• 한국산학기술학회논문지
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• 제17권7호
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• pp.459-466
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• 2016

본 연구는 아급성기 뇌졸중 환자에서 로봇 보조치료법이 운동능력 및 기능적인 회복에 미치는 효과를 알아보고자 하였다. 환자 53명이 연구에 참여하였다. 로봇보조 보행치료군은 고식적인 치료에 추가로 Lokomat$^{(R)}$ 이용하여 하루에 삼십분씩, 일주일에 5회, 4주 동안 시행하였으며, 대조군은 고식적인 치료에 추가로 하루에 삼십분씩 고식적인 치료를 시행 받았다. 모든 환자들은 임상지표의 비교를 위해, 치료 전과 4주간의 치료 후 Fugl-Meyer assessment, Motricity index, functional ambulation category, Berg balance scale, 10m 보행검사, 한국판 수정 바델지수, 한국판 간이 정신 상태검사와 벡 우울증 척도를 평가 받았다. 환자들은 기능회복과 체성 감각 유발전위 검사 결과의 관계를 알아보기 위해 유발 전위 검사를 시행하였다. 아급성기 뇌졸중 환자에서 로봇 보조 보행치료군에서 대조군에 비해 하지의 운동기능, 보행 능력, 일상생활능력의 유의한 호전이 나타났다. 체성 감각 유발 전위 검사의 결과는 임상 지표들의 관련성 분석에서 Motricity index와 한국판 수정 바델지수와 관련이 있는 것으로 나타나 아급성기 뇌졸중 환자의 기능을 예측하는데 유용할 것으로 생각된다. 로봇 보조 보행치료는 아급성기 뇌졸중 환자의 운동기능과 보행기능의 회복을 촉진하는 것으로 생각된다.

• 대한물리의학회지
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• 제8권4호
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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.

• 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.

• Journal of Magnetics
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• 제19권4호
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• pp.353-356
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• 2014

The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

• The Journal of Korean Physical Therapy
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• 제21권1호
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• pp.9-17
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• 2009

Purpose: The purpose of this study was to determine reliability and validity of the Postural Assessment Scale for Stroke Patients (PASS) in chronic stroke patients. Methods: A total of 43 stroke patients, who had a stroke more than 6 months previously, participated in the study. Reliability was determined by the intra-class correlation coefficient (ICC$_{3,1}$), Bland and Altman method and Cronbach's alpha by internal consistency. Validity was examined by correlation the PASS scores to the Berg Balance Scale (BBS), Trunk Control Test (TCT), and Fugl-Meyer Balance (FM-B) score. Results: The intra-rater reliability and the Absolute reliability of the PASS was good ICC$_{3,1}$=0.97 (95%CI 0.95$\sim$0.99) and excellent SEM=1.01 respectively. Cronbach's alpha value for PASS was found to be 0.94. There were significant correlations between the PASS and BBS, TCT, FM-B (r=0.65－0.96, p<0.01). Conclusion: The PASS provide reliable and valid instrument of the postural control assessment for chronic stroke patients.

• The Journal of Korean Physical Therapy
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• 제20권1호
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.91-99
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• 2005

We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

• 국제물리치료학회지
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• 제11권1호
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• pp.2005-2011
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• 2020

Background: Motor imagery is the mental representation of an action without overt movement or muscle activation. However, few previous studies have demonstrated motor imagery training effects as an objective assessment tool in patients with early stroke. Objective: To investigate the effect of motor imagery training on Somatosensory Evoked Potentials (SSEP) and upper limb function of stroke patients. Design: A quasi-experimental study. Methods: Twenty-four patients with stroke were enrolled in this study. All subjects were assigned to the experimental or control group. All participants received traditional occupational therapy for 30 minutes, 5 times a week. The experimental group performed an additional task of motor imagery training (MIT) 20 minutes per day, 5 days a week, for 4 weeks. Both groups were assessed using the SSEP amplitude, Fugl-Meyer assessment of upper extremity (FMA UE) and Wolf motor function test. Results: After the intervention, the experimental group showed significant improvement in SSEP amplitude and FMA UE than did the control group. Conclusion: These findings suggest that the MIT effectively improve the SSEP and upper limb function of stroke patients.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.297-303
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• 2021

Objective: Stroke patients generally have problems with motor function, muscle weakness, and gait.This study was purposed toevaluate the effect of the treadmill training with kinesio taping of tibialis anterior (TKT) on muscle function, tibialis anterior, muscle strength, and gait ability in poststroke patients. Design: A randomized controlled design Methods: The participants were randomly divided in the TKT group (experimental group) and treadmill training with sham kinesio taping (control group), with 21 patients assigned to each group. Both groups receive treadmill training with kinesio taping and sham kinesio taping for 30 minutes per day, five days per week, for four weeks. The motor function was measured using the Fugl-Meyer assessment. A disital manual muscle test and G-walk were used to evaluate ankle dorsiflexor and gait ability.Evaluation was performed baseline and 4 weeks after the experiment. Results: Both groups showed significantly more improvement in muscle function, tibialis anterior muscle strength, cadence, gait velocity, and stridelength in pre-post intervention change(p<0.05).The experimental group showed significantly more improvement in motor function, muscle strength, cadence, gait velocity, and stridelength ability comparedto the control group(p<0.05). Conclusions: These finding show the benefits of treadmill training with kinesio taping for functional recovery in poststroke patients

• 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.