• Title/Summary/Keyword: Hemiplegia with Stroke

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Effects of Removable Ankle-Foot Orthosis in Chronic Patients With Hemiplegia During Gait Training: A Pilot Study

  • Kim, Hyung-geun;Oh, Yong-seop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.91-97
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    • 2015
  • This study was conducted to investigate the effects of the removable ankle-foot orthosis (RAFO) which was developed to improve the gait of stroke patients. The subjects of this study were five stroke patients who agreed to participate in this study by signing a written consent form. To verify gait improvement after wearing the orthosis, a Timed Up and Go test and Functional Gait Assessment were performed, and spatiotemporal gait variables such as gait speed, cadence, stride length, double limb support, and the efficient gait test of body sway angle were performed. For every variable, the differences prior to and after wearing the RAFO were compared using the Wilcoxon signed-rank test. Every gait variable improved significantly after wearing the RAFO compared to prior to wearing it. The pilot study will enhance future efforts to evaluate orthotic function objectively during gait in stroke patients.

Influence of Body Weight Support and Walking Speed in the Static Posture of Stroke Patients using Indirect PNF Treatment: A Case Report (PNF의 방산을 이용한 간접치료가 뇌졸중환자의 정적 자세에서의 체중지지 및 보행 속도에 미치는 영향 : 증례보고)

  • Lee, Byung-Ki;Yun, Jeung-Hyun
    • PNF and Movement
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    • v.10 no.4
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    • pp.71-76
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    • 2012
  • Purpose : The purpose of this study was to examine the effects of PNF of irradiation using an indirect treatment of the stroke patient's static weight support and walking speed. Methods : Was carried out a total of nine different the PNF method of treatment for patients with left hemiplegia stroke. PNF of treatment is not in the non-paralyzed side of the trunk and upper and lower extremities by applying resistance and increased strength of the affected side. Assessment of treatment weight support both feet measured and modified using the timed up and go test were compared before and after treatment. Results : Treatment of the paralyzed side of the quadriceps and hamstring, gluteus medius muscle strength increased, and both sides of the foot body weight support improved walking speed was increased. Conclusion : Irradiation using PNF indirect treatment improves the function of the gait of stroke patients.

Physiotherapy For Pusher Behaviour in A Patient With Post-Stroke Hemiplegia - Case Report (밀기 증후군이 있는 편마비환자의 물리치료 - 사례연구)

  • Kim, Yong-Seon
    • Journal of Korean Physical Therapy Science
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    • v.14 no.1_4
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    • pp.55-60
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    • 2007
  • The purpose of this case report is to investigate whether an attempt to hold the repeated upright posture under blocking the patient's vision affects the deficits to push away from the paralytic side and the relapse time from down to stand up position without push away in patients with hemiplegia with pusher syndrome. Two hemiplegic patients with pusher syndrome were assessed. The task was performed 4 times per day for 6 weeks. The modified barthel index (MBI) was performed to assess activities of daily living (ADL). For assessing balance, the "balanced sitting" and "sit to stand" are analyzed using by modified motor assessment scale (MMAS). The scale for contraversive pushing (SCP) was used for determination of push away from paralyzed side. MBI, MMAS and SCP were assessed before and after trial of the task. In patient 1, total score of the scale is 0 in sitting posture and standing posture within 3 weeks and 4 weeks, respectively, In patient 2, total score of the scale is 0 in sitting posture and standing posture within 4 weeks and 6 weeks, respectively. These results demonstrated that pusher syndrome was completely resolved in at least 6 weeks. Our findings indicate that this physical therapy seems to be relevant for the hemiplegic patients with pusher syndrome.

