• Title/Summary/Keyword: Modified Ashworth scale

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The impact of convergence balance training and taping on spasticity and balance ability in patients with chronic stroke (균형훈련과 테이핑 융복합 적용이 뇌졸중 환자의 발목관절 경직 및 균형능력에 미치는 영향)

  • Park, Shin-Jun;Kim, Tae-Hyun;Go, Jun-Hyeok;Youn, Pong-Sub
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.297-306
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    • 2017
  • The study was performed to determine the impact of the gastrocnemius taping with balance training on spasticity and balance ability of the ankle joint. A total of 25 stroke subjects were divided into two groups: a taping with balance training (n=14), a sham taping with balance training (n=11). Spasticity assesment was scored by modified ashworth scale. Balance ability assesment was performed by functional reach test (FRT), the timed up & go test (TUG). The stability index (SI), the left-right weight distribution (left-right WD), the toe-heel weight distribution (toe-heel WD) were analyzed in the eyes open conditions(EO) and eyes closed conditions(EC) conditions using by the Tetrax interactive balance system. The experimental group showed a significant improvement in SI, left-right WD and toe-heel WD in the EO and EC, MAS, FRT, TUG. In comparison between the groups, a significant improvement was detected in FRT, TUG, SI and left-right WD in the EO, and left-right WD and toe-heel WD in the EC. It was found out that a short period of balance training with taping is effective on spasticity and balance ability in stroke patients. Therefore, any stroke patient without skin damage is encouraged to use the gastrocnemius taping for balance rehabilitation.

The Comparative Study of Effectiveness of Cotreatment with $Samgieum-gagam$, Acupuncture and Sweet Bee Venom Acupuncture on Post-stroke Shoulder Pain (삼기음가감방과 봉약침, 체침의 병행치료가 뇌졸중 후 견관절 통증에 미치는 효과 비교연구)

  • Cho, Song-Hyun;Cho, Hong-Seok;Lee, Kyung-Yun;Yun, Suk-Hoon;Jung, Woo-Suk;Kim, Sang-Ho
    • Journal of Acupuncture Research
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    • v.29 no.2
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    • pp.15-27
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    • 2012
  • Objectives : The purpose of this study is to evaluate the effect of cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture on post-stroke shoulder pain. Methods : The subjects in this study were 43 patients with post-stroke hemiplegic shoulder pain. These patients were randomly divided into four groups : the group treated with acupuncture, the group cotreated with acupuncture and sweet bee venom acupuncture, the group cotreated with acupuncture and $Samgieum-gagam$, the group cotreated with acupuncture, sweet bee venom acupuncture and Samgieumgagam, They were treated for 4 weeks, and the effectiveness was assessed by visual analogue scale(VAS), Fugl-Meyer motor assessment(FMMA), painless passive ROM of shoulder external rotation(PROM), Modified Ashworth sacle(MAS) and Satisfaction. Results : All groups showed significant change in VAS, FMMA and PROM. The group cotreated with acupuncture, sweet bee venom acupuncture and $Samgieum-gagam$ showed more effectiveness in VAS and FMMA than the group treated with acupuncture. There was no significant difference in MAS among groups. Conclusions : This study suggests that cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture is more effective than acupuncture treatment only on post-stroke shoulder pain. Further study based on many other combination methods, larger population, and long term follow-up is needed to confirm this suggestion.

Effect of Bee-venom Acupuncture on Upper Limb Spasticity of Stroke Patients (중풍 환자의 상지 경직에 대한 봉약침의 효과)

  • Noh, Ju-Hwan;Park, Jung-Ah;Cho, Sung-Woo;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Ahn, Chang-Beohm;Kim, Cheol-Hong
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.115-125
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    • 2010
  • Objectives : The purpose of this study is to determine the effect of Bee-venom Acupuncture on upper limb spasticity control in stroke patients. Methods : Ten stroke patients with upper limb spasticity were randomly divided into two groups, a Bee-Venom Acupuncture group(group I) and a normal saline group(group II). After 1 week resting phase, this trial was used a cross-over trial. The numbers of Pharmacopuncture treatment were 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), WMFT(Wolf Motor Function Test), The 10-second Test 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 MAS, WMFT, The 10-second Test. But Group II showed no significant improvement(p<.05) in MAS, WMFT, The 10-second Test. The results showed significant difference in WMFT, The 10-second Test, but no significant difference in MAS between two groups. Conclusions : These results showed that Bee-venom Acupuncture might decrease upper limb spasticity and increase arm motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on upper limb in spasticity by Bee-Venom Acupuncture.

Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease (입원초기에 적용된 상지수동운동이 뇌혈관질환자의 환측 관절가동범위, 근력 및 상지 경직에 미치는 효과)

  • Shin, Dong Soon;Song, Rhayun;Shin, Eun Kyung;Seo, Sung Ju;Park, Jeong Eun;Han, Seung Yeon;Jung, Hoi Yong;Ryu, Choon Ji
    • Journal of Korean Academy of Nursing
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    • v.42 no.6
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    • pp.783-790
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    • 2012
  • Purpose: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. Methods: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. Results: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. Conclusion: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

Immediate effects of High-Frequency Transcutaneous Electrical Nerve Stimulation on the Lower Limb Spasticity and the Balance in the Stroke Patient (고빈도 경피신경전기자극이 편마비 환자의 하지 경직과 균형에 미치는 즉각적 효과)

  • Cho, Hwi-Young;In, Tae-Sung;Lee, Soon-Hyun;Lee, Gyu-Chang;Shin, Won-Seob;Lee, Yong-Woo;Song, Chang-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.487-498
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    • 2010
  • Purpose : To investigate the immediate effects of transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in the stroke patients. Methods : 26 subjects with spasticity over lower limbs were allocated randomly into two groups : (1) TENS group, (2) placebo-TENS group. TENS was applied on the both gastrocnemius for 60 minutes(100 Hz, 0.25 ms, 2 times sensory threshold). The modified Ashworth Scale(MAS) and Manual Muscle Tester were used to assess the spasticity of the ankle plantar flexors. Static balance under three conditions was measured by force-plate; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Results : When compared with the pre and post TENS application, TENS showed significant reduction of ankle spasticity in MAS and MMT measurement. Also, Application of high-frequency TENS improved the balance under three conditions. Conclusion : A single session of TENS to stroke patients could reduce spasticity and improve the balance.

Changes in Body Function, Activity and Participation Following Task-oriented Training in Children with Cerebral Palsy (과제지향 훈련 후 뇌성마비아동의 신체기능, 활동 및 참여의 변화)

  • Yang, Hye-Yun;Kang, Soon-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.4
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    • pp.71-80
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    • 2019
  • PURPOSE: This study examined whether a task-oriented training program is an effective intervention to improve the body function, activity, and participation of children with cerebral palsy (CP). METHODS: Ten children with CP (7-13 years old) performed a task-oriented training program for eight weeks (three sessions per week, 30 minutes each). The taskoriented training program consisted of eight activities. The subjects' body function was assessed using a handheld dynamometer, goniometer, Modified Ashworth Scale (MAS), Balance Performance Monitor (BPM), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The subjects' activity and participation were assessed using the Gross Motor Function Measure (GMFM) and Timed Up and Go (TUG) test. RESULTS: Task-oriented training provided significant improvements in the subjects' body function. The subjects improved the bilateral isometric muscle strength of the hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsi- and plantar flexors (p<.05). Bilateral passive hip flexion, abduction, and external rotation, knee flexion, and ankle dorsi- and plantar flexion were also increased (p<.05). In addition, the MAS score of the hip adductors decreased (p<.05) and the BOTMP score increased after training (p<.05). The subjects' activity and participation also improved significantly after training, increasing the GMFM score (p<.05) and decreasing the TUG score (p<.05). On the other hand, the BPM score did not change after training. CONCLUSION: This study suggests that a task-oriented training program can be an effective intervention to improve the body function, activity, and participation for children with CP.

Selective Musculocutaneous Neurotomy for Spastic Elbow

  • Shin, Dong-Keun;Jung, Young-Jin;Hong, Joo-Chul;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.236-239
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    • 2010
  • Objective : The purpose of this study was to investigate the effectiveness and outcome of selective musculocutaneous neurotomy (SMcN) for spastic elbow. Methods : We retrospectively reviewed the medical records of 14 patients with spasticity of their elbows. The patients were selected using clinical and analytical scales, as well as nerve block tests, for assessment. Their mean age was 37.29 years (range, 19-63 years). SMcN was performed for these patients, and the mean follow-up period was 30.71 months (range, 19-54 months). Results : The modified Ashworth scale (MAS) scores recorded before and after the SMcN showed that the patients' mean preoperative MAS score of $3.28{\pm}0.12$ was improved to $1.71{\pm}0.12$, $1.78{\pm}0.18$, $1.92{\pm}0.16$ and $1.78{\pm}0.18$ at postoperative 3, 6, 12 months and last follow-up, respectively. On the basis of a visual analogue score ranging from 0-100, the patients' mean degree of satisfaction score was $65.00{\pm}16.52$ (range, 30-90). Conclusion : We believe that SMcN can be a good and effective treatment modality with low morbidity in appropriately selected patients who have localized spastic elbow with good antagonist muscles and without joint contracture.

