• PNF and Movement
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• v.11 no.2
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• pp.41-48
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• 2013

Purpose : The aim of this study was to compare the effect of task-oriented training using the PNF(proprioceptive neuromuscular facilitation) and task-oriented training with chronic stroke patients. Methods : Sixteen chronic stroke patients participated. Participants were randomly assigned to the control and experimental group( 8 experimental, 8 control). All of participants were in-patients at local hospital and had been received training appropriate to the purpose of each group program. Experimental period was carried out 30 minutes/day, five days/week, during four weeks. The experimental group trained the task-oriented training using the PNF and control group trained the task-oriented training. Fugl-meyer assessment scale and Modified Barthel Index was measured to compare the upper arm function and activities of daily living. We were measured before and after the training. Results : The results of the study were as follow: Fugl-meyer assessment scale was significantly increased both groups(p<.05), and significant between groups(p<.05). Modified Barthel index was significantly increased both groups(p<.05) and between groups(p<.05). Conclusion : PNF can be effective in improving upper arm function and ability to perform daily life of chronic stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.31-39
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• 2017

Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.

• 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.

• Physical Therapy Korea
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• v.24 no.1
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• pp.30-40
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• 2017

Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.94-102
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• 2015

Objective: The purpose of this study is to investigate the effect of treadmill gait training with patellar taping on gait abilities in chronic stroke patients. Design: Randomized controlled trial. Methods: Thirty chronic stroke patients who have been diagnosed at least six months or before were recruited in Gyeongin Rehabilitation Center Hospital, located in Incheon. Patients who were enrolled in this study were randomized to experimental group (n=15) or control group (n=15). Treadmill with patella taping training group patients were applied with patellar taping when they were being trained on a treadmill. Control group patients were being trained on a treadmill without any kind of taping. Gait parameters were measured with a GAITRite$^{(R)}$ system which evaluated gait performances. Gait trainings were done for 30 min/day, 5 days/week, for 4 weeks. Results: After treadmill training, treadmill with patella taping training group showed a significant improvement in gait abilities, including velocity, cadence, paretic and non-paretic step length, and double support period (p<0.05). However, in general treadmill group, there were no significant differences in gait parameters except velocity and cadence. There was a significant difference in gait performance in the experimental group compared with the control group, except for the gait symmetry ratio (p<0.05). Conclusions: According to this result of this study, it seems that application of patellar taping in treadmill gait training for chronic stroke patients significantly improved gait abilities of these patients. Also, we can conclude that patella taping is thought to be useful in real clinical settings where there are many chronic patients who are in need of improvement in their gait abilities.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.1-9
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• 2016

PURPOSE: This study compared the effectiveness of trunk control exercise performed on an unstable surface with that of general balance exercise on dynamic balance in the patients with chronic stroke. METHODS: The persons of this study were thirty-seven chronic stroke patients were recruited and randomly divided into 2 groups; (1) those who performed trunk control exercise on a foam roll and (2) those who performed general balance exercise. The exercises were performed 5 times a week for 4 weeks. To determine the effectiveness of the 2 types of exercises, we measured dynamic balance at the beginning of the exercises and again after 4 weeks at the completion of exercises program. RESULTS: After 4 weeks of exercise, both the groups showed increased Berg's balance scale and timed-up-and-go test (p<.001) scores. However, Trunk control exercise group was more effective than general balance exercise group was in increasing the Berg's balance scale (p<.01) and timed-up-and-go test (p<.05) scores. CONCLUSION: We suggest that trunk control exercise may be effective in increasing the balance ability of patients with chronic stroke than general balance exercise. Thus, trunk control exercise is important for such patients. Further studies are needed for better understanding of the effectiveness of trunk control exercise in chronic stroke patients.

• PNF and Movement
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• v.15 no.1
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• pp.57-65
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• 2017

Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.

