• The Journal of Korean Physical Therapy
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• v.11 no.3
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• pp.89-96
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• 1999

The purpose of this study was to examine the effects of neuromuscular electrical stimulation(NMES) on the spasticity of elbow flexor. Ten spastic hemiplegia who have been at EUL-JI medical college hospital in Taejon with age range of 35 to 70 years$(56.8\pm9.5)$, were participated in this study. The subjects (5male, 5female) took neuromuscular electrical stimulation therapy on the triceps of the affected elbow. To compare the effect of the treatment, the grade of spasticity of affected elbow flexor was measured at pre-treatment and the end of each weeks using modified Ashworth scale. Then, the range of extension of the affected elbow was measured at pre-treatmen and the end of each weeks using full circle goniometer. The data were analyzed with ANOVA to determine significant differences with the passage of time. The results were as follows: 1. ANOVA test showed significant differences in reducing spasticity of NMES group with the passage of time (p<.01). 2. ANOVA test showed significant differences in increasing range of motion with the passage of time of NMES group(p<.01). The neuromuscular electrical stimulation is a effective method to reduce the spasticity of elbow flexor.

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

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

• Journal of Korean Academy of Nursing
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• v.42 no.6
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• pp.783-790
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• 2012

Purpose: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. Methods: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. Results: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. Conclusion: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

• The Journal of the Korea Contents Association
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• v.11 no.3
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• pp.262-270
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• 2011

This study examines the effects of spasticity, equilibrium and gait ability at lower extremity on lumbar stabilization exercise(LSE) with Swiss ball. This experiment was conducted to compare BBS, FRT, MAS and TUG by Swiss ball LSE with 34 stroke patients. equilibrium by BBS or FRT, spasticity by MAS and gait ability by TUG were measured after a 8-week traditional exercise physical therapy(17 subject of stroke patient) and a Swiss ball LSE(17 subject of stroke patient). These result lead us to the conclusion that BBS & FRT were statistically increased and MAS and TUG were decreased on Swiss ball LSE group. there were statistically differential effect between each group on FRT and MAS. These results suggest that Swiss ball LSE has the capability to improve spasticity, equilibrium and gait ability at lower extremity. Consequently, Swiss ball LSE would be lead to restoration of muscle spasticity, equilibrium and gait ability on stroke patients.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.371-378
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• 2006

Objectives : The aim of this study is to review the effects of acupuncture on lower limb spasticity control in stroke patients. Methods: H-reflex/M-response ratio and Modified Ashworth Scale was used for evaluation of spasticity control before acupuncture, within one hours after acupuncture , at twenty-four hours, and four weeks. We divided two groups. One is the yin meridian acupunctured goup and the other is the yang meridian acupunctured group. Results: H/M ratio is declined within 1 or 24 hours after acupuncture for poststroke spasticity patients. The yin meridian acupunctured group is a bit more efficient than the yang meridian acupunctured goup. But there is no meaning in the statistics because of small patient pool. Conclusions: We need more patients group to decide the effect of electro- acupuncture on leg spasticity of stroke patients.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.131-144
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• 2022

Objectives: This study aimed to review clinical studies on thread embedding acupuncture (TEA) for the treatment of patients with post-stroke spasticity (PSS) Methods: Clinical studies related to TEA treatment for PSS were searched for in several electronic databases, including PubMed, Cochrane Library, MEDLINE, OASIS, and CNKI. After the selection/exclusion process, information on study design, disease, experimental/control group, intervention, outcome measurement, between-group differences, and adverse events was extracted. Results: A total of 13 randomized controlled trials were included in this review. The usual frequency of TEA treatment was once every 1-2 weeks, and the treatment most commonly included 4 sessions. In the dorsal area, EX-B2 and the acupoints in governing vessel meridian were commonly used. Acupoints in the meridian of the large intestine were most frequently used in the treatment of upper limb spasticity. Except for HT1, PC6, and PC8, all TEA points for treating PSS of the upper limb were on the Yang meridians. For the lower limb spasticity, the most frequently used acupoints were ST36, GB34, GB30, BL60, and BL57 on Yang meridians, and LR3, SP6, SP9, and SP10 on Yin meridians. TEA treatment showed better effects than conventional treatment for PSS in terms of spasticity, motor dysfunction, and activities of daily livings. Nevertheless, the absence of the follow-up observation, lack of sham TEA treatment, and low quality of the included studies necessitated caution in interpreting the results. Conclusions: The results of this review are expected to provide basic data on the modalities of TEA treatment for PSS and provide insights to facilitate well-designed studies in the future.

• Physical Therapy Korea
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• v.29 no.2
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• pp.147-155
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• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• The Journal of Korean Medicine
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• v.36 no.4
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• pp.8-18
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• 2015

Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.

• 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.