This study aimed to pilot test a newly developed bilateral upper limb rehabilitation training program for improving the upper limb function of individuals with chronic stroke using a visual feedback method. The double-group pretest-posttest design pilot study included 10 individuals with chronic stroke (age >50 years). The intervention (four weekly meetings) consisted of five upper limb training protocols (wrist extension; forearm supination and pronation; elbow extension and shoulder flexion; weight-bearing shift; and shoulder, elbow, and wrist complex movements). Upper limb movement function recovery was assessed with the FuglMeyer Assessment of the Upper Extremity, the Wolf Motor Function Test, the Trunk Control Test, the modified Ashworth Scale, and the visual analog scale at baseline, immediately after, and four weeks after the intervention. The Fatigue Severity Scale was also employed. The Fugl-Meyer Assessment of the Upper Extremity and Wolf Motor Function Test showed significant improvement in upper limb motor function. The Trunk Control Test results increased slightly, and the modified Ashworth Scale decreased slightly, without statistical significance. The visual analog scale scores showed a significant decrease and the Fatigue Severity Scale scores were moderate or low. The bilateral upper limb training program using the visual feedback method could result in slight upper limb function improvements in individuals with chronic stroke.
Journal of Physiology & Pathology in Korean Medicine
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v.30
no.5
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pp.355-359
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2016
This study is to investigate the effect of the level of Korean medical intervention (KMI) on the recovery of activity of daily living (ADL) and the motor function in patients with stroke. A total of 43 stroke patients were recruited. The participants were divided into two groups, the basic Korean medical intervention (BKM) and the comprehensive Korean medical intervention (CKM) group. The patients in BKM group were treated with the basic acupuncture and the consultation of Korean medicine doctors. The treatments of CKM group patients included the comprehensive herbal medical therapies in addition to the treatments of BKM group. The western rehabilitation therapies were performed in all participants with KMI. The functional outcomes using modified Barthel Index of Korean version (K-MBI) and Fugl-Meyer assessment (FMA) were analyzed before and after the treatment between two groups. Significant differences between the BKM and the CKM group were demonstrated in both K-MBI and FMA (p<0.05). There were significant relationships between the level of the KMI and K-MBI/FMA (p<0.05). In conclusion, the comprehensive KMI was more effective to improve the ADL and motor function in patients with the stroke east-west integrative medical care.
Objective: The purpose of this review was to investigate whether motor imagery training has an effect on the recovery of upper extremity function in individuals with hemiparetic stroke or not. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to December 18th, 2018 and randomized controlled trials (RCTs) evaluating motor imagery training on upper extremity function in persons with a diagnosis of hemiparetic stroke were included. This review selected the following information from each study: surname of the first author, published year, nation, population, intervention, therapeutic intensity of intervention, therapeutic comparison, outcome measures, additional therapy, summary of results, and descriptive statistics of outcome measures. Results: This review selected seventeen RCTs with 487 stroke survivors and the following intervention methods: six motor imagery training with additional therapeutic technology, two motor imagery training with additional modified constraint-induced therapy, four mirror therapy, and five motor imagery training. Ten RCTs were eligible for meta-analysis after systematic review. The motor imagery group were more effective than the control group based on the Fugl-Meyer assessment (3.43; 95% confidence interval [CI], 1.65 to 5.22; heterogeneity [$chi^2=8.03$, df=8, $I^2=0%$], test of overall effect Z=3.76; test for subgroup differences [$chi^2=2.56$, df=2, $I^2=21.8%$]) and the Action Research Arm Test (1.32; 95% CI, -8.12 to 10.76; heterogeneity [$Tau^2=70.74$, $chi^2=15.22$, df=3, $I^2=80%$], test of overall effect Z=3.76). Conclusions: The results of this review suggests that motor imagery shows positive effectiveness on improving upper extremity function in persons with hemiparetic stroke.
Kim, Kyung-Yoon;Kim, Hyung-Woo;Lee, Sang-Yeong;Cha, Dae-Yeon;Lee, Seok-Jin;Kim, Gye-Yep;Kim, Hang-Jung;Jeong, Hyun-Woo
Journal of Physiology & Pathology in Korean Medicine
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v.22
no.3
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pp.556-561
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2008
ChongMyeong-Tang (CMT) have been used clinically to treat patient with amnesia and dementia. In addition, CMT have been also used for examinee to improve learning ability in Korea. This study was designed to investigate the effects of Gagam-ChongMeong-Tang (GCMT) on cognitive dysfunction recovery after ischemic brain injury in rats. Rats were divided into three groups; (1) normal, (2) commercial diet after ischemic brain injury (control), (3) CMT diet after ischemic brain injury (experiment). In our study, we carried out Morris water maze test for cognitive motor behavior test and immunohistochemistry study through the change BDNF in the hippocampus($7^{th},\;14^{th}\;day$). In Morris water maze test, cognitive motor function recovery was significantly increased in the experiment group as compared with control group on $7^{th}\;and\;14^{th}\;day$ day (p<0.01). In immunohistochemistric response of BDNF in the hippocampus, more immune reaction was investigated in the experiment group as compared with control group on $7^{th}\;and\;14^{th}\;day$. Especially more immune reaction was experimented $14^{th}$ day. These results imply that GCMT can play a role in facilitating recovery of cognitive function after ischemic brain injury in rats.
A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.
