• Journal of the Korean Society of Physical Medicine
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• v.4 no.3
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• pp.201-207
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• 2009

Purpose：The purpose of this study was to investigate the effect of $\alpha$-wave music and art appreciation on hand function in stroke with hemiplegia. Methods：A total of 32 stroke with hemiplegia participated in this study experimental group(16 subjects) received $\alpha$-wave music and art appreciation with general neurologic therapy. Control group(16 subjects) received general neurologic therapy. All subjects were assessed for hand function(manual dexterity, power grip, pinch grip, two point discrimination(parm, finger), tactile sense(parm, finger) using a purdue pegboard, dynamometer, pinch gauge, two-point anethesiometer and semmes-weinstein monofilament wire. The data were analyzed using paired and independent t-test. Results：The results were as follows : 1. In the experimental group, manual dexterity were significantly increased between pre and post intervention(p<.05). 2. In the experimental group, tactile sesne in finger were sifnificantly increased between pre and post intervention(p<.05). Conclusion：The results of this study shows that $\alpha$-wave music and art appreciation affect the hand function of hemiplegic side with regard to manual dexterity and tactile sense.

• Physical Therapy Korea
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• v.22 no.2
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• pp.30-40
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• 2015

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.41-51
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• 2019

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

• International Journal of Computer Science & Network Security
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• v.23 no.10
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• pp.37-43
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• 2023

The hospital situation, timing, and patient restrictions have become obstacles to an optimum therapy session. The crowdedness of the hospital might lead to a tight schedule and a shorter period of therapy. This condition might strike a post-stroke patient in a dilemma where they need regular treatment to recover their nervous system. In this work, we propose an in-house and uncomplex serious game system that can be used for physical therapy. The Kinect camera is used to capture the depth image stream of a human skeleton. Afterwards, the user might use their hand gesture to control the game. Voice recognition is deployed to ease them with play. Users must complete the given challenge to obtain a more significant outcome from this therapy system. Subjects will use their upper limb and hands to capture the 3D objects with different speeds and positions. The more substantial challenge, speed, and location will be increased and random. Each delegated entity will raise the scores. Afterwards, the scores will be further evaluated to correlate with therapy progress. Users are delighted with the system and eager to use it as their daily exercise. The experimental studies show a comparison between score and difficulty that represent characteristics of user and game. Users tend to quickly adapt to easy and medium levels, while high level requires better focus and proper synchronization between hand and eye to capture the 3D objects. The statistical analysis with a confidence rate(α:0.05) of the usability test shows that the proposed gaming is accessible, even without specialized training. It is not only for therapy but also for fitness because it can be used for body exercise. The result of the experiment is very satisfying. Most users enjoy and familiarize themselves quickly. The evaluation study demonstrates user satisfaction and perception during testing. Future work of the proposed serious game might involve haptic devices to stimulate their physical sensation.

• The Korean Journal of Pain
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• v.36 no.4
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• pp.408-424
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• 2023

Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• PNF and Movement
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• v.21 no.1
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• pp.11-18
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• 2023

Purpose: This study aims to compare the effects of obstacle walking training combined with cognitive tasks on balance, gait, and activities of daily living in patients with stroke. Methods: A single-subject design was used, where one stroke patient participated. Obstacle walking training combined with cognitive tasks was performed for 1 hour per day for a total of 10 times during the intervention phase. The subjects were measured five times in the baseline phase, 10 times in the intervention phase, and five times in the follow-up phase. The outcome measurements included the Berg balance scale (BBS), the 10-meter walk test (10 MWT), and the Korean modified Barthel index (K-MBI). Results: In this study, the results showed that the 10 MWT scores during the intervention period improved and that this improvement remained, even during the post-period. In addition, BBS and K-MBI values for stroke patients increased significantly after training. Conclusion: The results of this study revealed that obstacle walking training combined with cognitive task training may be helpful to improve balance, gait, and activities of daily living in stroke patients. Therefore, obstacle walking training combined with cognitive tasks is recommended for stroke patients.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.130-137
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• 2022

Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

• The Journal of the Society of Stroke on Korean Medicine
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• v.24 no.1
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• pp.25-40
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• 2023

Background: Although not clarified, the overall prevalence of visual field loss after stroke was estimated at 52% of stroke survivors and for visual acuity loss, at 70% of them. Among visual field loss patients after stroke, homonymous hemianopia is the most common symptom. Visual defect degrades the quality of life by disrupting independent life and affecting the survival of the patients, but highly-evidenced treatment has not been found until now. ■Case report A 51-year-old female with left-side homonymous hemianopia and central vision loss by a right occipital-temporal hemorrhage was treated with Hyeolbuchukeo-tang, Ikgibohyeol-tang, acupuncture, electroacupuncture, and moxibustion. We used a confrontation visual field exam, automated perimetry and visual analog scale, and visual acuity test to observe changes in the patient's symptoms and evaluate the efficacy of the treatment. After 61 days of such interventions, the patient's subjective discomfort lessened, followed by positive changes in the scales of tests mentioned above. ■Conclusion This case suggests that combined Korean medicine treatment might be an effective tool for treating post-stroke homonymous hemianopia and central vision loss. More studies should be conducted to support the effectiveness of the treatment.