• 한국전문물리치료학회지
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• 제24권2호
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• pp.66-75
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• 2017

Background: After a stroke, the control of the trunk muscle may be severely impaired. Due to the importance of trunk control in complex daily postures, the ability to adopt a correct sitting posture is considered a determinant of the recovery of independent function after a stroke. Objects: The purposes of this study were to compare differences in buttock pressure between the left and right sides of hemiplegic patients and differences in their pelvic tilting angles (sagittal and coronal planes) after sitting training with visual biofeedback (VBF) in real time. Methods: Twenty-two individuals with unilateral strokes (11 left-side and 11 right-side hemiplegic stroke patients) participated in this study. Buttock pressure was measured using a pressure mat, and pelvic angles were measured using a palpation meter. Results: The asymmetry of pressure between the right and left (first and third chamber) sides was significantly decreased after the VBF training. The measurements obtained using the palpation meter revealed a significant decrease in the pelvic angles pre- versus post-intervention. Conclusion: VBF training may be distribute a patient's buttock pressure equally while in a sitting posture and increase the length of time a stroke patient can maintain a symmetrical sitting posture. It can also improve pelvic control while sitting in a neutral position.

• The Journal of Korean Physical Therapy
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• 제23권3호
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• pp.71-77
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• 2011

Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

• The Journal of Korean Physical Therapy
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• 제17권3호
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• pp.351-367
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• 2005

The purpose of this study was to identity effects of virtual reality(VR) program related to standing postural control on balance, gait and brain activation patterns in chronic hemiplegic stroke patients. Subjects were assigned randomly to either VR group (n=12) or the control group (n=12) when the study began. Both groups received conventional physical therapy for 2 to 3 times per week. In addition to conventional physical therapies, VR group trained 3 types of virtual reality programs using IREX for standing postural control during 4 weeks (4 times/week, 30 minutes/time). Subjects were assessed for static and dynamic balance parameters using BPM, functional balance using Berg Balance Scale related to movement of paretic lower limb before and after 4 weeks of virtual reality training. The results of this study were as follows. 1. Following VR training, VR group demonstrated the marked improvement on dynamic mean balance, anteroposterior limits of stability (AP angle) and mediolateral limits of stability (ML angle). 2. Following VR training, both groups scored higher on Berg Balance Scale. However, a comparison of mean change revealed differences between groups. In conclusion, these data suggest that the postural control training using VR programs improve dynamic and functional balance performance in chronic hemiplegic stroke patients.

• 한국전문물리치료학회지
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• 제20권4호
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• pp.40-46
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• 2013

The purpose of this study was to determine which spatiotemporal gait parameters obtained during hemiplegic walking could be a predictive factor for the Timed Up and Go test (TUG). Two hundreds nine subjects who had suffered a stroke were recruited for this study. They were participated in two assessments; the TUG test and gait analysis. The relationship between the TUG test and spatiotemporal parameters was analyzed using Pearson's correlation coefficients. In addition, to predict the spatiotemporal gait parameters that correlated most with the TUG scores, we used multiple linear regression analyses (stepwise method). The results show that the normalized velocity was strongly correlated with the TUG performance (r=-.72, p<.001). Additionally, single support percentage (SSP), double support percentage (DSP), step time difference (STD), and step length difference (SLD) significantly were correlated with the TUG test. Normalized velocity, STD, DSP of affected side, and SSP of non-affected side explained 53%, 8%, 3%, 2%, of variance in the TUG test respectively. In conclusion, an increase in gait velocity and a decrease in STD would be effective indicators of improvement on the functional mobility in the stroke rehabilitation.

• The Journal of Korean Physical Therapy
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• 제11권1호
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• pp.55-61
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• 1999

The purpose of this study was to compare the moment and power of affected Side and those of unaffected side during gait in hemiplegic patients after stroke. Force plate ana kinetic gait analysis was used. The following is resulted from this study. 1. In the hip joint, moment values had not difference between affected side and unaffected side. Power values had difference between affected and unafected side. 2. In the knee joint, moment values and power values had difference between affected side and unaffected side. 3. In the ankle feint, moment and power values had not, difference between affected side and unaffected side.

• The Journal of Korean Physical Therapy
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• 제11권1호
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• pp.129-136
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• 1999

The purpode of this study was to determine the EMG characteristies of 7 subjects with hemiplegic gait receiving therapeautic exercise after stroke. The akin electrode and gait analysis system were used. The normal gait of 6 health volunteers was analysised. The results were following. 1. Gluteus maximus, the extensor of hip joint had high level of activity compared to normal, and had two peak in late stance phase and early Swing phase. 2. Medial hamstring, the flexor of knee joint had low level of activity compared to normal, and had continuous low amplitude pattern. 3. Vastus lateralis, the extensor of knee joint had high level of activity compared to normal, and had not continuous high amplitude. From early stance phase and mid stance phase, activity had high level but after swing phase. similar to normal. 4. Gastrocnemius, plantar flexor of ankle joint had low level of activity compared to normal and had continuous low amplitude. 5. Tibialis anterior, dorsiflexor of ankle joint had similar muscle activity to normal and had continuous low amplitude.

