• The Journal of Korean Physical Therapy
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• 제33권2호
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• pp.53-61
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• 2021

Purpose: This study examined the impacts of action observational physical training related to stair walking on the stair walking ability and self-efficacy of chronic stroke patients. Methods: This study was conducted on 24 chronic stroke patients, who were assigned randomly to an action observational physical training group (12 persons) and a landscape observation physical training group (12 persons). To the action-observational physical training group, five videos related to stair walking were presented, and after observing them, physical training was carried out. The landscape observation physical training group observed the videos consisting of landscape, where there were no humans and animals, and then underwent physical training. This study measured the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius to examine the muscle activity of the lower limb. A timed up and go and step test was performed to examine the balance ability, and a timed stair test was conducted to examine their stair walking ability. A self-efficacy scale was measured to examine the degree of their confidence of performing stair walking. The assessment was conducted three times in total: pre-, post-, and follow-up surveys. Results: As a result of this study, the action observational physical training group significant improvement after the intervention than in the landscape observation physical training group. Moreover, the follow-up study four weeks after the intervention showed significant improvements in the action observational physical training group (p<0.05). Conclusion: These results show that the action observational physical training had a positive impact on the stair walking ability and self-efficacy of chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.33-40
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• 2009

Purpose: This study examined the effects of a virtual reality-based exercise program on the functional recovery of balance and gait in chronic stroke subjects. Methods: A total of 42 chronic stroke patients were enrolled in this study. The participants were allocated randomly to 2 groups: a VR (n=22) and control group (n=20). Both groups received treadmill training for 3 sessions (10 minutes each), 30 minutes per week over a 6 week period. The VR group practiced additional virtual reality programs consisting of 3 programs for 10 minutes each. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. Results: The virtual reality-based exercise group showed significant increases in gait velocity, cadence and stride length compared to the control group (p<0.05). However, there were no significant differences in static balance. Conclusion: These results support the perceived benefits of exercise programs that incorporate virtual reality to augment the balance and ambulation of stroke patients. Therefore, virtual reality is feasible and suitable for stroke patients

• 한국전문물리치료학회지
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• 제22권2호
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• pp.1-10
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• 2015

The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects' impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity ($R^2=.41$), while ankle passive ROM was the most important determinant for temporal asymmetry ($R^2=.35$). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry ($R^2=.17$). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.

• 대한물리의학회지
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• 제14권1호
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• pp.1-5
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• 2019

Purpose: In chronic stroke patients, muscle tone and stiffness increase due to ankle spasticity. Electrotherapy may control the spasticity of patients with central nerve system damage via neurophysiological mechanisms. Therefore, this study was conducted to determine the immediate effects of interferential current therapy on gastrocnemius (GCM) muscle. Methods: This study was a one-group pretest-posttest design and 20 stroke patients participated. The experimental group underwent interferential current therapy for GCM for 30 minutes. Muscle tone (MT) and stiffness were assessed using MYOTONE(R) PRO. After 30 minutes of interferential current therapy, MT and stiffness of the affected side and unaffected side by GCM were measured. Results: After interferential current therapy, the medial GCM MT (Hz) was significantly reduced in stroke patients. There was a significant difference in MT between affected GCM muscles and unaffected side medial GCM muscles before intervention, but there was no significant difference after interferential current therapy. Conclusion: This study demonstrated that interferential current therapy had a positive effect, producing an immediate decrease in the medial GCM muscles tone of stroke patients. However, this study employed a one-group pretest-posttest design. Future studies will show differences in muscle tone compared to a control group or other electrical stimulation treatments.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.549-556
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• 2017

