• Therapeutic Science for Rehabilitation
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• v.6 no.1
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• pp.25-33
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• 2017

Objective : The purpose of this study were to investigate perception of occupational therapist and the current conditions about bilateral upper extremity training for patients with stroke. Methods : A survey was conducted on 10 occupational therapists for a month from June, 2016. The questionnaire was consisted total 17 items including 5 area related to characteristics of occupational therapist and patient, bilateral activities with difficulty to perform, bilateral activities used in bilateral training, and bilateral activities which are wanted for therapist to apply in bilateral training. Results : Drive a nail was bilateral activity with difficulty to perform for stroke patient, and unscrew lid of jar was bilateral activity used in bilateral training by occupational therapists. Also, wash one's face was bilateral activity wanted for therapists to use for bilateral training. Conclusions : This study will be used as basic data to select the bilateral upper extremity activities for bilateral upper extremity training.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.57-62
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• 2022

Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.

• Therapeutic Science for Rehabilitation
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• v.2 no.1
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• pp.36-47
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• 2013

Objective : To identify the effect of bilateral arm training for activities of daily living(ADL) of the chronic phase after stroke. Methods : 20 patients with stroke, randomized to an experimental group(n=10) and a control group(n=10). Both groups received the usual occupational therapy. In addition, an experimental group received an bilateral arm training, 30-min sessions per a day for 6 weeks. The Functional Independence Measure(FIM) was used to evaluate ADL for both groups. Results : First, there is a significant difference before and after receiving the bilateral arm training(p <.05). Second, there are significant differences in all ADL areas of Self-care, Transfer, Social cognition after bilateral arm training(p<.05). Third, there are significant differences in all sub-areas of Self-care, only stairs of Locomotion, and only Problem solving of Social cognition by comparing sub-areas as bilateral arm activity(before and after) and occupational therapy intervention(before and after). Conclusion : Using bilateral arm training for the chronic phase after stroke improved their abilities of ADL. Therefore, there are an expectation to use bilateral activity training for the chronic after stroke clinically and a need of further study about bilateral arm training related to ADL in the future.

• Journal of Biomedical Engineering Research
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• v.28 no.1
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• pp.139-147
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• 2007

The aim of this study was to evaluate effects of short-tenn repetitive-bilateral excercise on the activation of motor network using functional magnetic resonance imaging (fMRI). The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer Assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1); and (2) passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral sensorimotor cortex but increased in contralateral sensorimotor cortex and ipsilateral cerebellum. Task 2 showed cortical reorganizations in bilateral sensorimotor cortex, premotor area, supplemetary motor area and cerebellum. Therefore, this study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral excercise using the symmetrical upper-limb ann motion trainer.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.374-378
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• 2021

Objective: Bilateral movement training is an effective method for upper extremity rehabilitation of stroke. An approach to induce bilateral movement through functional electrical stimulation is attempted. The purpose of this study is to develop an EMG-triggered functional electrical stimulation device for upper extremity bilateral movement training in stroke patients and test its feasibility. Design: Feasibility and Pilot study design. Methods: We assessed muscle activation and kinematic data of the affected and unaffected upper extremities of a stroke patient during wrist flexion and extension with and without the device. Wireless EMG was used to evaluate muscle activity, and 12 3D infrared cameras were used to evaluate kinematic data. Results: We developed an EMG-triggered functional electrical stimulation device to enable bilateral arm training in stroke patients. A system for controlling functional electrical stimulation with signals received through a 2-channel EMG sensor was developed. The device consists of an EMG sensing unit, a functional electrical stimulation unit, and a control unit. There was asymmetry of movement between the two sides during wrist flexion and extension. With the device, the asymmetry was lowest at 60% of the threshold of the unaffected side. Conclusions: In this study, we developed an EMG-triggered FES device, and the pilot study result showed that the device reduces asymmetry.

