• 대한물리치료과학회지
• /
• 제27권2호
• /
• pp.13-24
• /
• 2020

Background: This study evaluates physical function, balance, and cognition rehabilitation motivation. Design: Cross-sectional study. Methods: The subjects include 67 stroke patients to measure physical function, balance, and cognition rehabilitation motivation. For evaluation of physical function, Manual Muscle Test, Range of Motion, Modified Ashworth Scale for spasticity, grasping power, and balance was measured using Functional reach test (FRT), Berg Balance Scale (BBS). For evaluating Cognition, Korean-Mini Mental State Examination, motivation for rehabilitation scale was used to measure for motivation. Results: The results of this study that the moderating effect of rehabilitation motivation was significant in the effect of physical function on BBS (p<0.01), The moderating effect of rehabilitation motivation was significant in the effect of FRT on physical function (p<0.01), The moderating effect of external motivation was also significant in the effect of FRT on physical function (p<0.01). However, the results of the rehabilitation motivations generally divided into three groups (Lower, Average, Upper) and all three results were statistically significant only in groups of average and lower. Conclusion: This study confirms that the rehabilitation motive has demonstrated significant adjustment effects between the body function and balance. In this study, physical function, balance and cognition were significantly correlated with each other, and rehabilitation motivation proved a significant moderating effect between physical function and balance.

• 대한물리의학회지
• /
• 제6권3호
• /
• pp.257-266
• /
• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• The Journal of Korean Physical Therapy
• /
• 제30권4호
• /
• pp.135-140
• /
• 2018

Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.

• Journal of Korean Neurosurgical Society
• /
• 제50권2호
• /
• pp.95-98
• /
• 2011

Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

• 대한약침학회지
• /
• 제12권4호
• /
• pp.97-110
• /
• 2009

Objective : The purpose of this study is to determine the effect of Hominis Placenta Pharmacopuncture(HPP) on lower limb spasticity control in stroke patients. Methods : Twenty stroke patients with Leg spasticity were randomly divided into two groups, a Distilled water Pharmacopuncture(group I) and a HPP(group II). The number of Pharmacopuncture was 5 times a week and acupuncture treatment was 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), H-reflex/M-response ratio(H/M ratio), Berg Balance Scale(BBS) and Time Up & Go(TUG) were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p$<$.05) in BBS but no significant improvement in MAS, H/M ratio, and TUG. Group II showed significant improvement(p$<$.05) in MAS, BBS, and TUG, but no significant improvement in H/M ratio. The results showed significant difference in TUG, but no significant difference in MAS, H/M ratio and BBS between 2 groups. Conclusion : These results showed that HPP might decrease lower limb spasticity and increase leg motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on lower limb in spasticity by HPP.

• 대한통합의학회지
• /
• 제8권1호
• /
• pp.57-66
• /
• 2020

Purpose : This study aimed to identify whether resistance exercise using elastic bands for six weeks can improve muscle strength, muscle tone, balance, and gait in patients with stroke. Methods : In total, 35 patients with stroke were randomly divided into three groups: resistance exercise using elastic band training combined with less affected side training group, more affected side training group, and both sides training group. Muscle strength, muscle tone, balance, and gait were assessed using a hand-held dynamometer, the modified Ashworth scale, the Berg Balance scale (BBS), and wireless 3-axis accelerometer, before and after training. Results : All three groups showed a significant increase in muscle strength of the lower extremity after training, and there was a significant difference among the groups. There was no change in muscle tone in all three groups. BBS scores increased significantly in all three groups after training, but these scores were not significantly different. The gait speed increased significantly in all three groups after the training, but the difference was not significant. The cadence increased significantly in Group 2 after training; however, there was no significant difference between Groups 1 and 3. There were no significant differences between the groups before and after the training. Step length increased significantly in Groups 2 and 3 after the training, but it was not significantly different in Group 1. After training, Groups 2 and 3 were significantly greater than Group 1 in the change in step length. Conclusion : The results show that resistance exercise using elastic bands can improve strength, balance, and gait in patients with chronic stroke. Especially, more affected side training was more effective in improving muscle strength than less affected side training. More affected side and both sides training are thought to be more effective than less affected side training to improve step length.

