• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.13-16
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• 2005

Background: The purpose of this study is to investigate the effect of the intensive functional electrical stimulation(FES) on the improvement of the gait pattern of the chronic hemiplegic patients. Method: Six hemiplegic patients, who could walk independently but have equinovarus deformity during the gait cycle, participated in this study. The affected peroneus longus and tibialis anterior muscles of all subjects were stimulated for 2 weeks period (20 minutes duration, 6 times/day). We measured the activities (mean voltage) of those muscles during the walking, using dynamic EMG. Results: After treatment, there were significant improvements in the strength of peroneus longus and tibialis anterior muscles and the gait speed, but there was no interval change of the spasticity of plantar flexor. The mean voltages of two muscles are significantly increased in all the patients (p<0.05). Conclusion: The results showed that the intensive FES on affected peroneus longus and tibialis anterior muscles in chronic hemiplegic patients could be useful for the improvement of functional gait.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.1
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• pp.9-17
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• 2011

Purpose : The purpose of this study was to compare the effects of performing feedback vs repeative tasks on lower extremity motor function and falls efficacy in chronic hemiplegic patients. Methods : 40 hemiplegic patients took part in this study. The average age of the feedback-task group was 68.45 years and 68.20 in the repeative-task group. All subjects participated in the study for 8 weeks, doing exercises 3 per day per week. All participants were assessed by using the Berg balance scale (BBS), the lower-extremity subscale of the Fugel-Meyer assessment of sensorimotor impairment (FMLE), and the falls efficacy scale (FES). The data were analyzed using a paired t-test. Results : After 8 weeks of exercise training, the results of this study were: the BBS and FMLE of hemiplegic patients showed a feedback-task and repeative-task groups (p<0.05). The FES of hemiplegic patients also showed a significant difference between the quantitative-task and qualitative-task groups (p<0.05). Conclusion : We present findings suggesting that chronic hemiplegic patients could improve their standing balance ability better through a feedback-task exercise program, as opposed to a repeative-task exercise program.

• Physical Therapy Korea
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• v.13 no.3
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• pp.67-74
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• 2006

The purpose of this study was to investigate the effects of walking aid on hemiplegic gait of chronic stroke patients. Twelve stroke patients participated in this study. Physiological cost index (PCI), gait speed, and climbing stairs with and without walking aid were measured and analyzed. The results showed that walking with walking aid significantly improved gait speed and reduced physiological cost index and time needed to climb stair (height 7 cm) in comparison with a walking without walking aid. In conclusion, walking aid may improve the speed and efficiency of hemiplegic gait in chronic stroke patients.

• Journal of Korean Academy of Nursing
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• v.36 no.2
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• pp.403-414
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• 2006

Purpose: The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E. Method: A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal. Result: After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups. Conclusion: The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.246-249
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• 2004

The purpose of this study was to investigate the characteristics between EMG timing of muscle contraction and motor impairment in chronic hemiplegic stroke patients. Delay time and co-contraction of 4 patients who had stroke less than 3 years were measured during isometric wrist flexion and extension along the 3 seconds beep signal. Onset and offset of muscle contraction were significantly delayed on the more affected sides than control sides. Offset was significantly delayed than the onset on the affected sides in wrist flexion. Also, recruitment of antagonist was larger than agonist on the affected sides. Co-contraction ratio on the affected side was significantly smaller than control sides in wrist flexion. In affected sides, Fugl-Meyer motor assessment(FMA) shows the correlation of onset delay in wrist flexion and extension. However, co-contraction ratio correlated with FMA in wrist flexion. EMG assessment is likely to be useful outcome measure and provide insights into mechanism for motor recovery in stroke patients.

• PNF and Movement
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• v.11 no.1
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• pp.7-16
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• 2013

Purpose : The purpose of this study is to analyze the effect of the proprioceptive exercise program on balance performance in order to the suggest hemiplegic patients the therapeutic intervention. Methods : In this study, Proprioceptive exercise program was applied to 11 hemiplegic patients for 6 weeks as follows: First of all, hemi leg flexion-extension pattern was applied in a supine position. Secondly, alternated leg flexion pattern was applied in a standing posture with one hand support on the unstable platform. Thirdly, rhythmic stabilization techniques were applied in a standing posture on the unstable platform. Results : Significant differences were observed the chronic low back pain patient for VAS, BBS. Chronic low back pain patient improved all test. The results of this study were summarized as follows: 1. After intervention, there was a statistically significant change in the dynamic balance (FSST, TUG, FRT) performance(p<.05). 2. After intervention, there was also a statistically significant change in the static balance (FICSIT-4) performance(p<.05). Conclusion : The result of the study suggests that muscle strength exercise by the intervention of proprioceptive exercise program improves the hemiplegic patients' static and dynamic balance performance.

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

Purpose : The purpose of this study is to investigate the impact on the ability to walk, balance after side walking training of hemiplegic patients caused by stroke. Method : The subjects were training before stroke onset whether more than one year elapsed 15 patients with chronic stroke patients, and Berg balance scale(BBS) and Timed up and go test(TUG), Functional reaching test(FRT), 20m walking time 200m walking time were measured and recorded. Training period, a total of three weeks, and training frequency circuit training times 10 minutes per training, 5-minute break, the 10-minute training total 25-minute training was conducted. Gait line of 3m to be based on the patient's side walking, and the risk of falling compared to the presence of the experimenter trained under was carried out. Result : 1. TUG, 2. 20m walking time, 3. 200m walking time 4. FRT, 5. All showed significant improvement in BBS. Judging from the results, the side walking training conducted three weeks due to chronic stroke hemiplegic patient's ability to balance and showed a positive effect on the improvement of walking ability. Conclusion : Accordingly, it was more effective to train hemiplegic patients with chronic stroke on side walking.

• Physical Therapy Korea
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• v.17 no.2
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• pp.60-66
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• 2010

In chronic ambulatory hemiplegic patients, structural changes might be developed at both ankles possibly due to unequal and repetitive weight bearing on tendons and ligaments. We examined ankles by sonography to find out structural changes of tendons and ligaments of both ankles in ambulatory hemiplegic patients. Nineteen ambulatory hemiplegic patients over 1 year were included as study subjects. All subjects had no previous trauma or disease history in their ankle joints and they were able to walk independently or with supervision but had spastic ankles with equinovarus tendency. We examined both ankle joints by sonography to see joint effusion and measure width, thickness, and area of tendons of the tibialis anterior, tibialis posterior, and Achilles, and also ligaments of the anterior talofibular and calcaneofibular. We compared sonographic features of the hemi-side ankle with the sound-side ankle. There were no significant differences between hemi-side and sound-side ankles in almost all measured parameters of tendons and ligaments. However, the width of the hemi-side tibialis posterior tendon ($7.24{\pm}1.52$ mm) was narrower than the sound-side tendon ($8.61{\pm}1.37$ mm). With the amount of active joint motion and weight bearing possibly preventing ligament and tendon atrophy even though marked weakness, spasticity occurred during the chronic hemiplegic phase.

• Physical Therapy Korea
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• v.19 no.3
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.738-742
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• 2014

This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.