• 대한물리의학회지
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• 제18권4호
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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.

• 한방재활의학과학회지
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• 제19권2호
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• pp.187-202
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• 2009

Objectives : The purpose of this study is to investigate the efficacy of adjusting leg length inequality(LLI) by chuna manual treatment for post-stroke hemiplegia. Methods : 39 patients with stroke-originated hemiplegia who had leg length inequality were included in this study. Chuna manual treatment at pelvic girdle was applied to 20 patients and they had been treated by general oriental rehabilitation therapy(test group). The other 19 patients had been treated by general oriental rehabilitation therapy only(control group). Outcomes were assessed by Modified Barthel Index(MBI), Berg Balance Scale(BBS), lower extremity Fugl-Meyer Assessment(FMA) at the point of beginning and end of the study. Results : 1. In terms of activity of daily living(ADL), test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group(onset had been past under 6 months), test group didn't showed statistically meaningful differences compared to control group. In chronic group(onset had been past over 6 months), test group didn't showed statistically meaningful differences compared to control group. 2. In terms of lower extremity function and balance, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.01). 3. In terms of lower extremity function of hemiplegic side, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.05). Coclusions : Adjusting LLI by chuna manual treatment is efficacious for rehabilitation of stroke-originated hemiplegia, in terms of ADL, balance and lower extremity function, and is especially efficacious for chronic patients.

• 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.

• 대한물리의학회지
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• 제5권4호
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• pp.655-666
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• 2010

Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.

• 대한물리치료과학회지
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• 제13권2호
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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.

• PNF and Movement
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• 제16권3호
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• pp.451-460
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• 2018

Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

• 대한물리의학회지
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• 제16권2호
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• pp.53-62
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• 2021

PURPOSE: Social participation is essential for stroke survivors. Although participation restrictions are affected by several factors, a few studies have focused on the effects of living in a particular residential area (urban versus rural) on the participation restrictions after a stroke. This study examined the factors affecting participation restrictions in stroke survivors according to the residential area. METHODS: One hundred sixty-six stroke patients (including 130 living in urban areas and 36 living in rural areas) were recruited for this study. The Korean Modified Barthel Index (K-MBI) was used to assess the activities of daily living (ADL). The Korean Mini-Mental Examination Status (MMSE-K) was used to assess cognition. The motor function was evaluated using the Fugl-Meyer function assessment (FMA). Path analysis was used to test the hypothesized model of participation restriction. RESULTS: The proposed path model showed good fit indices. In rural and urban areas, the direct effects were significant between the ADL and participation restrictions (β = -.673 and -.457, respectively). For urban areas, the direct effects were significant between cognition and participation restrictions (β = -.252). In both area types, motor function and cognition had a significant direct effect on the ADL. CONCLUSION: For urban community-dwelling stroke survivors, the ADL and cognition had direct effects on participation restrictions. For rural area stroke survivors, the ADL had direct effects on participation restrictions. Activity level exercise programs help reduce the participation restrictions. Moreover, it is essential to address cognition training to improve participation in urban community-dwelling stroke survivors.

• 대한물리치료과학회지
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• 제27권2호
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• pp.25-35
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• 2020

Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

• 재활치료과학
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• 제7권2호
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• pp.17-27
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• 2018

목적 : 본 연구는 만성 뇌졸중 환자를 대상으로 완전 몰입형 가상현실 기기를 이용한 작업치료 중재가 환자의 상지기능 향상에 미치는 효과를 알아보고자 하였다. 연구방법 : 본 연구의 연구 대상은 좌측 편마비를 가지고 있는 만성 뇌졸중 환자 1명이며, 개별사례 실험연구 중 ABA 설계를 사용하였다. 기초선 기간 4회, 중재 기간 12회, 기초선 회귀기간 4회로 총 20회의 실험을 휴지기간을 포함하여 총 10주간 진행하였다. 독립변수인 완전 몰입형 가상현실 기기를 이용한 작업치료 중재는 매 회기 30분씩 시행되었으며 종속변수 중 Fugl-Meyer Assessment(FMA) 평가는 각 기간 마다 1회씩 측정하였다. Box and Block Test(BBT) 평가와 Wolf Motor Function Test(WMFT) 평가는 매 회기 마다 시행하여 그 측정 결과를 꺾은선 그래프를 통해 제시하였다. 결과 : 완전 몰입형 가상현실 기기를 이용한 작업치료 중재 후 대상자의 환측 상지기능이 향상되었다. 기초선 회귀 기간에는 중재를 제거한 뒤 치료유지 효과를 확인하였지만 큰 변화는 나타나지 않았다. 결론 : 본 연구의 결과, 완전 몰입형 가상현실 기기를 이용한 작업치료 중재가 만성 뇌졸중 환자의 상지기능에 효과적인 중재라는 것을 알 수 있었다. 다만 치료유지 효과는 크지 않았기 때문에 보다 사용이 간편한 가정용 중재 프로그램 등의 개발이 필요하다.