• 대한물리의학회지
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• 제6권1호
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• pp.71-79
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• 2011

Purpose : The purpose of this study was carried out to investigate the effect of repetitive transcranial magnetic stimulation on increase of H-reflex inhibition and fascilitation of range of motion of spastic ankle joint in chronic stroke patients. Methods : 30 chronic stroke patients were randomly divided into three groups, a control group(placebo rTMS group), 5 Hz rTMS group and manual therapy group. The MAS and ROM of ankle joint and H-reflex inhibition of soleus muscle were evaluated on each group. Results : The rTMS group decreased MAS of ankle joint and increased H-reflex inhibition of soleus muscle, and ROM of ankle joint than manual therapy group. The placebo rTMS group did not affected the change of MAS, ROM of ankle joint and H-reflex inhibition of soleus muscle. Conclusion : The rTMS was a good therapeutic tool to improve the foot drop in the chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제31권4호
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• pp.236-241
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• 2019

Purpose: This study examined the effects of aquatic proprioceptive neuromuscular facilitation pattern exercise on the balance, gait ability, and depression in patients with chronic stroke. Methods: Thirty patients with chronic stroke were assigned randomly to an experimental (n=15) or control (n=15) group. The experimental group performed aquatic proprioceptive neuromuscular facilitation pattern exercise. The control group performed ground proprioceptive neuromuscular facilitation pattern exercise. Training was conducted once a day for 30 minutes, five days per week for six weeks. The balance ability was measured using the Berg balance scale. The gait ability was measured using the 10 Meter walk test. Depression was measured using the Beck depression inventory. Results: As a result of a comparison within groups, the experimental and control group showed a significant difference for balance, gait ability, and depression after the experiment (p<0.05). In a comparison between the two groups, the experimental group, in which aquatic proprioceptive neuromuscular facilitation pattern exercise was applied, showed more significant changes in balance, gait ability, and depression than the control group (p<0.05). Conclusion: Based on these results, aquatic proprioceptive neuromuscular facilitation pattern exercise effectively improved the balance, gait ability and depression in patients with chronic stroke.

• PNF and Movement
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• 제16권2호
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• pp.249-257
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• 2018

Purpose: This study aimed to explore the effects of additional trunk exercises on an unstable surface on the balance and walking ability of individuals with chronic stroke. Methods: Sixteen patients with chronic stroke participated in this study. The participants were randomly assigned to two groups: experimental group (n=8) and control group (n=8). All the participants underwent a typical physical therapy program for 30 min a day. Moreover, the experimental group participated in a 30 min trunk exercise program on an unstable surface, whereas the control group participated in a 30 min trunk exercise program on a stable surface. Both groups performed the exercises five times a week for three weeks. The Berg Balance Scale (BBS) was used to measure changes in balance. The gait variables were measured using the GAITRite system (CIR System Inc., Clifton, NJ, USA) to examine changes in walking ability. Results: Both groups showed a significant intragroup improvement in balance, gait speed, cadence, stride length, and double support period (p<0.05). In the intergroup comparisons after the intervention, the experimental group showed significant improvements over the control group in balance, gait speed, cadence, stride length, and double support period (p<0.05). Conclusion: This study applied additional trunk exercises on an unstable surface to chronic stroke patients, and the results showed a significant improvement in the patients' balance and walking abilities. Therefore, trunk exercise on an unstable surface may be applicable as an intervention method to improve the balance and walking ability of chronic stroke patients.

• 대한통합의학회지
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• 제8권2호
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• pp.211-220
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• 2020

Purpose : The purpose of the present study is to examine the effects of VR training with FES on improving the muscle strength, AROM, and function of the upper limb joints in patients with chronic stroke. Methods : The present study makes use of a pre-post control group design. Thirty patients with chronic stroke were randomly assigned to two groups according to treatment method - the VRFES group and the control group. The VRFES group received 15 minutes of VR training and 15 minutes of FES treatment. The control group received 15 minutes of conservative physical therapy and 15 minutes of VR training. All subjects received 30 minutes of treatment, three times a week, for eight weeks, which amounted to 24 sessions of training. The muscle strength, AROM, and function of the upper extremities were measured before the training and eight weeks after. Upper limb muscle strength was tested using the Digital Manual Muscle Tester while AROM was measured using the Digital Dual Inclinometer. The clinical assessment tools for upper extremity function included the use of the Manual Function Test and the Jebsen-Taylor Hand Function Test. Results : Both groups exhibited great improvements in muscle strength and upper extremity function during the intervention period. The VRFES group exhibited a significant difference in muscle strength, AROM, and function of the upper extremities in comparison with the control group(p<.05). Our results reveal that VRFES is more effective for the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke. Conclusion : VRFES treatment will be used as an important intervention for improving the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke and achieving the functional recovery of the upper extremities.