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.520-530
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• 2020

The purpose of this study was to investigate the effects of occupation-based bilateral upper extremity training and transcranial direct current stimulation on upper limb function in stroke patients. The study group was divided into 13 experimental groups with occupation-based bilateral upper extremity training and transcranial direct current stimulation, and 13 controls with only occupation-based bilateral upper extremity training. A total of 4 weeks, 50 minutes, 5 times a week conducted, the patients were tested with Canadian Occupational Performance Measure(COPM), Accelerometer, Fugle-Meyer Assessment(FMA), and Motor Activity Log(MAL). As a result of the study, the experimental group and the control group showed significant improvement in both occupation satisfaction and performance, usage of the affected side and the tendon side, recovery of upper limb function, and quality of movement, In particular, the experimental group showed a significant difference in the amount of the affected side than the control group. Therefore, it was found that the combination of occupation-based bilateral upper extremity training and transcranial direct current stimulation had a positive effect on the recovery of upper limb function in stroke patients.

• Therapeutic Science for Rehabilitation
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• v.6 no.1
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• pp.35-43
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• 2017

Objective : To identify the effect of symmetrical and asymmetric bilateral training For stroke patients in upper extremity recovery. Methods : 15 patients with stroke, randomized to an in- phase group(n =7) and anti-phase group(n =8). Each groups received symmetrical and asymmetric bilateral training, 30-min sessions per a day for 5 weeks, total 20 session.Accelerometer was used to evaluate the amount used for both groups. Y-BAT was used to evaluate performance status and satisfaction, ARAT was used to evaluate hand function. Results : the amount used of symmetrical movement training showed significant changes in affected and unaffected side. asymmetric bilateral training. there is a significant difference in affected side before and after receiving asymmetric bilateral training. Also, There was a significant difference between the groups on the affected side. Both training, there was no significant difference in performance, satisfaction, and upper limb function between group but, there was significant differences within-groups, Conclusions : Symmetric training showed higher motor performance than asymmetric training, but, To obtain a clearer difference, it would be necessary to use a neuromuscular assessment tool such as fMRI. Also, need a clearer training protocol and the need for follow-up studies on more stroke patients is suggested.

• Therapeutic Science for Rehabilitation
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• v.6 no.2
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• pp.47-58
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• 2017

Objective : The purpose of this study is to observe effects of Occupation-Based bilateral UE training for chronic stroke. Methods : 4 patients with hemiplegic stroke were divided into two groups: experimental group and control group. From May to August 2016, we conducted a occupation - based bilateral UE training and a traditional bilateral UE training for 5 weeks, 3 times a week, and 60 minutes per session for each subject. EMG, accelerometer, ARAT, Y-BAT, SIS, and COPM were performed before and after the intervention. Results : The experimental group showed a large changes before and after intervention in ECR, DA and all items except for hand function and memory of SIS, compared with the control group. Also, the experimental group showed a large change before and after the intervention compared to the control group in the accelerometer measuring the amount used of bilateral hand and grasp, pinch, and gross movement items of ARAT and COPM, Y-BIT. Conclusions : Occupation-based bilateral upper extremity training was effective in the recovery of upper limb function and social participation through neurological changes. Future research will be required development studies to ensure a high content validity of the Occupation-based bilateral upper extremity training protocol.

• Journal of Life Science
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• v.18 no.1
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• pp.30-37
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• 2008

The purpose of this study was to investigate the effect of Isotonic Training and Isotonic isometric complex Training to Knee joint Isokinetic muscle function in the high-school Taekwondo athlete. This subjects were randomly divided into two groups; a Isotonic Training group (n=7) Isotonic isometric complex Training group (n=7), Taekwondo athletes share each, 12 weeks between executes a motion. peak torque, H/Q ratio, bilateral muscular ratio muscular endurance of knee joint measured. For this study, two-way ANOVA with repeated measure were used. The result of this study presents between groups was not plain difference expressed. H/Q ratio, bilateral muscular ratio, muscular endurance was plain difference expressed after 12 weeks point of time (p>0.05) and peak torque was plain difference expressed (p<0.05). Conclusion each group did not appear all but one (peak torque), but point of view exercise was effect H/Q ratio, bilateral muscular ratio, muscular endurance, peak torque plain difference expressed.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.106-112
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• 2017

Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions: The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.