• 대한통합의학회지
• /
• 제7권4호
• /
• pp.231-240
• /
• 2019

Purpose : This study aimed to determine whether resistance exercise using elastic bands for 6 weeks could improve the muscle strength, muscle tone, balance and gait among stroke patients. Methods : A total of 11 stroke patients who had agreed to participate in the study were randomly divided into 3 groups receiving elastic band resistance training on their less affected side (experimental group 1, n=4), affected side (experimental group 2, n=3), and both the sides (experimental group 3, n=4). Muscle strength, muscle tone, balance and gait were assessed using a hand-held dynamometer, the modified ashworth scale (MAS), the berg balance scale (BBS), and G-walk respectively, before and after training. Wilcoxon signed-rank test was used to analyze intergroup changes after the intervention, whereas the Kruskal Wallis H test, and Mann-Whitney U test were used to analyze intergroup changes in all variables. Results : Strength in all the muscle, except for the flexor and extensor muscles in the affected knees, was increased in all the groups, however, no significant difference was observed. No change in the muscle tone (MAS) was found in any group. All the groups showed increased BBS scores walking speed, and walking symmetry following training, although, the differences were not significant. Changes in the affected step length of experimental group 1 were significantly greater than those of experimental group 3, whereas changes in the affected step length in experimental group 3 were significantly greater than those of experimental group 2. Conclusion : Our results suggest that resistance exercise using elastic bands are a potential intervention for improving lower extremity muscle strength, balance, and gait among stoke patients.

• Physical Therapy Rehabilitation Science
• /
• 제6권2호
• /
• pp.96-104
• /
• 2017

Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

• 대한한방소아과학회지
• /
• 제19권2호
• /
• pp.255-269
• /
• 2005

Objective : To evaluate the effect of Oriental Medical Treatment on a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation Method : We applied various methodology of Oriental Medical Treatment including Acupuncture, Electroacupuncture, Physical treatment, Herbal Medicine, Moxibustion treatment and Western medication as well. Result: Herbal medicine was applied on the basis of the patient's history. We applied formular to remove phelgm as a pathogenic factor after Hypoxic Ischemic Encephalopathy. At the same time, considering the patient spent more than a month in ICU lacking appropriate nutrition, we used formuli on the basis of 'Deficiency of Spleen' focusing to vitalize the function of digestive system. As the condition of the patient changed, we also adapted formular accordingly. We prescribed Herbal medication to strengthen Yin and Yang equally as she got hospitalized for long time. Also we applied Acupuncture treatment and Moxibustion treatment to control Qi flow. The general condition of the patient got better with successful removal of Foley catheter and elevated Glasgow Coma scale. We used Electroacupuncture, Physical treatment and Western medication at the same to get maximized effect on relaxing the contracted muscle. According to the Modified Ashworth Scale (MAS), we have some changes in muscle spasticity but later, the effect was not that significant. Conclusion : We had a patient with Hypoxic Ischemic Encephalopathy followed by Cardiopulmonary Resuscitation. In the management of Hypoxic Ischemic Encephalopathy, Conservative treatments are the mainstream but there are not many alternatives. Therefore, We suggest that Oriental medical approach may contribute to the management of Hypoxic Ischemic Encephalopathy.

• 대한통합의학회지
• /
• 제7권3호
• /
• pp.71-83
• /
• 2019

Purpose: This meta-analysis aimed to analyze to the effects of aquatic exercise programs in children with cerebral palsy and identify directions for future research. Methods: A systematic search based on the PRISMA guidelines was undertaken for studies conducted between 2006 and 2018 on aquatic exercise programs in children with cerebral palsy. A total of 10 studies were selected according to the inclusion criteria. The methodological quality was assessed using the Risk of Bias Tool for Randomized Controlled Trials (RoB) and Risk-of-Bias Assessment Tool for Non-randomized Studies (RoBANS). A meta-analysis software (CMA 3.0) was used to calculate the mean effect size, effect size by intervention (Halliwick and Watsu Aquatic methods), and effect size by outcome. Results: The mean effect size was 0.457. The effect size by intervention was largest for the Halliwick method, followed by the Watsu method. The effect size by outcome was largest for range of motion, followed by the gross motor function measure, the Pediatric Berg Balance Scale, and the Modified Ashworth Scale. Meta-regression analysis showed effect size increased when sample size, number of sessions, and length of sessions increased. Conclusion: The results show that aquatic exercise programs have a positive effect on children with cerebral palsy. Therefore, it is necessary to develop a guideline that recommends the appropriate intervention and the identifies the direction of future studies on aquatic exercise programs.