• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.73-80
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• 2016

PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.23-28
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• 2011

Purpose: The aim of this study was to evaluate functional gait and pulmonary function of patients with subacute or chronic stroke for aperiod after the onset of stroke. Healthy people of similar ages served as a control group. The study focused on the clinical importance of intervention with cardiopulmonary rehabilitation treatment in patients with stroke. Methods: The standard time period used to differentiate the subacute and the chronic stroke groups was six months. Each group, including the control, was allocated 11 subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume at one second ($FEV_1$) were measured with a spirometer for each subject. Walk tests (10 m and 6 min) and functional gait tests were then conducted. Results: Significant differences were noted for VC, FVC, and $FEV_1$ between the subacute stroke group and the normal group and between the chronic stroke group and the normal group (p<0.05), but no significant difference was evident between the subacute stroke group and the chronic stroke group (p>0.05). No significant difference was seen between the subacute stroke group and the chronic stroke group in the 6min walk test (p>0.05), whereas a significant difference was observed between the subacute stroke group and the chronic stroke group in the 10 m walk test (p<0.05). Conclusion: The general rehabilitation treatment is effective with respect to functional aspects, but it has limited effect in improving pulmonary function and muscular endurance. Therefore, additional intervention of cardiopulmonary rehabilitation is necessary in the rehabilitation treatment process of patients with stroke.

• Journal of Biomedical Engineering Research
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• v.29 no.2
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• pp.114-121
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• 2008

Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation. In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that tractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.

• Physical Therapy Rehabilitation Science
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• v.2 no.2
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• pp.81-86
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• 2013

Objective: The objective of this study was to investigate the feasibility and effects of balance training using a newly developed elastic band orthosis (aider) for improvement of mobility and balance in chronic stroke patients. Design: Cross-sectional study. Methods: Ten patients with chronic hemiplegia participated in this study. There were six males and four females; two patients had right hemiplegia and eight had left hemiplegia. This study investigated the effect of the elastic band orthosis on balance and gait ability compared with bare foot condition. Gait parameters were measured using the opto-gait system for analysis of the spatial and temporal parameters of walking in stroke patients. In addition, balance ability in stroke patients was evaluated using the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Results: This study investigated the effect of the elastic band orthosis on balance compared with bare foot condition. The TUG and BBS showed significant improvement with use of the elastic band orthosis (p<0.05). Use of the Elastic band orthosis resulted in significantly improved velocity, cadence, less-affected step length, less-affected stride length, and less-affected single limb support in stroke patients (p<0.05). Conclusions: We demonstrated a significant improvement in dynamic balance and gait ability in chronic stroke patients using the elastic band orthosis. This orthosis may aid in prevention of spastic foot drop, leading to improvement of walking ability.

• Physical Therapy Korea
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• v.22 no.2
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• pp.59-69
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• 2015

The purpose of this study was to identify the effects of an upper extremities group exercise program based on motor learning in chronic stroke patients and to assess improvements in upper sensory motor function and activities of daily living (ADL). Five chronic stroke patients participated for the duration of 25 weeks. On the assessment of motor and process skills, there was a statistically significant improvement in motor area functioning in 4 of the subjects. In process area functioning, there was a statistically significant change in 3 of the subjects. Therefore, further studies are needed to assess sensorimotor area and ADL changes in chronic stroke patients to reduce medical cost and assess for positive psychological changes.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.185-190
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• 2020

Purpose: Gait and cognitive impairment in stroke patients exacerbate fall risk and mobility difficulties during multi-task walking. Virtual reality can provide interesting and challenging training in a community setting. This study evaluated the effect of community-based virtual reality gait training (VRGT) using a 360-degree image on the gait ability of chronic stroke patients. Methods: Forty-five chronic stroke patients who were admitted to a rehabilitation hospital participated in this study. Patients meeting the selection criteria were randomly divided into a VRGT group (n=23) and a control group (n=22). Both these groups received general rehabilitation. The VRGT group was evaluated using a 360-degree image that was recorded for 50 minutes a day, 5 days per week for a total of 6 weeks after their training. The control group received general treadmill training for the same amount of time as that of the VRGT group. The improvement in the spatiotemporal parameters of gait was evaluated using a gait analyzer system before and after training. Results: The spatiotemporal gait parameters showed significant improvements in both groups compare with the baseline measurements (p<0.05), and the VRGT group showed more improvement than the control group (p<0.05). Conclusion: Community-based VRGT has been shown to improve the walking ability of chronic stroke patients and is expected to be used in rehabilitation of stroke patients in the future.

