• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.492-501
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• 2007

Objectives : This study was executed in order to evaluate the effects of electroacupuncture on upper-extremity spasticity control in stroke patients. Methods : Eighteen patients with stroke were enrolled and classified into two groups, the study and control group. The control group did not receive any oriental medical treatment. In the study group, the electroacupuncture points were applied to Kokt'aek (PC3) and $Ch'{\u{o}}ch'{\u{o}}n$ (PC2), Naegwan (PC6) and $Ch'{\u{o}}kt'aek$(LU5) of the affected limb. H-reflexl M-response ratio (HIM ratio), modified Ashworth scale (MAS) and Fugl-Meyer motor function assessment (FMA) were used for evaluation of spasticity control before electroacupuncture, within two hours after electroacupuncture, and at two weeks. Results : In MAS, the study group declined more than the control group. but there was no statisticallysignificant consideration. In H/M ratio. the study group was more efficient than the control group. and spasticity decreased successively during the series in the study group. In FMA, motor function in the study group improved more than in the control group and motor function in the study group increased successively during the series. Conclusions : These results showed that electro acupuncture was a useful method to decrease upper-extremity spasticity in patients with stroke. Further studies are needed to explore more cases and the long-lasting carryover effects on upper-extremity spasticity in electroacupuncture.

• Physical Therapy Korea
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• v.9 no.2
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• pp.83-96
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• 2002

The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

• Journal of Pharmacopuncture
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• v.4 no.2
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• pp.95-103
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• 2001

Background : Central poststroke pain(CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulty in the social activities and daily life. In this study, we evaluate the clinical effectiveness of east-west medical management for CPSP through VAS(visual analogue scale), infrared themography, MBI(Moderfied Barthel Index) and Rankin scale. Methods : We treated thirty patients with oriental medical treatment method and western & oriental medical treatment method. Each group has fifteen patients of the CPSP. We evaluated their pain(characterizes tingling and burning sensation, aching, hyperalgesia, and allodynia) through VAS(visual analog scale) pain score, the skin temperature of pain site by infrared thermography and assessed their mobility & rehabilitation ability through MBI(Moderfied Barthel Index), Rankin scale before and after pain treatment. Results : The skin temperature of pain site was lower than non-pain site. The difference of skin temperature improved from $0.65{\pm}0.45^{\circ}C$ to $0.39{\pm}0.25^{\circ}C$ after oriental medical treatment and $0.68{\pm}0.54^{\circ}C$ to $0.27{\pm}0.24^{\circ}C$ after western & oriental medical treatment VAS scores improved from $7.9{\pm}1.4$ to $4.7{\pm}1.6$ after oriental medical treatment and $8.1{\pm}1.3$ to $4.6{\pm}1.2$ after western & oriental medical treatment. MBI scores improved from $61.40{\pm}13.58$ to $85.00{\pm}13.85$ after oriental medical treatment and $52.26{\pm}13.52$ to $77.13{\pm}12.04$ after western & oriental medical treatment. And Rankin scale scores improved from $3.33{\pm}0.72$ to $2.46{\pm}0.74$ after oriental medical treatment and $3.60{\pm}0.82$ to $2.66{\pm}0.81$ after western & oriental medical treatment Conclusion : The difference of skin temperature and Rankin scale scores more significantly improved after western & oriental medical treatment than oriental medical treatment. According to the results, we thought east-west medical management is very useful treatment for CPSP and rehabilitation of the patients with stroke.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.36-43
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• 2006

Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.47-59
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• 2013

Objective : This study is conducted to find the influence on upper extremity function, cognitive function and activities of daily living when stroke patients receive task-oriented training in group or individually. Methods : Twenty-six inpatients are assigned to two groups(task training group and individual training group) randomly, who receive rehabilitation therapy after stroke diagnosis for 5 months(june to november, 2012) in a hospital. Both groups receive a task-oriented training for 30 minutes a day for 3 weeks. FMA were used to measure upper extremity function, K-MMSE were used to measure cognition, and MBI for ADL. Results : Before training. two groups were not different significantly in upper extremity function and cognitive function. But in activities of daily living, bathing self(p<.001), feeding, personal hygiene and total score(p<.05) are higher in group training group. After training, upper extremity function is higher in individual training group(p<.001). In both training group, upper extremity function, feeding, personal hygiene, bathing self, dressing, toilet, chair/bed transfers, ambulation and stair climbing, total score are improved significantly(p<.05). In comparing of variation before and after training, upper extremity function(p<.001), feeding and total score of activities of daily living are more improved significantly in individual training group(p<.05). Conclusion : The outcome shows that task-oriented training can improve upper extremity function and activities of daily living in both training group. Especially, the more upper extremity function is improved, the more activities of daily living is improved. In the future, it will be necessary longitudinal study for a long time for more patients.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.7-17
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• 2002

