• Journal of The Korean Society of Integrative Medicine
• /
• v.6 no.2
• /
• pp.1-16
• /
• 2018

Purpose : This meta-analysis was aimed at guiding future research in stroke treatment and to provide real-world data relating to the effects of aquatic exercise therapy on balance in patients with chronic stroke. Methods : We performed a meta-analysis comprising 22 studies involving aquatic exercise therapy performed between 2006 and 2017. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publishing bias. Results : The mean effect size was 0.563. The effect size by outcome was observed to be the largest for the functional reach test, followed by the Berg balance scale, balance equipment, the Timed Up and Go test and one leg standing. Meta-regression analysis showed that effect size increased with an increase in the duration, number, length of exercise session. Conclusion : Aquatic exercise therapy appears to show a moderate effect on balance in patients with chronic stroke. A meta-analysis is warranted for further research to determine the effects of aquatic exercise on walking, muscle strength, and range of motion.

• PNF and Movement
• /
• v.17 no.3
• /
• pp.353-368
• /
• 2019

Purpose: This study investigated the effects of trunk exercise using less-affected extremities on gait and balance in chronic stroke patients. Methods: Thirty subjects with chronic stroke disease were divided into two groups: a trunk exercise group that used less-affected extremities (n=15) and a general trunk exercise group (n=15). All interventions were conducted 30 min a day, 6 times per week, for 3 weeks. Gait parameters were measured before and after the intervention using Zebris FDM-1.5. In addition, all subjects were evaluated using the Trunk Impairment Scale, the Berg Balance Scale, and the Functional Gait Assessment before and after the intervention. Results: Both groups showed improvements on all outcome measured pre- to post-intervention (p<0.05). The groups exhibited significant differences for TIS, BBS, FGA, gait speed, step length, and cadence at post-intervention (p<0.05). Conclusion: This study showed that trunk exercise using less-affected extremities has therapeutic benefits on gait and balance in individuals with chronic stroke disease.

• PNF and Movement
• /
• v.16 no.3
• /
• pp.355-363
• /
• 2018

Purpose: The purpose of this study was to obtain detailed and quantified data concerning the effects of plantarflexor muscle fatigue induced in the non-paretic side on the spatial and temporal gait parameters of the bilateral lower extremities during walking in stroke patients. Methods: This study was conducted on 20 patients with chronic stroke. The load contraction fatigue test was applied to induce muscle fatigue in the non-paretic plantarflexor muscle. Step length, stride length, double support, gait velocity and cadence, and functional ambulatory profile (FAP) score in the bilateral lower extremities were measured using a gait analysis system in order to investigate changes in temporal and spatial gait parameters caused by muscle fatigue on the non-paretic side. The statistical significance of the results was evaluated using a paired t-test. Results: A review of the results for gait parameters revealed a significant increase in double support (p<0.05) and a significant decrease in step length, stride length, gait velocity and cadence, and FAP score (p<0.05). Conclusion: These results indicate that the muscle fatigue in the non-paretic side of the stroke patients also affected the paretic side, which led to a decrease in gait functions. This implies a necessity to perform exercise or training programs in a range of clinical aspects not causing muscle fatigue.

• PNF and Movement
• /
• v.10 no.1
• /
• pp.25-33
• /
• 2012

Purpose : The purpose of this study was to compare the effect of treadmill training and cognitive task with in the course of treadmill training at the same time with chronic stroke patients. Methods : Fourteen chronic stroke patients participated. Participants were randomly assigned to the control and experimental group(7 experimental, 7 control). All of participants were in-patients at local hospital and had been receiving a traditional rehabilitation program, five days a week. The both groups have undergone 4weeks. The experimental group trained in treadmill and cognitive task at the same time, but control group trained only treadmill. 10m walking test, Timed Up & Go (TUG) test and 6 Minutes walking(6M walking) test to measure the walking speed, dynamic balance and waling endurance ability were carried out before and after the training. Results : The result of the study were as follow:10m walking test were significantly increased both groups(p<.01), but not significant between groups(p>.05). TUG test were significantly increased both groups(p<.001) and between groups(p<.01). 6M walking test were significantly increased both groups(p<.001), but not significant between groups(p>.05). Conclusion : Ahead of return to the community to patients with stroke, cognitive task with in the course of treadmill training at the same time was effective in improving the dynamic balance ability.

