• Journal of Pharmacopuncture
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• 제12권4호
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• pp.97-110
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• 2009

Objective : The purpose of this study is to determine the effect of Hominis Placenta Pharmacopuncture(HPP) on lower limb spasticity control in stroke patients. Methods : Twenty stroke patients with Leg spasticity were randomly divided into two groups, a Distilled water Pharmacopuncture(group I) and a HPP(group II). The number of Pharmacopuncture was 5 times a week and acupuncture treatment was 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), H-reflex/M-response ratio(H/M ratio), Berg Balance Scale(BBS) and Time Up & Go(TUG) were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p$<$.05) in BBS but no significant improvement in MAS, H/M ratio, and TUG. Group II showed significant improvement(p$<$.05) in MAS, BBS, and TUG, but no significant improvement in H/M ratio. The results showed significant difference in TUG, but no significant difference in MAS, H/M ratio and BBS between 2 groups. Conclusion : These results showed that HPP might decrease lower limb spasticity and increase leg motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on lower limb in spasticity by HPP.

• The Korean Journal of Pain
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• 제19권1호
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• pp.107-110
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• 2006

Tremor is a rhythmic, involuntary and oscillatory movement of body parts, and it is the most common movement disorder. Spasticity is also one of the movement disorders that is commonly accompanied with Complex Regional Pain Syndrome; however, the basic nature of spasticity has not yet been proved. A 25-year-old male patient had two operations and he was being treated because of a back injury that occurred 4 years ago. He suffered from pain, tremor and spasticity on both his lower legs, and his symptoms were diagnosed as failed back surgery syndrome. The tremor and spasticity were aggravated despite of continuous treatments. We then treated him with spinal cord stimulation. His pain, tremor and spasticity disappeared after spinal cord stimulation.

• Journal of Korean Neurosurgical Society
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• 제43권4호
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• pp.182-185
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• 2008

Objective : The purpose of the present study is to assess the long-term results of microsurgical dorsal root entry zonotomy (MDT) for the treatment of medically intractable upper-extremity spasticity. Methods : The records of nine adult patients who underwent MDT by one operating neurosurgeon from March 1999 to June 2004 were retrospectively reviewed by another investigator who had no role in the management of these patients. In all patients, MDT was performed on all roots of the upper limb (from C5 to T1) for spasticity of the upper extremity. The degree of spasticity was measured by the Modified Ashworth Scale (grade 0-4). Severity of the pain level was determined using the Numeric Rating Scale (NRS, score 0-10). Also, patient satisfaction of the post-operative outcome was assessed. Results : Comparing the preoperative and postoperative spasticity using the Modified Ashworth Scale, we observed improvement in all patients, particularly in five of the nine patients (55.6%) who improved by three grades over an average of 66.4 months (range, 40-96). Regarding patient satisfaction, seven patients (77.8%) had affirmative results. None of the patients experienced severe, life-threatening, postoperative complications. We observed a decrease in the intensity of painful spasms to less than three scores as measured by NRS in all four patients with associated pain. Conclusion : This study shows that MDT provides significant, long-term reduction of harmful spasticity and associated pain in the upper limbs.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.67-73
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• 2020

Objective: The purpose of this study was determine the effect of Balance Trainer training with Transcutaneous Electrical Nerve Stimulation (TENS) on spasticity and balance in persons with chronic stroke. Design: Randomized controlled trial. Methods: A total of 30 subjects with hemiparetic stroke were recruited and randomly divided into the Balance Trainer training with TENS group (n=15) and Balance Trainer training with placebo TENS group (n=15). The Balance Trainer training with TENS group practiced additional Balance Trainer training with TENS for 30 minutes a day, 5 days per a week during 4 weeks and the Balance Trainer training with placebo TENS group practiced additional Balance Trainer training with placebo TENS for the same period. Spasticity and balance were assessed by ability (static balance, dynamic balance) and were measured before and after the 4-week programs. Results: The result of spasticity and dynamic balance were improved significantly in both groups (p<0.05). The Balance Trainer training with TENS group showed significantly greater improvement in spasticity of the gastrocnemius & dynamic balance, compared to the Balance Trainer training with placebo TENS group (p<0.05). The Balance trainer training with TENS group showed a significant improvement in static balance, especially during the eye-closed condition (p<0.05). Conclusions: The Balance Trainer training with TENS was effective in improving spasticity and balance in subjects with chronic stroke. Based on these results, it is suggested that Balance Trainer training with TENS could clinically be used more actively in conjunction with conventional physical therapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제12권4호
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• pp.1740-1748
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• 2011

