• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.35-44
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• 2020

Background: This study was to confirm the effect and feasibility of knee extension assist orthosis (KEAO) on balance and gait in subacute stroke patients. Design: Case study. Methods: The subjects of the study were 4 subacute stroke patients, who had an onset period of less than 6 months. The limit of stability (LOS) and berg balance scale (BBS), timed up and go test (TUG) were used to verify the dynamic balance ability, static balance ability, and gait ability pre and post and after wearing the knee extension assist orthosis (KEAO). In addition, the satisfaction survey was to confirm the feasibility of the knee extension assist orthosis (KEAO) through the to Korean quebec user evaluation of satisfaction assistive technology 2.0 (K-QUEST 2.0). Results: After the wearing on KEAO, the distance for the limit of stability decreased by mean 541.25±240.46 mm2, and the score on the berg balance scale improved by mean 5±2.71 point, and the time for the timed up and go test deceased by mean 3.75±1.71 second. The stability and durability were found to be full score, and the control, ease, effectiveness were some high score, and the size, weight, comfort were some low score in the satisfaction and feasibility. Conclusion: The knee extension assist orthosis (KEAO) produce in this study was improved the static balance ability, dynamic balance ability and gait ability of subacute stroke patients, and the satisfaction and feasibility were high in the stability, durability and effectiveness of the user.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.155-164
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• 2024

PURPOSE: The purpose of this study was to evaluate the effects of simultaneous application of gaze stabilization exercise and cognitive training on the balance and gait ability in subacute stroke patients. METHODS: Thirty-five patients diagnosed with stroke within 3-6 months were randomly assigned, and the experimental group (n = 18) to which both gaze stabilization exercise and cognitive training were applied and the control group (n = 17) to which only gaze stabilization exercise was applied were targeted. It was performed for 30 minutes at a time, three times a week, for a total of 4 weeks. Berg Balance Scale, Timed Up and Go test, 10Meter Walking Test, and Walking symmetry were evaluated. RESULTS: In the comparison of changes between Berg Balance Scale, Time Up and Go test, 10 Meter Walking Test, and Gait symmetry, both experimental and control groups showed significant differences before and after the intervention, and in the evaluation of Gait symmetry, significant differences between groups. CONCLUSION: As a result of this study, when gaze stabilization exercise and cognitive training were allied simultaneously, it was possible to improve the balance and gait ability of subacute stroke patients, and had a more significant effect on gait ability. In considered that training that simultaneously applies gaze stabilization exercise and cognitive training can be presented as a balance and gait rehabilitation for stroke patients on the future.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.1-7
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• 2008

Purpose: Implicit motor learning is the capacity to acquire skill through physical practice without conscious awareness of what elements of performance improved. This study investigated whether subacute stroke patients can implicitly learn a perceptual-motor task. Methods: We recruited 12 patients with subacute stroke and 12 age-matched controls. All participants performed a perceptual-motor task that involved pressing a button corresponding with colored circles (blue, green, yellow, red) on a computer screen. The task consists of 7 blocks composed of 10 repetitions for a repeating 12-element sequence (total 120 responses). Results: Both groups demonstrated significant improvement in acquisition performance. Reaction times deceased in both groups at similar rate within the sequential block trials (2-5 blocks), and reaction times increased at a similar rate when the task paradigm was transferred from the sequential block trial to the random block trial (5-6-7 blocks). Conclusion: The results of this study suggest that patients with sub-actue stroke can implicitly learn a perceptual motor skill. Although explicit instructions should be used to focus the learner's attention rather than provide information about the task, the application of implicit motor learning strategies in the rehabilitation setting may be beneficial.

