• The Journal of Korean Physical Therapy
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• v.31 no.6
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• pp.358-362
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• 2019

Purpose: We investigated the difference in injury of the corticospinal tract (CST) and the spinothalamic tract (STT) in patients with putaminal hemorrhage, using diffusion tensor tractography (DTT). Methods: Thirty one consecutive patients with PH and 34 control subjects were recruited for this study. DTT scanning was performed at early stage of PH (7-63 days), and the CST and STT were reconstructed using the Functional Magnetic Resonance Imaging of Brain (FMRIB) Software Library program. Injury of the CST and STT was defined in terms of the configuration or abnormal DTT parameters was more than 2 standard deviations lower than that of normal control subjects. Results: Among 31 patients, all 31 patients (100%) had injury of the CTS, whereas 25 patients (80.6%) had injury of the STT: the incidence of CST injury was significantly higher than that of STT (p<0.05). In detail, 20 (64.5%) of 31 patients showed a discontinuation of the CST in the affected hemisphere; in contrast, 14 patients (45.2%) of 31 patients showed a discontinuation of the STT in the affected hemisphere. Regarding the FA value, 6 (19.4%) of 31 patients and 2 (6.4%) of 31 patients were found to have injury in the CST and STT, respectively. In terms of the fiber number, the same injury incidence was observed in 11 patients (35.5%) in both the CST and STT. Conclusion: The greater vulnerability of the CST appears to be ascribed to the anatomical characteristics; the CST is located anteriorly to the center of the putamen compared with the STT.

• Science of Emotion and Sensibility
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• v.5 no.4
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• pp.67-75
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• 2002

The purpose of this study is to assess the ability of balance control in virtual moving surround stimulation using head mount display (HMD) device and force platform in patients with brain injury. Fifteen patients with stroke (mean age 54.47 yrs) and fifteen healthy normal persons participated. COP parameters were obtained total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) during comfortable standing with opened or closed eyes, (2) during virtual moving surround stimulation delivered using HMD with four different moving pattern. Moving patterns consisted of close-far, superior-inferior lilting (pitch) , right-left tilting (roll) and horizontal rotation (yaw) movement. In all parameters, the test-retest reliability was high. Also, the construct validity of virtual moving surround stimulation was excellent (p＜0.05). A posturographic balance assessment system equiped with virtual moving surround stimulation using HMD is considered clinically useful in evaluation of balance control in patients with brain injury.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.201-207
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• 2013

연구목적: 닌텐도 위를 이용한 가상현실기반 비디오게임 프로그램을 만성기 뇌졸중 환자에게 적용하여 균형능력 및 일상생활동작에 어떠한 영향을 미치는지 알아보고, 뇌졸중 환자의 재활프로그램으로서 적용 가능성이 있는지 알아보고자 한다. 연구방법: 만성기 뇌졸중 환자를 무작위로 가상현실기반 비디오게임 프로그램을 적용한 실험군(n=7)과 적용하지 않은 대조군(n=10)으로 구분하여 연구를 진행하였다. 연구에 참여한 모든 대상자에게 30분의 Bobath therapy와 15분간의 FES 치료를 기본적으로 실시하였다. 이에 더하여 실험군은 가상현실기반 비디오게임 프로그램을 1일 30분이내, 주 5회, 3주간 실시하였다. 대조군은 자전거 운동과 보행훈련으로 30분간 시행하였다. 실험 전 후 눈뜨고 외발서기(OLST; open leg standing test), Timed Up and Go(TUG) 검사, 10m 걷기 검사, Functional Independence Measure(FIM)를 측정하였다. 실험 전과 실험 후 측정값의 차이를 비교하기 위해 Wilcoxon Signed Ranks Test를 실시하였다. 그리고 각 측정값의 변화량에 대한 실험군과 대조군 사이의 차이를 알아보기 위해 Mann-Whitney U Test를 실시하였다. 연구결과: 실험결과는 다음과 같다. 1) 실험군에서는 FIM의 유의한 증가와 TUG, 10m 걷기 검사의 유의한 감소를(p<.05) 보였다. 대조군에서는 OLST의 증가와 TUG, 10m walking test의 감소가 나타났지만 통계적으로 유의하지 않았다. 오직 FIM에서만 유의한 증가가 나타났다(p<.05). 2) 실험 전 후의 실험군과 대조군의 각 측정값들의 평균차를 비교한 결과 실험군은 대조군보다 실험 전 후 OLST, TUG, 10m walking test 차이의 평균은 컸지만 통계적으로 유의하지 않았다. 결론: 이상의 결과로부터 가상현실기반 비디오게임이 만성기 뇌졸중 환자의 동적균형능력 및 일상생활동작 향상에 효과가 있음을 알 수 있었다.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.2
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• pp.109-118
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• 2011

Purpose: The purpose of this study was to investigate the effect of core stabilization exercise on foot pressure in the hemiplegic patients. Methods: A total of 28 subjects(n=28) who were diagnosed with hemiplegic caused by a stroke were randomly divided into bridge exercise(BX, n=14) and crunch exercise(CX, n=13) groups and each group executed the exercises 20 minutes a day, 4 times per week over an 8 week period. Foot pressure was measured on the fore, mid, and hind foot for peak pressure, and distance of center of pressure(COP). Results: The peak pressure on the mid foot for BX and CX were significantly different according to the exercise period(p<.05). Peak pressure on the hind foot of BX was significantly different according to exercise period(p<.05), however there was not in CX. The effects of each exercises period were significantly different according to pre-after 8weeks(p<.05). According to exercise period(p<.05), COP distances of BX and CX were significantly different. Conclusion: The results show that both BX and CX verified an improvement in gait ability. Especially, since we confirmed BX was attributed more to gait ability than CX. This is considered to be effective on those hemiplegic patients who need core-stabilization and gait stability.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.32-48
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• 2004

