• 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.

• Journal of Korea Multimedia Society
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• v.20 no.12
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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.

• Journal of the Korean Society for Precision Engineering
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• v.30 no.4
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• pp.450-458
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• 2013

The aim of this study was to develop and verify gait training system for post-stroke hemiplegia patients with step length asymmetry. Most post-stroke hemiplegic patients show gait asymmetry and weight shifting training has been suggested as a useful method for improving the walking ability. However, verbal cue by physical therapist may be not effective. Therefore, our weight shift training system was designed to give a feedback to patients through precise plantar pressure and center of pressure (COP) measurement. This weight shifting biofeedback training system is composed of F-Scan plantar pressure measurement system and software development kit (SDK) for Windows operating system. Two post-stroke patients with step length asymmetry were enrolled in this study. After training for six weeks, the weight shift score and step length ratio of two all patients were improved and approached to them of non-disabled. This system developed in this study may improve the step length asymmetry, and therefore this system is also expected to improve a walking ability in hemiplegic patients.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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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.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.11-24
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• 2007

Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.3
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• pp.39-45
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• 2015

PURPOSE: The purpose of this study was to investigate the effect of weight shift training with electrical sensory simulation feedback on quiet standing balance in hemiplegic stroke patients. METHODS: 30 stroke patients were equally allocated at random to an experimental group or a control group. Patients in both two groups underwent comprehensive rehabilitation physical therapy for 30 minutes per day for 5 days per week for 4 weeks. Members of the experimental group received additional weight shift training with electrical sensory simulation feedback was conducted for 15 minutes after 30 minute sessions, whereas members of the control group underwent additional leftward/rightward weight shift training by themselves after 30 minutes per day for four weeks. COP (center of pressure) path lengths, COP velocities, and foot forces were measured before and immediately after the 4-week training period in both groups and results were compared. RESULTS: COP path lengths significantly decreased by 3% after training in the experimental group and this was significantly greater than that observed in the control group (p<0.05). In both groups, foot forces of affected sides showed significant increases after intervention, whereas foot forces of unaffected sides showed significant decreases (p<0.05). No significant difference was observed between the two groups with respect to these changes. CONCLUSION: Weight shift training using electrical sensory simulation feedback has a positive effect on quiet standing balance in hemiplegic stroke.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.493-501
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• 2016

Objective: This study analyzes the effect of angle conditions of rehabilitation equipment used for supporting hemiplegic patients on their rehabilitation training for standing action. The study was performed by adjusting the rear angle of seat inclination through a motion analysis. Background: Owing to a loss of muscle rigidity and degradation of muscle control ability, hemiplegic stroke patients suffer from asymmetrical posture, abnormal body balance, and degraded balance abilities due to poor weight-shifting capacity. The ability to shift and maintain one's weight is extremely essential for mobility, which plays an important role in our daily life. Thus, to improve patients' ability to maintain weight evenly and move normally, they need to undergo orthostatic and ambulatory training. Method: Using a motion analysis system, knee movements on both hemiplegic side and non-hemiplegic side were measured and analyzed in five angles ($0^{\circ}$, $10^{\circ}$, $30^{\circ}$, $50^{\circ}$, $70^{\circ}$) while supported by the sit-to-stand rehabilitation equipment. Results: The knee movements on both sides increased as the angle increased in angle support interval to support a hemiplegic patient's standing up position. In standing up interval, a hemiplegic patient's knee movement deviations on both sides decreased, and the movement differences between hemiplegic and non-hemiplegic legs also decreased as the angle increased. Conclusion: The results of this study showed that the rehabilitation effectiveness increases as the angle increases, leading to a balanced standing posture through the decrease of movement difference between hemiplegic and non-hemiplegic sides and an improved standing up ability through the increase of knee movement on both sides. However, angles higher than $50^{\circ}$ didn't provide a significant effect. Therefore, a support angle under $50^{\circ}$ was proposed in this study. Application: The results of this study are expected to be applicable to the design of sit-to-stand support equipment to improve the effectiveness of the rehabilitation process of hemiplegic patients.