• 대한물리치료과학회지
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• 제28권2호
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• pp.30-39
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• 2021

Background: The purpose of this study was to compare the differences in gait and mobility according to the types of assistive device for ankle joint including ankle foot orthosis (AFO), non-elastic tape, elastic tape, and high ankle shoes in chronic hemiplegic stroke survivors. Design: A cross-over design. Methods: Twelve hemiplegic stroke survivors participated in this study, and they walked under 5 different conditions including bare feet, wearing a AFO, wearing a non-elastic tape, wearing a elastic tape, and wearing a high ankle shoes. During the participants walked, the spatio-temporal gait analysis and mobility examinations were performed. For the spatio-temporal gait analysis (gait velocity and cadence, step length, stride length, and single and double leg support time) and mobility examinations, the gait mat, TUG and TUDS were used. Results: As s results, on the AFO, non-elastic tape, elastic tape, and high ankle shoes, there were significantly differences in the all spatio-temporal gait parameters, TUG, and TUDS compared to barefoot (p<0.05). In particular, all spatio-temporal gait parameters, TUG, TUDS were significantly improved with AFO compared to barefoot. TUG was significantly improved with AFO compared to non-elastic tape, TUG and TUDS were significantly improved with AFO compared to elastic tape, gait velocity was significantly improved with non-elastic tape compared to high ankle shoes, gait velocity and TUG were significantly improved with elastic tape compared to high ankle shoes, and TUDS was significantly improved with non-elastic tape compared to elastic tape. Conclusion: The AFO, non-elastic tape, elastic tape, and high ankle shoes showed a positive effect on gait and mobility compared to barefoot, and among them, wearing AFO was most effective for improving gait and mobility of chronic hemiplegic stroke survivors.

• 한방재활의학과학회지
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• 제26권2호
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• pp.85-96
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• 2016

Objectives This study was performed to evaluate the effects of acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy on upper extremity of healthy people and hemiplegic patients by D.I.T.I.. Methods 20 healthy people and 20 hemiplegic patients caused by stroke were selected. They have been treated three different types of treatment; acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy. And skin temperature of upper extremity has been measured before and after each treatment by D.I.T.I.. The thermographic data was analyzed by 'Independent T-test' and 'Repeated measures ANOVA test'. Results 1. In healthy group, there was very statistical significant difference (p<0.001) of the amount of thermal change by each treatment, and the amount of change was arranged in descending order; acupuncture with pulsed electromagnetic, acupuncture and electro-acupuncture. 2. In hemiplegic group, the skin temperature of hemiplegic side was $0.97^{\circ}C$ cooler than non-hemiplegic side. 3. Skin temperature of all hemiplegic patients was increased after acupuncture treatment. 4. In hemiplegic group, there was statistical significant difference (p<0.05) of the amount of thermal change by each treatment, and the amount of change was arranged in descending order; acupuncture with pulsed electromagnetic, acupuncture and electro-acupuncture. Conclusions The results indicate that acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy had good effect on the change of skin temperature by stimulating sympathetic nervous system.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.11-19
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• 2016

Background: In the stroke patients with the characteristics of hemiplegic gait, turning direction of the affected and unaffected side influences turning time. Therefore, it is important to investigate the walking response to turning directions in stroke patients. Objects: This study aimed to measure the walking time while turning direction in hemiplegic patients depending on balance ability measured by Berg Balance Scale. Methods: A group of forty-five subjects with stroke (Berg Balance Scale score${\geq}46$ were twenty-eight, Berg Balance Scale score${\leq}45$ were seventeen) were enrolled in this study. Subjects were asked to perform the Timed Up and Go test. Testing indications included two directions for turning in each subject. These indications were for turning toward the affected and unaffected side in stroke patients. The duration of total analysis duration, sit to stand phase, stand to sit phase, mid-turning phase, and end turning phase 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 45 points of Berg Balance Scale score. The significance level was set at ${\alpha}=.05$. Results: There were significant increase time in the analysis duration and end turning phase duration while subjects were turned the unaffected side in stroke patients that presented a Berg Balance Scale score${\leq}45$ (p<.05). However, the comparison between the affected side and the unaffected side in the stroke patients with Berg Balance Scale score${\geq}46$, revealed no significant differences of the measured parameters. Conclusion: This finding should be suggested in the specific definition of turning direction for evaluation with Timed Up and Go test in the Berg Balance Scale score${\leq}45$, and other intervention for hemiplegic patients need to be suggested the direction of turning during walking training program.

• 대한한의학회지
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• 제23권2호
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.