• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.43-52
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• 2017

PURPOSE: This study aimed to compare the impact of exercise with that of functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS) on muscle tone, calf muscle stiffness, and balance ability in patients with stroke. METHODS: Thirty patients with stroke were randomly divided into an FES group (n=15) and a TENS group (n=15), and a progressive task-oriented exercise was assigned to them. These exercises were performed non-synchronously from December 5, 2016 to January 31, 2017. Patients underwent TENS and simultaneously exercised for 30 minutes daily, 5 times a week for 4 weeks. To determine the effect of the interventions, muscle tone and stiffness of the medial and lateral region of gastrocnemius muscle were measured using the MyotonPRO instrument and balance was assessed using the Berg Balance Scale. RESULTS: Both groups revealed a significant decrease in muscle tone and stiffness of the medial part of gastrocnemius muscle before and after the interventions (p<.05). Berg Balance Scale scores increased significantly (p<.05). However, none of the other parameters were significantly different (p>.05). CONCLUSION: Our results prove that progressive task-oriented exercise along with FES and TENS decreases muscle tone and stiffness of the gastrocnemius muscle in patients with stroke and improves balance. TENS could serve as a complementary replacement for functional electrical stimulation for in-house training, as TENS poses less risk of muscle fatigue and has lesser contraindications than does functional electrical stimulation.

• The Journal of Korean Physical Therapy
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• v.19 no.1
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• pp.11-22
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• 2007

Purpose: The purpose of this study were to analysis the effect on change of spinal neuron excitability during gait training of hemiplegia patients by the functional electrical stimulation. Methods: Thirty six hemiplegia patients participated in this study. Stimulation conditions of FES were pulse rate 35pps, pulse width $250{\mu}s$, and on-time 0.3 second, treatment hour was 30 min. and treatment period was once a day for five days a week through six weeks. For functional evaluations before and after treatment, Modified Ashworth Scale (MAS), active range of motion (AROM), Hmax threshold, H/Mmax ratio were measured and the following conclusions were obtained. Results: Functional evaluation showed significant changes in experimental group as MAS(p<0.01), AROM(p<0.001), compared to control group. In spinal neuron excitability evaluation, change of Hmax threshold was significantly reduced in both non weight bearing (p<0.001) and bearing condition (p<0.05), H/Mmax ratio was significantly reduced in non weight bearing (p<0.05) and bearing condition (p<0.05). Conclusion: In conclusion, application of FES to hemiplegia patients in recovery stage during gait training improved mitigation of muscular spasticity, balance adjustment and moving ability and it was interpreted that it was caused by mitigation of muscular spasticity by the spinal neuron excitability.

• Fire Science and Engineering
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• v.30 no.5
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• pp.144-150
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• 2016

An apartment house with a pilotis that raises the architectural volume and provides a space for circulation is becoming popular. With the popularity of pilotis in apartment houses, people also have a keen interest in the potential fire risk at the pilotis. As residents can only access their apartment house through the pilotis, there is a risk to the occupants if there is fire there. Therefore, this study evaluated the pilotis fire cases of urban multifamily housing to conduct a Fire Dynamics Simulator (FDS) and Fire Evacuation Simulation (FES). Through these two simulation methods, it is possible to validate the riskiness of fire at an apartment with a pilotis. The study identified that the toxic gases and flame spread out to the pilotis within hundred seconds after ignition. In addition, the toxic gases and flame also reach the second floor within three seconds and the entire building within 735 seconds if the entrance doors at the pilotis are opened. On the other hand, the FES simulation results showed that it also takes about approximately 609 seconds to excavate from the apartment house with a pilotis. Therefore, this research shows that an apartment house with a pilotis can ensure the building occupants' lives and their safety if there is fire.

• Journal of Korean Physical Therapy Science
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• v.27 no.1
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• pp.1-8
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• 2020

Background: This study analysed the effect of the fall prevention education activities on balance, fall efficacy, activities of daily living (ADL) of sub-acute stroke patients. Design: Randomized controlled trial. Methods: The subjects of the study were 24 subacute patients, who have onset period of less than 6 months. They are randomly allocated in the conventional therapy group (n=12) and fall prevention education group (n=12) and observed with frequency for 5 times a week for four weeks. Measuring took place before and after the experiment leading to following results of the Fall efficacy scale (FES), Berg balance scale (BBS) and Functional Independence Measure (FIM). Results: FES, BBS and FIM score was significantly greater in the post-test than in the pre-test in both groups (p<0.01). Independent t-test confirmed that the fall prevention education group showed much greater improvement change in the FES, BBS and FIM score than conventional therapy group (p<0.05). Conclusion: The present study demonstrated the importance of clinical contribution of the fall prevention education in the individuals with subacute stroke patients to the balance, fall efficacy and ADL following the stroke rehabilitation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.36-43
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• 2007

