, as to the quadriceps muscles of thigh in the subjects composed of patients with spastic hemiplegia and normal adults. Using isokinetic exercise analyser(Biodex Medical Systems Inc., Biodex System 3PRO, U.S.A.), experiment was conducted as to the normal group composed of fifteen adults and the patient group composed of fifteen patients with spastic hemiplegia. As to each group, MVIC(maximal voluntary isometric contraction) of the quadriceps muscle of thigh caused by voluntary exercise and the aspects of decrease and restoration of the isometric contraction were examined with the method to induce isometric exercise, and their SDI(strength decrement index) and SRI(strength recovery index) were also calculated. The results can be summarized as follows: 1. As for decrease of maximal isometric contraction, both groups showed slow decrease in voluntary exercise, but the normal group showed rapid decrease later phase. 2. As for SDI, no significant differences could be observed in comparison between groups. 3. As for restoration of maximal isometric contraction, both groups showed slow restoration in voluntary exercise, but the normal group showed rapid restoration early phase. 4. As for SRI, comparison between groups showed significant differences in voluntary exercise. These results lead us to the conclusions that spastic muscle is characterized by slow decrease and restoration of MVIC in comparison with normal muscle in voluntary exercise.

• Journal of Yeungnam Medical Science
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• v.26 no.1
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• pp.78-83
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• 2009

Fibromuscular dysplasiais an uncommon condition of idiopathic, non-inflammatory and non-atherosclerotic disease of the musculature of arterial walls. The disease is rare, but it commonly affects young and middle aged women. Isolated intracranial cerebral fibromuscular dysplasia is extremely rare because cerebral fibromuscular dysplasia usually affects extracranial vessels. A 20-year-old woman was admitted with light hemiplegia and global aphasia. Brain MRI and MRA demonstrated acute left middle cerebral artery territory infarction with a multifocal stenosis and dilatation of the left middle cerebra artery and left internal carotid. The characteristic conventional cerebral angiographic findings demonstrated a typical string-of-beads appearance in the left distal internal carotid artery and proxiaml portion of the left middle cerebral artery, which suggested a medial type fibromuscular dysplasia. We report a case of isolated intracranial fibromuscular dysplasia with left middle cerebral artery territory infarction. Fibromuscular dysplasia should he considered as a stroke risk factors in children and young adults, especially in patients with no known cardiovascular risk factors.

• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.205-211
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• 2016

Purpose: This study investigated the influence of muscle activity of the trunk and lower limb during a bridge exercise using a unstable surface and during one-legged bridge hip abduction in healthy adults. Methods: Nineteen healthy participated in this study (12 males and 7 females, aged $29.0{\pm}5.0$). The participants were instructed to perform the bridge exercises under six different conditions. Trunk and lower limb muscle activation, such as the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO), was measured using surface electromyography. The six different bridge exercise conditions were conducted randomly. Data analysis was performed by using the mean scores after three trials of each condition. Results: On the ipsilateral side, muscle activity of the IO, EO, and ES during the hip abduction condition (Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction, Bridge with use of a sling and single-leg hip abduction) was significantly higher than those during Unstable surface (Bridge with use of a ball, Bridge with use of a sling) and General bridging exercise (p<0.05). In the contralateral side, activities of the GM and EO during Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction and Bridge with use of a sling and single-leg hip abduction was significantly higher than that during Bridge with use of a ball, Bridge with use of a sling and General bridging exercise (p<0.05). Conclusion: This study demonstrated that performing a bridge exercise with use of a sling and single-leg hip abduction had an effect on trunk and gluteal muscle activation. The findings of this study suggest that this training method can be clinically effective for unilateral training and for patients with hemiplegia.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.253-259
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• 1990

Between January, 1970 and August, 1989, a total of 81 patients whose age were more than 20 years of life, received total correction for tetralogy of Fallot. This report analyzed 70 patients among them and excluded the remaining 11 patients whose clinical data could not be found. Their mean age was 25.750.39 years[range 20 \ulcorner50]. The clinical manifestations were cyanosis and clubbing [64 pts], frequent URI[40 pts], anoxic spell [19 pts], infective endo-carditis[4 pts], brain abscess[3 pts], pulmonary tuberculosis[3 pts] and CHF, chest tightness, nephrotic syndrome, left hemiplegia, and tamponade. The types of right ventricular outflow tract obstruction were combined[46 pts], pure infundibular [21 pts] and pure valvular[3 pts]. Associated cardiovascular anomalies were PFO [27 pts], ASDi8 pts], LSVC[8 pts], aortic regurgitation [5 pts], right aortic arch, coronary artery anomalies, PDA and dextrocardia. Hospital mortality was 5.7%. The causes of death ware low cardiac output [2 pts], aggravation of CRF[1 pts] and brain damage[1 pts]. There was one late death because of residual intracardiac shunt and congestive heart failure. During the follow-up period, 16 patients were lost and the remaining 49 patients were asymptomatic and leading normal lives. Residual intracardiac shunt was detected in 5 patients with radionuclide single pass study but all of them had Qp / Qs ratio less than 1.5.

• Physical Therapy Korea
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• v.13 no.3
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• pp.41-48
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• 2006

This study investigated therapeutic effects of pelvic tilt exercise (PTE) on weight bearing and body sway during sit-to-stand (STS) on 18 hemiplegic patients who had visited the Hanyang University Seoul Hospital and Injae University Sanggyebek Hospital physiotherapy rooms. The study compared the patients with 18 normal adults. The subjects were sampled out from those who could get up independently, maintain a standing posture more than 10 seconds, understand the movements of this study and have no difficulty in performing the tasks. By executing STS in a natural way with habitual movements before and after PTE, the weight bearing was measured by using Mediance II. In order to compare the difference of weight distribution, weight bearing and body sway on affected and nonaffected sides during STS before and after PTE, the Wilcoxon Signed Ranks Test was used. The statistical significance level was based on p<.05. The results revealed that the difference of weight distribution in the hemiplegic group was significantly decreased (p<.05), whereas there was no significant difference in the healthy group (p>.05). Weight bearing loaded on the affected side was $42.53{\pm}7.65%$ and $44.20{\pm}6.32%$, respectively, in the hemiplegic group during STS before and after PTE. Weight bearing during STS after PTE is increased significantly, as compared with weight bearing before PTE (p<.05). Body sway in the hemiplegic group was significantly decreased (p<.05). As mentioned, PTE proved to be effective for improvement in weight bearing on the affected side during STS of hemiplegic patients.