• PNF and Movement
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• v.17 no.1
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• pp.47-56
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• 2019

Purpose: This study investigated the effects of neck pattern of proprioceptive neuromuscular facilitation (PNF) on balance and walking ability in patients with chronic stroke. Methods: Fourteen participants with chronic stroke were randomly assigned to vestibular rehabilitation and then divided into two groups: the neck pattern group or treadmill group. Each group underwent 20 sessions (20 minutes/day, five days/week, for four weeks). Patients were assessed with the Berg balance scale (BBS) and gait parameters (gait speed, cadence, step length, and double-limb support period) using a GAITRite system. Results: Vestibular rehabilitation for the neck pattern group and the treadmill group showed significant intragroup improvement on the BBS and in terms of gait speed, cadence, step length, and double-limb support period (p < 0.05). Vestibular rehabilitation was more effective for the neck pattern group than for the treadmill group in terms of the BBS (p = 0.00; 95% CI, 1.49-5.94), gait speed (p = 0.01; 95% CI, 0.05-0.16), cadence (p = 0.02; 95% CI, 0.54-4.99), and step length (p = 0.00, 95% CI, 1.55-4.62). Conclusion: This study used the neck pattern of PNF for vestibular rehabilitation in patients with chronic stroke. The results showed significant improvement in the patients' balance and walking ability. Therefore, the neck pattern of PNF for vestibular stimulation may be more effective than treadmill training to improve balance and walking ability in patients with chronic stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.101-108
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• 2023

Purpose : To investigate effects of transcranial directed current stimulus (tDCS) combined with abdominal draw-in maneuver (ADIM) on balance ability and trunk impairment scale of chronic stroke patients. Methods : Twenty-six chronic stroke patients were recruited and twenty-four participated after excluding two patients who met the exclusion criteria. After screening tests, they were randomized through excel program into an experimental group (n = 12) to apply a tDCS combined with ADIM and a control group (n = 12) to apply a sham tDCS with ADIM. The intervention lasted three times a week for six weeks. To compare tDCS intervention effects, trunk impairment scale and balance ability were measured. Comparisons between experimental and control groups were statistically processed using an independent t-test and comparisons within groups were statistically processed using a paired t-test. Results : The experimental group showed significant increases of pre- and post-intervention medial lateral velocity, anterior posterior velocity and area of balance ability, and trunk impairment scale (p<.05). The control group showed significant increases in pre- and post-intervention medial lateral velocity of balance ability and trunk impairment scale (p< .05). The experimental group showed significant increases of medial lateral velocity of balance ability and trunk impairment scale compared to the control group (p<.05). Conclusion : Results of this study suggest that tDCS combined with ADIM for chronic stroke patients can be effective in improving medial lateral velocity of balance ability and trunk impairment scale. Thus, tDCS can be used as an effective treatment protocol for trunk rehabilitation of chronic stroke patients.

• Journal of Korean Physical Therapy Science
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• v.24 no.3
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to investigate the effects of virtual reality based treadmill training on muscle architecture of gastrocnemius in chronic stroke patients. Methods: Thirty chronic stroke patients were randomly assigned to either the virtual reality based treadmill training (VRTT) group (n=15) or treadmill training (TT) group (n=15). Both groups participated in a standard rehabilitation program; in addition, the VRTT group participated in virtual reality based treadmill training for 30 minutes per day, three times per week, for 6 weeks, and TT group participated in treadmill walking training for 30 minutes per day, three times per week, for 6 weeks. Ultrasound image was used for measurement of pennation angle and muscle thickness of the medial gastrocnemius muscle at rest and during maximum voluntary contraction. Results: In the paretic side medial gastrocnemius muscle, greater improvement on the pennation angle and muscle thickness while resting and maximal voluntary contraction were observed in the VRTT group compared with the TT group. Conclusion: Findings of this study demonstrated that the virtual reality based treadmill training has an effect on muscle architecture of medial gastrocnemius in chronic stroke patients.