• Title/Summary/Keyword: Hemiplegic stroke

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Characteristics of Muscle Contraction During the Wrist Movement in Chronic Hemiplegic Stroke Patients (만성 편마비 환자의 손목 운동 시 근수축 특성)

  • 태기식;김사엽;송성재;이지용;이영희;김영호
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.246-249
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    • 2004
  • The purpose of this study was to investigate the characteristics between EMG timing of muscle contraction and motor impairment in chronic hemiplegic stroke patients. Delay time and co-contraction of 4 patients who had stroke less than 3 years were measured during isometric wrist flexion and extension along the 3 seconds beep signal. Onset and offset of muscle contraction were significantly delayed on the more affected sides than control sides. Offset was significantly delayed than the onset on the affected sides in wrist flexion. Also, recruitment of antagonist was larger than agonist on the affected sides. Co-contraction ratio on the affected side was significantly smaller than control sides in wrist flexion. In affected sides, Fugl-Meyer motor assessment(FMA) shows the correlation of onset delay in wrist flexion and extension. However, co-contraction ratio correlated with FMA in wrist flexion. EMG assessment is likely to be useful outcome measure and provide insights into mechanism for motor recovery in stroke patients.

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Changes in Balance and Gait Following Backward Walking Exercise in Hemiplegic Stroke Patients (뒤로 걷기 운동에 따른 뇌졸중 편마비 환자의 균형능력 및 보행능력의 변화)

  • Shin, Kyu-Hyun;Kang, Soon-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.21-31
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    • 2017
  • PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.

Walking behaviors for stroke survivors: comparison between straight line and curved path

  • Hwang, Wonjeong;Choi, Bora;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.141-145
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    • 2019
  • Objective: The purpose of this study was to compare walking conditions (straight line and curved path) on walking patterns in persons who had experienced hemiplegic stroke and to determine whether if they adapt their walking pattern and performances according to changes in environmental conditions. Design: Cross-sectional study. Methods: Forty-four hemiplegic stroke survivors participated in this study. This study measured walking performance in three different walking conditions, such as straight walking, the more-affected leg in the inner curve walking, and less-affected leg in the inner curve walking conditions, and a 2-dimentional gait analysis system was used as a primary measurement. This study also measured secondary clinical factors including the Timed Up-and-Go Test, the Trunk Impairment Scale, and the Dynamic Gait Index. Results: After analyzing, cadence and step length of the less-affected side, stride length in the more-affected side, and stride length in less-affected side were significantly different among the three different walking conditions in this study (p<0.05), but other temporospatial parameters were not significant. Cadence was the largest in the straight walking condition. Step length in the less-affected side, stride length in the more-affected side, and stride length in less-affected side were also the longest in the straight walking condition. Conclusions: The results of the study suggest that hemiplegic stroke survivors show walking adaptability according to changes in walking demands and conditions, and moreover, cadence and step and stride lengths were significantly different between straight and curved walking conditions.

Acceptance of Disability and Related Factors of Hemiplegic Elderly and Non-Elderly (편마비 노인과 편마비 청장년의 장애수용과 관련요인)

  • Kim, Mi-Hee
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.547-558
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    • 2009
  • Purpose: This study was conducted to study the acceptance of disability and influential factors between hemiplegic elderly and non-elderly after stroke. Methods: Data were collected with questionnaires from 104 elderly and 134 non-elderly with hemiplegia. Data were analyzed by $x^2$-test, t-test, ANOVA, ANCOVA, Pearson correlation coefficient, and multiple regression. Results: Significant predictors of acceptance of disability were family support, activities of daily living, and age, and these factors accounted for 24.2% of variance in acceptance of disability in the hemiplegic elderly. On the other hand, the significant predictors were family support and employment, and these factors accounted for 32.3% of variance in acceptance of disability in the non-elderly. Family support was the most influential variable in both the elderly and the non-elderly. Conclusion: An acceptance of disability program for the hemiplegic elderly should be designed differently from that for the non-elderly.

