• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.1-12
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• 2023

Objective: Although chronic carotid artery occlusion seems to be associated with significant risk of ischemic stroke, revascularization techniques are neither well established nor widespread. In contrast, extracranial-intracranial bypass is common despite the lack of evidence regarding neurological improvement or prevention of ischemic events. The aim of current review is to evaluate the effectiveness of various methods of recanalization of chronic carotid artery occlusion. Methods: Comprehensive literature search through PubMed, Scopus, Cochrane and Web of Science databases performed. Various parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion. Results: 40 publications from 2005 to 2021 with total of more than 1300 cases of revascularization of chronic carotid artery occlusion have been reviewed. Further parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion: mean age, male to female ratio, mean duration of occlusion before treatment, rate of successful recanalization, frequency of restenosis and reocclusion, prevalence of ischemic stroke postoperatively, neurological or other symptoms improvement and complications. Based on proposed through reviewed literature indications for revascularization and predictive factors of various recanalizing procedures, an algorithm for clinical decision making have been formulated. Conclusions: Although treatment of chronic carotid artery occlusion remains challenging, current literature suggests revascularization as single option for verified neurological improvement and prevention of ischemic events. Surgical and endovascular procedures should be taken into account when treating patients with symptomatic chronic carotid artery occlusion.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.364-368
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• 2015

Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.

• Physical Therapy Korea
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• v.18 no.2
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• pp.18-26
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• 2011

The purpose of this study was to investigate the effects of a task-oriented approach on weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement in 18 chronic stroke patients. Both groups were received neurodevelopmental treatment for 30 min/day and then the experimental group ($n_1$=9) followed additional a task-oriented approach (sit-to stand training with controlled environment) and the control group ($n_2$=9) followed a passive range of motion exercise for 15 min/day, five days/week, for four weeks. Weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement were measured before and after four weeks of training. There was significantly improved weight-bearing distribution of the paretic leg during sit-to-stand movement in the experimental group compared with that of the control group after four weeks of training (p<.05). But electromyographic activities of the quadriceps and the tibialis anterior of the paretic leg were not significantly different (p>.05). Thus, it is necessary to apply a task-oriented approach to improve the weight-bearing distribution of the paretic leg during sit-to-stand movement in chronic stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.1
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• pp.207-213
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• 2011

In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

• Research in Community and Public Health Nursing
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• v.17 no.2
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• pp.166-175
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• 2006

Purpose: This study was to evaluate the effects of a rehabilitation exercise program on physical function and mental health status in chronic stroke Patients with hemiparesis Method: This study used a single group experimental design with repeated measures. Data collection and intervention were done from August, 2004 to November. 2004 at a community. Participants were fifteen patients (mean age: 68.6), and a 100 meter walking time and box and block tests were conducted at baseline, 4weeks, and post-intervention (8weeks) Activities of daily living and the levels of depression and anxiety were measured by using SCL-90-R at pre and post Intervention. This program consisted of 1 hour individual exercise 3 times a week for 8 weeks, and it focused on stretching, walking, arm and hand exercise, and hand massage. Result: 1. ADL, IADL, and the 100m walking time in the patients were improved compared with baseline. However. box and block tests was not shown significant improvement compared with baseline. 2. Depression and anxiety scores were improved more than that of baseline. Conclusion: The rehabilitation exercise program can be effective in improving physical function and mental health status, and it has a potential for improving Physical health status in Patients with chronic stroke hemiparesis.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.4
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• pp.9-14
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• 2013

Purpose : The purpose of this study was to investigate the effect of visual Auditory rhythmic stimulation(VARS) in gait ability and proprioception with chronic stroke patients. Twenty-one persons after six months post stroke participated in pre test-post test control. Method : The subjects were randomly assigned to a visual Auditory rhythmic stimulation(VARS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the FRT(functional reach test) by static balance and TUG(timed up and go test) by dynamic balance. Results : In static balance, FRT distance was significantly different between two group. In dynamic balance, TUG time was significantly different between two group. This study showed that the VARS training increase a balance by postural adjustment of chronic stroke patients more than control group. And so, the VARS training of hemiplegic patients was very important to successive rehabilitation. Conclusion : A continuous examination of VARS training could practical used of physical therapy with exercise.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.351-367
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• 2005

