• 대한물리치료과학회지
• /
• 제29권3호
• /
• pp.75-84
• /
• 2022

Background: This study was to investigate the effect of non-invasive transcranial direct current stimulation due to hemiplegic patients due to stroke on temporal and spatial gait ability. Design: Randomized sham controlled trial. Methods: For the study method, 42 patients with hemiplegia due to stroke were randomly assigned to 14 patients each, and the general walking group, tDCS walking group, and tDCS (sham) walking group were subjected to 5 times a week, 30 minutes a day, and 6 weeks. In the temporal gait variables of hemiplegic patients due to stroke, the effect of the gait time, gait cycle, single support, double support, swing phase, stance phase, gait speed, cadence were measured. In spatial variables, one step length and one step length were measured. Results: As a result of the study, the EG group significantly increased in the step time, gait velocity, and cadence of the paralysis side in the comparison of temporal walking variables between groups according to the application of tDCS of walking ability in hemiplegic patients due to stroke patients(p<.05). In the change in spatial walking variables between groups according to the application of tDCS, the step length and stride length of the EG group showed a significant increase. Both the comparison of temporal and spatial symmetry walking variables between groups according to tDCS application was not significant(p>.05) Conclusion: As a result, tDCS has an effective effect on the improvement of the gait ability of stroke patients. In particular, it is an effective method of physical therapy that can improve the cadence and speed of gait, which can be combined with the existing gait training to effectively increase the gait of hemiplegia due to stroke patients.

• 대한물리치료과학회지
• /
• 제6권2호
• /
• pp.1007-1017
• /
• 1999

The purpose of this study was to evaluate the factors influencing the ambulatory status in hemiplegia with intracerebral hemorrhage after rehabilitation. Thirty patients with stroke who was admitted in the Chosun University Hospital, between from January 1st' 1998 and December 31st' 1998, were included in this study. The following variables as a potential predictors for ambulation were evaluated at treatment of the stroke onset; 1) general characteristics including age and sex, and 2) clinical characteristics including frequency and onset time of the stroke, affected side, duration of the treatment, time interval between onset and rehabilitation, manual muscle test of paretic limb, sitting and standing balance, proprioception, perception, cognitive function. We compared and analyzed the these variables to the two type of ambulatory status at the time of the discharge by Modified Barthel Index, independent, dependent. The data were analyzed by student t-test, Fisher-exact test, Mann Whitney-U test, $X^{2}$-test, correlation analysis(spearman's). The results were as follows; 1. Were no significantly inflenced independent ambulatory status among general characteristics. 2. Frequency of the stroke and proprioception (p<0.05), muscle strength of the lower limb, cognitive function and standing balance (p<0.01), perception and sitting balance (p<0.001) were significantly inflenced independent ambulatory status among clinical characteristics. 3. Independent Variable correlated with the ambulatory status were muscle strength of the lower limb, proprioception and sitting balance (p<0.05), standing balance, frequency of the stroke, perception and cognitive function (p<0.01). Therefore the muscle strength of the lower limb, proprioception, sitting balance, standing balance, frequency of the stroke, perception, cognitive function were the most significant influencing factors of ambulatory status after rehabilitation.

• 동의생리병리학회지
• /
• 제35권1호
• /
• pp.28-35
• /
• 2021

To analyze the clinical efficacy of acupuncture for spastic hemiplegia after stroke, this study was accomplished by considering Randomized Controlled Trials. We searched for papers that performed acupuncture for spastic hemiplegia after stroke in the China Academic Journal of the China National Knowledge Infrastructure, from January 1, 2017 to June 30, 2020. In total, 23 reports were included in this review. There are 18 studies conducted with more than 50 subjects and less than 100 subjects. The largest number of treatment was 20 times. 28days(4weeks) was the largest number of treatment period, which accounted 10 studies. The most frequently used evaluation index was The Fugl-Meyer Assessment(FMA) and Clinical Efficacy, each used 21 times and 17 times. The most frequently used acupuncture point was LI3, which was used 13 times. The retention time was 30 minutes and 11 studies were conducted. Western medicine treatment was the most common control group in 15 studies. Most of studies showed result of the intervention group was statistically significant, compared with the control group. These results suggest that acupuncture for spastic hemiplegia after stroke was effective and it was statistically more significant than the control group. However, it is difficult to confirm a conclusion, because the quality of most of studies was low.

