• 대한통합의학회지
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• 제1권1호
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• pp.1-9
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• 2013

Purpose : The purpose of this study is to investigate the impact on the ability to walk, balance after side walking training of hemiplegic patients caused by stroke. Method : The subjects were training before stroke onset whether more than one year elapsed 15 patients with chronic stroke patients, and Berg balance scale(BBS) and Timed up and go test(TUG), Functional reaching test(FRT), 20m walking time 200m walking time were measured and recorded. Training period, a total of three weeks, and training frequency circuit training times 10 minutes per training, 5-minute break, the 10-minute training total 25-minute training was conducted. Gait line of 3m to be based on the patient's side walking, and the risk of falling compared to the presence of the experimenter trained under was carried out. Result : 1. TUG, 2. 20m walking time, 3. 200m walking time 4. FRT, 5. All showed significant improvement in BBS. Judging from the results, the side walking training conducted three weeks due to chronic stroke hemiplegic patient's ability to balance and showed a positive effect on the improvement of walking ability. Conclusion : Accordingly, it was more effective to train hemiplegic patients with chronic stroke on side walking.

• The Journal of Korean Physical Therapy
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• 제16권4호
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.97-111
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• 2004

This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

• 한국전문물리치료학회지
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• 제24권2호
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• pp.66-75
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• 2017

Background: After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke. Objects: The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time. Methods: Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter. Results: The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention. Conclusion: VBF training may be distribute a patient's buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

• PNF and Movement
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• 제7권4호
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• pp.37-43
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• 2009

Purpose : The purpose of this study was to evaluate the effect of core stability training at deep abdominal muscle for balance control of hemiplegic patient. Method : The subject of this study was a 47-year-old man with right hemiplegia. He was treated five times a week for three weeks with core stability training at deep abdominal muscles. Evaluation tool was used Functional reach test(FRT), timed up and go test(TUG) and one leg standing for stroke patients. Result : The FRT distance increase, TUG time decrease, one leg standing time increase core stability training at deep abdominal muscles for right hemiplegia improved was the ability for maintain balance. Posture and control of trunk stability are changing posture, and so which showed significant improve of total balance control. Conclusion : The result of this study showed that core stability training at deep abdominal muscles is an effective treatment for balance control. Therefore, it could be considered as a treatment method in the rehabilitation of stroke patient with poor postural control and imbalance, although further studies are needed.

• 대한물리의학회지
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• 제4권2호
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• pp.87-92
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• 2009

Objects：The purpose of this study is to investigate the values of foot pressure of the stance phase during a gait cycle in hemiplegic gait. Method：42 patients who had a stroke and 42 healthy adults were evaluated by the RSscan system to analyze the stance phase of hemiplegic gait. The stance phase was evaluated as plantar foor pressure. Results：1) Foot plantar pressure of toe area, affected side and less affected side showed low distribution of the plantar foot pressure which is lower than plantar foot pressure of normal adults(p<0.05). 2) Foot plantar pressure of metatarsal area, showed significantly differences among hemiplesic patient's affected side and less affected side and distribution of plantar foot pressure of normal adults(p<0.05). 3) Foot plantar pressure of heel area, hemiplesic patients' affected side and less affected side showed lower distribution of the plantar foot pressure than plantar foot pressure of normal adults(p<0.05). Conclusion：The results of this study suggest that not only affected side but also less affected side in hemiplegic patients showed significantly differences in distribution of the plantar foot pressure of normal adults.

• 한국멀티미디어학회논문지
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• 제20권12호
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• pp.1980-1991
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• 2017

Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.

• 대한중풍순환신경학회지
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• 제14권1호
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• pp.15-22
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• 2013

■ Objectives The aim of this study is to look into the correlation between motor performance and displacement of center of pressure(CoP) in hemiplegic patients with cerebral stroke. ■ Methods We measured manual muscle test(MMT) as motor performance value and, anterior/posterior position(Ant./Post. position) and lateral symmetry of CoP as displacement of CoP values from 129 stroke patients. The gait analysis was carried out using treadmill gait analysis equipment. ■ Results In terms of motor performance, MMT of upper extremity negatively correlated with Ant/Post position of CoP, however, one of lower extremity did not. In addition, MMT of both extremities negatively correlated with lateral symmetry of CoP. ■ Conclusion Displacement of CoP was negatively correlated with hemiplegic patient's motor performance.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.11-15
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• 2009

Purpose : This study aims to comparison of ultrasonography on both sides of biceps brachii muscle of hemiplegic patient. Methods : The biceps brachii muscle of fifteen subjects (5 male, 10 female) with stroke were scanned with ultrasonography at the muscle belly at rest at elbow angles of 90 deg. The echogenicity (density, white area index; WAI, anatomic cross-sectional area; ACSA, volume) of ultrasonography was examined. Results : In the biceps brachii muscle, there were significant differences of density, WAI, ACSA, and volume between affected side and non-affected side. biceps brachii muscle, echogenicity (density, WAI) of the affected side was higher than non-affected side. biceps brachii muscle, echogenicity (ACSA, volume) of the non-affected side was higher than affected side. Conclusion : This study showed that change of skeletal muscle architecture properties occurred biceps brachii muscle of the affected side muscle of hemiplegic patient.

• 대한임상전기생리학회지
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• 제5권1호
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• pp.1-10
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• 2007

This study aims to comparison of ultrasonography on both sides of the upper arm of hemiplegic patient. The biceps brachii and deltoid muscle of ten subjects(4 men, 6 women) with stroke were scanned with ultrasonography at the muscle belly at rest at elbow angles of 90 deg. The echogenicity(densit, white area index; WAI) and muscle thickness of ultrasonography was examined using real-time B-mode ultrasonography with 7.5 MHz linear-array prob. In the biceps brachii muscle, MHz there were significant differences of thickness, density, and WAI between affected side and non-affected side. In the deltoid muscle, there were significant differences of thickness, density, and WAI between affected side and non-affected side. Both of the muscles, thickness of the affected side was thin than non-affected side and echogenicity(density, WAI) of the affected side was higher than non-affected side. This study showed that change of skeletal muscle architecture properties occurred in the upper arm of the affected side muscle of hemiplegic patient.