• PNF and Movement
• /
• v.18 no.3
• /
• pp.445-452
• /
• 2020

Purpose: The purpose of this study was to evaluate the analysis of the association between upper extremity function and the Wolf Motor Function Test (WMFT) for chronic hemiparetic stroke patients and investigate the evidence of the WMFT as a clinical tool of upper extremity function in individuals with chronic hemiparetic stroke. Methods: This study applied an observational, cross-sectional design in outpatients at three local rehabilitation units in Seoul. Forty-nine individuals who had a diagnosis of first stroke participated in this study. All participants were analyzed for four clinical measures, including the Box and Block Test (BBT), the WMFT, grip strength, and the Canadian Occupational Performance Measure (COPM). Results: Upon analysis, a significant relationship was found between the WMFT scores and BBT scores as well as the grip strength. The WMFT score was statistically and positively associated with the COPM satisfaction score; however, it was not related to the COPM performance score. Conclusion: The results of this study suggest that the WMFT is positively related to simple tasks, such as hand muscle strength and manual dexterity. However, the WMFT does not have a relationship with complex tasks, which are measured by COPM performance abilities.

• Biomolecules & Therapeutics
• /
• v.30 no.1
• /
• pp.55-63
• /
• 2022

Oleanolic acid (OA), a natural pentacyclic triterpenoid, has been reported to exert protective effects against several neurological diseases through its anti-oxidative and anti-inflammatory activities. The goal of the present study was to evaluate the therapeutic potential of OA against acute and chronic brain injuries after ischemic stroke using a mouse model of transient middle cerebral artery occlusion (tMCAO, MCAO/reperfusion). OA administration immediately after reperfusion significantly attenuated acute brain injuries including brain infarction, functional neurological deficits, and neuronal apoptosis. Moreover, delayed administration of OA (at 3 h after reperfusion) attenuated brain infarction and improved functional neurological deficits during the acute phase. Such neuroprotective effects were associated with attenuation of microglial activation and lipid peroxidation in the injured brain after the tMCAO challenge. OA also attenuated NLRP3 inflammasome activation in activated microglia during the acute phase. In addition, daily administration of OA for 7 days starting from either immediately after reperfusion or 1 day after reperfusion significantly improved functional neurological deficits and attenuated brain tissue loss up to 21 days after the tMCAO challenge; these findings supported therapeutic effects of OA against ischemic stroke-induced chronic brain injury. Together, these findings showed that OA exerted neuroprotective effects against both acute and chronic brain injuries after tMCAO challenge, suggesting that OA is a potential therapeutic agent to treat ischemic stroke.

• Journal of The Korean Society of Integrative Medicine
• /
• v.2 no.4
• /
• pp.49-58
• /
• 2014

Purpose : The purpose of this study was to research the effects on resistance CKC & OCK exercise method on lower limb muscle activity, in chronic stroke patients. Method : In this study, 18 patients with stroke caused by hemorrhage or infarction were participated. resistance exercise method was conducted in tow different group : one is a close kinetic chain exercise(CKC) group and the other is an open kinetic chain exercise(OKC) group. CKC with physical therapy was applied to 9 patients, and OKC with physical therapy was applied to 9 patients. Under the researcher's guidance, exercise for CKC and OKC group carried out 3 times a week for 30 minutes during 4weeks. Result : There was significantly different for the vastus lateralis, tibialis anterior and gastrocnemius muscle activity within the intervention period both group. The vastus lateralis, tibialis anterior and gastrocnemius muscle activity was significantly increased within the CKC group. The vastus leteralis and tibialis anterior muscle activity was significantly increased within the OKC group. Conclusion : It was confirmed in this study that the CKC exercise was more effective than OKC exercise in improving lower limb muscle activity of chronic stroke patients. This study seggested that CKC may be suitable for individuals with a chronic stroke. furthermore study should be made a lot of researches regarding in other method and varying conditions for many hemiplegic patients.

