• 한국전문물리치료학회지
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• 제27권3호
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• pp.178-184
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• 2020

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

• 대한물리치료과학회지
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• 제27권2호
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• pp.25-35
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• 2020

Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.48-54
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• 2024

Background: Promoting patients' safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI). Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors. Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient's medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge. Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay. Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.

• 대한한방내과학회지
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• 제37권5호
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• pp.893-902
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• 2016

Objective: To describe the effects of traditional Korean medicine on dizziness and gait disturbance arising after removal of a vestibular schwannoma. Methods: The patient was treated using Korean medical treatments, such as herbal medicines (Jaeumkunbi-tang-gagambang and Yookmijihwang-Insamyangyoung-tang-gagambang), acupuncture, and moxibustion. We measured the state and progress of this case with the Korean Vestibular Disorder Activities of Daily Living Scale (K-VADL), Berg Balance Scale (BBS), and a visual analogue scale (VAS). Results: After treatment, the K-VADL score decreased from 167 to 74 and the VAS score decreased from 10 to 5.7, while the BBS score increased from 3 to 42. Conclusion: Jaeumkunbi-tang-gagambang (滋陰健脾湯) and Yookmijihwang-Insamyangyoung-tang-gagambang(六味地黃湯 合 人蔘養榮湯 加減方) appear to be effective for controlling dizziness and gait disturbances occurring after removal of vestibular schwannomas.

• The Journal of Korean Physical Therapy
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• 제19권5호
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• pp.77-85
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• 2007

Purpose: This study was to investigated the effect of physical function and quality of life through physical therapy and occupational therapy by Bobath approach to patient with ALS. Methods: The data of 1 patient with ALS, who visited D hospital in Busan, was collected from June 5, 2006 to August 19, 2007. To determine the physical function and quality of life, Berg Balance Scale (BBS), Gait, Skate. Purdue Pegboard, WHOQOL-BREF, COPM were used. Results: BBS score was increased 0 to 33 in the pre and post test. Gait distance was increased 0m to 500m in pre and post test. Skate score was increased 13 to 22 in the pre and post test, Purdue Pegboard score was increased 0 to 3 in the pre and post test, WHOQOL-BREF was increased 1.92 to 2.46 in the pre and post test. Average COPM score of performance and satisfaction grade of pre test score was 1 then Post test score of performance score increased to 5.7 and satisfaction increased to 4. Conclusion: Physical therapy and Occupational therapy increase physical function and quality of life in ALS patients. Physical therapy and occupational therapy should study more about patients with ALS.

• The Journal of Korean Physical Therapy
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• 제32권1호
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• pp.39-43
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• 2020

Purpose: This study examined whether the motivation for rehabilitation influences the functional performance of stroke patients. Methods: To elucidate the same, correlation analysis between the 'rehabilitation motivation level' and 'functional performance improvement' was performed. Thirty-three stroke patients, who were hospitalized in rehabilitation and nursing hospitals, were enrolled in this study. Functional performance was assessed using the 10MWT, FRT, and the BBS. Statistical analysis was performed to determine the correlation between the reactivation symptoms and rehabilitation therapy at four weeks, eight weeks, and 12 weeks. Results: The results showed a significant correlation between the reactivation symptoms and rehabilitation therapy, as evidenced by the 10MWT, FRT, and BBS (8-12 weeks 10M gait test, Berg balance scale for 4-8 weeks, and 8-12 weeks). The FRT did not reveal any significant correlation between the rehabilitation program and reactivation. Conclusion: The present study confirmed that a higher motivation for rehabilitation in stroke patients resulting in a higher likelihood of it acting as a factor in improving their functional ability. Based on the above-mentioned results, this study suggests that a rehabilitation program could be considered for the motivation of patients to participate in a rehabilitation program.

