• Journal of Magnetics
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• v.19 no.2
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• pp.170-173
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• 2014

The purpose of the present study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with task oriented training, on cortical excitability and upper extremity function recovery in stroke patients. This study was conducted with 31 subjects who were diagnosed as a hemiparesis by stroke. Participants in the experimental (16 members) and control groups (15 members) received rTMS and sham rTMS, respectively, during a 10 minutes session, five days per week for four weeks, followed by task oriented training during a 30 minutes session, five days per week for four weeks. Motor cortex excitability was performed by motor evoked potential and upper limb function was evaluated by motor function test. Both groups showed a significant increment in motor function test and amplitude, latency in motor evoked potential compared to pre-intervention (p < 0.05). A significant difference in post-training gains for the motor function test, amplitude in motor evoked potential was observed between the experimental group and the control group (p < 0.05). The findings of the current study demonstrated that incorporating rTMS in task oriented training may be beneficial in improving the effects of stroke on upper extremity function recovery.

• 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.

• PNF and Movement
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• v.13 no.2
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• pp.55-72
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• 2015

Purpose: The purpose of this study was to propose a new therapy algorithm that combines motor imagery and physiotherapy as a physiotherapeutic clinical intervention technique that can stimulate the recovery of damaged physical function for patients with stroke. Methods: A variety of scientific research results related to motor imagery were reviewed and analyzed to investigate their applicability to physiotherapy in clinics. Results: As a new therapy algorithm for the therapeutic approach of motor imagery in stroke rehabilitation, a therapy algorithm that combines motor imagery with physiotherapy is proposed, which consists of three stages or steps: STEP 1 motor imagery familiarization, STEP 2 explicit learning stage, and STEP 3 implicit learning. Conclusion: The new therapy algorithm proposed in this study is expected to be a very useful clinical therapeutic approach for stimulating the recovery of damaged physical function in patients with stroke. It is believed that it will be necessary to confirm and standardize the effects of the therapeutic algorithm proposed in this study in the future by conducting diverse clinical studies.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.111-115
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• 2009

Purpose: The aim of this study was to present fundamental information regarding clinical prognosis and clinical criteria for therapeutic intervention in stroke patients with focal pons infarction. Methods: Four stroke patients (male: 2, female: 2) who were diagnosed with pons infarction were recruited. All subjects had motor functions evaluated using methods such as the Motricity Index (MI), the Modified Brunnstrom Classification (MBC), Functional Ambulatory Category (FAC), and the Bathel Index (BI). Evaluations were done at least 4 times over a period that was approximately 8~11 months from stroke onset. We compared the final evaluation with the first evaluation. Results: All patients with focal pons infarction showed improvement with time in motor function. The physical strength of all patients was improved to normal or good grades from zero or trace grades in the Motricity Index test. Also, other motor functions such as ambulatory capacity and activities of daily living (ADL) improved with time. Conclusion: Aspects of functional recovery and clinical prognosis are clearly predictable for specific patients with focal pons infarction. In addition, adequate therapeutic interventions can be provided clinical criterion to patients, according to aspect of functional recovery. Accordingly, patients with pons infarction change for the better over time.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.3
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• pp.1-17
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• 2008

Objectives : Ohyaksungi-san(Wuyaoshunqi-san) has been used for many years as a treatment for cerebrovascular diseases in Oriental medicine. This study was designed to evaluate the effects of Ohyaksungi-san(Wuyaoshunqi-san) on cognition and motor function recovery after ischemic brain injury, and also the expression of BDNF in hippocampus. Methods : This study was designed with 4 subgroups to evaluate the effects of Ohyaksungi-san(Wuyaoshunqi-san). As control groups, group I has no treatment during 1 week after ischemic brain injury and group II has no treatment during 2 weeks after ischemic brain injury. As experimental groups, group III has been treated with Ohyaksungi-san(Wuyaoshunqi-san) during 1 week after ischemic brain injury and group IV have treated with Ohyaksungi-san(Wuyaoshunqi-san) during 2 week after ischemic brain injury. Each group has been examined by tests as follows, neurological motor behavioral tests, cognitive motor behavior test and histological test. Neurological motor behavior tests consisted of limb placement test, beam-walking test and horizontal wire test. Cognitive motor behavior test was performed by using Morris water maze. In the histological test, TTC(2,3,5-triphenylteterazolium chloride) staining, hematoxylin & eosin staining, and immunohistochemical staining were used. Results : 1. The tests for motor function recovery change had significantly good result in the experimental groups as compared with control groups(p<.05). 2. The Morris water maze test on cognition also had significantly good result in the experimental groups as compared with control groups(p<.05). 3. In the immunohistochemical staining for the expression of BDNF in hippocampus, more immune reaction was investigated in the experimental groups as compared with control groups. Especially group IV has the greatest immune reaction. Conclusions : Ohyaksungi-san(Wuyaoshunqi-san) has good effects on cognition and motor function recovery after ischemic brain injury, and also the expression of BDNF in hippocampus.