Change of Plantar Fascia Thickness in Hemiplegic Patients (편마비 환자에서 족저근막의 두께 변화)

  • Park, Ji-Won;Park, Sung-Hee;Ko, Myoung-Hwan
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.41-46
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    • 2009
  • Purpose: This study investigated the change in plantar fascia thickness in hemiplegic and non-hemiplegic feet in stroke patients using an ultrasonographic evaluation. Methods: Sixteen hemiplegic and non-hemiplegic feet from 16 hemiplegic patients (patient group) and 16 feet from 8 healthy subjects (control group) were evaluated by ultrasonography. The sagittal sonograms were obtained in the prone position, and the plantar fascia thickness was measured at its insertion into the calcaneus. Results: The mean plantar fascia thickness was measured to be $4.5\pm0.8$mm in hemiplegic feet of the patient group, $3.4\pm1.0$mm for the contralateral non-hemiplegic feet and $2.8\pm0.3$mm for the control group. There was a statistically significant difference in plantar fascia between the hemiplegic feet and contralateral non-hemiplegic feet as well as between the contralateral non-hemiplegic feet and control group (p<0.01 and p<0.05, respectively). The plantar fascia thickness according to the Brunnstrom stage and modified Ashworth scale was increased significantly in the hemiplegic feet (p<0.01). Conclusion: These results show that the plantar fascia is overloaded in the hemiplegic and non-hemiplegic feet of stroke patients. A therapeutic approach should be considered for these patients.

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The Effect of Electroacupuncture by Yin and Yang meridians on Leg Spasticity of Stroke Patients (뇌졸중 환자의 하지 강직에 대한 음양경락별 전침의 효과)

  • Park, Sae-Wook;Lee, Min-Goo;Lee, Sun-Woo;Kang, Baek- Gyu;Son, Ji-Woo;Park, Sang-Moo;Lee, In;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.27 no.2
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    • pp.371-378
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    • 2006
  • Objectives : The aim of this study is to review the effects of acupuncture on lower limb spasticity control in stroke patients. Methods: H-reflex/M-response ratio and Modified Ashworth Scale was used for evaluation of spasticity control before acupuncture, within one hours after acupuncture , at twenty-four hours, and four weeks. We divided two groups. One is the yin meridian acupunctured goup and the other is the yang meridian acupunctured group. Results: H/M ratio is declined within 1 or 24 hours after acupuncture for poststroke spasticity patients. The yin meridian acupunctured group is a bit more efficient than the yang meridian acupunctured goup. But there is no meaning in the statistics because of small patient pool. Conclusions: We need more patients group to decide the effect of electro- acupuncture on leg spasticity of stroke patients.

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The Effect on Change of Spinal Neuron Excitability during Gait Training of Hemiplegia Patients by the Functional Electrical Stimulation (편마비 환자의 보행훈련 시 기능적 전기자극 병용이 척수신경원의 흥분성 변화에 미치는 효과)

  • Kang, Yang-Hoon;Yoon, Se-Won;Seo, Sam-Ki;Park, Keyong-Soon;Kim, Yong-Eok;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.19 no.1
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    • pp.11-22
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    • 2007
  • Purpose: The purpose of this study were to analysis the effect on change of spinal neuron excitability during gait training of hemiplegia patients by the functional electrical stimulation. Methods: Thirty six hemiplegia patients participated in this study. Stimulation conditions of FES were pulse rate 35pps, pulse width $250{\mu}s$, and on-time 0.3 second, treatment hour was 30 min. and treatment period was once a day for five days a week through six weeks. For functional evaluations before and after treatment, Modified Ashworth Scale (MAS), active range of motion (AROM), Hmax threshold, H/Mmax ratio were measured and the following conclusions were obtained. Results: Functional evaluation showed significant changes in experimental group as MAS(p<0.01), AROM(p<0.001), compared to control group. In spinal neuron excitability evaluation, change of Hmax threshold was significantly reduced in both non weight bearing (p<0.001) and bearing condition (p<0.05), H/Mmax ratio was significantly reduced in non weight bearing (p<0.05) and bearing condition (p<0.05). Conclusion: In conclusion, application of FES to hemiplegia patients in recovery stage during gait training improved mitigation of muscular spasticity, balance adjustment and moving ability and it was interpreted that it was caused by mitigation of muscular spasticity by the spinal neuron excitability.

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