• The Journal of Korean Physical Therapy
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• v.20 no.1
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• pp.41-47
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• 2008

Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

• Journal of Music and Human Behavior
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• v.10 no.1
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• pp.1-23
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• 2013

Upper extremity dysfunction is a common consequence following stroke. Spontaneous recovery during the first six months post-stroke is rigorous and considered as a significant indicator of potential long-term progress. Various approaches have been utilized to regain functional upper limb movement necessary for independent living; however, conventional therapy approaches have failed to prove consistency, especially for subacute stroke patients. There is, thus, a need for innovative therapeutic strategies that motivate stroke survivors to facilitate neural and functional recovery during the critical window immediately following stroke. The effect of music on physical enhancement has been frequently reported in the field of medicine as well as neurorehabilitation. The efficacy of rhythm on lower extremity deficits has been well established. Yet, the rationale for using instrumental music making enhancing subacute upper extremities rehabilitation is not clearly described to date. Based on the key mechanism of music as sensori-motor movement facilitator, this paper reviews previous empirical research that utilized music-based interventions for upper extremity rehabilitation for stroke patients, either in the form of receptive or expressive activity. This paper, further, focuses on the current research trends in subacute stroke upper limb rehabilitation and provides applicable rationale of using instrumental music playing.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.1-12
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• 2021

Purpose : We aimed to determine whether improvements in balance, gait, and motor function were different when the same exercise was performed, with and without mirror therapy, by patients with subacute stroke using the affected and unaffected lower limbs. Methods : Eight patients with subacute stroke were randomly divided into experimental groups 1, 2 and the control group. A mirror therapy program was performed with group 1 using the unaffected lower limb and group 2 the affected lower limb. The exercise lasted 30 min per session, five times weekly, for 4 weeks. The control group did not perform the exercises. BT-4, BBS, POMA, 10MWT, and BRS were used to evaluate balance, gait, and motor function before and after the intervention. Results : Post-intervention analysis showed that all three groups had higher BBS scores. After training, the postural sway in groups 1 and 2 decreased in the post eye opened and closed positions; that of the control group increased. The scores of two subjects in group 1 increased by 4 and 5 points in POMA, resulting in significant changes compared to those in the other groups. No group showed significant results in 10MWT. BRS improved in all subjects in group 1 from BRS 2 to 1 and in only one subject in group 2 there was no change in the control group. Conclusion : Static and dynamic balance and significant results are noted in POMA, BBS, but not gait velocity. Therefore, mirror therapy seems to show a positive change in subacute patients, but the research results are not clear and the difference between groups is unknown due to the small number of subjects. The effects of mirror therapy and exercise therapy should be compared using more subjects in future.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.105-114
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• 2023

Purpose : This study systematically reviewed occupational therapy programs for upper extremity functions in subacute patients implemented over the last decade at home and abroad to utilize the findings as the basis for intervention protocols. Methods : This study was conducted with domestic and foreign randomized controlled experimental studies published from January 2013 to May 2023. Acute or subacute, CVA or stroke, upper extremity function, and program or therapy were used as search keywords in the search databases Scopus, PubMed, Riss, and DBpia. A total of 3,723 documents were retrieved, and 1,007 duplicate papers were excluded. In addition, 2,640 papers that did not meet the inclusion and exclusion criteria were excluded by the researcher examining the titles and abstracts. Thereafter, the full texts were checked. Consequently, 67 documents were excluded, and nine documents were finally used for analysis. Results : Due to the evaluation of the quality of the documents of nine studies, five items were rated "low," and two items were rated "unclear" in many studies. Males predominated the genders, and infarction predominated the types. The average age was over 50 but under 60 years, and the number of days after onset was predominantly fewer than one month. Occupational therapy programs were classified into mental programs, mirror therapy, music programs, and virtual reality programs, and virtual reality programs were frequently used. The intervention periods were predominantly 15-30 sessions for less than 30 minutes, and the Fugl-Meyer assessment-upper extremity was predominantly applied as an evaluation tool. Conclusion : This study is significant because it attempted to present the direction of intervention protocols for upper extremity functions in subacute stroke patients in clinical settings. Studies should be conducted with an expanded scope for a literature review.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.135-144
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• 2008

