• 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.

• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.205-210
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• 2018

Purpose: This study was to examine the effects of treadmill gait training at different controlled inclinations on the standing balance of hemiplegic patients caused by cerebrovascular injury. Methods: The study's subjects were 44 patients with chronic stroke, randomly divided into three experimental groups: $0^{\circ}$ treadmill gait training (n=14), $5^{\circ}$ treadmill gait training (n=15), and $10^{\circ}$ treadmill gait training (n=15). In addition to conventional physical therapy, the subjects underwent gait training on a treadmill with one of three different inclinations for 30 min per session five times per week for six weeks. The Biodex balance system SD, Berg balance scale, and timed up and go tests were used to measure the postural balance of the patients. Results: This study showed that gait training on a treadmill at controlled inclinations of $0^{\circ}$, $5^{\circ}$, and $10^{\circ}$ positively influenced the stroke patients' standing balance. The $5^{\circ}$ and $10^{\circ}$ inclination gait training groups showed significantly more improvement than the $0^{\circ}$ inclination group. Conclusion: Gait training on a treadmill with inclinations of $0^{\circ}$, $5^{\circ}$, or $10^{\circ}$ can be said to positively affect the postural balance of hemiplegic patients due to stroke. In particular, $5^{\circ}$ and $10^{\circ}$ inclination gait training offered more significant improvement than the $0^{\circ}$ inclination gait training group. When added to regular treatment routines, gait training at controlled inclinations is an effective intervention for improving hemiplegia due to postural balance.

• Physical Therapy Korea
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• v.18 no.3
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• pp.8-15
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• 2011

Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

• 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.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2126-2134
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• 2020

Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

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

• 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.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.399-404
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• 2013

Purpose: To investigate the effects of initiation side on gait symmetry in the chronic stroke patients. Methods: Twenty one patients with independent gait after stroke were divided into the paretic-leg gait initiation group (PLI) and the nonparetic-leg gait initiation group (NPLI). The symmetry ratio (SR) was calculated from of the spatiotemoral and kinematic parameter which measured by 3D motion analysis. Results: In the spatiotemporal variables, SR-step length and SR-velocity was significantly different between groups (p<0.05). In the kinematic variables, SR-TOAA and SR-SwPAA of the hip joint was significantly different between groups (p<0.05). Conclusion: We suggest that the initiating leg may influence on the gait symmetry of stroke patient These results will be a helpful reference in hemiplegic gait training or intervention.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.1-9
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• 2018

PURPOSE: This study investigated the neurophysiological and behavioral adaptation during one or both hands movement in chronic stroke patients. METHODS: The study included sixteen hemiplegic stroke patients. Neurophysiological data (brain activation and muscle activation) were examined by electroencephalography (EEG) and electromyography (EMG), and behavioral adaptation was examined by wrist extension angle during wrist extension with one hand or both hands. Outcome variables of one hand or both hands were; mu rhythm of the EEG, EMG amplitude of wrist extensor and flexor muscles, and wrist angle of Myomotion 3D motion analysis. RESULTS: Our results revealed that wrist extension angle was significant increased during both hands movement compared to one hand movement (p<.05). Furthermore, in affected sensorimotor area, there was significant increase in the brain activation during both hands movement compared to one hand movement (p<.05). However, there was no significant different between one hand and both hands movement in muscle activation (p>.05). CONCLUSION: According to the findings of this experiment, bilateral arm movement improved brain activity on affected sensorimotor area and wrist extension angle. Therefore, we suggest that bilateral arm movement would positive effect on stroke rehabilitation in terms of increase in brain activation on affected motor area and wrist extension during bilateral arm movement.