The purpose of this study was to investigate the effect of taping therapy on activities of daily livings (ADL), hand function and range of motion in poststroke-hemiplegic patients. Sample were selected from 20 poststroke-hemiplegic patients at public health center in the period from September 5 to November 21, 2001. The research design was one group pretest-posttest design. The hemiplegia period of the participants was from one year to five years. The pretest and posttest included measuring activity of daily livings(ADL), instrumental activity of daily livings(IADL), hand function, range of motion, quality of life. In this research design, a treatment were to expose taping therapy who were received self-help management program. This self-help management program was composed of five sessions and each session had health education on stroke, diet, risk factor, ROM exercise and recreation. 20 patients were treated with kinesio taping(Nippon Sigmax Co., Ltd., Benefact(r), width 50mm). Tapes were applied to the Deltoid, Supraspinatus, Infraspinatus, Brachioradialis with paralyzed upper extremity. The taping therapy was performed once a week for 5 weeks. SPSS Win 8.0 was used for the data analysis. The results of this study were as follows: 1) The score of BADL was increased from 30.5 to 33.95 after program, and that was statistically significant(p=.019). 2) The score of IADL was increased from 11.6 to 12.75 after program, but that was statistically insignificant(p=.161). 3) The score of hand function was increased from 17 to 20.35 after program, and that was statistically significant(p=.026). 4) The shoulder's ROM(p=.000) and wrist's ROM(p= .004) were significantly increased. According to the results of this study, taping therapy is effective for improving ADL, hand function, ROM, quality of life. However, this study found no significant differences in IADL. Consequently, these findings showed that the taping therapy was effective in improvement of physical aspects(BADL, hand function, upper extremity's ROM) in poststroke-hemiplegic patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.12
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• pp.7259-7265
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• 2014

This study examined the gait ability and foot pressure after backward walking training in hemiplegia patients after stroke to provide evidence for the application of backward walking to the rehabilitation of those patients. Twenty hemiplegia patients hospitalized at one rehabilitation hospital were enrolled in this study, which was conducted from 23 April to 18 May, 2012. The subjects were randomized into either the experimental group or control group. The control group received general physical therapy for 30 minutes and the experimental group received 20 minutes of physical therapy and 10 minutes of backwards walking training five times a week for four weeks. The gait ability and foot pressure of both feet were measured quantitatively and compared. The results showed the weight bearing (entire foot, anterior and posterior of foot) of the paralyzed foot during the stance phase showed a significant difference (p<.05). The difference in the foot pressure of right and left feet was more significant in the experimental group than that of the control group (p<.05). Therefore, this study confirmed that backward walking training in a rehabilitation program would be helpful for improving the gait ability of hemiplegia patients after stroke.

• The Journal of Korean Physical Therapy
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• v.26 no.1
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• pp.33-40
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• 2014

Purpose: The aim of this study was to identify the effects of the lower trunk stabilization exercise using neurodevelopmental technique (NDT) on muscle activity in lumbar region and balance in the patients with hemiplegia. Methods: Fifteen participants were allocated in two groups: NDT group (n=8) or control group (n=7). NDT group performed NDT exercise program, while control group conducted walking exercise. Both interventions were given for 30 minutes a day, 3 times a week, for 5 weeks. To measure the muscle activity in rectus abdominis (RA), external oblique (EO) and internal oblique (IO), electromyography (EMG) was used. And, Timed-Up and Go (TUG) test and Berg-Balance Scale (BBS) were performed to assess balance before and after intervention. Results: NDT group showed a significant improvement of muscle activity in RA and EO, while control group did not show significant changes in three muscles. Also, there was a significant difference in muscle activity of RA and EO between two groups. In BBS and TUG test, participants in two groups showed significant improvements after intervention. Especially, significant difference was observed in TUG test between two groups (p<.05). Conclusion: This study demonstrated that NDT exercise is an effective intervention to improve the muscle activity in trunk region and to increase balance in patients with stroke. Thus, we suggested that NDT exercise program would be a treatment intervention in stroke rehabilitation.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• Korean Journal of Acupuncture
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• v.31 no.1
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• pp.40-47
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• 2014

Objectives : Postural instability and gait difficulty(PIGD) can develop in all Parkinson's disease patients, especially late in the disease course, but does not respond well to conventional dopamine treatment. This study aimed to report three cases of PIGD in Parkinson's disease patients treated with Korean and Western medicine treatment. Methods : We used acupuncture, bee venom acupuncture, herbal medicine and moxibustion to treat patients during hospitalization. They continued Western medication and received rehabilitation treatment. We observed the changes of PIGD using the Unified Parkinson's Disease Rating Scale(UPDRS). Results : After treatment, PIGD symptoms improved and UPDRS scores were decreased. Especially, scores of falling, walking, gait and postural stability subsections related with PIGD were decreased. In addition, general conditions of patients were improved. Conclusions : This study suggests that Korean medicine treatment could be effective in the treatment of PIGD in Parkinson's disease patients.