• Proceedings of the KIEE Conference
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• 2005.10b
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• pp.542-544
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• 2005

This paper describes the detection of spatio-temporal parameter using an accelerometer and footswitches to evaluate a symmetry and balance of hemiplegic patients. We detected gait data using a 3-axis accelerometer that mounted between L3 and IA intervertebral area and footswitches made by FSR-Sensor attached insole. To minimize the error of the gait parameters to be detected incorrectly in case of using only accelerometer, we enhancement the performance of detection by measuring an accelerometer and foots witches data at the same time. So, it was possible to detect more accurate gait parameters. As a result, we can confirm the symmetry and balance of hemiplegic patients. In the future. these results could be used to evaluate the walking ability in hemiplegic patients in clinical pratice.

• Physical Therapy Korea
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• v.6 no.1
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• pp.15-22
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• 1999

The Posterior Leaf Spring (PLS) has been used for hemiplegic patients in order to help their walking and to increase their balance function. Past studies have mainly focused on the PLS's influence on patients' walking without taking balance function into consideration. The purpose of this study was to identify the immediate effect of PLS on the standing balance in hemiplegic patients. Fifteen hemiplegic patients participated in this study: 10 men and 5 women, with an average age of 53.8 years. Standing balance was measured using a computerized dynamic posturography device under three conditions namely bare-foot standing, standing in shoes without PLS, and standing in shoes with PLS. The results were as follows: 1) The composite equilibrium scores of patients who stood in shoes only and stood in shoes with PLS were higher than those of patients who stood bare-foot. 2) There were no statistical difference in the composite equilibrium scores between the standing condition of patients who stood bare foot and that of patients who stood in shoes with PLS. In conclusion, it is not clear whether or not the PLS affects the standing balance of hemiplegic patients. Further study is required to determine the precise effect of the PLS on standing balance in hemiplegic patients who are not wearing shoes. This is particularly relevant in Korea culture where custom demands the removal of shoes when entering any house or even many restaurants.

• The Journal of Internal Korean Medicine
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• v.24 no.2
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• pp.283-289
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• 2003

Background and Purpose : Hemiplegic upper extremity is a problem frequently encountered in the rehabilitation of patients with stroke. In Korean traditional medicine, moxibustion has been used clinically in treatment of stroke patients with hemiplegia. So far, its efficacy has not been proven clinically. The purpose of this study was to evaluate the efficacy of the moxibustion in treating hemiplegic upper extremity in stroke patients. Design : Randomized Control Trial. Subjects and Methods : Forty hemiplegic stroke patients admitted to Kyunghee oriental medicine hospital were randomized into the treatment with standard physiotheraphy combined with Moxibustion-group or Control-group with standard physiotherapy alone. It took them 2-5 weeks from the onset to start this study. Moxibustion was applied at LI4(合谷), LI11(曲池), TE3(中渚), TE5(外關) in hemiplegic hand, once a day for 2weeks. The effect of treatment on hemiplegic upper extremity was assessed using Fugl-Myer motor scale, Motricity Index and Modified Barthel Index(drinking/feeding, dressing upper body, grooming) Results : These 2 groups had comparable clinical characteristics; sex, age, plegic side (Rt., Lt.), pretreatment impairment. After two weeks, patients in the moxibustion group perfomed better on Fugl-Myer test and Motricity index test. The differences were significant.(P=0.038, 0.002) But Results on the Modified Barthel Index revealed no effect.(P=0.348) Conclusion : This results suggest that moxibustion is an effective treatment for improvement of motor function of hemiplegic upper extremity.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.23-29
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• 2009

Purpose: This study examined the effects of the symmetrical scapular alignment on the weight bearing of hemiplegic patients in the standing position. Methods: PALM (PALpation Meter) test and Gaitview AFA-50 were used to measure the skeletal alignment of the scapula and the weight bearing loaded on the affected and unaffected sides before and after training. The data was analyzed using a paired t-test on the SPSS 12.0 program for descriptive statistics. A p value <0.05 was considered significant. Results: The mean difference in the scapular alignments on sup. & mid. & inf. area in the hemiplegic side before and after training was $0.93\pm0.50cm$ and $0.58\pm0.43cm$, respectively. There was a significant decrease after training rather than that before (p<0.05). The mean weight bearing on the foot area in the hemiplegic patients before and after training was $9.12\pm5.51N/cm^2$ and $4.36\pm4.11N/cm^2$, respectively,. There was a significant decrease after training rather than that before (p<0.05). The scapuar alignments and weight bearing data on the standing position were grouped around the average (to central point) in the distribution graph. Conclusion: These findings suggest that the symmetrical scapular alignment can serve as an effective means of improving the weight bearing ability of hemiplegic patients.

• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.13-16
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• 2005

Background: The purpose of this study is to investigate the effect of the intensive functional electrical stimulation(FES) on the improvement of the gait pattern of the chronic hemiplegic patients. Method: Six hemiplegic patients, who could walk independently but have equinovarus deformity during the gait cycle, participated in this study. The affected peroneus longus and tibialis anterior muscles of all subjects were stimulated for 2 weeks period (20 minutes duration, 6 times/day). We measured the activities (mean voltage) of those muscles during the walking, using dynamic EMG. Results: After treatment, there were significant improvements in the strength of peroneus longus and tibialis anterior muscles and the gait speed, but there was no interval change of the spasticity of plantar flexor. The mean voltages of two muscles are significantly increased in all the patients (p<0.05). Conclusion: The results showed that the intensive FES on affected peroneus longus and tibialis anterior muscles in chronic hemiplegic patients could be useful for the improvement of functional gait.

• Annals of Clinical Neurophysiology
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• v.6 no.1
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• pp.35-38
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• 2004

Background: The purpose of this study is to evaluate the difference between the hemiplegic patients and controls with the newly developed three demensional electrogoniometer gait analysis program. Methods: The basic kinematic data of hip, knee and ankle joints on the sagittal plane and of temporospatial gait parameters were obtained from 25 hemiplegic patients and 25 healthy adults with three-dimensional electrogoniometer Domotion$^{(R)}$ Results: Significant difference were observed between patients and controls in kinematic parameters. Mean maximal hip flexion of healthy adults and hemiplegic limb of patient was $32.89{\pm}1.8^{\circ}$ and $18.24{\pm}4.8^{\circ}$, maximal knee flexion was $50.32{\pm}2.4^{\circ}$ and $34.98{\pm}10.4^{\circ}$, maximal ankle dorsiflexion was $5.34{\pm}1.2^{\circ}$ and $1.22{\pm}2.8^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.46{\pm}3.2^{\circ}$(p<0.05). Mean maximal hip flexion of healthy adults and unaffected limb of hemiplegic patient was $32.89{\pm}1.8^{\circ}$ and $28.36{\pm}6.6^{\circ}$, and maximal ankle plantar flexion was $15.63{\pm}2.0^{\circ}$ and $8.62{\pm}3.7^{\circ}$, respectively(p<0.05). Conclusions: The gait parameters of hemiplegic patients showed significant differences as compared with normal gait parameters with the using of three dimensional gait analysis with electrogoniometer.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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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 Academy of Orthopedic Manual Physical Therapy
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• v.18 no.2
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• pp.67-75
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• 2012

Background: Hemiplegic patients have the problems of the balance and weight shifting to the affected leg in walking. The aim of this study was to investigate the effect of unilateral stepping exercise combined with auditory feedback on balance and walking ability of the hemiplegic patients. Methods: Thirty hemiplegic patients were allocated in study group (n=15) or control group (n=15). General exercise and weight supporting exercise were conducted for the control group, and general exercises and unilateral stepping exercise combined with auditory feedback were conducted for the study group. Exercise were conducted three times a week for six weeks. Balance ability was measured by Berg Balance Scale (BBS), postural assessment scale for stroke (PASS), and performance-oriented mobility assessment (POMA). Walking ability was measured by time up and go test (TUG), 10m walk test (10mWT), and six minutes walk test (6MWT). Results: Balance and walking ability were significant increased in both group (p<.05). Balance and walking ability of the study group were more increased than that of the control group (p<.05). Conclusions: Unilateral stepping exercise combined with auditory feedback is more effective than weight supporting exercise to increase on balance and walking ability for the hemiplegic patients.

• Physical Therapy Korea
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• v.29 no.3
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• pp.225-234
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• 2022

Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke. Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients. Methods: This is an observational study, in which twenty participants were clinically diagnosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland-Altman plot and 95% limit of agreement (LoA) was calculated. Results: The intrarater reliability (rotation with DG: 0.96-0.98, SP: 0.98; lateral flexion with DG: 0.97-0.98, SP: 0.96) was excellent. A strong and significant correlation was found between DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, -5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, -7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, -3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, -8.68°]). Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.

• Journal of Korean Physical Therapy Science
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• v.3 no.1
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• pp.855-861
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• 1996

The purpose of this study was to compare a pelvic tilt angle between sound side and affected side in hemiplegic patients and the changing affected pelvic posterior tilt angle was measured at intervals of 3, 6, 9 weeks after Bobath approach. The subject for the study were 10 hemiplegic patients(mean age of 54.1 years)without orthopedic disability on pelvic bone. The data were analyzed by t-test, one-way ANOVA. The results of this study were as follows. There was a significant difference in the pelvic tilt angle between sound side and affected side in hemiplegic patients. There was a significant difference in affected pelvic posterior tilt angle between pre-treatment and post-treatment(9 weeks).