• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.270-277
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• 2021

Objective: The purpose of this study is to compare the effect of static balance, lower extremity function, and gait ability between a lower extremity restrain robot gait training and a general robot gait training in subacute stroke subjects. Design: Two-group pretest-posttest design. Methods: A total of 12 subacute stroke patients were randomly divided into an Experimental group (n=6) and a control group (n=6). Both groups were performed for four weeks, three times a week, for 20 minutes. To compare the Static balance function, the center of pressure (COP) path-length and COP velocity were measured. The Fugl-Meyer assessment lower extremity (FMA-LE) were evaluated to compare the Lower Extremity function. 2D Dartfish Program and 10 Meter Walking Test (10 MWT) on Gait ability were evaluated to compare the gait function. Results: In the intra-group comparison, Experimental groups showed significant improvement in COP path-length, velocity, Lower Extremity Function, 10 MWT, Cadence, by comparing the parameters before and after the intervention (p<0.05). Comparison of the amount of change between groups revealed significant improvement for parameters in the COP path-length, velocity, Lower extremity function, 10 MWT by comparing the parameters before and after the intervention (p<0.01). Conclusions: The Experimental group showed enhanced efficacy for variables such as COP path-length, velocity, Lower extremity function, 10 MWT as compared to the control group.

• 재활치료과학
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• 제2권2호
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• pp.5-20
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• 2013

강제유도 운동치료는 2주간 건측의 사용을 억제하기 위해 깨어 있는 시간의 90%를 제한하는 동시에 환측에 매일 6시간 이상 강도 높은 훈련을 실시하는 것이다. 하지만 강제유도 운동치료가 뇌졸중 환자의 임상 적용에 있어서 문제점을 보였고, 이를 최소화하기 위해 수정된 강제유도 운동치료가 고안되었다. 뇌졸중 환자를 대상으로 수정된 강제유도 운동치료의 적용이 다양한 방법으로 연구되어져 왔고, Motor Activity Log(MAL), Fugl-Meyer Assessment(FMA), Wolf Motor Function Test(WMFT), Action Research Arm Test(ARAT), Functional Independence Measure(FIM), Stroke Impact Scale(SIS)을 통해 뇌졸중 환자의 기능 향상에 대한 효과를 증명하였다. 수정된 강제유도 운동치료가 뇌졸중 환자의 상지기능, 일상생활활동과 삶의 질 향상을 위한 치료 방법으로써 작업치료 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• 재활치료과학
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• 제6권2호
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• pp.37-45
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• 2017

Background: The presence of visuospatial impairment can make patients slow functional recovery and impede the rehabilitation process in TBI patients. Objective: The aim of this study is to investigate effects of prism adaptation treatment for functional outcomes in patients following traumatic brain injury. Methods: The subject received prism adaptation treatment for 2 weeks additionally during traditional rehabilitation for 4 weeks. The Patient has prism adaptation treatment while wearing wedge prisms that shift the external environment about $12^{\circ}$ leftward. The patient received 10 sessions, 15-20min each session. Outcome measures were visuospatial deficit(line bisection, latter cancellation), Visual and spatial perception(LOTCA-visual perception and spatial perception), motor function of upper extremity(FMA U/E; Fugl-Meyer motor assessment upper extremity, ARAT; Action research arm test), balance(BBS; Berg Balance Scale), mobility(FAC; Functional ambulation classification) and functional level(FIM; Functional independent measure). All Assessments took place on study entry and post-treatment assessments were performed at discharge from the hospital. Results: After prism adaptation, the visuospatial impairment scores improved as indicated in the line bisection(-15.2 to -6.02), latter cancellation(2 to 0) and LOTCA- spatial perception scores(7 to 9). The upper motor function improved as indicated in the scores of affected FMA U/E(21 to 40) and ARAT(4 to 22). Ambulation and balance improved as indicated in the BBS scores(25 to 38) and FAC scores(0 to 4). ADL function improved as indicated in the FIM total scores 54 to 70(motor 34 to 61, cognition 20 to 29). Conclusion: Prism adaptation did improve functional level such as motor functions and ADL abilities in TBI patient. Further research is recommended.

• 대한통합의학회지
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• 제6권3호
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• pp.123-130
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• 2018

Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.

• 대한통합의학회지
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• 제5권1호
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• pp.43-53
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• 2017