• Korean Journal of Applied Biomechanics
• /
• v.23 no.3
• /
• pp.253-259
• /
• 2013

The purpose of this study is to evaluate the influence of posture elements on symmetrical weight bearing during STS (sit-to-stand) in patients with chronic stroke. The subjects were patients diagnosed with stroke: a total of 24 patients (16 males and 8 females) participated in this study. All the participants performed STS tasks(3 foot postures and 2 arm postures). Two force plates (AMTI) were used to measure the peak vertical ground reaction force(Peak Fz) and the symmetrical ratio to peak vertical ground reaction force. The data were analyzed using independent t-test and 2-way repeated analysis of variance. The results of this study were as follows: 1) The peak Fz placed more weight on the paretic leg during STS and 2) The symmetrical ratio to the peak Fz showed a significant difference according to the foot and arm posture (p<.05), and had the highest AYM_GA ($0.87{\pm}0.12$). These results indicate that arm and leg postures during STS in patients with chronic stroke had the highest AYM_GA. We believe that the outcome of this study will be a reference for the prognosis of STS in patients with stroke.

• Physical Therapy Rehabilitation Science
• /
• v.8 no.2
• /
• pp.112-123
• /
• 2019

Objective: Based on the results of previous studies, it is necessary to analyze gait and discuss and present the effects of aquatic exercise for chronic stroke. The purpose of this study was to present objective data on the effect of aquatic exercise on the gait of persons with stroke by performing a meta-analysis. Design: A systematic review and meta-analysis. Methods: We performed a meta-analysis of 23 studies that investigated the effects of aquatic exercise performed between 2006 and 2017. The studies were searched on the basis of the participants, intervention, comparison, outcomes standard. The quality of the research method was assessed using a tool that can assess the risks posed by each study design. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publication bias. Results: The mean effect size of the patients' gait was 0.65 (p<0.05). The largest effect size by outcome was observed at the 6-m walk test, followed by the 6-minutes walk test, 10-m walk test, and the walking equipment test (p<0.05). The meta-regression analysis showed that the effect size increased with increased duration, number, and length of sessions. Conclusions: Aquatic exercise appears to show a moderate effect on the gait of chronic stroke survivors. Meta-analyses on the effects of aquatic exercise in other patient populations are needed. This study suggests standard criteria establishments for the effect of aquatic exercise on the walking ability of persons with chronic stroke.

• Physical Therapy Korea
• /
• v.26 no.2
• /
• pp.49-60
• /
• 2019

Background: After stroke, in order to improve gait function, it is necessary to increase the muscle strength and to enhance the propriocetive function of the lower extremity. Objects: This study aimed to compare the effects of open kinetic chain (OKC) versus closed kinetic chain (CKC) isokinetic exercise of the hemiparetic knee using the isokinetic equipment on lower extremity sensorimotor function and gait ability in patients with chronic stroke. Methods: Thirty participants with chronic hemiplegia (> 6 months post-stroke) were randomly divided into 2 equal groups: CKC group and OKC group. Patients from both groups attended conventional physiotherapy sessions 3 times a week for 6 weeks. Additionally, subjects from the CKC group performed isokinetic exercise using the CKC attachment, while those from the OKC group performed isokinetic exercise using the OKC attachment. The isokinetic knee and ankle muscles strength, position sense of the knee joint, and spatiotemporal gait parameters were measured before and after interventions. Results: The knee muscles peak torque/body weight (PT/BW) and hamstring/quadriceps (H/Q) ratio significantly increased in both groups (p<.01). In particular, ankle plantarflexors PT/BW, position sense of the knee, gait velocity, and spatial gait symmetry significantly improved in the CKC group (p<.01, p<.05, p<.01, and p<.01, respectively). Conclusion: CKC isokinetic exercise can be an effective therapeutic intervention for the improvement of sensorimotor function of the lower extremity and gait functions, such as gait velocity and symmetry. CKC position in isokinetic strength training is effective to improve functional ability in patients with chronic stroke.