• 대한물리치료과학회지
• /
• 제15권3호
• /
• pp.1-8
• /
• 2008

The purpose of this study was to compare the relationship among the Dynamic Gait Index(DGI), Berg Balance Scale(BBS) scores, Timed Up & Go Test(TUG), and subject characteristics. The subjects were fifteen stroke with hemiplegia were chosen in the Konyang University Hospital. Dynamic balance was measured Dynamic Gait Index(DGI), and balance was measured using Berg Balance Scale(BBS). Timed Up & Go Test(TUG) was used to evaluate functional mobility. Data were analyzed using Spearman correlation. There was significant correlated among Dynamic Gait Index(DGI), Berg Balance Scale(BBS) and Timed Up & Go Test(TUG)(p<.01). The correlation among subject characteristics and Dynamic Gait Index(DGI), Berg Balance Scale(BBS), Timed Up & Go Test(TUG) score was significant result in r = -.527 from Dynamic Gait Index(DGI) and pathogenesis(p<.05). There were no significant statistical differences among the types of spasticity and Dynamic Gait Index(DGI), Berg Balance Scale(BBS), Timed Up & Go Test(TUG). The comparison among the sex, type of hemiplegia, pain, pathogenesis and Dynamic Gait Index(DGI), Berg Balance Scale(BBS), Timed Up & Go Test(TUG) score was significant result in pathogenesis(p<.05). The results of this study showed that there was high correlations among the Dynamic Gait Index(DGI) and balance test of people with stroke.

• 재활치료과학
• /
• 제5권2호
• /
• pp.71-80
• /
• 2016

목적: 본 연구는 뇌졸중으로 인한 편마비 환자를 대상으로 거울치료의 임상적용 가능성 및 효과를 제시하는 데에 목적이 있다. 연구방법: 2005년 1월부터 2016년 1월까지 국외 학술지에 게재된 논문을 PubMed를 통하여 검색하였다. 포함기준과 배재기준을 고려하여 최종적으로 9개의 논문을 대상으로 분석하였다. 결과: 거울치료의 효과를 알아보기 위한 중재방법으로는 손목과 손의 단순한 움직임과 과제기반 거울치료가 사용되었다. 중재효과를 알아보기 위해 상지기능, 일상생활동작, 신체적 상태, 삶의 질 평가도구가 사용되었다. 상지의 기능은 근위부보다 원위부에서 더욱 효과가 있고, 일상생활동작에서도 유의한 효과가 있는 것으로 나타났으나, 삶의 질에서는 실험군과 대조군 사이에 유의한 차이가 없는 것으로 나타났다. 결론: 연구를 통해 임상 치료사들은 대상자의 특성에 따라 거울치료를 적절하게 사용할 근거를 찾을 수 있을 것이라 생각된다. 하지만 다양한 거울치료의 프로토콜로 인해 효율적인 적용방법을 확인하는 데 어려움이 있었다. 앞으로는 거울치료의 효과를 극대화 할 수 있는 체계화된 치료 프로토콜이 개발되어야 할 것이다.