• The Korean Journal of Physiology and Pharmacology
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• v.14 no.3
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• pp.157-161
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• 2010

Heat shock proteins (HSPs) are specifically induced by various forms of stress. Hsp70.1, a member of the hsp70 family is known to play an important role in cytoprotection from stressful insults. However, the functional role of Hsp70 in motor function after spinal cord injury (SCI) is still unclear. To study the role of hsp70.1 in motor recovery following SCI, we assessed locomotor function in hsp70.1 knockout (KO) mice and their wild-type (WT) mice via the Basso, Beattie and Bresnahan (BBB) locomotor rating scale, before and after spinal hemisection at T13 level. We also examined lesion size in the spinal cord using Luxol fast blue/cresyl violet staining. One day after injury, KO and WT mice showed no significant difference in the motor function due to complete paralysis following spinal hemisection. However, when it compared to WT mice, KO mice had significantly delayed and decreased functional outcomes from 4 days up to 21 days after SCI. KO mice also showed significantly greater lesion size in the spinal cord than WT mice showed at 21 days after spinal hemisection. These results suggest that Hsp70 has a protective effect against traumatic SCI and the manipulation of the hsp70.1 gene may help improve the recovery of motor function, thereby enhancing neuroprotection after SCI.

• PNF and Movement
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• v.12 no.3
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• pp.143-150
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• 2014

Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.31-35
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• 2010

Purpose: The aim of this study was to use fMRI and clinical prognosis criteria to evaluate therapeutic interventions in stroke patients with corona radiata infarct and acquire fundamental information about recovery mechanisms. Methods: Four subjects (2 men, 2 women) who had strokes with corona radiata infarct were recruited. For all subjects, motor functions such as motricity index (MI), modified brunnstrom classification (MBC), functional ambulatory category (FAC), and bathel index (BI) were evaluated. Evaluations were done at least 4 times over a period of approximately 6~7 months from stroke onset. We compared the final evaluation with the first. Results: All patients with corona radiata infarct showed improvement in motor outcomes with the passing of time. The strength of all patients improved from zero or trace levels to normal or good levels in the MI (Motricity Index) test. Other motor outcomes including the modified brunnstrom classification (MBC), the functional ambulatory category (FAC), and the bathel index (BI) also improved with the passing of time. Conclusion: Stroke patients with corona radiata infarcts change for the better over time. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.2
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• pp.265-272
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• 2010

Purpose : This study was investigated the effect of electroacupuncture stimulation on the change of blood biochemical components in the rat spinal cord injury(SCI) damaged by the 6-hydroxydopamine. Methods : SCI model rats were damaged in L1-L2 injected with 6-hydroxydopamine. The thirty Sprague-Dawley adult male rats were randomly divided into normal group, control group and electroacupuncture group. Experimental groups were applied as electroacupuncture(Es-160, ITO, Japan) for 15minutes during the low frequency(2 Hz) stimulation to zusanli. The enzyme concentration levels analysis of the hematological changes were measured of Glutamate Oxaloacetate Transaminase(GOT), Glutamate Pyruvate Transaminase(GPT), Lactate dehydrogenase(LDH) and motor function recovery change was evaluated by the rota-rod test. Results : This study were as follow : The concentration of GOT, LDH in experimental group was lower than control group(p<.05). The experimental group showed increase of motor function recovery more in compared to control group(p<.05). Conclusion : The results of this study showed that electroacupuncture to zusanli point have an effect on functional recovery after the 6-hydroxydopamine induced SCI in rats.

• Physical Therapy Korea
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• v.12 no.1
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• pp.91-99
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• 2005

We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.