• 대한물리의학회지
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• 제14권3호
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• pp.127-133
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• 2019

PURPOSE: The aim of this study was to obtain detailed and quantified data concerning the effects of plantarflexor fatigue induced to the non-paretic side on muscle activities of the bilateral lower extremities during walking in chronic stroke patients. METHODS: In this study, chronic stroke patients were evaluated for six months after the onset of stroke. To induce the non-paretic plantarflexor fatigue, 20 chronic stroke patients were asked to perform their given fatigue affecting assignments, which were presented in a forced contraction fatigue test method, until the range of motion of the plantarflexor was reduced to less than 50%. The muscle activities of the rectus femoris, tibialis anterior and gastrocnemius in the paretic and non-paretic lower extremities were measured using a wireless surface EMG before and after muscle fatigue induction. RESULTS: The findings showed that after plantarflexor fatigue was induced on the non-paretic side, a significant decrease in muscle activities of the rectus femoris on the paretic side was noted (p<.05). The muscle activities of the tibialis anterior and gastrocnemius were also observed to decrease, but, these results were not statistically significant (p>.05). In the non-paretic side, there was a significantly decrease in the muscle activities of the rectus femoris, tibialis anterior, and gastrocnemius (p<.05). CONCLUSION: These finding suggest that the muscle fatigue of the non-paretic plantarflexor affects not only the muscle activity of the ipsilateral lower extremity but also the muscles activity of the contralateral lower extremity. This highlights the necessity of performing exercise or training programs that do not cause muscle fatigue in clinical aspects.

• 대한물리치료과학회지
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• 제30권1호
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• pp.62-71
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• 2023

Background: This study was performed to evaluate the effects of Thermal stimulation combined virtual reality training (TV) on improvement of upper extremity AROM and function in patient with chronic stroke. Design: Two groups pre-post randomized controlled design. Methods: A single-blind, randomized controlled trial was conducted with 30 chronic stroke patients. They were randomly allocated two groups; the TV group (n=15) and Virtual Reality training group (VT) (n=15). The TV group received treatment for 30 min - 15 min of Thermal stimulation, and 15 min of VR training. The VT group received 15 min of VR training. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome upper extremity AROM and function were measured by a active range of motion test, Manual Function Test (MFT) and Jebsen-Taylor hand function Test (JTT). The upper extremity active range of motion was evaluated using a digital dual inclinometer. MFT and JTT were used to evaluate the hand function. The measurement were performed before and after the 8 weeks intervention period. Results: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke. Conclusion: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.76-85
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• 2012

The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.

• PNF and Movement
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• 제16권3호
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• pp.355-363
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• 2018

Purpose: The purpose of this study was to obtain detailed and quantified data concerning the effects of plantarflexor muscle fatigue induced in the non-paretic side on the spatial and temporal gait parameters of the bilateral lower extremities during walking in stroke patients. Methods: This study was conducted on 20 patients with chronic stroke. The load contraction fatigue test was applied to induce muscle fatigue in the non-paretic plantarflexor muscle. Step length, stride length, double support, gait velocity and cadence, and functional ambulatory profile (FAP) score in the bilateral lower extremities were measured using a gait analysis system in order to investigate changes in temporal and spatial gait parameters caused by muscle fatigue on the non-paretic side. The statistical significance of the results was evaluated using a paired t-test. Results: A review of the results for gait parameters revealed a significant increase in double support (p<0.05) and a significant decrease in step length, stride length, gait velocity and cadence, and FAP score (p<0.05). Conclusion: These results indicate that the muscle fatigue in the non-paretic side of the stroke patients also affected the paretic side, which led to a decrease in gait functions. This implies a necessity to perform exercise or training programs in a range of clinical aspects not causing muscle fatigue.

• PNF and Movement
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• 제21권2호
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• pp.193-202
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• 2023

Purpose: We investigated the effects of transcranial stimulation and task-oriented training on upper extremity and cognitive function in chronic stroke patients. Methods: A total of 30 patients were randomly divided into transcranial stimulation and task-oriented training groups (TT) and task-oriented training groups (TO). The TT group performed 30 min 5 times a week for 4 weeks in task-oriented training combined with transcranial direct current stimulation. The TO group performed 30 min 5 times a week for 4 weeks in task-oriented training. To measure upper extremity function, the Jebsen-Taylor Hand Function Test, Manual Function Test, and Cognitive Function Test were performed using the Stroop Test and the Trail Making Test. Results: There was a significant difference (P < 0.05) before and after training in both groups, and the TT group showed significant improvement in both groups. Conclusion: In this study, we confirmed transcranial stimulation and task-oriented training in upper extremity function and cognitive function in patients with chronic strokes.

• 대한물리치료과학회지
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• 제28권2호
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• pp.65-74
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• 2021

Background: The purpose of this study was investigated of effect of neuromuscular electrical stimulation combined with mirror therapy on static balance, weight support and ankle movement incline with chronic stroke patients. Design: Two-group pretest-posttest design. Methods: Thirty chronic stroke patients participated in this study. The study design is a two-group pretest-posttest design. A total of 30 people participated in the study, and 15 people were each assigned to the experimental group and control group. Experimental group received neuromuscular electrical stimulation combined with mirror therapy 30 minutes, and conventional physical therapy 30 minutes. Control group received conventional physical therapy 30 minutes. Both groups were conducted 5 times a week for 4 weeks. static balance and weight support was measured by force plate and ankle movement incline was measured by goniometer. Results: As a result of comparing the static balance, weight support and ankle movement incline change between experimental group and control group, statistically significant differences were found in all variables (p<.05). In the evaluation before and after the intervention, there was a statistically significant difference in all variables in the experimental group (p<.05), but there was no statistically significant difference in the control group (p>.05). Conclusion: Neuromuscular electrical stimulation combined with mirror therapy intervention improves static balance, increase paretic side weight support and ankle movement incline in chronic stroke patients. It could be an effective intervention for improve static balance, weight support and ankle movement for chronic stroke patients.