Purpose: The purpose of this study is to understand the effect of balance and gait when simultaneous application of Kinesio Taping on the lower extremities is done to improve the pattern of hemiplegic patients asymmetric lower extremity. Methods: This study was performed with 7 patients who have hemiplegia symptoms due to stoke. The taping on the paralyzed side was done on tibialis anterior, gluteus medius, gluteus maximus and psoas major and the taping on the unparalyzed side was done on the calf muscle and quadriceps. Berg Balance Scale(BBS) and Time Up and Go Test(TUG) was used to assessment the balance and gait of the patient after the kinesio taping was done on the lower extremities. The results of the test was analyzed by Wilcoxon Signed Rank Test on SPSS(Ver. 10.1). Results: When the taping was done on the paralyzed side, there was a significant improvement of balance and gait in BBS and TUG. When the taping was done on the lower extremities, it showed significant improvement of balance and gait, compared to when the taping was only done on the paralyzed side, according to BBS and TUG. Conclusion: The result of this study shows that the simultaneous taping of the lower extremities of the hemiplegic patients improves balance and gait by improving the pattern of patients lower extremities.
Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.
Objectives : The purpose of this study is to report the clinical effect of Korean and Western medical treatment on a hemiplegic inpatient with central pontine myelinolysis(CPM). Methods : A patient who was diagnosed with central pontine myelinolysis(CPM) was treated with acupuncture, herbal medicine, Korean physical therapy, along with receiving continuous Western medication and rehabilitation treatment. The patient was evaluated through Manual Muscle Testing(MMT), measurement of grip strength, dysarthria, and dysuresia. The Korean and Western medical treatment was conducted for 4 weeks. Results : After the 4 weeks of Korean and Western medical treatment, MMT grade improved from 2 to 4 and grip strength improved from 6 to 13. Dysarthria and dysuresia also improved. Conclusion : According to these results, this report suggests that Korean and Western medical treatment could be effective in the treatment of central pontine myelinolysis(CPM) patients.
Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.
Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.
Background: Hemiplegic patients usually have difficulty maintaining balance. Balance training is a major component of there habilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of PLS(Posterior Leaf Spring), FES(Functional Electrical stimulation), treadmill training, and neurodevelopmental treatment on the improvement of balance in patients with hemiplegia. Methods: We looked into published studies from Dankook University’s electronic library databases of RISS4U, KMbase, NCBI, and MEDLIS concerning the effectiveness of any form of intervention leading to improvement of balance. All types of studies relevant to the topic that were published in English during the time period of 1986 to 2005 were included. Results: 1. There were significant differences in standing balance, dynamic activity balance, and gait speed between barefoot subjects and subjects who wore SPAFO and HPAFO(p<.05). 2. The changes in ROM and FRT related to sex, age, height, and weight part of the diagnosis, as well as experience relapse, was of meaningless value. Changes in ROM related to the duration of pain and experiences of falling down were also meaningless. However, FRT showed significant static differences(p<.05). 3. The body-weight-support treadmill training scoring of standing balance, step length, and a timed 10m walking test showed definite improvement. 4. The proprioceptive control approach improved dynamic balance in patients with hemiplegia. Conclusion: Consequently, further study is needed to verify methods when physical therapists are researching balance ability in hemiplegic patient.
Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.
Objective: Mirror therapy is one of the promising methods suggested for the upper limb rehabilitation of stroke patients. While mirror therapy was presented to be effective in improving motor function of stroke patients, problems were raised as preceding studies had various methods in applying mirror therapy. Some studies even reported no effect in mirror therapy. Our supposition for the reason of such problems was a decrease of attention on the illusive image during mirror therapy of stroke patients, and we aimed to observe this. Design: A cross-sectional preliminary study. Methods: Three hemiplegic acute patients were recruited for the traditional mirror therapy. It lasted for 30 minutes, and 12 different tasks were asked to perform. All procedures were video-recorded, and Observer XT was used to analyse mirror-gazing time, gaze-distracted time, preparation time, frequency of mirror gazing, frequency of distraction, frequency of preparation for treatment. Results: Subjects spent an average of 4-5 minutes having instructions about the mirror therapy intervention (preparation duration), an average of 11 minutes watching the mirror during therapy (mirror-gazing duration), and the rest of 14-15 minutes looking around the environment (gaze-distracted duration). During the mirror therapy, the number of distracted moments (frequency of distraction) was eight times more than focusing on the mirror (frequency of mirror gazing). Conclusions: Once the patient looks at the mirror, it only lasts about 5 seconds on average. Thus, we confirmed that patients could not concentrate on the illusion during the session and therefore it may have affected the effectiveness of the therapy.
Purpose: The purpose of this study was to determine the effect of modified golf swing training on gait characteristic in hemiplegic patient through Kwon 3D motion analysis system. Methods: This study has performed single subject design from September to October 2008. The subject had left hemiplegia due to CVA in December 2003. He has treated Bobath approach twice a week. In order to increase ankle dorsiflexion and knee flexion, the subject has applied modified golf swing training on the basis of Bobath approach. The measurement of gait characteristic was taken by Kwon 3D motion analysis system. Results: The results were as follows : 1) Walking velocity was increased 0.62m/sec than before the training. 2) Step length was increased 0.09m than before the training. 3) Left ankle and hip angle were increased, but left knee angle was decreased. Conclusion: It could be concluded that the activity modified golf swing training in walking pattern contributed to improve the movement quality and speed of gait.
Purpose : The purpose of this study is to improve the stroke patient's gait ability by applying a closed or kinetic chain lower limb exercise Methods : The study subjects were 48 hospitalized hemiplegic patients who agreed to participate in the study. 48 subjects went through the intervention: 24 in the experimental group and 24 in the control group. One set consisted of 10 repeats of the exercise. The subjects performed three sets of the exercise once a day, 5 times a week, for 6 weeks. Results : TUG and FGA were significantly improved in the experimental group. The spatio-temporal gait variables in the experimental group all showed significant improvement. In the control group, velocity, cadence, and double limb support showed significant improvement, Trunk sway angle showed significant improvement in all three axes in both groups. Conclusion : The results of this study indicate that a more positive effect in terms of improvement of the stroke patient's gait ability will be seen for closed rather than open kinetic chain lower limb resistance exercise.
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