• Physical Therapy Korea
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• v.19 no.2
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• pp.59-68
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• 2012

This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

• Journal of Korean Physical Therapy Science
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• v.4 no.4
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• pp.519-528
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• 1997

The purpose of this research were to evaluate the overall capacity of activity in hemiplegic patients caused by stroke, to learn the relationship of the overall capacity of activity with 8 out of 9 subtest of the Motor Assessment Scale (MAS) excluding general tonus subtest, and to use in creation of more efficient rehabilitation program by using Motor Assessment Scale (MAS). Twenty-four stroke patients (14 men and 10 women) were the subjects in this study. Their average age was 59.5 and they received average of 17.88 month of therapy. Collected data analysis was completed by using Statistic Analysis System (SAS). The results were as follows: 1) There was no difference in capacity of activity between right hemiplegia and left hemiplegia. 2) There was no difference in capacity of activity compared therapeutic period and age. 3) In comparing the relationship of the each subtest with the overall capacity of activity, upper arm function showed the highest relation (pearson's r = 0.914), and balance sitting (pearson's r= 0.812) and supine to sitting overside of bed (pearson'sr = 0.746) also showed large relationship. 4) Hand movement (pearson's r = -0.45) and advanced hand activity (pearson's r = -0.401) revealed relationship of general tonus with each subtest. 5) Supine to sitting over side of bed (pearson's r = 0.74), balanced sitting(pearson's r = 0.523), and sitting to standing (pearson's r = 0.723) showed large relationship with walking.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.19 no.3
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• pp.115-120
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• 2019

Hemiplegic patients who suffered from a stroke struggle with a deterioration in upper limb functions, which can both be psychologically and physically discomforting; this can also limit patients' daily tasks involving any upper limb motions. In this study, we developed an assistive device for hemiplegic patients to improve their upper limb functions. It was manufactured to train patients by using their grip strength and the range of motion of the arm. Furthermore, we produced game contents in virtual reality to induce users' immersion and interaction. It was configured as a multi-player game to help ease the mental burden of receiving the training alone, hence allowing the patient and the caregiver to join the rehabilitation training simultaneously. The assistive device and game contents developed in this study enables patients and caregivers to easily check the degree of improvements in upper limb function by viewing quantitative analysis and visualized results.

• Journal of Mechanical Science and Technology
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• v.18 no.11
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• pp.1949-1960
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• 2004

This paper presents a robot system developed for medical purpose. A 6-degree-of-freedom robot was introduced for physical exercise and rehabilitation. This system was proposed for stroke patients or patients who cannot use one of their arms or legs. The robot system exercises the hemiplegic part based on the motion of normal part of a patient. Kinematic studies on the human body and robot were applied to develop the robotic rehabilitation exercise system. A clamp which acts as an end effector of the robot to hold a patient was designed and applied to the robot to guarantee the safety of patients. The proposed robotic rehabilitation system was verified by simulations and experiments on arm (elbow and shoulder) motion. Patients are expected to be able to exercise various motions by themselves with the proposed robotic rehabilitation system.

• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.57-64
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• 1999

The purpose of this study is to evaluate the effects of the lower extremities patterns in proprioceptive neuromuscular facilitation to the gait and stair up of the hemiplegic stroke patient. the patient was taken lower extremities patterns in porprioceptive neuromuscular facilitation with 5 times per week for 8 weeks. The results were as followings ; 1. The walking times was decreased from 78 seconds to 39 seconds at 20m, 2. The stride length was increased from 48.3cm to 93.3cm. 3. The step length was increassed from 25.2cm to 47.2cm. 4. The stair up was increased from 3.2cm to 15.5cm.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.11-20
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• 2017

Purpose: The purpose of this study was to determine the effects of rotation direction during curved walking on gait parameters in stroke patients. Methods: A group of thirty subjects with stroke (Berg Balance Scale score${\geq}41$ were fifteen, Berg Balance Scale score${\leq}40$ were fifteen) were enrolled in this study. Testing indications included two directions for rotation in each subject. These indications were for rotation toward the affected and unaffected side in stroke patients. The gait speed, affected side single support duration, affected side double support duration were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 40 points of Berg Balance Scale score. Results: There was significant increase affected side single support duration was turned the affected side in stroke patients that presented a Berg Balance Scale score${\geq}41$ (p<.05). There were significant increase gait speed, affected side single support duration, and significant decrease affected side double support duration while subjects were turned the affected side in stroke patients that presented a Berg Balance Scale score${\leq}40$ (p<.05). Conclusion: This result may be effective to rotate in the paralyzed direction to improve the ability of the paralyzed lower limb to gain weight during gait training for stroke patients with a Berg Balance Scale score<40. Therefore, walking training program for hemiplegic patient needs to be suggested in the direction of turning for suitable balance ability.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.209-220
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• 2000

