• 대한물리의학회지
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• 제18권4호
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• pp.133-144
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• 2023

PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.

• 대한한방내과학회지
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• 제33권4호
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• 디지털융복합연구
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• 제11권8호
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• pp.235-242
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• 2013

본 연구는 아급성뇌졸중환자의 상지기능과 일상생활수행능력에 대한 상상훈련의 효과를 알아보기 위해 시행되었다. 연구대상자들은 총 16 명으로 상상훈련군과 대조군에 8 명씩 무작위로 할당되었다. 상상훈련군은 4주 동안 주 5회, 매일 30의 상상훈련과 30분의 과제지향훈련을 시행하였고 대조군은 4주 동안 주 5회, 매일 30분간 과제지향훈련을 시행하였다. 측정은 상지기능의 변화를 알아보기 위해 울프운동 기능검사(Wolf motor function test, WMFT)와 Fugl-meyer 운동기능평가(Fugl-Meyer motor function assessment, FMA)를 측정하였고, 일상생활수행능력의 변화를 알아보기 위해 수정된 바델 지수(modified Barthel index, MBI)를 사용하여 측정하였다. 본 연구의 결과는 상상훈련이 대조군에 비해 모든 검사에서 더 유의한 향상을 보였다(p<.05). 그리고 훈련 전후의 효과크기는 상상훈련을 시행하였을 때 WMFT와 FMA는 각각 1.59, 2.02로 큰 효과를 나타냈으며, MBI는 0.37로 최소의 효과를 나타났다. 이러한 결과는 상상훈련이 상지기능과 일상생활수행능력 향상에 도움이 될 수 있으며, 상상훈련의 임상적용 가능성을 지지한다.

• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.851-859
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• 2013

본 연구는 뇌졸중 편마비 환자를 대상으로 비마비측과 상지부종이 있는 마비측의 정량적 감각 평가(QST)를 비교함으로서 부종 관리 및 치료에 대한 기초자료를 제공하고자 하였다. 연구의 목적에 맞는 아급성기 뇌졸중 환자I군(n=15)과 만성기 뇌졸중 환자II군(n=17)을 대상으로 비마비측과 마비측에 대한 상지용적의 차이, 기계적 동통 역치(MPT), 냉감역치(CST), 온감역치(WST), 냉통증역치(CPT), 온통증역치(WPT), 진동감각 역치(VST)에 대한 정량적 감각 평가(QST)를 실시하였다. 그 결과, 각 군내 비교 시 모든 측정 항목에서 유의한 차이가 나타났고(p<.001), I군과 II군의 군간 마비측 감각 평가 비교에서는 기계적 동통 역치(MPT)를 제외한 모든 측정 항목에서 유의한 차이가 나타났다(p<.05). 아급성기에는 만성기에 비해 상지부종으로 감각역치 증가로 인한 감각저하가 초래되었음을 확인할 수 있었다. 뇌졸중 환자의 부종에 따른 감각적 특성 차이를 정량적 평가를 통해 알아보고자 하였다.

• PNF and Movement
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• 제16권3호
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• pp.307-315
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• 2018

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from $2482.13mm^2$ to $626mm^2$), and walking speed improved by 18.70% (from 0.75 m/s to 0.64 m/s). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.167-174
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• 2021

Objective: Single leg bridge exercise (SLBE) improves trunk muscle activation and provides muscle stability by aligning joints related to posture. This preliminary study aimed to investigate the effects of SLBE on abdominal muscle activation in subacute stroke patients. Design: Cross-sectional study. Methods: Fifteen subacute stroke patients (9 males, 6 females) voluntarily participated in this study. SLBE was performed on the affected side. Each individual patient performed an SLBE ten times in three sets and was asked to hold their position for 5 s. Muscles activity was recorded using a surface electromyography (EMG) system before and after the SLBE. A surface EMG system was used to analyze the muscle activity during general bridge exercise, including the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) abdominal muscles. Results: Muscle activity of both EO and IO on the affected side significantly increased (p<0.05), whereas the muscle activity of the RA and the three muscles on the unaffected side did not show a significant difference. In addition, improvement in muscle asymmetry of the EO and IO showed a significant change after SLBE (p<0.05). Conclusions: SLBE is effective in activating the abdominal muscles of stroke patients on the affected side and is a helpful exercise intervention that activates the muscles to transform asymmetric abdominal muscles into symmetric patterns.

