• Korean Journal of Applied Biomechanics
• /
• v.20 no.3
• /
• pp.285-292
• /
• 2010

The purpose of this study was to evaluate the influence of respiratory capacity(forced vital capacity), EMG of rectus abdominal muscle, phonation by respiratory muscle strengthening exercise in children with spasticity cerebral palsy. 24 children with spasticity cerebral palsy was randomized in 2 groups, respiratory muscle strengthening exercise and contro group. In the exprimentral groups, respiratory muscle strengthening exercise for 30minutes duration 3 time per week for 8weeks were respectively preformed, Control group was not performed. Before and after experiments, respiratory capacity(forced vital capacity), EMG of rectus abdominal muscle and phonation was measured in all children. In comparison of difference before and after experiment, the respiratory capacity(forced vital capacity) of respiratory muscle strengthening exercise group was significantly increased than the control group(P<.05), rectus abdominal muscle EMG of the respiratory muscle strengthening exercise group was significantly increased more than the control group(P<.05) and MPT of the respiratory muscle strengthening exercise group was significantly increased more than the control group(P<.05). We found that the respiratory muscle strengthening exercise is useful to improve the respiratory capacity and phonation in children with spasticity cerebral palsy.

• Physical Therapy Korea
• /
• v.1 no.1
• /
• pp.1-9
• /
• 1994

This study was performed to determine the inter-rater reliability of manual tests of elbow, knee flexor, and ankle dorsiflexor muscle spasticity graded on the Modified Ashworth Scale. Two raters each independently graded the spasticity of 32 patients with intracranial lesions after moving the paretic limb passively through the available range of motion. The patients were asked to simultaneously squeeze therapeutic putty with their non-paretic hand for reinforcement. The ratings were compared by the Wilcoxon matched pairs signed-rank test and by the Kendall's coefficient of rank(tau) correlation. There was singificant correlation between two raters for spasticity at the elbow, knee flexor, and ankle dorsiflexor. The correlations of the two raters ranged from .6746 to .9308. The highest correlation was for the elbow with reinforcement and the lowest was for the knee without reinforcement. Poorer correlation was evident in the knee joint. The positive results of this study encourage the continued use of manual tests of muscle spasticity, using the Modified Ashworth Scale.

• The Journal of Korean Physical Therapy
• /
• v.31 no.1
• /
• pp.56-61
• /
• 2019

Purpose: The spasticity of stroke patients decreases the ankle range of motion and increases the gastrocnemius muscle tone. This study examined the effects of stretching exercise and far infrared irradiation on the ankle function in stroke patients with spasticity. Methods: This study was conducted on 20 stroke patients admitted to Jesaeng General Hospital, who were divided into a study group (stretching exercise with far infrared) and control group (stretching exercise only). The dorsiflexion range of motion was measured using a smartphone and the medial gastrocnemius muscle tone and stiffness were measured using a Myoton pro. Results: With the exception of the non-paretic gastrocnemius muscle tone in the control group, the medial gastrocnemius muscle tone and stiffness decreased significantly in both groups. In both groups, the dorsiflexion range of motion increased significantly. In addition, the experimental group had a significantly higher dorsiflexion range of motion than the control group. On the other hand, there was no significant difference between the two groups in terms of the medial gastrocnemius muscle tone and stiffness. Conclusion: For stroke patients with spasticity, stretching exercises increased the ankle's range of motion and decreased the gastrocnemius muscle tone. The addition of heat therapy further increased the ankle's range of motion. On the other hand, as the sample size was small, future studies should include more subjects.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.232-234
• /
• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• Therapeutic Science for Rehabilitation
• /
• v.7 no.3
• /
• pp.23-33
• /
• 2018

Objective : This systematic review aimed to investigate the effect of focal muscle vibration in patients with post-stroke spastic hemiplegia. Methods : We searched literature published between April 2009 and October 2017 using PubMed and RISS databases. The main search terms were Vibration therapy, Focal vibration, Somatosensory, Upper limb, and Spasticity after stroke. Based on inclusion/exclusion criteria, 6 articles were selected. Results : Articles on focal muscle vibration intervention ranged from evaluation of application-only vibration to muscle vibration with task-oriented activity. Intervention effects on upper extremity spasticity and function and activities of daily living were assessed. There were significant effects on upper extremity spasticity, function, and cortical excitability. Conclusions : This study can provide information on focal muscle vibration for use by clinical therapists. However, further studies are needed to identify the optimal stimulation site and frequency/amplitude of application to maximize the effects of focal muscle vibration.

