• Therapeutic Science for Rehabilitation
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• v.6 no.2
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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.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.1
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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.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.549-558
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• 2013

PURPOSE: This study is designed as a retrospective study, and identified the clinical usability of Sit to Stand (STS) test for predicting of fall incidence in stroke patients who experienced a fall within 1 year. METHODS: Between July 2011 and November 2012, 69 inpatients with stroke in K rehabilitation hospital were participated under voluntarily signing the informed consent form. STS test and 10m walk test (10MWT) were used to assess the muscle strength of lower-extremity and walking velocity, respectively. Also, we tested dynamic balance and motor function of lower-extremity in affected-side using with the Berg balance scale (BBS) and the Fugl-Meyer assessment of lower extremity (FM-L/E). METHODS: There were significant differences between subjects with fall-experienced group and without subjects without fall-experienced group in STS test, 10MWT, BBS scores and FM-L/E. STS test significantly showed a negative correlation between 10MWT (r=-.657), BBS (r=-.512), and FM-L/E (r=-.563). And, 10MWT have a influence on the performance of STS test (the capacity of explanation = 20%). The cut-off value of STS performance predicting falls experience is ${\geq}14.36$ seconds (sensitivity=76%; specificity=79%, area under curve=.785). According to logistic regression analysis of falls experience, subjects ${\geq}14.36$ s showed that 4.164 times (odd ratio) increased in falls than subjects < 14.36 s in STS test. CONCLUSION: This study demonstrated that STS test may be a useful tool predicting and measuring falls in patients with stroke. Further study will be needed to elucidate the kinematic analysis of STS test and the relationship between physical activity level and falls in stroke patients.

• Journal of Acupuncture Research
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• v.28 no.4
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• pp.37-47
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• 2011

Objective : The purpose of this study is to evaluate the effect of sweet bee venom pharmacopuncture on the post-stroke hemiplegic shoulder pain. Methods : 40 patients with post-stroke hemiplegic shoulder pain were randomly divided into 2 groups : study group(sweet bee venom pharmacopuncture treatment group, n=21) and Control group(normal saline treatment group, n=19). They were monitored for 4 weeks, followed up with visual analog scale(VAS), pain rating score(PRS), painless passive shoulder range of movement(PROM) and Fugl-Meyer Motor assessment(FMMA) at before treatment(T0), after 2 weeks(T2) and after 4 weeks(T4). Results : 1. Study group and control group showed pain decrease, but study group showed more significant effectiveness in VAS and PRS than control group. 2. Although there is no significant difference in PROM between study group and control group, both groups showed increase of PROM, and study group had some effectiveness on abduction and flexion as the treatment progresses. 3. There is no significant difference in FMMA between study group and control group. Conclusions : This study suggests that sweet bee venom pharmacopuncture has significant analgesic effect on the post-stroke hemiplegic shoulder pain. And it seems that sweet bee venom pharmacopuncture can be applicable to improve PROM in hemiplegia patients with stroke. Further studies based on larger population and long term follow-up are needed to confirm this suggestion.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.29-42
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• 2019

Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.85-98
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• 2006

This study was performed to examine the influences of the mental practice to the hemiplegic upper limb motor function improvement. 20 minute neurologic treatment based on the neurophysiological theory, 10 minute activities of daily living training, and 10 minute mental practice 5 times a week were given in turn to the experimental group(N=11). On the other hand 20 minute neurologic treatment, and 10 minute activities of daily living training 5 times a week were given in turn to the control group(N=11). Both Fugl-Meyer Assessment Scale and Manual Function Test were used to evaluate upper limb motor recovery, upper limb motor function and movement ability. And the Motor Activity Log; Amount of Use and Motor Activity Log; Quality of Movement before training, 2 weeks after training, and 4 weeks after training were measured to assess the upper limb motor quantitatively and qualitatively each. The results are as follows. 1) Considering the interactions of the rate of change on the upper limb motor recovery, motor function, movement ability improvement, and qualitative motor improvement in ADL of experimental group and control group, the change rates of experimental group were found to be greater than those of the control group. 2) In experimental group, the higher the achievements were, the better upper motor recovery was.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.11-24
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• 2007

Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

• PNF and Movement
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• v.17 no.2
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• pp.167-175
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• 2019

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder's active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder's active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.133-144
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• 2023

PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.