• 대한물리의학회지
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• 제17권4호
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• pp.123-132
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of cognitive orientation to daily occupational performance (CO-OP) interventions on the upper extremity function and occupational performance in subacute stroke patients. METHODS: A total of 30 eligible stroke patients were randomly distributed into the CO-OP experimental group (n = 15) and the traditional occupational therapy (OT) control group (n = 15). The CO-OP approach was applied for twelve 60-minute sessions. The Jebson Taylor Hand Function Test (JTHFT), the Korean version of the Modified Barthel Index (K-MBI), and the Performance Quality Rating Scale (PQRS) were used for outcome evaluations. RESULTS: There was a statistically significant difference in the paralytic upper extremity function before and after treatment (p < .01) between the group treated with the CO-OP approach and the group treated with traditional OT. The occupational performance of the CO-OP approach group showed a significant improvement (p < .01), and this group also showed a statistically significant improvement in quality of performance compared to the traditional OT group (p < .01). CONCLUSION: The CO-OP approach may be useful in clinical practice as a therapeutic intervention for improving the functional recovery and performance of subacute stroke patients. Future research should be carried out to investigate the persistence of this effect involving more participants and follow-up studies should also be undertaken.

• 대한물리의학회지
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• 제18권2호
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• pp.115-123
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• 2023

PURPOSE: This study examined the effects of combined conventional exercise therapy plus respiratory exercise program with combined conventional exercise therapy plus aqua exercise program in the pulmonary function of subacute stroke patients. METHODS: The respiratory exercise program group underwent inspiration and expiration training using the Threshold IMT and Threshold PEP three days per week for four weeks. The aquatic exercise program group had aquatic aerobics, halliwick, and bad ragaz ring training three days per week for four weeks. Before and after the experiment, Pony fx was used to examine the FVC, FEV1, FEV1/FVC, VC, and MVV. RESULTS: Significant improvement was found after the experiment in the FVC. FEV1, VC, MVV, excepting FEV1/FVC, of the pulmonary function in the aquatic exercise program group. After the experiment, significant improvement was found in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function in the respiratory rehabilitation therapy group. No significant difference in FVC, FEV1, FEV1/FVC, VC, and MVV of pulmonary function was observed in the inter-group comparison. CONCLUSION: Significant improvement was found after the experiment in both the aquatic exercise program group and the respiratory exercise program group. No difference in pulmonary function was noted in the inter-group comparison. Therefore, combining general exercise therapy and an aquatic or respiratory exercise program is expected to be effective for the pulmonary function of acute stroke patients. These results are expected to provide basic data to help research intervention of aquatic and respiratory exercise programs for subacute stroke patients.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.31-38
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• 2018

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

• Journal of Magnetics
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• 제19권2호
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• pp.192-196
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• 2014

The aim of the present study was to examine the effects of high and low frequency repetitive transcranial magnetic stimulation on motor cortical excitability and the balance function in subacute stroke patients. Twenty-four subjects were randomly assigned to either the high frequency (HF) rTMS group, or the low frequency (LF) rTMS group, with 12 subjects each. All subjects received routine physical therapy. In addition, both groups performed a total of 20 sessions of rTMS for 20 minutes, once a day, 5 times per week, for a 4-week period. In the HF rTMS group, 10 Hz rTMS was applied daily to the hotspot of the lesional hemisphere; and in the LF rTMS group, 1 Hz rTMS was applied daily to the hotspot of the nonlesional hemisphere. Motor cortex excitability was determined by motor evoked potentials, and the balance function was evaluated by use of the Balance Index (BI) and the Berg Balance Scale (BBS), before and after the intervention. The change rate in the value of each variable differed significantly between the two groups (p<0.05). Furthermore, significant differences were observed between all post-test variables of the two groups (p<0.05). In the HF rTMS, significant differences were found in all the pre- and post-test variables (p<0.05). On the other hand, in the LF rTMS, significant difference was observed only between the pre- and post-test results of BI and BBS (p<0.05). The findings demonstrate that HF rTMS can be more helpful in improving the motor cortical excitability and balance function of patients with subacute stroke treatment than LF rTMS, and that it may be used as a practical adjunct to routine rehabilitation.