• The Journal of Korean Physical Therapy
• /
• 제15권3호
• /
• pp.388-411
• /
• 2003

The purpose of this study has been conducted to reduce the lower limbs' spasticity of the patients with hemiplegia caused by cerebral stroke of apoplexy and find differences about spasticity effects among each group. The objects of this study covered 24 patients with hemiplgia who are either in the oo hospital in Daegu or under treatment from home to hospital. The objects fall into three groups which are a group of neurological development treatment, a group of functional stimulus treatment and a group of neurological development treatment and functional stimulus treatment. The result of this study were as follows : 1) The neurological development treatment has been found to reduce the lower limbs' spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity has been shown to be statistically meaningful ,and gradually over the period of between 4 weeks and 8 weeks(P <.05). 2) The functional electric stimulus treatment has been shown to reduce the lower limb's spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity was statistically meaningful and compared to 4 weeks, even at the time of 8 weeks, the MAS value of spasticity have shown statistical meaningness. (P <.05) 3) When neurological development treatment and functional electric stimulus treatment was applied at the same time, the lower limbs' spasticity of patients with hemiplegia was reduced meaningfully(P <.05). Compared to before-treatment at the time of 4 weeks, the MAS value of spasticity was statistically meaningful and compared to 4 weeks at the time of 8 weeks the MAS value of spasticity was also statistically meaningful(P <.05) 4) In the case of time-based MAS value of each group, functional electric stimulus treatment reduced the spasticity more meaningfully than neurological development treatment, and the group of same application of functional electric stimulus treatment and neurological development treatment showed better statistical meaningness than functional electric stimulus treatment alone(P <.05) and finally the group of same application of neurological development treatment and functional electric stimulus treatment showed more meaningful difference than neurological development treatment alone(P <.05)

• 한국응급구조학회지
• /
• 제24권2호
• /
• pp.27-38
• /
• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• 대한물리치료과학회지
• /
• 제15권1호
• /
• pp.67-74
• /
• 2008

A decrease in the ability to maintain static and dynamic balance after stroke could be related to the inability to select reliable sensory information in producing relative motor action needed to maintain postural stability. The purpose of this study was to compare the effects of two different types of surface conditions on the balancing ability of subjects with stroke. Eighteen hemiparetic subjects were assigned to an experimental and control group participating in a six－week rehabilitative therapeutic exercise program focusing on balance and mobility. Exercises were performed 3 to 5 times per week in a stable surface condition by the control group, and in an unstable surface condition by the experimental group. Pre－ and post test assessments involved the measurement of the static balance and dynamic balance, respectively by 7－item Berg Balance Scale－3P and by Pro－3 Balance System. Results showed that under the unstable surface condition, static balance in the experimental group showed more improvement than that of the control group.(Statistically, not very significant.) All the aspects of dynamic balance and mediolateral sway(balance) improved significantly than those of the control group. However, there were no significant differences between two groups. Overall, it can be concluded that under the unstable surface condition, the rehabilitative therapeutic exercise programs are effective in improving the dynamic balance of stroke subjects. The results suggest that the adaptation of the unstable surface in the rehabilitative therapeutic exercises could be effective for the patients with hemiplegia in balance. Further studies are needed to confirm the effectiveness of the unstable surface on improving balance and postural stability of hemiplegics.

• 대한의용생체공학회:의공학회지
• /
• 제36권5호
• /
• pp.155-161
• /
• 2015

In the paper, we developed the mobile based rehabilitation system for patients with upper extremity hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built in the smartphone were used to track patients' upper limb motion and the movements was transferred to the tablet PC through bluetooth connection so that the game contents could be interact with the movements. The rehabilitation game contents was based on Brunnstrom stage(B-stage), and was designed to lead accurate movement of upper limb. For the clinical evaluation of the effectiveness, 11 patients were recruited and make them perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The change of upper limb motor function was measured using fugl-meyer assessment(FMA), Brunnstrom stage(B-stage). And the change of quality of life was measured using EuroQoL-5 Dimension(EQ-5D), Beck Depression Inventory(BDI). The results showed significant improvement in upper limb function but not in quality of life. We verified mobile based rehabilitation program could be useful and effective for the clinical use.

• 대한물리치료과학회지
• /
• 제10권1호
• /
• pp.7-17
• /
• 2003

The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.