• Physical Therapy Rehabilitation Science
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• 제7권1호
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• pp.1-5
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• 2018

Objective: Setting therapeutic goals assist to identify patient priorities and predict problem that may arise in performing daily and functional activities. Goal setting is associated with improved rehabilitation outcomes in individuals with hemiparetic stroke. This study was conducted to assess the effects of having awareness and satisfaction of goals on the functional status of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: Eighty-one people who had been diagnosed with stroke participated in this study. The study was conducted through a face-to-face surveys to identify participants' awareness and satisfaction of goals and standard assessment tools were used to evaluate patients' functional status. This study measured functional status through three clinical measures including the manual function test (MFT), Berg Balance scale (BBS), and modified Barthel index (MBI). Results: In participants with hemiparetic stroke, the MBI, BBS, and MFT scores were significantly higher in the participants who were aware of the therapeutic goal than in those who were unaware (p<0.05). The MBI, BBS, and MFT scores were not significant between the participants who were satisfied with the goal and those who were unsatisfied. Conclusions: This study suggests that having awareness in therapeutic goal-setting could lead to improvement of functional status in those with hemiparetic stroke. This study highlights how goal-setting can have a positive effect on persons with hemiparetic stroke.

• 한국전문물리치료학회지
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• 제11권3호
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• pp.59-70
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• 2004

The purpose of this study was to propose a task-related circuits program for stroke patients and to test the difference in functional improvements between patients undergoing conventional physical therapy and those participating in a task-related circuits exercise program. The subjects were 10 stroke in-patients of the Korea National Rehabilitation Center in Seoul. We measured the following variables: Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Tone Assessment Scale (TAS), speed of gait, rate of step, physiological costs index, age, weight, height, site of lesion, onset day and whether the subject participated in an exercise program. Collected data were statistically analyzed by SPSS 10.0/PC using descriptive statistics, Mann-Whitney U test, Wilcoxon rank sum test and Spearman's correlation. The results of the experiment were as follows: (1) In the pre-test and post-test for function, there was not a statistical significance between the group partaking in a task-related circuits program and the group of conventional physical therapy (p>.05). (2) In the MAS, BBS and speed of gait test, the group undergoing conventional physical therapy showed a statistical significance (p<.05). (3) In the MAS, BBS, speed of gait, PCI, TAS (passive, associated reaction, TAS total score), the group of task-related circuits program showed a statistical significance (p<.05). As a result, the group participating in a task-related circuits program had a more functional improvement than the group participating in conventional physical therapy. Therefore, an intervention recommended for a stroke patient would be a task-related circuits program consisting of a longer session of each task for a more improved functional recovery.

• PNF and Movement
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• 제15권3호
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• pp.361-371
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• 2017

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.

• 재활치료과학
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• 제9권3호
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• pp.63-75
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• 2020

목적 : 본 연구는 Lee Silverman Voice Treatment-BIG(LSVT-BIG) 프로그램이 뇌졸중 환자의 작업수행과 운동기능에 미치는 변화를 알아보고 임상적용 가능성을 확인하고자 하였다. 연구방법 : 뇌졸중 환자 2명을 대상으로 LSVT-BIG 프로그램을 4주 동안 주 4일, 회당 1시간, 총 16회기를 실시하였다. 중재 전·후의 변화를 비교하기 위해 캐나다 작업수행 측정(COPM), Berg 균형 척도(BBS), Time Up and Go(TUG), 기능적 뻗기 검사(FRT), 뇌졸중 상지기능 검사(MFT)를 사용하여 측정하였다. 자료 분석은 중재 전·후의 점수 변화를 비교하였다. 결과 : 대상자 2명 모두 중재 전·후로 작업수행의 수행도 및 만족도는 증가하였다. TUG의 수행시간은 대상자마다 각 0.91, 8.42초로 감소하여 보행 속도가 증가하였다. FRT 거리변화에서 대상자는 환측과 건측 모두에서 증가를 보였고, BBS 점수는 대상자마다 각 3점, 6점 증가하였다. 또한 MFT 점수에서 대상자 A는 건측에서만 1점 향상을 보였고, 대상자 B는 건측에서 1점, 환측에서 3점 향상된 점수를 보였다. 결론 : LSVT-BIG 프로그램이 뇌졸중 환자의 새로운 중재기법으로써의 임상적용 가능성을 확인하였다. 향후에는 LSVT-BIG 프로그램 효과에 대한 보완 연구가 필요할 것이다.