Purpose : The purpose of this study was to identify the effect of body weight support treadmill training (BWSTT) and parallel bar gait training(P-bar) on gait and balance ability of subacute stroke patients. The subjects were consisted of 27 patients with subacute stroke, and they were randomly devided into two groups which were BWSTT group and P-bar group. Method : The timed up and go(TUG), 10m gait speed were used to measure gait speed, Bergs balance scale(BBS) was used to measure dynamic balance ability, and balance performance monitor(BPM) was used to measure sway area, sway path, max velocity. Result : 1. The TUG and 10m gait speed of BWSTT group and P-bar group were significantly decreased (p<.05). The TUG and 10m gait speed were different significantly between BWSTT group and P-bar group(p<.05). 2. The BBS and sway area of BWSTT group and P-bar group were significantly decreased (p<.05). The BBS and sway area were not different significantly between BWSTT group and P-bar group(p>.05). 3. The sway path and max velocity of BWSTT group and P-bar group were significantly decreased (p<.05). The sway path and max velocity were not different significantly between BWSTI group and P-bar group(p>.05). Conclusion : The outcomes suggest that patient with subacute stroke can improve their gait and balance through body weight support treadmill training.

• The Journal of Internal Korean Medicine
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• v.37 no.6
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• pp.990-997
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• 2016

Objectives: This study observed changes in gait pattern according to the motor grade of the paretic lower limb in patients with basal ganglia stroke who are in the subacute phase. Methods: We used the Manual Muscle Test (MMT) to evaluate the motor grade of the paretic lower limb of 21 patients with subacute basal ganglia stroke and then divided them into two groups based on the MMT results. Stroke patients with a motor grade above Gr. III were put in group I (15 people) and those with a grade less than Gr. III in group II (6 people). We also estimated spatiotemporal factors using treadmill gait analysis equipment. The values were gait velocity, step length, step time, double support phase, and cadence. The first measure was conducted during the early period of admission and the second was between four and five weeks after admission. Results: In Group I, the gait velocity and step length of both legs significantly increased. In Group II, the step length and step time of the paretic side and the gait velocity tended to decrease, but not significantly. The step length of the paretic side in Group II was significantly longer than that in Group I at the first measure. The step time of the paretic side in Group I was significantly shorter than that in Group II and gait velocity and cadence in Group I were significantly higher than in Group II at the second measure. Conclusions: The gait parameters of all stroke patients improved in terms of time. In addition, the changes in gait pattern were different depending on the motor grade of the paretic lower limb.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.163-174
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• 2020

PURPOSE: This study examined the effects of Robot Tilt-table Training (RTT) on the lower extremity strength, balance, gait, and satisfaction with rehabilitation, in patients with subacute stroke (less than six months after stroke onset), and requiring intensive rehabilitation. METHODS: A total of 29 subacute stroke patients were divided into an RTT group (n = 14) and a Body Weight Support Treadmill Training (BWSTT) group (n = 15). The mean age of patients was 62 years. RTT and BWSTT were performed for four weeks, three times a week, for 30 minutes. Isometric strength of the lower extremities before and after intervention was compared by measuring the maximal voluntary isometric contraction of the lower extremity muscles. To compare the balance function, the center of pressure (COP) path-length and COP velocity were measured. Timed Up & Go test (TUG) and 10 Meter Walking Test (10 MWT) were evaluated to compare the gait function. A satisfaction with rehabilitation survey was conducted for subjective evaluation of the subject's satisfaction with the rehabilitation training imparted. RESULTS: In the intra-group comparison, both groups showed significant improvement in lower extremity strength, balance, gait, and satisfaction with rehabilitation, by comparing the parameters before and after the intervention (p < .05). Comparison of the amount of change between groups revealed significant improvement for all parameters in the RTT group, except for the 10 MWT (p < .05). CONCLUSION: Both groups are effective for all variables, but the RTT group showed enhanced efficacy for variables such as lower extremity strength, balance, gait, and satisfaction with rehabilitation, as compared to the BWSTT group.