• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.1894-1903
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• 2015

The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke. Six chronic stroke patients participated for a duration of 31 weeks. Treatment outcomes were assessed via Chedoke-McMaster Stroke Assessment, the Berg Balance Scale, the Assessment of Motor and Process Skill (AMPS), and the Stroke Impact Scale pre- and post-intervention. The participants exhibited significant improvements in impairment, static and dynamic balance, and mood and emotion after group TOCT. The results of AMPS indicated an improvement in the motor area in 3 of the subjects. In the process area, 4 of the subjects exhibited improvement. The results of this study suggest that TOCT is beneficial to physical functions for chronic hemiparetic stroke patients in community-dwelling.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.223-230
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• 2012

Purpose : The purpose of this study was to analyze weight bearing of cane and affected foot at different speeds during walking. Methods : Thirteen subjects (6 males, 7 females) with stroke enrolled in the study. A foot sensor and an instrumented cane were integrated to analyze the vertical peak force on the affected foot and the cane. Results : The applied vertical peak force on the cane were $12.02{\pm}4.80%$ (slow speed), $7.97{\pm}3.95%$ (comfortable speed), and $6.86{\pm}3.30%$ (fast speed) body weight, respectively. The results indicated significantly lower vertical peak force on the affected foot in the low speed walking condition when compared to the fast walking (p<.05) and the comfortable walking (p<.05) conditions. The correlations between TUG and vertical peak force on the cane and affected foot were .71, and -.70 (p<.01). There was a higher correlation between the vertical peak force on the cane and affected foot were -.87(p<.01). Conclusion : In conclusion, slower walking speed applied greater vertical peak force on the cane. On the contray, slower walking speed applied less vertical peak force on the affected foot. Further studies, duration of force should be measured at different speeds during walking in lower and higher functioning hemiparetic subjects, as its use may mask underlying gait impairment.

• The Journal of Korean Physical Therapy
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• v.24 no.2
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• pp.113-117
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• 2012

Purpose: The purpose of this study was to analyze the weight bearing of the cane and foot for the different walking aids during walking. Methods: A total of 12 subjects (6 males, 6 female) with stroke were enrolled in the study. Foot sensor and an instrumented cane were integrated to analyze the vertical peak force on the foot and cane. Results: The vertical peak force applied on the quad cane gait resulted in a significantly higher rate, which was $10.60{\pm}6.48%$ of the body weight, when compared to that of mono cane gait which was $7.91{\pm}4.11%$. The results indicated significantly lower vertical peak force on the affected foot, without the help of a walking aid, as compared to that of walking with a cane (respectively, p<0.05). However, results showed that the differences in vertical peak force on the affected foot, between mono cane and quad cane, were not significant. Conclusion: In conclusion, the vertical peak forces were significantly greater, during a comparison between walking with a quad cane and walking with a mono cane. On the contrary, no significant difference in the vertical peak force on the affected foot between walking with quad cane and walking with a mono cane. Muscle activation pattern and walking pattern should be measured in future studies, to study the differences between walking with various walking aids in the lower and higher functioning hemiparetic subjects, as its use may mask underlying gait impairment.

• Physical Therapy Rehabilitation Science
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• v.9 no.2
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• pp.67-73
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• 2020

Objective: The purpose of this study was determine the effect of Balance Trainer training with Transcutaneous Electrical Nerve Stimulation (TENS) on spasticity and balance in persons with chronic stroke. Design: Randomized controlled trial. Methods: A total of 30 subjects with hemiparetic stroke were recruited and randomly divided into the Balance Trainer training with TENS group (n=15) and Balance Trainer training with placebo TENS group (n=15). The Balance Trainer training with TENS group practiced additional Balance Trainer training with TENS for 30 minutes a day, 5 days per a week during 4 weeks and the Balance Trainer training with placebo TENS group practiced additional Balance Trainer training with placebo TENS for the same period. Spasticity and balance were assessed by ability (static balance, dynamic balance) and were measured before and after the 4-week programs. Results: The result of spasticity and dynamic balance were improved significantly in both groups (p<0.05). The Balance Trainer training with TENS group showed significantly greater improvement in spasticity of the gastrocnemius & dynamic balance, compared to the Balance Trainer training with placebo TENS group (p<0.05). The Balance trainer training with TENS group showed a significant improvement in static balance, especially during the eye-closed condition (p<0.05). Conclusions: The Balance Trainer training with TENS was effective in improving spasticity and balance in subjects with chronic stroke. Based on these results, it is suggested that Balance Trainer training with TENS could clinically be used more actively in conjunction with conventional physical therapy.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.526-534
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• 2022

Objective: The purpose of this study was to compare muscle activities of stroke patients and healthy participants during bimanual tasks. Design: A cross sectional study. Methods: A total of 25 participants (13 hemiparetic stroke patients and 12 healthy participants) were recruited. The muscle activities using electromyogram (EMG) during bimanual tasks were collected from the following muscles: extensor carpi radialis longus (ECRL), biceps brachii (BB), and triceps brachii (TB). The bimanual tasks included eight tasks consisted of (1) raising the wrists up and down, (2) supinating and pronating the palms, (3) touching the shoulder with fingertips, (4) drawing vertical dot, (5) reaching for a cup and bring it in to drink, (6) drawing a circle outward and (7) inward, and (8) grasping the fingers. The EMG data collected from the muscles of paretic and non-paretic sides of stroke patients and the average from both sides of healthy subjects were normalized and compared after calculating the percentage of maximal isometric voluntary contraction. Results: The ECRL, BB and TB of the paretic side of the stroke patients showed relatively greater muscle activity compared to the non-paretic side as well asaverage of the healthy subject duringall tasks (p<0.05). In addition, the ECRL showed the highest muscle activity during most of the tasks. All of the non-paretic side musclesfrom stroke patients showed higher muscle activity compared to those of healthy subjects. Conclusions: The current study showed that muscle activities of upper extremity varied between paretic and non-paretic sides of stroke patients during bimanual tasks. Interestingly, the non-paretic side muscle activities were also different from those of normal participants.

• 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 Rehabilitation Science
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• v.9 no.1
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• pp.43-48
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• 2020

Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

• PNF and Movement
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• v.12 no.3
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• pp.143-150
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• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• The Journal of the Korea Contents Association
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• v.12 no.1
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• pp.318-328
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• 2012

The purpose of present study was to determine effects of a PNF combination pattern training on muscle activity of lower extremities and gait ability in hemiparetic subjects. Twenty chronic stroke patients participated. Participants were randomly divided into either control group and experimental group. Experimental group received PNF combination pattern training, four times per a week for six weeks and control group received general exercise training. For the lower limbs muscle activity, RMS of action potential were analyzed and gait ability tests was conducted with 10MWT, DGI and F8WT. For the significance test of control and experimental group for measuring time by exercise application method, two-way repeated measure ANOVA. As the result, muscle activity of RF(p<.05), VM, TA, LH, LG was significantly increased between measurement period(p<.001), In VM, TA, LH, LG, there were interactions each measurement time and between group. 10MWT, DGI, F8WT in gait ability was significantly improved between measurement periods(p<.001) and In 10MWT, DGI, F8W, there were interaction each measurement time and between group. In conclusion, the PNF combination pattern application will be effective strategy to increasing the muscle activity and improving gait ability in the rehabilitation of stroke patients.