• PNF and Movement
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• v.13 no.4
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• pp.175-180
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• 2015

Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.

• PNF and Movement
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• v.18 no.1
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• pp.133-141
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• 2020

Purpose: The purpose of this study was to conduct balance training through vision control to improve the balance, postural control, and balance confidence and to decrease the visual and sensory dependence of stroke patients. Methods: Twenty-eight chronic stroke patients volunteered to participate in the study. They were randomly assigned to the eyes-closed and the eyes-open training groups. Three times a week for four weeks each group performed an unstable-support session and a balance training session for thirty minutes per set. Their balance, postural control, and balance confidence were assessed using BIO Rescue (BR), the postural assessment scale for stroke (PASS), and the Korean activity-specific balance confidence scale (K-ABC), respectively. All data were analyzed using SPSS version 22.0. Statistical methods before and after working around the average value of each dataset were independent T-test. The significance level for statistical analyses was set at 0.05. Results: Comparison between the groups showed statistically significant effects on all variables before and after the intervention (p < 0.05). Conclusion: This study reflected that balance-training programs involving vision control improve the balance, postural control, and balance confidence of chronic stroke patients. Thus, stroke patients should undergo training programs that increase the use of their other senses with vision control in clinical practice.

• PNF and Movement
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• v.19 no.2
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• pp.287-301
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• 2021

Purpose: Gait training for stroke patients focuses on adjusting to new environments to facilitate outdoor walking. Therefore, the purpose of this study was to identify the effects of various ground obstacle walking combined with treadmill walking on the gait parameters and functional gait ability of chronic stroke patients. Methods: Twenty-four chronic stroke patients were divided into two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group received a combined gait training using various ground obstacle walking and treadmill walking (VGOW) five times/week for four weeks. The control group received traditional treadmill training (TW) five times/week for four weeks. Patients were evaluated using the figure-8 walk test (F8WT) and the Functional Gait Assessment (FGA) before and after each intervention. Results: The ANCOVA results showed that both treatments significantly influenced F8WT steps, F8WT time, and FGA score. The paired t-test results showed a significant improvement in F8WT steps, F8WT time, and FGA score in the experimental group compared to those in the control group. Conclusion: Combined gait training using various ground obstacle walking and treadmill walking can improve gait ability in chronic stroke patients.

• The Journal of Korean Physical Therapy
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• v.21 no.1
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• pp.9-17
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• 2009

Purpose: The purpose of this study was to determine reliability and validity of the Postural Assessment Scale for Stroke Patients (PASS) in chronic stroke patients. Methods: A total of 43 stroke patients, who had a stroke more than 6 months previously, participated in the study. Reliability was determined by the intra-class correlation coefficient (ICC$_{3,1}$), Bland and Altman method and Cronbach's alpha by internal consistency. Validity was examined by correlation the PASS scores to the Berg Balance Scale (BBS), Trunk Control Test (TCT), and Fugl-Meyer Balance (FM-B) score. Results: The intra-rater reliability and the Absolute reliability of the PASS was good ICC$_{3,1}$=0.97 (95%CI 0.95$\sim$0.99) and excellent SEM=1.01 respectively. Cronbach's alpha value for PASS was found to be 0.94. There were significant correlations between the PASS and BBS, TCT, FM-B (r=0.65－0.96, p<0.01). Conclusion: The PASS provide reliable and valid instrument of the postural control assessment for chronic stroke patients.