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The Effect of Simulation Task Oriented on Balance in Patients with Stroke (시뮬레이션 과제 수행이 뇌졸중 환자의 균형 능력에 미치는 효과)

  • Goo, Bong-Oh;Kang, Seung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.509-515
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    • 2010
  • Purpose : This study was performed to examine the effect of stimulation task-oriented training on the balance ability of the hemiplegic patients caused by stroke. Methods : We made a random sampling of 25 hemiplegic patients caused by stroke. 10 patients(experimental group)were treated by simulation Task-oriented training and Conventional training used by balance pad. The other 10 patients(control group) were only treated by Conventional training used by balance pad. During the training, 3 patients from the experimental group and 2 patients from the control group were excluded by private affairs. The control group has done Conventional training 6 times a week for 6 weeks. And experimental group has done Simulation task-oriented training two times, conventional training four times a week for 6 weeks. Balance ability was assessed by Fuctional Reaching Test (FRT) : unilateral and bilateral reaching. Results : In comparison of FRT before and after training, two groups all was significantly improved(p<.05). But bilateral reaching variation was significantly improved in experimental group. Conclusion : we can use simulation Task-oriented training valuably to increase balance ability of hemiplegic patients.

EMG Study for Muscle Activation during Variable Gait Training in Stroke Patients: Stepper Climbing, Stair-up and Level-ground Gait

  • Kim, Cho-Rong;Choi, Sung-Jin;Shin, Won-Seob
    • The Journal of Korean Physical Therapy
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    • v.25 no.6
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    • pp.393-398
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    • 2013
  • Purpose: The purpose of this study was to compare muscle activation patterns of lower extremities in stroke patients during stepper climbing, stair-up, and level-ground gait conditions by surface electromyography (EMG). Methods: Subjects included 19 hemiplegic patients comprehensive rehabilitation center for inpatients with stroke. Surface EMG was used to measure the subjects' medial gastrocnemius (GCM), tibialis anterior (TA), biceps femoris (BF), and rectus femoris (RF) activity as they took six steps during stepper climbing, stair-up, and level-ground gait conditions. Results: There was no significant difference in the BF or RF muscle activity for the stepper climbing, stair-up, and level-ground gait conditions. However, there were significant differences in the medial GCM and TA muscle activity between each condition on the patients' hemiplegic side(p<0.05). There was significant difference in the medial GCM, TA, RF, and BF muscle activity between each condition on the patients' non-hemiplegic side (p<0.05). Conclusion: As a result, the overall muscle activity during the level-ground gait was higher than the stair-up condition, and the muscle activity during the stair-up condition was higher than the muscle activity during the stepper climbing condition. As one of the many methods used for gait training, we suggest that the stepper exercise could be applied at an earlier stage in the gait training process.

The Change of Lateral Shift of Center of Pressure according to the Gait Improvement in Post-Stroke Hemiplegic Patients (뇌졸중 후 편마비 환자의 보행능력 향상에 따른 질량중심 좌우이동의 변화)

  • Lee, Il-Suk;Park, Kee-Eon;Hong, Hae-Jin;Sung, Kang-Keyng;Lee, Sang-Kwan
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.448-454
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    • 2014
  • Objectives: The aim of this study was to analyze the change of lateral shift of Center of Pressure (CoP) according to the gait improvement in post-stroke hemiplegic patients and to investigate relationship between the change of motor grade and lateral shift of CoP. Methods: We measured the lateral shift of CoP and motor grade of eight post-stroke hemiplegic patients at the beginning of dependent gait and independent gait. Results: We found that CoP tended to be shifted to the non-affected side when patients started to walk independently. Furthermore, there was no relationship between the change of motor grade and lateral shift of CoP. Conclusions: This result may suggest it is more important to control the non-affected side than the affected side, at least until the beginning independent gait.