Spasticity, an abnormal increase in resting muscle tone, is one of the most common symptoms of stroke, and its management is becoming a major issue in rehabilitation. The aims of this study are to determine the effects of electroacupuncture(EA), TENS and neuromuscular electric stimulation(NMES) on spasticity, as well as the possibility of tissue comliance method as a spasticity scale. 45 stroke patients participated in a study of the effects on hemiplegic spasticity of EA, TENS and NMES. Spasticity was measured by modified Ashworth scale on the upper extremity and tissue compliance measurement, penetration mm/kg, on Susamni(LI10) area at just before and after stimulation, and 30 minutes, 1 hour, 2 hours and 24 hours after stimulation. The acupuncture points were applied to Kokchi(LI11), Susamni(LI10), Hapkok(LI4) and Oegwan(TE5) of the affected limb. The electrodes were placed unilaterally on LI11 to LI10 and TE5 to LI4. EA with biphasic wave, 60Hz, 0.4 msec pulse duration and low intensity was applied continuously for 20 minutes. TENS with high frequency, low intensity was applied. NMES was applied with spasticity program for 20 minutes. Each electric stimulation was done on extensor muscles group of forearm for 20 minutes. EA and NMES groups were found to produce a statistically significant decrease(p〈0.05) of spasticity and these effects lasted up to 30 minutes after stimulation. There was no definite correlation between the modified Ashworth scale and tissue compliance measurement. But tissure compliance method was found to be possible as a quantitative measurement on spasticity. There was no significant correlation between the effects of EA and NMES and the characteristics of patient, but significant correlation between the effects of EA and NMES and the modified Ashworth scale.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.377-390
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• 2005

The purpose of this study is to investigate the effect of neuromuscular re-education program and general intervention program. It is focused on difference between changes of experimental before and after on 20 stroke patient's motor control ability. The obtained results are as follows; In change in motor control ability, neuromuscular re-education program group about the motor control ability was a significant difference(p<.01). And traditional intervention program group, the motor control ability was a significant difference in all of items (p<.01; p<.05) but, were not a significant difference in bladder management, social interaction, problem solving and memory. And also comparison of change in motor control ability between the experimental group and control group, the between-subjects factors were a significant difference. Most of the functional items on the functional items on the functional measurement and neuromuscular function measurement are concerned with the physical autonomy of the hemiplegic patients. More in depth knowledge may be acquired about the distribution of physical and motor control patterns with respect to the degree of neurologic deficit for the enhencement of residual motor control function in hemiplegia. In conclusion, the neuromuscular re-education program was more effect then traditional intervention program in motor control ability.

• Physical Therapy Korea
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• v.18 no.3
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• pp.8-15
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• 2011

Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.159-163
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• 2015

Purpose: This study aimed to determine the interaction among the neck, trunk, and lower extremities on the non-paretic side in head rotation along with non-paretic-side weight shifting of stroke patients. To compare stroke patients' ability to control posture through muscle activity variation related to pertubation during head rotation along with the non-paretic limb. Methods: We tested 15 hemiplegic patients and 15 normal individuals. Each group's muscle activity was measured by electromyography in neutral head position and head rotation position. We compared each group's resu lt based on measured values in patients' non-paretic neck muscles, trunk muscles, and lower limbs muscles activation. Results: The study showed that muscle activity increased in the sternocleidomastoid muscle (102.26%, 53.00%), splenius capitis muscle (97.93%, 54.93%), erector spinae muscle (241.00%, 127.60%), external oblique abdominal muscle (256.66%, 152.00%), and internal oblique abdominal muscle (252.80%, 152.6%), peroneus longus muscle (117.53%, 137.13%) and gastrocnemius muscle (119.06%, 137.20%), while the results for the sternocleidomastoid muscle, splenius capitis muscle, erector spinae muscle, external oblique abdominal muscle, internal oblique abdominal muscle, peroneus longus muscle, and gastrocnemius muscle showed a statistically significant difference (p<0.05). Conclusion: It is hard for stroke patients to engage in normal movement control under suggested conditions because of the insufficient movement against gravity on the stroke patient's non-paretic side and impaired cooperative patterns. To solve these problems, patients need their bodies to improve through effective movement, resulting in advanced control of their effective and functional activity.