The purpose of this study was to identity effects of virtual reality(VR) program related to standing postural control on balance, gait and brain activation patterns in chronic hemiplegic stroke patients. Subjects were assigned randomly to either VR group (n=12) or the control group (n=12) when the study began. Both groups received conventional physical therapy for 2 to 3 times per week. In addition to conventional physical therapies, VR group trained 3 types of virtual reality programs using IREX for standing postural control during 4 weeks (4 times/week, 30 minutes/time). Subjects were assessed for static and dynamic balance parameters using BPM, functional balance using Berg Balance Scale related to movement of paretic lower limb before and after 4 weeks of virtual reality training. The results of this study were as follows. 1. Following VR training, VR group demonstrated the marked improvement on dynamic mean balance, anteroposterior limits of stability (AP angle) and mediolateral limits of stability (ML angle). 2. Following VR training, both groups scored higher on Berg Balance Scale. However, a comparison of mean change revealed differences between groups. In conclusion, these data suggest that the postural control training using VR programs improve dynamic and functional balance performance in chronic hemiplegic stroke patients.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.11 no.1
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• pp.7-12
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• 2013

Purpose : The purpose of this study was to identify effects of virtual reality-based closed kinetic chain (CKC) exercise on lower extremity muscle activity in chronic stroke patients Methods : Subjects were assigned randomly either to VR+CKC exercise group (n=15) or the CKC exercise group (n=15). When the study began, both groups received conventional physical therapy five times per week. The VR+CKC exercise group received virtual reality programs and the CKC exercise group received close kinetic chain exercises. Each exercise program was performed for six weeks (5 times per weeks; 20 minutes per time). Participants were measured on lower extremity muscle activity using EMG. Results : There was a significant increase of muscle activity (%RVC) in vastus lateralis and vastus medialis. Conclusion : In this study, the virtual reality-based closed kinetic chain exercise program was an effective exercise for improving lower extremity muscle activity in chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.169-175
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• 2019

Purpose: This study examined the effects of a spiral elastic band for the walking function on patients with chronic stroke. Methods: Twenty one chronic stroke patients were recruited and divided randomly into the experimental group and control group. Both groups performed mat exercises and gait training three times a week for four weeks, and gait training was applied to the experimental group with additional spinal elastic bands. Results: The results of this research were as follows. The 10MWT measurements showed that the velocities within and between the groups decreased significantly, and the results of TUG showed significant decreases in velocities after the interventions in both the control group and experimental group. On the other hand, there were no significant differences between the control and experimental group. The FRT measurements showed significantly increased stride lengths within and between the groups. The measurements of the stride length, stride velocity, cadence, and step length showed significant improvement within the groups, but there was no significant difference between the groups. The measurement of stance showed that the non-paralytic patients had a significant increase in the rates within the groups and a significant difference was observed between the groups. Conclusion: Spiral elastic bands are an effective intervention method for rehabilitation programs to enhance the walking function in the clinical field. A treatment needs to be developed for patients with walking problems due to various disorders by investigating the action mechanism of spiral elastic bands.

• Journal of Korean Academy of Medicine & Therapy Science
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• v.10 no.2
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• pp.21-30
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• 2018

Objective: The purpose of this study was to investigate questions and instructions for internal feedback effects on functional recovery and task performance while chronic stroke patients practised task-specific training. Method: Twenty-four chronic stroke patients were randomly divided into two groups; when patients performed same tasks, one was treated using questions and the other using instructions for internal feedback Both lasted 30 minutes, 5 times a week for 8 weeks. Outcome measures included Erasmus MC Modifications to the Nottingham Sensory Assessment (EmNSA), Measurement Properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), Chedoke Arm and Hand Activity Inventory (CAHAI), Korean version of Modified Barthel Index (K-MBI). Results: There were no significant differences between the two groups in EmNSA and K-MBI(p>.05). But, in MESUPES and CAHAI, there was significant difference between the two groups(p<.05). Conclusion: In this study, questions for internal feedback during task-specific training are more effective in improving upper extremity motor function and task performance than instructions for internal feedback.