• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.655-666
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• 2010

Purpose : The examine the reliability and validity of the modified Emory Functional Ambulation Profile(mEFAP) for assessing gait function in chronic stroke patients. Methods : A total of 45 stroke patients, who had a stroke more than 6 months, participated in the study. Reliability was determined by Intra-class Correlation Coefficient($ICC_{3,1}$), including Bland and Altman method (Standard Error of Measurement: SEM, Small Real Differences: SRD). Validity was examined by correlating results to the gait ability(mEFAP, Modified Motor Assessment Scale-Gait(MMAS-G), Scandinavian Stroke Scale-Gait(SSS-G), Functional Ambulation Category(FAC), 10m Waking Test(10m WT)), and Fugl Meyer-Lower/Extremity(FM-L/E), Berg Balance Scale(BBS). Results : Inter-rater reliability for the total mEFAP was High($ICC_{2,1}$=.998), and absolute reliability were excellent (SEM: 1.75, SRD: 4.85). Subjects without assistance factor performed better on all tests than did subjects who had stroke. There were significant correlations between the mEFAP and MMAS-G, SSS-G, FAC(r=-.66~-.79), 10 m WT(r=-.86), and FM-L/E, BBS(r=-.72~-.78), indicating good validity. Increased times on the mEFAP correlated with poor performance on the gait ability, motor function of lower extremity, BBS and slow gait speeds on the 10 m WT in stroke patients. Conclusion : The mEFAP can be administered easily and comprehensively. It is a reliable gait assessment tool for patients with stroke and correlated with known of function, the mEFAP may be a clinically useful measure of ambulation.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.85-98
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• 2006

This study was performed to examine the influences of the mental practice to the hemiplegic upper limb motor function improvement. 20 minute neurologic treatment based on the neurophysiological theory, 10 minute activities of daily living training, and 10 minute mental practice 5 times a week were given in turn to the experimental group(N=11). On the other hand 20 minute neurologic treatment, and 10 minute activities of daily living training 5 times a week were given in turn to the control group(N=11). Both Fugl-Meyer Assessment Scale and Manual Function Test were used to evaluate upper limb motor recovery, upper limb motor function and movement ability. And the Motor Activity Log; Amount of Use and Motor Activity Log; Quality of Movement before training, 2 weeks after training, and 4 weeks after training were measured to assess the upper limb motor quantitatively and qualitatively each. The results are as follows. 1) Considering the interactions of the rate of change on the upper limb motor recovery, motor function, movement ability improvement, and qualitative motor improvement in ADL of experimental group and control group, the change rates of experimental group were found to be greater than those of the control group. 2) In experimental group, the higher the achievements were, the better upper motor recovery was.

• Perspectives in Nursing Science
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• v.7 no.1
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• pp.43-49
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• 2010

Purpose: Rapid and accurate assessment of impaired consciousness is very important, especially for critically ill patients. Therefore, the Glasgow coma scale (GCS) has been widely adopted in the assessment of adult and pediatric comas. But the GCS should not be used for small children who show various normal responses according to their developmental stage. Therefore, the objectivity of pediatric coma measurements was verified by applying the modified GCS to patients in a pediatric intensive care unit (PICU) at a university hospital in Korea. Methods: The level of consciousness was evaluated for 200 cases who were admitted to a PICU from July 4, 2009 to September 18, 2009 and could show a verbal response, with our modified GCS for children. In addition, and we confirmed the frequency analysis and Kappa statistics with SPSS/WIN 17.0. Results: Kappa statistics which show inter-observer reliability were very good for all components (eye opening, verbal, and motor score) and was good for total GCS scores. Conclusion: It is concluded that our modified GCS is reliable. Therefore, reliable assessment for the level of consciousness is clinically practicable if enough training is supported.

• Journal of Oriental Neuropsychiatry
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• v.8 no.1
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• pp.151-165
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• 1997

The primary purpose of this study was to assess the relation of stress perception and poststroke. This study was done on 50 stroke patients in hospital. According to activities of functional impairment, they were classified into walking disturbance, motor weakness, dysphagia, or reattack etc. The stress perception test(GARS Scles) and stress response assessment shows the follwing results. 1. On the distribution in the stroke 50 patients, For the majority group were male in sex, sixty inage, middle towns people in residence. 2. On the comprehensive GARS scale scores, It marked the higest scores thirty at age, merchandise or salesman on jobs, a city in residence. There was no signigicant difference in mean GARS Scales scores between males and females group, the left hemiplegia and the Rt hemiplegia. 3. On the comprehensive GARS Scale tests, Overall glogal stressor(G8) and sickness stresor(G4) marked the highest scores of all GARS Scales. 4. On the comparative assessment of each group's stress reponse test scores, zung-bu(中腑) was showed higher scores than the other group in oriental diagnosis and hemorrage was showed higher scores than the other group in western medical diagnosis. 5. On the comprehensive assessment of each group's stress reponse test scores, aphsia(不語) marked the highest scores in another disphagia group's. It marked the highest scores in another group's that banshinbulsoo(半身不遂) as regards as hemiplegia generally. Standing disability is the higher scores than another group's walking alone or assist, and standing alone. 6. Secondary attack is the highest scores of all reattack stroke on the stress repones test. 7. Comparing and analyzing the GARS Scale total scores and GARS Scale subject fator at stroke, we found that sickness stressor and fininial stressor is showed the highest correlated to stress response fowlloing stroke. With those results, we can see that functional impairment following stroke is correlated to stress perception and reponse. In the furture studies using, we hope that the findings the study would have clinical relevance to the psychosocial adjustment and total rehabilation of stroke patients.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.18-29
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• 2003