The purpose of this study was to evaluate the change of functional ambulation profile(FAP) and temporal-spatial gait parameters in hemiplegic patient by forceful respiratory exercise. 28 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. FAP and temporal-spatial gait parameters was measured at before and after experiments. The results of this experimental study were as follows : 1. In comparison of FAP before and after experiment, the FAP was significantly increased in the FET and FIT group (p<.01). In comparison of difference of FAP among 3 groups, there was the significant difference between the FIT group and the control group (p<.05). 2. The results of temporal-spatial gait parameters are as follows : 1) In comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the FET and FIT group (p<.05). In comparison of difference of the gait velocity among 3 groups, there was the significantly difference between the FIT group and the control group (p<.05). 2) In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in FIT group (p<.05). In comparison of the difference of the gait cadence among 3 groups, there was no significant difference between the FIT group and the control group (p>.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the FAP and temporal-spatial gait parameters in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.41 no.2
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• pp.125-133
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• 2017

This paper presents the inter-rater reliability of finger spasticity assessment tested realized by using finger simulator that mimics finger spasticity of patients after a stroke. For controlling the simulator torque, finger spasticity was modeled, and the model parameters were obtained by measuring quantitative data while grading based on Modified Ashworth Scale (MAS). A robotic finger simulator was designed for mimicking finger spasticity. Evaluation of this simulator with the help of seven rehabilitation doctors showed that the simulator had a Cohen's kappa value of 0.619 for Metacarpophalangeal Joint and 0.514 for Proximal Interphalangeal Joint. Fleiss' kappa between raters is 0.513 for Metacarpophalangeal Joint and 0.486 for Proximal Interphalangeal Joint. Therefore, the spasticity assessment made by MAS grade system is not reliable owing to the subjectivity of the assessment. The proposed robotic simulator can be used as a training tool for improving the reliability of the spasticity assessment.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1131-1141
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• 2021

Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.60 no.9
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• pp.454-462
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• 2017

Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders.

• PNF and Movement
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• v.17 no.1
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• pp.1-9
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• 2019

Purpose: This study investigates the effects of task-oriented training for a left trunk flexion pattern using real-time ultrasound imaging in a stroke patient with unilateral neglect symptoms. Methods: This study used the ABA experimental design, which is a single-subject research method among individual case research methods. For the ABA experimental design, changes in the degree of unilateral neglect, balance ability, and the thickness of the lateral abdominal muscle were visually analyzed during the baseline process, in the intervention period, and after the intervention. The experiments were performed 24 times in total for 8 times in each of the 3 periods. The unilateral neglect was measured using the Albert test, balance ability was measured using the Berg balance test, and the thickness of the lateral abdominal muscle was measured using ultrasound imaging. The subject was a 50-year-old male patient with unilateral neglect caused by right cerebral hemorrhage. He performed task-oriented training for a voluntary left trunk flexion pattern using real-time ultrasound imaging during the intervention period. Results: The result of comparing the data collected during the intervention period with the data point average of the baseline process showed that balance ability improved and the tendency line was above the baseline. The tendency line of unilateral neglect was below the baseline and showed a decreasing tendency. The thickness of the lateral abdominal muscle showed an increasing trend and the tendency line was above the baseline. Conclusion: The results of this study suggest that the task-oriented training for left trunk flexion pattern using real-time ultrasound imaging has a beneficial effect on balance ability, the degree of unilateral neglect, and the strength of the lateral abdominal muscle in unilateral neglect patients.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.277-289
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• 2020

Purpose : This study aims to confirm the clinical usefulness of computerized cognitive therapy program for patients with brain diseases in Korea and to present basic data that can confirm the effectiveness of computerized cognitive therapy program to experts related to rehabilitation in the future. Methods : A systematic review and meta-analysis research method was used to confirm the clinical effectiveness of computerized cognitive therapy applied to patients with brain diseases in Korea. Based on the national institute of health and medical colleges association (NECA) systematic literature manual and preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for conducting research through systematic review and meta-analysis methods. Systematic review was PICOST-SD was used to research and select papers. For meta-analysis, the data was input and analyzed separately by literature result using the revman manager 5.3 program and the results were presented visually through tables and forest, funnel plot figure. Results : As a result of comprehensive analysis of the contents of the finally selected literature, it as found that studies on stroke and dementia were mainly conducted. In addition, through the evaluation of the quality of the literature, most of the existing computerized cognitive therapy studies were identified as high-quality studies, but the results were insufficient for randomization and blinding. And through meta-analysis, the clinical effectiveness of computerized cognitive therapy on cognitive function, activities of daily living, and visual perception function of patients with brain disease was found. Conclusion : The research literature that applied computerized cognitive therapy to brain disease subjects was comprehensively analyzed and identified. It is thought that this could be used as basic data on the characteristics of cognitive therapy that should be applied to patients with brain diseases in the future and the usefulness of computerized cognitive therapy program in actual clinical practice.