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Accelerometry of Unimanual and Bimanual Activities in Stroke Patients (뇌졸중 환자에서 한손 및 양손 활동 수행 시 가속도 분석)

  • Lee, Jeong-Eun;Kim, Do-Yeong;Kim, Tae-Hoon
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.129-140
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    • 2021
  • Objective : This study evaluated the differences between the upper and lower arm activities of the affected and non-affected sides in stroke patients performing activities of daily living. It was intended to gather basic data for the measurement of daily activities. Methods : The participants in the study consisted of 20 patients, 10 had left hemiplegia and 10 had right hemiplegia. Between September and November 2017, they performed drinking and dressing as unimanual and bimanual tasks. The 3-axes accelerometers were placed 2cm below the lateral epicondyle on the upper arm and 2cm below the radial styloid on the lower arm. The data were collected at intervals of 1/32 Hz and analyzed. Results : In patients with right hemiplegia, the tendon activity was significantly higher in the lower arm when performing a bimanual activity (p<.05), for all the other activities, those of the lower arm were significantly higher than those of the upper arm (p<.01, p<.05). There was no significant difference between the unimanual and bimanual activities of the affected and tendon sides in patients with left hemiplegia (p>.05). In both hands, the activity of the lower arm was significantly higher than that of the activities of the upper and lower arms, except on the affected side (p<.05). In all patients, the activities of the upper and lower arms were significantly higher (p<.05), and the activity of the lower arm was significantly higher than that of the upper (p<.001, p<.05). Conclusion : The activity was higher on the non-affected side than the affected side during the dressing task, and the overall activity was higher in the lower arm than the upper arm.

The effects of dual-task training on ambulatory abilities of stroke patients: Review of the latest trend

  • Lee, Gyu Chang;Choi, Won Jae
    • Physical Therapy Rehabilitation Science
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    • v.1 no.1
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    • pp.1-5
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    • 2012
  • Objective: Dual-task walking deficits impact functional daily life, which often requires walking while performing simultaneous tasks such as talking, thinking or carrying an object. This study is to find out the latest trend of dual-task training's influence on ambulatory abilities of a stroke patient. Design: Systematic review of randomized controlled trials. Methods: This literature review was conducted in Pubmed and Sciencedirect with the follwing key words:stroke, cerebro-vascular accident, hemiplegia, gait, rehabilitation, exercise. 7 studies were chosen in findings by search tool. 3 studies were case study, 3 studies were cross sectional observational study and 1 study was randomized controlled trial. Results: It was found that stroke patients have difficulties in doing 2 motor tasks simultaneously and when they do 2 tasks, one is done in a naturally preferred activity areas. Moreover, when simply applying dual-tasks, the walking speed decreased. Meanwhile, when applying them through training, the speed increased. This showed the improvement of effective task-implementation abilities after dual-task training using task-integration models. Conclusions: In the beginning of the 2000s, dual-tasks were implemented by simply combining walking and cognition or exercise task, and the results of this study suggest that subjects with stroke have difficulty performing dual task. However, the latest trend is to let patients do the dual-task training by combining it with virtual reality. Therefore, dual task training could be performed in a safe in the environment such as virtual reality or augment reality.

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Effects of Sling Exercise on Balance and Gait in Patients with Stroke: Meta-Analysis of Studies in Korea

  • Cho, Woonsu;Lee, Seongjin;Kim, Byeonggeun
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.3
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    • pp.2164-2172
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    • 2020
  • Background: Stroke patients have multiple disorders, but most have problems with balance and gait. Post-stroke rehabilitation exercise has been shown to be very important for functional recovery. Objectives: To systematically review and meta-analyze the effects of sling exercise (SE) on patients with stroke in studies published in Korea. Design: Meta-analysis. Methods: Five databases, namely, RISS, KISS, NDSL, DBpia and Earticle, were used to collect articles on vibration. Keywords such as "Stroke," "Hemiplegia," "Sling," and "Sling Exercise" were used in the search for published articles. Interventions and comparisons were SE and other exercise (OE). Outcome measures were berg balance scale (BBS) and timed up and go (TUG). Consequently, eight studies were selected in the second screening using meta-analyses. Results: Based on the results of the meta-analysis, SE was effective for BBS in the comparison of SE and OE [2.71, 95% CI (1.42, 4.01)]. It was effective for TUG in the comparison of SE and OE [-1.89, 95% CI (-3.01, -0.77)]. Conclusion: Based on eight limited studies, SE improved BBS and TUG over OE, suggesting improved stroke balance and gait. Therefore, more studies and large-scale sample randomized controlled trials are needed to confirm clinical application.

