• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.89-95
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• 2020

Purpose : This study aims to evaluate the correlation of cognitive function, activities of daily living (ADL), and driving performance in stroke hemiplegic patients residing in Korea. Methods : Subjects of the study were 18 stroke hemiplegic patients admitted to hospitals situated in Seoul. A clock drawing test (CDT), a modified Barthel index (MBI), and a virtual reality driving simulator (Eca faros-driving simulator) were used to examine their cognitive function, their ADL ability, and their driving skills, respectively. Results : Driving skills of stroke hemiplegic patients were shown to be associated with the CDT evaluation tool (r=-.777) (p<.001), but they were found to have any correlation with MBI (r=-.022) (p>.05). Additionally, an individual's CDT showed that the driving simulator evaluation result (pass/fail) could be discriminated with a sensitivity of 100.0 %, a specificity of 40.0 %, and an accuracy of 66.7 %. The result confirmed that the CDT is a useful evaluation tool for screening driving ability in people with stroke. But the MBI did not show any significant results (sensitivity of 62.5 %, specificity of 40.0 %, and predicted the results of the simulator with 50.0 % of accuracy) (p>.05). Conclusion : This study shows that cognitive function influences the driving performance in people with stroke. Driving skills of stroke hemiplegic patients are seen to be highly related to CDT. In the field of driving rehabilitation, these findings could be useful for evaluating driving skills relating to CDT. Furthermore, the study results will set a guideline for domestic occupational therapists to use the evaluation tool for assessing driving abilities in people with stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.4
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• pp.15-24
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• 2013

Purpose : The purpose of this pilot study was to examine the effects of task-oriented training program on balance, activities of daily living(ADL) performance, and self-efficacy in stroke patients. Method : Two subjects with stroke in experimental group participated in the task-oriented training program, while two subjects with stroke in control group received traditional rehabilitation therapy for 4 weeks, 30 minutes per session, four times per week. The task-oriented training program consisted of four tasks with 4 difficulty levels. In two groups, balance was examined with using the Berg Balance Scale(BBS), ADL performance was examined with using the Modified Barthel Index(MBI), and Self Efficacy was evaluated with using the Self-Efficacy scale(SES) before and after 4-week training. Result : After 4 weeks training, all scores of measurement variables increased in both the experimental group and the control group, but the average rates of change differed between the two groups. After the training program, the scores of BBS, MBI, and SES in experimental group increased to 11.4%, 9.9%, 15.4%, respectively than pre-training. Conclusion : According to the results of this study, task-oriented training program might be proposed as a intervention to improve balance ability, ADL performance, and self-efficacy in stroke patients.

• Physical Therapy Korea
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• v.14 no.1
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• pp.64-73
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• 2007

The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance ($R^2$=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.53-58
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• 2017

Objective: The purpose of this study was to determine the effect of upper extremity coordination exercise (UECE) during standing on the paretic side on balance, gait ability and activities of daily living (ADL) in persons with stroke. Design: A randomized controlled trial. Methods: A total of 27 patients with hemiplegic diagnosis after stroke were divided into two groups. Fourteen patients were in the study group and 13 patients were in the control group. The study group received conventional physical therapy and UECE during standing on the paretic side. The control group received conventional physical therapy and simple upper extremity exercise (SUEE). Subjects in both groups were given upper extremity training for 30 minutes per day, five times a week for 4 weeks. Initial evaluation was performed before treatment and reevaluated 4 weeks later to compare the changes of balance, gait ability and ADL (Korean version of modified Barthel index, K-MBI). Results: Both groups showed a significant effect for balance, gait ability and ADL (p<0.05). In the Independent t-test, between both groups showed a significant effect for balance and gait ability except ADL (p<0.05). Conclusions: In this paper, we investigated the changes in balance, walking, and ADL through UECE. We found significant changes in the study group and the control group. Results of the present study indicated that UECE during standing on the paretic side for 4 weeks had an effect on balance, gait ability and ADL (K-MBI) in persons with hemiplegia after stroke.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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• pp.1007-1017
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• 1999

The purpose of this study was to evaluate the factors influencing the ambulatory status in hemiplegia with intracerebral hemorrhage after rehabilitation. Thirty patients with stroke who was admitted in the Chosun University Hospital, between from January 1st' 1998 and December 31st' 1998, were included in this study. The following variables as a potential predictors for ambulation were evaluated at treatment of the stroke onset; 1) general characteristics including age and sex, and 2) clinical characteristics including frequency and onset time of the stroke, affected side, duration of the treatment, time interval between onset and rehabilitation, manual muscle test of paretic limb, sitting and standing balance, proprioception, perception, cognitive function. We compared and analyzed the these variables to the two type of ambulatory status at the time of the discharge by Modified Barthel Index, independent, dependent. The data were analyzed by student t-test, Fisher-exact test, Mann Whitney-U test, $X^{2}$-test, correlation analysis(spearman's). The results were as follows; 1. Were no significantly inflenced independent ambulatory status among general characteristics. 2. Frequency of the stroke and proprioception (p<0.05), muscle strength of the lower limb, cognitive function and standing balance (p<0.01), perception and sitting balance (p<0.001) were significantly inflenced independent ambulatory status among clinical characteristics. 3. Independent Variable correlated with the ambulatory status were muscle strength of the lower limb, proprioception and sitting balance (p<0.05), standing balance, frequency of the stroke, perception and cognitive function (p<0.01). Therefore the muscle strength of the lower limb, proprioception, sitting balance, standing balance, frequency of the stroke, perception, cognitive function were the most significant influencing factors of ambulatory status after rehabilitation.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.2
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• pp.105-123
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• 2020