• Korean Journal of Adult Nursing
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• v.16 no.4
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• pp.626-635
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• 2004

Purpose: The purpose of this study was to explain the effects of upper extremity exercise program on hemiplegic stroke patients. Method: The research was designed by a non-equivalent pretest-posttest way. The data were collected from February to August 2003 at a community health center located in Seoul. The study subjects were a conveniently selected group of 27 hemiplegic patients. The subjects were divided into two groups, the experimental group and the control group. 14 subjects were assigned to the experimental group in which the subjects did the upper extremity exercise training for 2 hours once a week during four weeks, while 13 subjects were assigned to the control group. The outcomes were evaluated on the basis of the upper extremity motor ability(hand power, pinch power, upper extremity ROMs), amount of motor use and the degree of depression. Result: 1. After treatment, the motor abilities of the affected upper extremity(hand power, pinch power, ROMs of wrist flexion/extension, shoulder extension) were significantly different between the two groups. However, there were no significant differences in elbow and shoulder flexion between experimental and control group. 2. After treatment, amount of motor use of affected upper extremity were significantly different between the two groups. 3. After treatment, the degree of depression were significantly different between the two groups. Conclusion: In considering these results, the upper extremity exercise program could be effective for hemiplegic patients by improving the function of their upper extremity. Long-term studies are needed to determine the effects of upper extremity exercise program.

• Journal of Acupuncture Research
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• v.23 no.4
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• pp.69-80
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• 2006

Objectives : The occurrence of shoulder pain after attack of stroke varies from 15% to about 80% in patients. Hemiplegic shoulder pain has been shown to affect stroke outcome in a negative way that it interferes with recovery after a stroke. These following processes have been all postulated as causes of a shoulder pain: glenohumeral subluxation, spasticity, impingement, soft tissue trauma, glenohumeral capsulitis, shoulder hand syndrome. And stroke patients may suffer from pain caused by stroke itself(central post-stroke pain). The aim of this study is to investigate the effectiveness of Bee venom therapy for shoulder pain in stroke patients. Methods : To evaluate the effectiveness of Bee Venom Acupuncture Therapy, 40 patients were allocated into control and treatment group. They were monitored for 3 weeks and followed up with VAS score(with the interval of Initial(YAS1)), 1 week later(VAS2), 2 weeks later(VAS3), 3 weeks later(VAS4), Motor Grade and Passive ROM. Results : VAS score decrease in treatment group compared to control group. Bee Venom Acupuncture Therapy seems to decrease hemiplegic shoulder pain and this effect was statistically significant after 3 weeks. Therefore this therapy could be recommended for the treatment of patients with shoulder pain after stroke and further extensive clinical studies are expected. Conclusion : We suggest that GDS oral administration and electro-acupuncture at $BL_{52}$ & $GB_{39}$ are available for prevention and curing about the postmenopausal osteoporosis.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.3
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• pp.89-101
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• 2020

Objectives The purpose of this study is to assess the effectiveness of Chuna manual therapy for shoulder pain in hemiplegic patients after stroke. Methods For a systematic review and meta-analysis, we set a key question in accordance with participants, intervention, comparison, outcome, study design (PICO-SD). we searched for clinical studies that conducted chuna manual therapy for shoulder pain in hemiplegic patients after stroke 7 databases until September 2019. Only randomized controlled trials were chosen. Results Total 14 randomized controlled trials were chosen for systematic review and meta-analysis. 9 studies used efficacy rate as evaluation tool, and 8 used visual analogue scale. Pressure method (壓力型) was used in 11 studies, followed by osteopathy method (整骨型) and wave motion method (波動型) in 9 studies. Chuna manual therapy showed statistically significant pain reduction effect. Through meta analysis, Chuna manual therapy showed significant pain reducing effect except the study with Chuna manual therapy and electroacupuncture compared to electroacupuncture only. Conclusion As a result, Chuna manual therapy showed statistically significant effect in pain reduction. However, almost studies were evaluated in a state of having probable high risk of bias. This suggests that it requires attention to make an interpretation in this study. Furthermore, more clinical research need to be accomplished in the future.