The Effect of Shoe Lift of the Paretic Limb on Gait Patterns in Hemiplegics (환측 신발 높이기가 편마비 환자의 보행 특성에 미치는 영향)

  • Yoon, Jung-Gyu;Park, Jeong-Mee;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.83-96
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    • 2002
  • The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

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Effects of self stretching exercise and movement with mobilization in lunge position on the muscle activity and balance in chronic stroke patients (런지자세에서의 자가 신장운동과 능동운동을 동반한 가동술이 만성 뇌졸중 환자의 근활성도 및 균형에 미치는 영향)

  • Jeong, Yong-Sik
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.549-556
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    • 2013
  • In this study, we investigated the effects of stretching and movement with mobilization in lunge position on the muscle activity of the lower limb and limited of stability in chronic stroke patients with hemiplegia. Sixteen subjects were randomly selected and classified into the experimental and control groups. The experimental group performed self stretching exercises in the lunge position, and in the control group performed movement with mobilization in the lunge position. The interventions were conducted for 20 min, 5 times a week for 8 weeks. Statistical analyses were performed using repeated ANOVA. The analysis results showed no statistically significant between-group differences with respect to the muscle activity(%MVIC;maximum voluntary isometric contraction) of lower limb and limited of stability(LOS)(p>.05). However, statistically significant within-group differences were observed in the maximum voluntary isometric contraction and limited of stability for both the groups (p<.05). Therefore, self stretching in the lunge position is considered to have positive influences on the muscle strength and balance in stroke patients with hemiplegia.

The Relationship Between Asymmetrical Weight Bearing and Bone Mineral Density in Chronic Hemiplegic Limbs

  • Shin, Hwa-Kyung;Kim, Tae-Ho
    • Physical Therapy Korea
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    • v.16 no.4
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    • pp.31-36
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    • 2009
  • Hemiplegia-induced immobilizatoin and reduction of mechanical loading in chronic stroke limbs are common cause of disuse osteoporosis. The purpose of this study was to investigate the effects of asymmetrical weight bearing on the loss of bone mineral in the individual with chronic stroke. Sixteen hemiplegic patients with strokes were evaluated. The measurements of bone mineral density (BMD) were evaluated with the quantitative ultrasound system on the calcaneus region of the paretic and non-paretic side. Plantar pressure was measured using the Mat-Scan system. The paretic side showed significantly smaller values in the T-score of BMD, and peak value of plantar pressure, which included forefoot, midfoot, and hindfoot, than the non-paretic side (p<.05). Results from the pearson correlation analysis showed statistically significant correlation between the BMD difference and the peak-pressure difference of midfoot pressure (p<.05). This finding indicated that BMD loss depended on decrease of body weight born on the paretic leg.

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Combined BOLD fMRI and Transcranial Magnetic Stimulation Study: Evaluation of Ipsilateral Motor Pathway of Stroke Patients

  • 배성진;장용민;장성호;변우목;강덕식
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.104-104
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    • 2001
  • Purpose: In this study, we investigated the possible motor pathways of hemiplegic stroke patients usin combined TMS and BOLD fMRI approach and evaluated the correlation between TMS a fMRI methods. Method: Four subjects, who demonstrated left hemiplegia after stroke, are included. TMS was performed using a Dantec Mag2 stimulator (Dantec Company, USA) in single puls mode with figure eight-shaped coil. Following TMS localization, The BOLD T2*-weight images were acquired with echo planar imaging sequence (TR = 1.2 sec, TE = 60 msec, and flip angle = 90). Motor activation was studied by means of a repetitive fing flexion-extension task. The stimulation protocol comprised 10 cycles of alternating activati and rest (10 images per cycle). Total 60 cycles were performed and each cycle take abou 1.5 sec. The resulting images were then analyzed with STIMULATE (CMRR, U, o Minnesota) to generate functional maps using a student t-test (p < 0.0005) and cluste analysis.

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