Objectives This study was conducted to verify the effectiveness of east-west integrative rehabilitation therapy on activity of daily living and cognitive functional recovery in stroke patients by comparing with integrative rehabilitation therapy group and conventional rehabilitation therapy group in a single institution. Methods The medical records of 106 stroke patients hospitalized in Department of Rehabilitation Medicine, Dongguk University Bundang Oriental Hospital from January 1, 2017 to February 28, 2019 were reviewed. After screening and dividing it into conventional rehabilitation (CR) group and integrative rehabilitation (IR) group, Korean version of Modified Barthel Index (K-MBI), functional independence measure (FIM), clinical dementia rating-sum of boxes (CDR-SB) were statistically analyzed. Results IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.001) and there was a statistically significant difference in K-MBI and CDR-SB score changes than CR group (p<0.05). And chronic patient of IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.01) and there was a statistically significant difference in CDR-SB score changes than CR group (p<0.05). In particular, the earlier the treatment initiation time, the more the improvement in function and when the treatment started within 2 years from the onset and patients took acupuncture and pulsed electromagnetic therapy, all scales significantly improved (p<0.001). Conclusions IR showed more improvement on activities of daily life and cognitive functional recovery than CR in this study.

• Physical Therapy Korea
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• v.14 no.3
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• pp.64-71
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• 2007

The purposes of this study were to determine correlations between the Berg Balance Test (BBS), Timed -UP & Go Test, Fugl Meyer-L/E, Balance, Sensory (FM-L/E, B, S), Motor Assessment Scale-Gait (MAS-G), Comfortable maximal Gait Speed (C MGS), and the Modified Barthel Index (MBI). The subjects were 40 stroke patients of the Korea National Rehabilitation Center in Seoul. Main outcome measures were Balance control (BBS, FM-B), Gait (TUG, C MGS, MAS-G), ADL (MBI) and Motor Function of Lower Extremities (FM-L/E, S). The data were analyzed using Pearson product correlation. FM scales between other clinical and instrumental indexes and multiple stepwise regression analyses were performed to identify prognostic factors for Balance, Gait and ADL Motor Function of Lower Extremity inclinations. The results of this study were as follows: The BBS, FM-L/E, balance, sensory and MBI showed positive correlation relations, but TUG and C MGS showed negative correlations. The sensory factor of the FM-scale showed the strongest variance in predicting BBS. However the FM-balance showed the strongest variance in predicting TUG, MAS-G and C MGS. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patients.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.213-222
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• 2014

PURPOSE: This study was conducted to determine the effect of patient-selected, task-oriented training on activities of daily living, quality of life, and depression for stroke patients. METHODS: This study included 40 stroke subjects, randomly assigned to either an experimental group or a control group. Both the experimental group and the control group included 20 stroke patients. Patients from the experimental group selected and performed task-oriented training. In the exercise program, the patient chose two categories from six categories and trained for 30 minutes a day, three times a week, for four weeks. Patients from the control group performed conventional task-oriented training. Outcomes were measured using the Korean version of a modified Barthel Index (K-MBI), the Korean Instrumental Activities of Daily Living (K-IADL), the Stroke-specific Quality of Life (SS-QOL), the Short Form 8 (SF-8), and the Beck Depression Inventory (BDI), both before and after training. RESULTS: There were significant differences between the before- and after-intervention data of the K-MBI and the K-IADL (p<.05) for both groups. Also, there were more significant improvements in the experimental group compared to the control group (p<.05) for the SS-QOL, SF-8 and BDI. CONCLUSION: The results of this study showed that patients-selected, task-oriented training had positive effects on stroke patients' activities of daily living, quality of life, and depression.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.920-928
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• 2019

Objectives: After epidural hemorrhage, sequelae may cause cognitive impairments, such as attention, memory, and performance disturbances. This case study reports on the use of traditional Korean medicine in a patient with cognitive impairments after a traumatic epidural hemorrhage. Methods: During the 46-day hospitalization period, traditional Korean medicine treatments, including Sunkihwalhyul-tang-gamibang, Ukgan-san-gajinpibanha Granule, Kyungohk-go, acupuncture, and cupping, were administered. The degree of cognitive impairment was measured based on the Mini Mental State Examination-Korea (MMSE-K), Modified Barthel Index (MBI), and correct answer ratio. Results: After traditional Korean medicine treatment, the MMSE-K score increased from 13 to 19 and the MBI score increased from 63 to 71. The patient's conversations in daily life also proceeded more smoothly than before hospitalization, and the correct answer ratio rose. Conclusion: This case reports the improvement of cognitive impairment after traumatic epidural hemorrhage in response to traditional Korean medicine treatment; further study is needed.

• PNF and Movement
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• v.18 no.1
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• pp.77-86
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• 2020

Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.