• Title/Summary/Keyword: Non-paretic side

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Effect of Auditory Stimulus using White Nosie on Dynamic Balance in Patients with Chronic Stroke during Walking

  • Lim, Hee Sung;Ryu, Jiseon;Ryu, Sihyun
    • Korean Journal of Applied Biomechanics
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    • v.30 no.4
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    • pp.301-309
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    • 2020
  • Objective: This study aimed to investigate the effect of white noise on dynamic balance in patients with stroke during walking. Method: Nineteen patients with chronic stroke (age: 61.2±9.8 years, height: 164.4±7.4 cm, weight: 61.1±9.4 kg, paretic side (R/L): 11/8, duration: 11.6±4.9 years) were included as study participants. Auditory stimulus used white noise, and all participants listened for 40 minutes mixing six types of natural sounds with random sounds. The dynamic balancing ability was evaluated while all participants walked before and after listening to white noise. The variables were the center of pressure (CoP), the center of mass (CoM), CoP-CoM inclined angle. Results: There is a significant increase in the antero-posterior (A-P) CoP range, A-P inclination angle, and gait speed on the paretic and non-paretic sides following white noise intervention (p<.05). Conclusion: Our findings confirmed the positive effect of using white noise as auditory stimulus through a more objective and quantitative assessment using CoP-CoM inclination angle as an evaluation indicator for assessing dynamic balance in patients with chronic stroke. The A-P and M-L inclination angle can be employed as a useful indicator for evaluating other exercise programs and intervention methods for functional enhancement of patients with chronic stroke in terms of their effects on dynamic balance and effectiveness.

Altered Peripheral Nerve Excitability Properties in Acute and Subacute Supratentorial Ischemic Stroke (급성 및 아급성 천막상 허혈성 뇌졸중에서 발생하는 말초신경 흥분성 변화)

  • Seo, Jung Hwa;Ji, Ki Whan;Chung, Eun Joo;Kim, Sang Gin;Kim, Oeung Kyu;Paeing, Sung Hwa;Bae, Jong Seok
    • Annals of Clinical Neurophysiology
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    • v.14 no.2
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    • pp.64-71
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    • 2012
  • Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

Immediate Effects of Abdominal Pressure Belt on Limited of Stability and Gait Parameter in Patients after Chronic Stroke: one-group pretest-posttest design (복부압박벨트가 만성 뇌졸중 환자의 균형 및 보행에 즉각적으로 미치는 융복합적 영향)

  • Park, Shin-Jun;Cho, Kyun-Hee
    • Journal of the Korea Convergence Society
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    • v.11 no.4
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    • pp.63-69
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    • 2020
  • This study was conducted to investigate the immediate effects of abdominal pressure blet on limited of stability and gait parameter in patients after stroke. Thirty stroke patients were recruited to measured pre and post wearing the abdominal pressure belt. The assessment measured limited of stability and spatiotemporal gait parameter. This study result were significantly increase in paretic side area, non-paretic side area, forward side area, backward side area (p<.05) and cadence, gait velocity, stride length (p<.05). This study found that abdominal pressure belt had an immediate effect on improving balance and gait function in stroke patients. Future studies require studies of efficient abdominal pressure levels and intervention periods to improve the balance and walking function of stroke patient.

Effects of Knee Tracking Training on Gait in Stroke Patients (무릎관절 추적훈련이 편마비 환자의 보행에 미치는 영향)

  • Shin, Hwa-Kyung;Yeom, Ho-Joon;Cho, Sang-Hyun;Jang, Sung-Ho
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.71-79
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    • 2003
  • Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of $-20^{\circ}$ to $20^{\circ}$ and $0^{\circ}$ to $60^{\circ}$. The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.

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The Reliability and Convergent Validity of the 180 ° Turn Test in Stroke Patients and the Effects of Turn Direction on Time and Step Count (뇌졸중 환자의 180 ° 회전 검사의 신뢰도와 수렴 타당도 및 회전 방향이 소요시간과 걸음 수에 미치는 효과 )

  • Sung-Heon An;Byoung-Kwon Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.189-199
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    • 2024
  • Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

A Reliability Study of the Scale for Contraversive Pushing in Stroke Patients (뇌졸중 환자의 Scale for Contraversive Pushing의 신뢰도 연구)

  • Kim, Chung-Sun;Chang, Jong-Sung
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.31-36
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    • 2009
  • Purpose: Pusher syndrome in stroke patients is the tendency to push strongly toward the paretic side with the non-affected limbs. The purpose of this study was to estimated inter-rater and intra-rater reliability of the Scale for Contraversive Pushing (SCP). Methods: Fourteen patients in the acute phase after stroke onset were diagnosed with pusher syndrome. Two physical therapists randomly assessed the same patients on different occasions on the same day. Almost all patients were assessed on more than one day. The inter-rater and intra-rater reliability of the SCP was estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of the SCP ranged from 0.87 to 0.97; the inter-rater reliability of the SCP ranged from 0.71 to 0.99 in sitting and standing positions. These results show good reliability for the calculated variables. Conclusion: The results provide support for the use of the SCP in assessing pusher syndrome based on its reliability in stroke patients. It may use the standardized clinical assessments in clinical implication.

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Effects of Changes in Postural Alignment on Foot Pressure and Balance of Patients with Stroke (뇌졸중 환자에서 자세정렬변화가 족저압 및 균형에 미치는 영향)

  • Yang, Dae-Jung;Park, Seung-Kyu;Kang, Jeong-Il;Park, Seong-Bin
    • The Journal of Korean Physical Therapy
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    • v.26 no.4
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    • pp.226-233
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    • 2014
  • Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.