• Physical Therapy Rehabilitation Science
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• 제5권4호
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• pp.170-176
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• 2016

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

• 대한물리의학회지
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• 제12권1호
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• pp.35-42
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• 2017

PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

• 대한통합의학회지
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• 제1권4호
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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.

• 대한물리의학회지
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• 제10권4호
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• pp.81-90
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• 2015

PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

• 대한한의학회지
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• 제22권1호
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• pp.96-103
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• 2001

Clinical symptoms of stroke patients vary widely, and include headache, dizziness, vomiting, dysphagia, dysphasia, incontinence, confusion, chest discomfort, dyspnea etc. Stroke patients who had chronic respiratory disease or had tracheostomy cannula usually have high levels of sputum, but there have been rare clinical reports about treatment of oriental medicine. High levels of sputum in stroke patients can cause pneumonia and dyspnea, and so can delay rehabilitation. By use of Haepyoleejin-tang.Jungchun-tang with change of Ephedrae Herba capacity, we could improve sputum secretion and respiratory function of two stroke patients, and so we report on the clinical course of two stroke patients with high levels of sputum.

• 대한물리의학회지
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• 제14권1호
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• pp.35-41
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• 2019

PURPOSE: This study examined the effects of a vestibular stimulation training program on the walking ability of chronic stroke patients over a six month period. METHODS: Forty stroke patients were enrolled in this study. The patients were divided randomly into a control group (n=20) and experimental group (n=20). A general exercise program was applied to Group I and vestibular stimulation training was applied to Group II(30 min, three times a week for six weeks). The changes in straight walking ability, curved walking ability, and functional walking ability were measured using a 10 m walking test figure-of-eight-walking test, and dynamic gait index, respectively. The measures before and after the program were compared using a paired t-test for a comparison of each group and an independent t-test for a comparison between groups. RESULTS: The changes in each group were examined according to the measurement period. The Experimental group showed significant functional improvement in all three tests after the vestibular stimulation training program, but the control group did not show significant improvement in any of the tests after the general exercise program. A comparison of the changes between groups revealed the experimental group to show significantly higher improvement than the control group in all tests. CONCLUSION: The vestibular stimulation training program helps improve the gait function of stroke patients. Based on the results of this study, it is expected that various vestibular stimulation training programs will be developed and applied in a range of places.

• PNF and Movement
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• 제12권3호
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• pp.143-150
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• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.55-63
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• 2021

Objective: The purpose of this study was to examine the effects of balance training with Functional Electrical Stimulation (FES) on balance and gait in patients with chronic stroke. Design: A cross over design Methods: Nine patients with stroke were recruited into this study. They were measuring their balance ability and gait ability. The intervention "A" included 4 weeks of balance training with Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Intervention "B" included 4 weeks of balance training with placebo Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Of the 9 patients who completed the study, 5 were randomly assigned to" group A-B", and 4 to group B-A. The crossover occurred after 4 weeks. Results: Following are the specific results of balance training with Functional Electrical Stimulation (FES) on patients with chronic stroke. First, patients who received treatment A showed improvement compared with patients who received treatment B in static balance. There were significant decreases in anterioposterior, mediolateral postural sway extension and velocity moment (p<0.05) with their eyes opened and closed conditions. Second, they had significantly improved in dynamic balance (p<0.05). Lastly, there were also improvement in their gait velocity and cadence (p<0.05). Conclusions: These findings suggest that, the Functional Electrical Stimulation (FES) combined with balance training more effectively improves the balance and gait ability, I'm convinced that it could be actively used in clinics added to the conventional physical therapy in the future.

• 대한물리의학회지
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• 제12권1호
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• pp.25-33
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• 2017

PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS: A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14). All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS: The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION: The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.

• 대한통합의학회지
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• 제4권4호
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• pp.41-51
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• 2016

PURPOSE : The purpose of this study was to identify whether 3D motion input device based mirror therapy could improve on upper extremity function, quality of life and depression in chronic stroke patients METHOD : Thirty six patients with chronic stroke were enrolled and randomly divided into three groups: 3D leapmotion mirror therapy group, mirror therapy group, and sham therapy group. 3D leapmotion mirror therapy group performed 3D motion input device based mirror therapy, mirror therapy group performed general mirror therapy, control group performed sham therapy. All patients received a total of 15 exercise session over a 5 week period (three times per week). Fugl-Meyer Assessment-upper extremity(FMA-UE), Stroke Specific-Quality of Life(SS-QOL), Beck Depression Inventory(BDI) were performed prior to and five weeks after the treatment RESULT : Subjects in the 3D leapmotion mirror therapy group showed significant improvements in upper extremity function, quality of life and depression following training. The changes of upper extremity function, quality of life and depression in the 3D leapmotion mirror therapy group were significantly more than them of the control group. CONCLUSION : The result of this study suggest that 3D motion input device based mirror therapy is an intervention to improve on upper extremity function, quality of life and depression in chronic stroke patients.