본 연구의 목적은 급성기와 직업 사회 복귀전에 있는 뇌졸중 환자의 신경학적 인지기능 및 사회 인지기능의 차이를 비교하고 그 관계를 입증함으로서 급성기 뇌졸중 환자의 인지재활 중재 시 사회 인지 중재의 중요성을 파악하고자 하였다. 2015년 5월에서 2016년 6월까지 서울 소재 재활병원에서 재활치료를 받고 있는 뇌졸중 입원환자 30명과 주간재활센터를 이용하는 환자 30명을 대상으로 LOTCA, 만화 의도추론과제, 사회행동배열과제를 실시하였다. 각 그룹간의 차이를 알아보기 위해 이표본 t 검정을 실시하였다. 각 그룹내에서의 각 변인들간의 상관관계를 알아보기 위해 Pearson's correlations 검정을 실시하였다. 그 결과, 뇌졸중 급성기 뇌졸중 환자군과 지역사회 복귀 전 재활훈련을 받고 있는 만성 뇌졸중 환자군의 신경학적 인지기능과 사회인지 기능 모두에서 통계학적으로 유의한 차이를 나타내었다(p<0.05). 신경학적 인지와 사회인지와의 선형적 관련성을 알아본 결과 급성 뇌졸중군에서는 사고 조직력 항목이 사회행동배열 척도와 상관성을 나타내었다(r=0.539. p<0.05). 만성 뇌졸중군에서는 만화 의도 추론과제는 시지각(r=0.530, p<0.05), 시운동조직화(r=0.655, p<0.05), 사고조작력(r=0.764, p<0.05) 항목과 상관성을 나타내었다. 또한 사회행동배열척도와 시운동조직화(r=0.534, p<0.05). 사고조작력(r=0.650, p<0.05)이 상관성을 나타내었다. 다중회귀 분석 결과, 만화의도 추론과제 결과에서 급성기 뇌졸중 환자의 사회인지기능에 영향을 미치는 신경학적 인지기능은 사고조작력으로 나타났으며(B=0.431), 만성 뇌졸중 환자군의 경우 사고 고작력(B=0.272), 시운동 조직화(B=0.218)로 나타났다. 또한, 사회행동배열과제 결과에서는 급성기 뇌졸중 환자의 경우 사고 조작력(B=0.417)으로 나타났고, 만성 뇌졸중 환자의 경우 사고 조작력(B=0.267), 시운동조직화(B=0.274), 시지각(B=0.151)으로 나타났다. 이번 연구 결과에 의하면, 두 그룹 간 신경학적 인지와 사회인지 수준에 차이를 보였다. 사회인지는 주로 신경학적 인지기능 고차원적 인지 기능인 사고조작력과 높은 관련성이 있고 영향을 받을 것으로 사료된다. 따라서 추후 연구에서는 뇌졸중 환자에게 사회인지기능에 대한 훈련 프로그램을 적용 후 신경학적 인지기능 중 고차원적 인지기능의 변화가 있는지 추정해보는 연구가 필요하겠다.

• 지역사회간호학회지
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• 제17권2호
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• pp.166-175
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• 2006

Purpose: This study was to evaluate the effects of a rehabilitation exercise program on physical function and mental health status in chronic stroke Patients with hemiparesis Method: This study used a single group experimental design with repeated measures. Data collection and intervention were done from August, 2004 to November. 2004 at a community. Participants were fifteen patients (mean age: 68.6), and a 100 meter walking time and box and block tests were conducted at baseline, 4weeks, and post-intervention (8weeks) Activities of daily living and the levels of depression and anxiety were measured by using SCL-90-R at pre and post Intervention. This program consisted of 1 hour individual exercise 3 times a week for 8 weeks, and it focused on stretching, walking, arm and hand exercise, and hand massage. Result: 1. ADL, IADL, and the 100m walking time in the patients were improved compared with baseline. However. box and block tests was not shown significant improvement compared with baseline. 2. Depression and anxiety scores were improved more than that of baseline. Conclusion: The rehabilitation exercise program can be effective in improving physical function and mental health status, and it has a potential for improving Physical health status in Patients with chronic stroke hemiparesis.