Objectives : The purpose of this study was to investigate the effects of Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang, YGKT) and electrical acupuncture treatment in spinal cord injury(SCI)-induced rats. Methods : The subjects were divided into 5 groups ; Normal, Control-no treatment after SCI, Experimental I(Exp. I)-taken with YGKT 500 mg/kg $0.5m{\ell}$ daily after SCI. Experimental II(Exp. II)-taken with electrical acupuncture after SCI and Experimental III(Exp. III)-taken with YGKT 500 mg/kg $0.5m{\ell}$ and electrical acupuncture after SCI. After each operation, the present author observed cytological changes, the motor behavior recovery and nerve regeneration by analysis of the motor behavior tests, EMG, hematological(AST, ALT, WBC), histological and immunological changes. Rats were tested by Motor behavior test at 1st, 3rd, 7th, 14th and 21st day. Results : 1. All the experimental groups were improved compared with control group in the motor behavior tests including Tarlov test, Basso-Beattle-Bresnahan locomotor rating scale, modified inclined plane test, open field test, grid walk test and narrow beam test. Especially Exp. III was significantly improved among other groups. 2. In EMG test, H and M wave were significantly increased in Exp. III. 3. All the experimental groups were significantly decreased compared with control group in AST, ALT and WBC. 4. NGF, BDNF and Trk B of spinal cord gray matter in all the experimental groups were increased compared with control group. Especially, Exp. III was more effective. 5. In histological observations, muscle contraction and denaturation of gastrocnemius muscle of all the experimental groups were inhibited. Especially, those of Exp. III was more effective. On the observations of liver and kidney, cell atrophy and apoptosis of all the experimental groups were decreased compared with control group. Especially, those of Exp. III was more effective. Conclusions : It can be suggested that YGKT and electrical acupuncture may improve motor behavior, EMG, hematological, histological and immunological findings in SCI-induced rats. Especially, combination of these two treatments will be somewhat better in spinal nerve recovery and motor function improvement.
Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.
Background: Neuromodulation therapy has been used to an adjunctive treatment promoting motor recovery in stroke patients. The objective of the study was to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on neurobehavioral recovery and evoked potentials in rats with middle cerebral artery occlusion. Methods: Seventy Sprague-Daley rats were induced permanent middle cerebral artery occlusion (MCAO) stroke model and successful stroke rats (n=56) assigned to the rTMS (n=28) and sham (n=28) group. The 10 Hz, high frequency rTMS gave on ipsilesional forepaw motor cortex during 2 weeks in rTMS group. The somatosensory evoked potential (SSEP) and motor evoked potential (MEP) were used to evaluate the electrophysiological changes. Behavioral function of the stroke rat was evaluated by the Rota rod and Garcia test. Results: Forty rats ($N_{rTMS}=20;\;N_{sham}=20$) completed all experimental course. The rTMS group showed better performance than sham group in Rota rod test and Garcia test at day 11 (p<0.05) but not day 18 (p>0.05). The amplitude of MEP and SSEP in rTMS group was larger than sham group at day 18 (p<0.05). Conclusions: These data confirm that the high frequency rTMS on ipsilesional cerebral motor cortex can help the early recovery of motor performance in permanent middle cerebral artery stroke model and it may simultaneously associate with changes in neurophysiological activity in brain.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.11
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pp.4374-4381
/
2010
The purpose of this research was to investigate the effects of complex exercise program for upper extremity function and balance proficiency in person with stroke. The subject in this study was a 68 year old woman with left hemiplegia after stroke, and the study period was from April 16th, 2005 to August 30, 2007. Complex exercise program was compromised of range of motion exercises, strengthening exercises, and repetitive task-oriented activities and so on, and the subject performed exercises three times a week, one hour a day. The upper extremity function of the subject was evaluated by the Brunnstrom Hand Recovery Stage, the Brunnstrom Upper Extremity Recovery Stage, the Fugl-Meyer Assessment of Motor Function, and the Manual Function Test, and the balance proficiency was measured by the Tinetti Gait & Balance Scale, and the One Leg Standing Test. The results indicated that the upper extremity test scores were all improved, the balance proficiency test marks were maintained and improved, therefore complex exercise program was effective method to forward upper extremity and balance proficiency in person with stroke.
Roh, Sung Woo;Kim, Young Soo;Yoon, Do Heum;Rhim, Seung Chul;Kong, Kyung Yup;Park, Sung Hye;Lee, Kyung Hee
Journal of Korean Neurosurgical Society
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v.29
no.9
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pp.1153-1160
/
2000
Objectives : This study was undertaken to investigate the effect of noncompetitive NMDA receptor blocker, MK801 on motor recovery, SSEP and pathology in spinal cord injured rat. Methods : The effects of MK801 on neuronal function protection, SSEP, and pathology were measured on spinal cord injury rats which were divided into 6 groups according to dose, time of drug delivery and magnitude of injury. Spinal cord injury was made with the magnitude of 25gm-cm and 50gm-cm on 42 rats. BBB locomotor function test was performed to evaluate the motor power recovery in hindlimb for 2 weeks after injury. After motor function test was completed, SSEP was measured. Amplitude and latency of the P1, N1 peak was measured and compared between groups. Finally rats were sacrificed, and pathologic findings including measurement of area of necrotic cord were studied and compared between groups. Results : Motor recovery at 2 weeks was better in MK801 group comparing to saline control group. SSEP at 2 weeks showed no difference in N1, P1 latencies, but significantly greater amplitude in MK801 group, compared to saline control group. On light microscope, there was no specific histologic differences between experimental groups. The cystic necrotic area in coronal plane was measured and compared in each group. The necrotic area was significantly smaller in MK801 1mg/kg group(delivered after injury) than vehicle group. The necrotic area in MK801 5mg/kg group and MK801 1mg/kg group(delivered before injury) was smaller than vehicle group even though it was not statistically significant. Conclusion : From the above result, it is speculated that NMDA blocker, MK801 can improve impaired neuronal function in spinal cord injury.
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