The purpose of this study by examine the effect of visual neglect on hemiplegia motor recovery are showing trouble which can be raised by visual neglect and helping the patient's ADL and functional recovering. Among the patients who are being taken physical therapy in many other hospitals in Busan From February 1st 2002 to august 31st, we chose 20 patients as control group who did not have symptoms of visual neglect and 20 other patients who did have as case group. We used Albert's test and line bisection as visual neglect test, and MAS as motor recovery. The average age of the patient group is 51.55 and that of control is 44.9. The men's rate is higher than women' s in both groups. Although the rate of left hemiplegia is higher than right hemiplegia in case group, that of right hemiplegia is higher than left hemiplegia in control group. There is much lesion site of basal ganglia in case group. There is the most amount of transformation of MAS when visual neglect is shorter than 1.5centimeter. Each change of MAS point before and after therapy in case group and control group is revealed $6.5{\pm}4.37$ and $12.5{\pm}5.95$.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.304-306
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• 2021

Objectives: We report on a patient who showed mild bradykinesia due to injury of the corticofugal tract (CFT) from the secondary motor area following direct head trauma, which was demonstrated on diffusion tensor tractography (DTT). Case summary: A 58-year-old male patient underwent conservative management for subarachnoid hemorrhages caused by direct head trauma resulting from a fall from six-meter height at the department of neurosurgery of a local hospital. His Glasgow Coma Scale score was 3. He developed mildly slow movements following the head trauma and visited the rehabilitation department of a university hospital at ten weeks after the fall. The patient exhibited mild bradykinesia during walking and arm movements with mild weakness in all four extremities (G/G^-). Results: On ten-week DTT, narrowing of the right CFT from the supplementary motor area (SMA-CFT), and partial tearing of the left SMA-CFT, left CFTs from the dorsal premotor cortex (dPMC-CFT) and both corticospinal tracts (CSTs) at the subcortical white matter were observed. Conclusion: This case demonstrated abnormalities in both CSTs (partial tearing at the subcortical white matter and narrowing), both SMA-CFTs (narrowing and partial tearing) and left dPMC-CFT. We believe our findings suggest the necessity of assessment of the CFTs from the secondary motor area for patients with unexplained bradykinesia following direct head trauma.

• The Journal of Korean Medicine
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• v.42 no.4
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• pp.75-101
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• 2021

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.3
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• pp.69-80
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• 2009

Objectives : The purpose of this study was to evaluate the effects of core stability training on postural control and balance of hemiplegia patients who are difficult to control posture due to stroke. Methods : Subjects of the study were consisted of 25 adult hemiplegia patients(experimental 12, control 13) who were receiving rehabilitation therapy in hospital. Its group had a core stability training program by a physical therapists for 40 minutes, five times a week for nine-week period. Measurements of postural assessment scale for stroke(PASS), berg balance scale(BBS) and manual function test(MFT) were evaluated at initial presentation(pretest) and after completion of the each therapy program(posttest). Independent t-test and paired t-test was utilized to detect the mean difference between the groups. Results : Firstly, the result of PASS showed that postural control was significantly increased after the completion of core stability training(p<.01). Secondly, the result of BBS showed that balance control was significantly increased after the completion of core stability training(p<.01) and general physical therapy(p<.01). Lastly, the result of MFT showed that upper extremity's motor function was significantly increased after the completion of core stability training(p<.001). Conclusions : This study showed that core stability training is an effective treatment strategy on postural control, balance and upper extremity's motor function.

• Journal of Pharmacopuncture
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• v.9 no.1
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• pp.139-154
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• 2006

Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.

• Journal of Pharmacopuncture
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• v.3 no.2
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• pp.213-232
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• 2000

Hemiplegic shoulder pain(HSP) is one of the most frequent and difficult problems affecting poststroke hemiplegic patients. Honeybee venom acupuncture therapy(BVAT) is known for its pain relieving effects in arthralgia. To evaluate the effectiveness of BVAT on HSP, 24 patients were sequential1y allocated into BVA T treatment group and control group and monitored for 4 weeks at time interval of initial(T0), 1 week(T1), 2 weeks(T2) and 4 weeks(T4). In treatment group, 1:10000 honeybee venom solution 0.2㎖ was injected into acupoint(s) following Deqi three times a week. Kyonu(LI15) was used in the first week. Thereafter Kyonu(LI15) and Nosu(SI10) were used. Visual analogue scale of pain severity showed significant decrease in treatment group compared to control group at T2 and T4 evaluation. Painless passive range of motion of shoulder external rotation showed significant increase in treatment group compared to control group at T4 evaluation. Fugl-Meyer Motor Assessment of upper limb motor function and Modified Ashworth scale of the spasticity of upper limb showed no difference between two groups. BVAT showed as an effective therapy in HSP and further extensive clinical studies are expected.