• The Journal of Korean Physical Therapy
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• 제31권4호
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• pp.169-175
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• 2019

Purpose: This study examined the effects of a spiral elastic band for the walking function on patients with chronic stroke. Methods: Twenty one chronic stroke patients were recruited and divided randomly into the experimental group and control group. Both groups performed mat exercises and gait training three times a week for four weeks, and gait training was applied to the experimental group with additional spinal elastic bands. Results: The results of this research were as follows. The 10MWT measurements showed that the velocities within and between the groups decreased significantly, and the results of TUG showed significant decreases in velocities after the interventions in both the control group and experimental group. On the other hand, there were no significant differences between the control and experimental group. The FRT measurements showed significantly increased stride lengths within and between the groups. The measurements of the stride length, stride velocity, cadence, and step length showed significant improvement within the groups, but there was no significant difference between the groups. The measurement of stance showed that the non-paralytic patients had a significant increase in the rates within the groups and a significant difference was observed between the groups. Conclusion: Spiral elastic bands are an effective intervention method for rehabilitation programs to enhance the walking function in the clinical field. A treatment needs to be developed for patients with walking problems due to various disorders by investigating the action mechanism of spiral elastic bands.

• 대한치료과학회지
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• 제10권2호
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• pp.21-30
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• 2018

Objective: The purpose of this study was to investigate questions and instructions for internal feedback effects on functional recovery and task performance while chronic stroke patients practised task-specific training. Method: Twenty-four chronic stroke patients were randomly divided into two groups; when patients performed same tasks, one was treated using questions and the other using instructions for internal feedback Both lasted 30 minutes, 5 times a week for 8 weeks. Outcome measures included Erasmus MC Modifications to the Nottingham Sensory Assessment (EmNSA), Measurement Properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), Chedoke Arm and Hand Activity Inventory (CAHAI), Korean version of Modified Barthel Index (K-MBI). Results: There were no significant differences between the two groups in EmNSA and K-MBI(p>.05). But, in MESUPES and CAHAI, there was significant difference between the two groups(p<.05). Conclusion: In this study, questions for internal feedback during task-specific training are more effective in improving upper extremity motor function and task performance than instructions for internal feedback.

• 대한정형도수물리치료학회지
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• 제18권1호
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• pp.65-72
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• 2012

Background: The purpose of this study is on finding the effects of the lumbar stabilization exercise applied with the proprioceptive neuromuscular facilitation technique (PNF) to the balance and the gait of chronic stroke patients. Methods: An experiment was conducted using two sets of behavioral measures with 30 chronic stroke hospitalized patients in the rehabilitation center located in Incheon city. The 15 participants in group A were instructed to apply the traditional exercise therapy. And the other 15 participants were assigned to apply the lumbar stabilization exercise with the PNF technique. It was conducted for 30 minutes per three days for six weeks, which had eighteen times. Using the balance system, it was checked about the static and dynamic balance. Using the Gaitrite, it was checked about the ability of the gait. Results: There was a better effect on both groups especially with the static balance. Those who were applied the lumbar stabilization exercise with the PNF technique had a better result on the dynamic balance and the gait than those applied the traditional exercise therapy. Conclusion: This research shows that the Lumbar Stabilization Exercise applied with the PNF technique is more effective on dynamic balance and the gait performance ability of the chronic stroke patients.

• 융합정보논문지
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• 제10권6호
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• pp.217-227
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• 2020

본 연구는 만성기 뇌졸중 환자에서 이중과제 훈련이 균형, 상지기능, 일상생활활동 수행능력에 미치는 효과를 알아보고자 실시하였다. 14명의 만성기 뇌졸중 환자를 대상으로 7명은 이중과제 훈련을, 7명은 단일과제 훈련을 주 3회, 회당 30분, 4주간 실시하였다. 균형능력의 평가는 Balance Trainer 4(BT 4)를 사용하였고, 상지기능은 젭슨-테일러 손 기능 평가(JTT)를, 일상생활활동 수행능력 평가는 한글판 수정바델지수(K-MBI)를 사용하였다. 중재 후, 이중과제 훈련군이 BT 4, JTT에서 유의한 변화를 보였다(p<.05). 두 그룹 간의 차이도 BT 4, JTT에서 유의한 차이를 보였다(p<.05). K-MBI 점수의 향상은 있었지만 유의한 차이는 보이지 않았다(p>.05). 이중과제 훈련군이 만성기 뇌졸중 환자의 균형, 상지기능, 일상생활활동 수행능력을 향상하는데 도움이 될 것으로 사료된다.