Purpose : To examine the relative absolute reliability and validity of step test (ST) scores in subjects with chronic stroke. Method : A total of 27 stroke patients, participated in the study. A relative reliability index (intraclass correlation coefficient, ICC) was used to examine the level of agreement of inter-rater test-retest reliability for ST score. Absolute reliability indices, including the standard error of measurement(SEM) and the minimal detectable change (MDC), and limits of agreement by Bland and Altman analysis. The validity was demonstrated by spearman correlation of ST score with 10 m Walk Test (10mWT), Fugl-Meyer Assessment-Lower/Extremity (FMA-L/E)-total score, Berg Balance Scale (BBS)-total score. Result : An excellent inter-rater reliability in ST scores was found (paretic, ICC=0.993~0.996; nonparetic, ICC=0.982~0.991). In addition, excellent test-retest reliability was found (paretic, ICC=0.992; nonparetic, ICC=0.967). It all showed acceptable SEM of the ST score as paretic and nonparetic were 0.22 and 0.46 respectively (average score <10 %), and the MDC of the paretic and nonparetic were 0.61 and 1.27 respectively (possible highest score <20 %). indicating that measures had a small and acceptable measurement error. The ST score of paretic and nonparetic were also found to be significantly associated with 10MWT (r=0.77~0.79), FMA-LE scores (r=0.73~0.81) and BBS scores (r=0.72~0.76). Conclusion : The ST showed highly sufficient Inter-rater test-retest agreement and validity and acceptable measurement errors caused by due to chance variation in measurement. It also can be used by clinicians and researchers to assess the balance and mobility performance and monitor functional change in chronic stroke patients.

• 대한한방내과학회지
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• 제35권1호
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• PNF and Movement
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• 제15권3호
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• pp.237-246
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• 2017

Purpose: The purpose of this study was to investigate the effects of forward-and-backward shift trunk exercise using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern in a closed kinematic chain exercise on the upper limb function and activity of daily living (ADL) in a stroke patient. Methods: One subject participated in this study. The study used a reversal A-B-A' design, where A and A' were the baseline period (no intervention), and B was the intervention period. The intervention was a forward-and-backward trunk shift exercise, using a PNF diagonal pattern on both a stand-on-hand position and a quadruped position of closed kinematic chain exercises, for 20 min per day for 2 weeks. The range of motion (ROM) of the shoulder joint was measured and a Fugl-Meyer assessment of upper extremity (FMA-UE) and a functional independence measure (FIM) were performed to measure upper limb function and activity of daily living (ADL). Results: ROMs of shoulder joint (flexion, extension, abduction, and external rotation) increased in the intervention phase. The FMA-UE score increased (from 28 to 36) in the intervention phase. The FIM score increased (from 20 to 25) in the intervention phase. These increases were maintained after intervention (Baseline II). Conclusion: These results suggest that forward-and-backward shift trunk exercises using a PNF diagonal pattern in a closed kinematic chain exercise have a positive effect on stroke patients' upper limb function and ADL ability.

• 대한통합의학회지
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• 제8권1호
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• pp.87-99
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• 2020

Purpose : This study aims to investigate the effect of somatosensory stimulation on the upper limb sensory and function and self-esteem of stroke patients. Methods : This study period was march 4 to april 4 (5 weeks). The subject were 20 stroke patients with somatosensory impairment in B hospital, seongnam, gyeonggi province. They were devided into two group-experimental and control-with 10 members each. The members of the experimental group underwent somatosensory stimulation, whereas the members of the control group underwent an occupation-based intervention for 5 weeks. Thirty-minute therapy was provided 3 times per week for 5 weeks. Before and after the intervention, both groups were evaluated via light touch, static two-point discrimination, stereognosis, Fugl-Meyer assessment (FMA), and self-esteem scale Results : In this study, light touch was not significant in both groups. Static two-point discrimination was significant among the experimental group member's index fingers. Among the control group members, it was significant in the ring finger. The comparison between the two groups was significant in the index finger. The stereognosis results were significant in the experimental group but not in the control group. The comparison between the groups after the intervention was not significant. FMA was significant in the shoulder/ elbow/ forearm (SEF), hand and coordination among the experimental group. Among the control group, it was significant in the SEF and hand. The comparison between the groups was significant in the SEF, hand and coordination. The self-esteem scale results were significant among both groups, and the comparison between the group's score was likewise significant. Conclusion : In conclusion, somatosensory stimulation therapy increases the static two-point discrimination, stereognosis, upper extremity function, and self-esteem of patients with stroke. Therefore, while somatosensory stimulation therapy is not the best therapy, it is one of the best occupational therapies for stroke patients.

• 대한물리의학회지
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• 제8권2호
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• pp.245-252
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• 2013

PURPOSE: The aim of this study is to verify the effectiveness of modified constraint-induced movement therapy(mCIMT) on upper function and activities of daily living in people with subacute stroke patients. METHODS: Eighteen participants, with subacute stroke that were randomly assigned to either the experimental group(n=9) or the control group(n=9). For subjects from the experimental group modified Constraint-Induced Movement Therapy was performed. exercise program, the patient trained in affected side upper extremity with restricted non-affected side for 1 hour and using in activity daily living for 4 hours for five times per week, during 4 weeks. For subjects from the control group, conventional upper extremity training was performed. Outcomes such as the box and block test(BBT), Fugl-Meyer motor function assessment(FMA), and modified Barthel index(MBI) were measured before and after training. Between-group and within-group comparisons were analyzed by using Independent t-test and Paired t-test respectively. RESULTS: These finding suggest that experimental group was significant increase in BBT, FMA, MBI(p<.05). In comparison of two group, experimental group was high upper function and activity daily living than control group. CONCLUSION: This study showed experimental group can be used to improve upper function and activity daily living than control group. Thus it indicates that mCIMT will be more improved through the continued upper extremity exercise program.

• PNF and Movement
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• 제18권1호
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.