The purpose of this study was to investigate effects of the long-term high-frequency transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in chronic stroke patients. Twenty-six subjects with spasticity over lower limbs were allocated randomly into two groups under standard rehabilitation: (1) TENS group, (2) placebo-TENS group. TENS stimulation was applied on the both the gastrocnemius for 30 minutes, 5 days a week for 4 weeks(100 Hz, 0.25 ms, 2 times sensory threshold). The Modified Ashworth Scale(MAS) and Hand-held manual muscle tester were used to assess the ankle plantarflexor spasticity. Balance function under three conditions was measured by using force-plate and the amount of postural sway was assessed; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Both groups showed significant improvement in spasticity and balance function after treatment for 4 weeks(p<.05). Especially, TENS group showed a significant reduction of spasticity compared to placebo-TENS group(p<.05). These results suggested that additional stimulation of a long-term high-frequency TENS to standard rehabilitation induced an improved balance function and a spasticity reduction. The long-term application of high-frequency TENS will be an effective intervention for reducing spasticity and increasing balance ability in the chronic stroke patients.

• The Transactions of The Korean Institute of Electrical Engineers
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• 제59권1호
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• pp.217-219
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• 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.

• Journal of the Korean Society for Precision Engineering
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• 제26권7호
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• pp.142-149
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• 2009

The aim of this study was to identify both the mechanical and reflex properties associated with spasticity in hemiplegic patients. Ten hemiplegic patients were included in this study. Multiple pendulum tests were executed for each subject, and knee joint angle and EMG of Rectus Femoris muscle were measured. The neuromusculoskeletal system model was developed from generally accepted mechanism and identified through minimization of the error in the model-predicted pendulum trajectories. The identification was successful in terms of small error in simulated kinematics and high sensitivity and precision of simulated torque against EMG activity. The reflex threshold showed significant difference between different clinical scores (p<0.01) and significant negative correlation (r=-0.93) with the EMG duration. It is expected that the suggested method may help in understanding mechanisms underlying spasticity.

• Physical Therapy Korea
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• 제2권2호
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• pp.73-84
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• 1995

Spasticity has been defined as a motor disorder characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting in hyperexcitability of the stretch reflexes as one component of the upper motor neuron syndrome. Weakness and loss of dexterity, however, are considered to be more disabling to the patient than changes in muscle tone. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakness. This paper considers both the neural and mechanical components of spasticity and discusses, in terms of clinical intervention, the implications arising from recent research. Investigations suggest that the resistance to passive movement in individuals with spasticity is due not only to neural mechanisms but also to changes in mechanical properties of muscle. The emphasis is on training the individual to gain control over the muscles required for different tasks, and on preventing secondary and adaptive soft tissue changes and ineffective adaptive motor behaviours.

• Journal of Korean Medicine Rehabilitation
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• 제28권1호
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• pp.145-152
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• 2018

Post-stroke spasticity is a common complication that can be deleterious to the daily living function and quality of life of stroke survivor. This case report was conducted to introduce the use of miniscalpel-acupuncture as a novel method for the treatment of post-stroke spasticiy in three patients with chronic stroke. Patients received miniscalpel-acpuncuture treatment for 4~7 session. The flexor digitorum brevis, pronator teres, pronator quadratus, brachioradialis, tibialis posterior, gastrocnemius on the affected side were needled. The main outcome were the Modified Ashworth Scale (MAS) muscle spasticity score and the range of motion. The evaluation indices were measured after the initiation of treatment and after treatment. After miniscalpel-acupuncture session, three patients improved as indicated in the MAS grade and range of motion. This retrospective case report presents miniscalpel-acupuncture as a potentially effective approach in Korean medicine rehabilitation treatment of post-stroke spasticity. Further research is needed to confirm these findings.

• Journal of the Korean Society for Precision Engineering
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• 제23권7호
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• pp.152-158
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• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.