Purpose: An objective analysis and observations were to be done on hemiplegia patients that are wearing a walking support device, Stroke shoes. Their improvements in walking pace, the reduction of distance between the two knee joint, the increase of curve angle of the knee joint and their steps and the reduction of ankle joint upon swing phase were analyzed using a 20 walking analyzer. Methods: An examination was carried out to see the patients' communication skill and independent walking and then let them walk with the Stroke shoes on to get results before and after wearing it. Simi Reality Motion Systems GmbH (Germany, 2007) was used to analyze the results regarding knee joint and ankle joint angle changes of sagitta plane and coronal plane, stepping distances, distances between the knees and walking pace. Results: 1. The articulation angle of ankle joint during swing phase decreased and knee joint has shown a statistically significant increase in such value(p<0.05). 2. Only knee joint showed a significant increase in articulation angle during heel strike(p<0.05). 3. Knee joint showed a significant increase in articulation angle during toe off(p<0.05). 4. The distance between the two knees as well as their foot steps significantly decreased compared with when Stroke shoes were not worn(p<0.05). 5. Stroke shoes with FES have shown positive effects on the patients in improving their walking styles overall. (p<0.05). Conclusion: There was an improvement in rotation walking pattern by a reduction in the distance between the knees after wearing Stroke shoes with FES. Plantar flexion reduced that occurred in ankle joint during walking and flexion angle increased in knee joint, both of which improved foot drop which was a major problem in hemiplegia patients. Also it is believed that the device will have some positive influences on knee joint stiffening paralysis to aid in improving inefficient walking phases.

• PNF and Movement
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• v.15 no.1
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• pp.77-84
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• 2017

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

• Korean Journal of Schizophrenia Research
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• v.24 no.2
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• pp.60-67
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• 2021

Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear. We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwide claim database. Methods: Data from the Health Insurance Review and Assessment Service database in South Korea for 2007-2016 were used. Linear regression analysis and Cox proportional hazard models were used to evaluate the associations between the duration of the first antipsychotic treatment, time to re-initiation of treatment, and occurrence of treatment re-initiation. Results: Of 30,143 patients with FES, 80.4% (n=24,231) received <2 years of the first antipsychotic treatment. In patients who discontinued treatment (n=23,030), the rate of treatment re-initiation was 74.2% (n=17,086). As the duration of the first antipsychotic treatment increased, the time to re-initiation of treatment decreased (β=-0.146, p<0.001); however, the rate of treatment reinitiation was relatively constant (hazard ratio=1.001, p<0.001). Conclusion: Long-term antipsychotic treatment was not significantly associated with the rate of treatment re-initiation but showed a negative association with the time to re-initiation of treatment. Further research is needed to better understand the optimal treatment duration for FES.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.1-11
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• 2022

Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.119-129
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• 2022

Purpose : The purpose of the study was to find out the effects of obstacle walking training according on gait and balance in stroke patients. Methods : Twenty-four stroke patients are randomly assigned to experimental group 1 (n=8), experimental group 2 (n=8) and control group (n=8). Experimental group 1 performed unexpected obstacle walking training, experimental group 2 performed fixed obstacle walking training and control group performed non obstacle walking training for 12 minutes per session, 5 times a week for 4 weeks. The gait analyzer G-walk were evaluated using gait cadence, gait velocity, and stride length, balance was evaluated using FES-K and BBS. Results : In within-group comparison of gait cadence, gait velocity and stride length of change, the experimental 1,2 groups showed significant improvements post intervention (p<.05) but control group showed no significant improvement. In between-groups comparison there was significant difference in the change of gait cadence, gait velocity and stride length pre and post intervention. In within-group comparison of FES-K and BBS scores, the experimental 1,2 groups showed significant improvements post intervention (p<.05) but control group showed no significant improvement. In between-groups comparison there was significant difference in the change of FES-K and BBS scores pre and post intervention (p<.05). Conclusion : Obstacle walking training can improve the gait, function and balance of stroke patients and obstacle walking training is effective for improving gait and balance compared to non-obstacle walking training.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.167-176
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• 2023

Objective: The purpose of this study was to investigate the effects of anon-contact complex exercise program on muscle strength, fall efficacy, quality of life, and balance ability in older over 65 years of age. Design: A randomized controlled trial Methods: A total of 37 people in older over 65 years of age participated in the study. Random program was conducted and assigned to the experimental group (n=19) and the control group (n=18). Both groups performed the older people welfare center program. In addition, in the experimental group, a non-contact complex exercise program for muscle and balance exercise was performed. All interventions were performed 2 times a week, for a total of 6 weeks. chair stand test (CST), fall efficacy scale (FES), Euro quality of life 5 dimension (EQ-5D), Berg balance scale (BBS), timed up and go test (TUG), Fullerton advanced balance scale (FAB) were measured before and after the intervention to compare their effectiveness. Results: Both groups showed significant differences in CST, FES, EQ-5D, BBS, and TUG before and after intervention (p<0.05). FAB showed significant differences before and after intervention in all items except for FAB 8 and 9 items in the experimental group. In addition, the experimental group showed significant differences in CST, FES, BBS, TUG, FAB (except 1, 7, 8, 9) compared to the control group (p<0.05). Conclusions: The non-contact complex exercise program is an effective intervention method that has clinical significance in improving muscle strength, fall efficacy and static and dynamic balance abilities for the older over 65 years of age.