Effect of Trans cranial Directed Current Stimulus on Temporal and Spatial Walking Capacity for Hemiparalysis Patients (경 두개 직류자극이 뇌졸중 환자의 시간적, 공간적 보행능력에 미치는 영향)

  • Lee, Yeon Seop;Jun, Hun Ju
    • Journal of Korean Physical Therapy Science
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    • v.29 no.3
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    • pp.75-84
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    • 2022
  • Background: This study was to investigate the effect of non-invasive transcranial direct current stimulation due to hemiplegic patients due to stroke on temporal and spatial gait ability. Design: Randomized sham controlled trial. Methods: For the study method, 42 patients with hemiplegia due to stroke were randomly assigned to 14 patients each, and the general walking group, tDCS walking group, and tDCS (sham) walking group were subjected to 5 times a week, 30 minutes a day, and 6 weeks. In the temporal gait variables of hemiplegic patients due to stroke, the effect of the gait time, gait cycle, single support, double support, swing phase, stance phase, gait speed, cadence were measured. In spatial variables, one step length and one step length were measured. Results: As a result of the study, the EG group significantly increased in the step time, gait velocity, and cadence of the paralysis side in the comparison of temporal walking variables between groups according to the application of tDCS of walking ability in hemiplegic patients due to stroke patients(p<.05). In the change in spatial walking variables between groups according to the application of tDCS, the step length and stride length of the EG group showed a significant increase. Both the comparison of temporal and spatial symmetry walking variables between groups according to tDCS application was not significant(p>.05) Conclusion: As a result, tDCS has an effective effect on the improvement of the gait ability of stroke patients. In particular, it is an effective method of physical therapy that can improve the cadence and speed of gait, which can be combined with the existing gait training to effectively increase the gait of hemiplegia due to stroke patients.

The effect of taping therapy on hemiplegic gait (테이핑 요법이 편마비 환자의 보행에 미치는 영향)

  • Lee, Ilsuk;Lim, Hyungmoon;Choi, Sanho;Oh, Jaegun;Lee, Sangkwan;Sung, Kang-keyng
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.49-60
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    • 2013
  • ■ Objectives The aim of this study is to analyze the change of gait pattern by the taping therapy in a hemiplegic patient. ■ Methods We conducted the taping therapy for 7 days to affected ankle joint of hemiplegic patient and analyzed the change of gait pattern using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) ■ Results In terms of affected side, cadence, total double support, step length and stance phase decreased, while swing phase and step time increased by taping therapy. In terms of unaffected side, step length increased by taping therapy. Center of pressure intersection point moved to posterior and affected side in cyclogram pattern. ■ Conclusion Taping therapy to affected ankle joint of hemiplegic patient would be advantages to gait improvement in hemiplegic patients.

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The Effect of Presynaptic Inhibition Using the Transcutaneous Electrical Stimulation for Global Synkinesis on the Post-Stroke Hemiplegic Patients (경피전기자극을 이용한 연접 전 억제가 만성 뇌졸중 환자의 global synkinesis에 미치는 영향)

  • Park, Young-Hyun;Kim, Su-Hyun;Choi, Hyun;Oh, Seok;Choi, Ji-Ho;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.7-13
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    • 2010
  • Purpose : This study was performed as follows in order to investigate the effect of presynaptic inhibition mechanism using the transcutaneous electrical stimulation (TES) for global synkinesis (GS) on the post-stroke hemiplegic patients. Methods : The subjects consist of 38 post stroke hemiplegic patients; experiments were performed on thirty patients excluding eight. The experiment was performed on sham group, sensory level stimulation group, and motor level stimulation group for 20 minutes a day 5 times a week for 6 weeks total. We compared the differences in GS levels and walking ability. The measurements were carried out pre, immediated, post 10th, and 20th, for a total of four measurements. Results : The GS level using sEMG found significant differences between groups at the post 10th and post 20th in dorsiflexion, and post 20th in plantarflexion (p<0.05, p<0.01). The motor level group indicated more significant differences when the number of electrical stimulations increased. TUG and 10 m walking test indicated a significant difference at immediated, post 10th, and post 20th. The motor level group showed more significant decreasing tendency than the sensory level group. Conclusion: From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.