• PNF and Movement
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• v.19 no.3
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• pp.351-359
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• 2021

Purpose: This purpose of this study was to investigate the effects of initial cognitive status on the recovery of functional status in patients with subacute stroke. Methods: The participants were 111 patients with subacute stroke, divided into two groups: mini-mental state examination (MMSE) <20 (n=49) group and MMSE ≥20 (n=62) group. Clinical evaluation scores were collected before and after rehabilitation. The repeated measurements ANOVA was used to confirm the changes in functional status before and after intervention in the two groups. Changes in functional status within the group were examined through a paired test. A Pearson correlation coefficient analysis was performed to identify the correlation between MMSE change amount and functional status score. Results: In each of the two groups, according to the initial cognitive status, the clinical evaluation score increased statistically significantly, but there was no difference between the two groups in the degree of significant increase. When examining the correlation between the MMSE change amount, according to the initial cognitive state and the functional state score change amount, it was found, only in the group with MMSE <20, that the larger the change in the MMSE score, the greater the functional state change of Berg balance scale, Rivermead Mobility Index, and motor assessment scale. This did not apply to the group with MMSE ≥20. Conclusion: Initial cognitive status should be considered when setting the patient's goal, and considering cognitive improvement when constructing a rehabilitation program is thought to have a positive effect on rehabilitation services.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.88-92
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• 2009

Purpose: The purpose of this study was to evaluate the effects of exercise on functional status in stroke patients. The understanding of the course of recovery after stroke and factors affecting outcomes are important in planning and evaluation of stroke rehabilitation. Methods: To predict the outcom of stroke patient, we measured in the beginnig of rehabilitation, on 36 patients. The variables were gender, age, duration of rehabilitation treatment, motor assessment scale(MAS). Results: The patient age in 50-59 years was 41.7%. The stroke left side motor weakness were found 55.6%. The duration of rehabilitation treatment in 2-3 months was 50.0%. In the difference 24.63 for motor assessment scale after a rehabilitation treatment had significantly higher than 10.86 for motor assessment scale at initial. Gender by motor assessment scale after a rehabilitation treatment was 25.7 in male and 23.2 in female(P<0.05). Past history by motor assessment scale after a rehabilitation treatment was 26.7 in hypertension, 24.6 in cardiac disorder and 21.8 in diabetes mellitus(P<0.05). Conclusion: The subjective symptoms of motor assessment scale after a rehabilitation treatment was significantly associated with gender.

• PNF and Movement
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• v.12 no.3
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• pp.159-165
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• 2014

Purpose: The purpose of this study was to investigate the effect of early ankle exercise with functional electrical stimulation(FES) on spasticity, strength and active range of motion of ankle in patients with stroke. Methods: This study included 21 patients with stroke, who were performed early ankle exercise combined FES. The exercise program comprised 5 sessions of 30 minutes per week for 4 weeks. The spasticity, strength and active range of motion of ankle were evaluated before and after training. The spasticity was measured by modified ashworth scale(MAS), strength of ankle was measured by hand-held dynamometer and active range of motion of ankle dorsi-flexion was measured by goniometer. All data were analyzed using SPSS 18.0. Results: Significant differences were observed the subjects for strength of ankle and active range of motion. The results of the study were as follow: strength of ankle was significantly increased subjects(p<.001) and active range of motion was significantly increased subjects(p<.001). Conclusion: Ankle is very important part of body in stroke patients. early ankle exercise with FES is effective for improvement of strength of ankle and active range of motion in patients with stroke. ealry ankle exercise with FES about stroke patient is very useful and effective. It is effective in clinical practice.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.11-20
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• 2022

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.

• The Journal of Korean Medicine
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• v.23 no.2
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

• Physical Therapy Korea
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• v.27 no.1
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• pp.63-69
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• 2020

Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients' high motivation and committed participation. Patients' motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients' participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients' level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients' participation at early intervention were important determinants of functional outcome. These findings suggest that patients' participation should be encouraged in order to achieve successful stroke recovery.

• PNF and Movement
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• v.6 no.2
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• pp.39-50
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• 2008

Purpose : This article reviewed the advances in the understanding of the effect of motor rehabilitation and brain plasticity on functional recovery after CNS damage. Methods : This is literature study with Pubmed, Medline and Science journal. Results : The inability of CNS neurons to regenerate is largely associated with nonneuronal aspects of the CNS environment. Especially, this neuronal growth inhibition is mediated by myelin associated glycoprotein, olygodendrocyte-myelin glycoprotein, and NOGO. Enriched environment, motor learning, forced limb use have been utilized in scientific studies to promote functional reorganization and brain plasticity. Especially, enriched environment and motor enrichment may prime the brain to respond more adaptively to injury, in part by expressed neurotrophic factors. Conclusions : These reviews suggest that activity-induced neural plasticity occur in damaged brain areas in order to functional reorganization, where it could contribute to motor recovery, and represent a target for stroke rehabilitation.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.3
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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.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.123-132
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• 2020

PURPOSE: This study examined the effects of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patients. METHODS: Ten patients with stroke were divided randomly into two groups of five patients each who met the selection criteria. The training was conducted five times a week, for 60 minutes. The experimental group received both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation while the control group received general physical therapy with functional electrical stimulation. RESULTS: The timed Up-and-Go (TUG) test result was statistically significant after the intervention in the experimental group (p<.041). Berg Balance Scale (BBS) assessment was statistically significant after the intervention in the experimental group (p<.047) and between the experimental and control groups (p<.012). The cadence assessment was statistically significant after intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). The stride length assessment was not statistically significant after intervention in the experimental group and between the experimental and control groups. Gait velocity assessment was statistically significant after the intervention in the experimental group (p<.031) and between the experimental and control groups (p<.015). CONCLUSION: Both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation had positive effects on the balance and gait of stroke patients.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.296-312
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• 1998

BACKGROUND The purpose of this study was to find out predictors influencing on the clinical course of stroke during the first 4 weeks after the onset through statistical research, especially whether the blood glucose level after stroke and the stroke with Diabetes Mellitus correlate with functional impairments and neurological outcome or not. METHOD During 7 months period(from 1-1-1997 to 7-31-1997), 32 selected patients prognosed as acute cerebral thrombosis were studied by using Modified Barthel Index, PULSES profile in an attempt to correlate Diabetes Mellitus and hyperglycemia(more than $120mg/d{\ell}$, $150mg/d{\ell}$) with functional impairment and neurological outcome and to evaluate the influence of sex, the side of hemiparesis and age at admission, 1 week and 4 weeks after admision(admitted within 2 days after the onset). RESULT 1. The sex, side of hemiparesis and age had no significant effect upon functional impairment during first 4 weeks after the onset, but recurrent-stroke resulted in significantly higher degree of functional impairment than first-stroke during first 4 weeks after the onset. 2. The patients with Diabetes Mellitusin in acute cerebral thrombosis resulted in significantly higher degree of functional impairment than the patients without Diabetes Mellitus in acute cerebral thrombosis during first 4 weeks after the onset. 3. The patients with hyperglycemia in acute cerebral thrombosis resulted in significantly more severe neurological outcome than the patients without hyperglycemia in acute cerebral thrombosis within 2 days after the onset. CONCLUSION The study suggested that recurrent-stroke and Diabetes Mellitus were the poorer prognosis factors of functional impairment in acute cerebral thrombosis patients during first 4 weeks after the onset. and the poorer prognosis factor of neurological outcome in acute cerebral thrombosis patients was hyperglycemia within 2 days after the onset.