• Journal of the Korean Society of Physical Medicine
• /
• v.6 no.3
• /
• pp.277-286
• /
• 2011

Purpose : This study was to investigate the prevention of spasticity with modified Ashworth scale(MAS) and range of motion(ROM) increase with goniometer in ankle joint by functional electrical stimulation(FES) and exercise for 4 weeks in chronic stroke patients. Methods : 60 chronic stroke patients participated in this study. The subjects were divided into 3 groups, FES group(n=20), FES+exercise group(n=20) and control croup(n=20). After FES application on tibialis anterior muscle by 35Hz for 4 weeks, the change of ankle joint movement was measured by goniometer. Results : The spasticity in ankle joint was decreased greatly in FES and FES+excercise groups(p<.05), and the ROM of ankle joint was increased greatly in FES and FES +exercise groups(p<.05) than control group(p>.05). Conclusion : It shows that FES made the angle of dorsiflexion in spastic ankle joint increase with functional improvement of tibialis anterior muscle in chronic stroke patients. This show that the FES is avaliable for facilitation of ROM and decrease of spasticity as a therapeutic tool.

• The Journal of Korean Physical Therapy
• /
• v.30 no.4
• /
• pp.135-140
• /
• 2018

Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.

• The Transactions of The Korean Institute of Electrical Engineers
• /
• v.59 no.1
• /
• pp.217-219
• /
• 2010

Spasticity is a motor disorder characterized by a velocity dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex. The aim of this study is to develop a portable system for quantifying the grade of spasticity which could calculate the biomechanical as well as neurophysiologic parameters, and for determining the relationship between the Tonic Stretch Reflex Threshold (TSRT) and Modified Ashworth Scale (MAS). Eleven patients with stroke participated in the study (6 males and 5 females, the average age of $64.5\pm16.0$ years). As a results, the mean and standard deviation values of the TSRT were $129.8\pm4.2$, $123.4\pm5.2$ and $119.1\pm2.6$ in the MAS 1, MAS 1+ and MAS 2 groups, respectively. Also, there was a negative correlation between the TSRT and MAS (rho=-0.72, p<0.05). This demonstrated that the TSRT could be made clinically available for the more objective and reliable evaluation of the spasticity, instead of using the conventional clinical scales and an isokinetic dynamometer.

• PNF and Movement
• /
• v.21 no.2
• /
• pp.213-222
• /
• 2023

Purpose: The purpose of this study was to investigate the effects of heel-raise-lower with Kinesio Taping (HKT) on spasticity and balance ability in patients with chronic strokes. Methods: The participants were divided randomly into the HKT group and heel-raise-lower with sham (control group), with 38 participants assigned to each group. Both groups received heel-raise-lower lifting 100 times, 5 times/week for 4 weeks. The HKT group applied Kinesio Taping to the calf muscles. The control group applied Kinesio Taping transversely to the ankle joint and tibialis anterior muscle. The composite spasticity score was used to evaluate the ankle plantar flexors. The center of pressure with the eyes open and closed and limited stability was measured using BioRescue equipment. Both groups evaluated spasticity and balance ability before the experiment and after 4 weeks. Statistical methods before and after working around spasticity and balance ability were independent t-tests. Results: After training, spasticity showed significant improvement in the HKT group and in the control group (p < 0.05). Similarly, balance ability was significantly more improved in the HKT group after 4 weeks of training compared to the control group (p < 0.05). Conclusion: We confirmed the effects of heel-raise-lower with Kinesio Taping (HKT) on spasticity and balance ability in patients with chronic strokes.

• The Journal of Korean Physical Therapy
• /
• v.16 no.3
• /
• pp.97-111
• /
• 2004

This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.