• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.777-787
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• 2018

Objective To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with task-specific training on paretic hand function following subacute stroke. Methods Sixteen participants were randomly selected and grouped into two: the experimental group (real LF-rTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour task-specific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training. Results Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks. Conclusion The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.405-408
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• 2012

Purpose: We examined the effect of dual-task and single-task training on serial reaction time (SRT) task performance to determine whether SRT is based more on motor or perception in a dual-task. Methods: Forty healthy adults were divided into two groups: the dual-task group (mean age, $21.8{\pm}1.6$ years) and the single-task group (mean age, $21.7{\pm}1.6$ years). SRT task was conducted total 480 trial. The four figures were presented randomly 16 times. A unit was set as 1 block that would repeat 10 times. Thus, there were a total of 160 trials for each of the three color conditions. The dual-task group performed an SRT task while detecting the color of a specific shape. The end of the task, subjects answered the specific shape number; the single-task group only performed the SRT task. The study consisted of three parts: pre-measurement, task performance, and post-measurement. Results: Differences of pre and post reaction time between two group was higher for the dual-task group as compared to the single task group and there was a significant interaction between time and group (p<0.05). Conclusion: Our results indicate that. short term period SRT is not quiet effective under dual-task conditions, individuals need additional cognitive processes to successfully navigate a task This suggests that dual-task training might not be appropriate for motor learning enhancement, at least when the training is over a short period.

• 대한통합의학회지
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• 제5권1호
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• pp.1-9
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• 2017

Purpose : This study is to examine the effects of different task-related circuit training by types of tasks on the depression and quality of life in stroke patients. Method : Forty-four chronic stroke patients were divided into a dual motor circuit task training group, a dual cognitive circuit task training group and a simple task training group. Over the course of eight weeks, before training, all the patients were identically encouraged to receive conservative physical therapy for 30 minutes, five times a week for a total of eight weeks with individual additional tasks. The dual motor circuit tasks training consisted of continuous circuit training motor tasks and additional motor tasks and the dual cognitive circuit task training consisted of tasks combining the same circuit training motor tasks and additional cognitive tasks. The simple task training consisted of natural walks on a flat terrain to the front, rear and lateral sides of the terrain. Result : As for the Stroke-Specific Quality of Life(SS-QOL) that showed significant diffe rences in comparison between the groups over the training period, the dual motor circuit task training group showed statistically significant differences in both different types of tasks at 8 weeks(p<.05). The score of Hospital Anxiety and Depression Scale(HADS) decreased in three groups, in the HADS showed significant changes over the training time in the three training groups(p<.05). Conclusion : It could be seen that the practical and continuous dual circuit task training was more effective than simple task training on quality of life. In comparison between the types of dual tasks, the dual motor circuit task training group showed more effects than the dual cognitive circuit task training group. This researcher hopes that the results of this study will be actively applied as rehabilitation methods for chronic stroke patients.

• 대한치료과학회지
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• 제10권2호
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• pp.21-30
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• 2018

Objective: The purpose of this study was to investigate questions and instructions for internal feedback effects on functional recovery and task performance while chronic stroke patients practised task-specific training. Method: Twenty-four chronic stroke patients were randomly divided into two groups; when patients performed same tasks, one was treated using questions and the other using instructions for internal feedback Both lasted 30 minutes, 5 times a week for 8 weeks. Outcome measures included Erasmus MC Modifications to the Nottingham Sensory Assessment (EmNSA), Measurement Properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), Chedoke Arm and Hand Activity Inventory (CAHAI), Korean version of Modified Barthel Index (K-MBI). Results: There were no significant differences between the two groups in EmNSA and K-MBI(p>.05). But, in MESUPES and CAHAI, there was significant difference between the two groups(p<.05). Conclusion: In this study, questions for internal feedback during task-specific training are more effective in improving upper extremity motor function and task performance than instructions for internal feedback.

• The Journal of Korean Physical Therapy
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• 제27권2호
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• pp.112-117
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• 2015

Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

• 대한통합의학회지
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• 제9권4호
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• pp.211-223
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• 2021

Purpose : The purpose of this study was to examine the effect of task-oriented circuit training using unstable support surface on balance, gait ability, and balance confidence in subacute stroke patients. Methods : Forty-five patients with subacute stroke were randomly divided into the three following groups of 15: 1) TOCT-US group; task-oriented circuit training using unstable surface (experimental group 1), 2) TOCT-SS group; task-oriented circuit training using stable surface (experimental group 2), and 3) CON group; conventional physical therapy (control group). All patients participated in one of the three training programs for 6 weeks, 30 minutes per session, 3 times per week. Patients' balance ability was assessed using the BT-4, BBS (berg balance scale), TUG (time up and go test), and LOS (limit of stability). Gait speed was measured to examine gait ability. K-ABC (activities-specific balance confidence scale) was also used to assess the level of patients' confidence in daily activities. Results : After the intervention, the sway area in experimental groups 1 and 2 decreased, but that in the control group increased. Experimental group 1 showed significant improvement compared with experimental group 2 and the control group. BBS, TUG, and LOS scores of experimental group 1 were significantly improved compared with those of experimental group 2 and the control group. Also, gait speed significantly improved in experimental group 1 compared with experimental group 2 and the control group. Experimental groups 1 and 2 showed significant improvement in K-ABC scores after training. Conclusion : Patients with subacute stroke had significantly improved balance, gait, and level of confidence in performing activities of daily living following task-oriented circuit training using the unstable surface. This indicates that task-oriented circuit training using unstable surfaces can be an effective treatment method for the recovery of balance and gait in subacute stroke patients.

• BMB Reports
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• 제49권11호
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• pp.635-640
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• 2016

Recent evidence indicates that the ephrin receptors and ephrin ligands (Eph/ephrin) expression modulate axonal reorganization and synaptic plasticity in stroke recovery. To investigate the effect of task-specific training (TST) on Eph/ephrin expression in the corticospinal tract (CST) after stroke, we compared Eph/ephrin expression in the peri-infarct cortex, pyramid, and spinal cord of a photothrombotic stroke model of rat brains treated with or without TST. The TST treatment showed significantly better recovery in the behavioral tests compared with no treatment. The significant upregulation of ephrin-A1 and ephrin-A5 observed in activated astrocytes of the CST at 2 weeks' post-stroke was decreased by TST. At 5 weeks, post-stroke, the elevated ephrin-A5 levels were decreased in the ipsilateral pyramid and spinal cord by TST. Glial fibrillary acidic protein was upregulated concomitantly with the altered ephrin expression after stroke, and the expression of these proteins was attenuated by TST. These data suggest that TST alters the expression of ephrin ligands in the CST after stroke.

• 한국전문물리치료학회지
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• 제21권2호
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• pp.18-27
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• 2014

The purpose of this study was to examine the effects of dual-task training (cognitive and exercise tasks) on the balance and gait performance of chronic stroke patients. Eighteen subjects with chronic stroke were divided equally into two groups, an experimental group and a control group. Subjects in both groups participated in an exercise program, performing the same tasks, for 45 minutes per day, three times per week for four weeks. The experimental group also performed additional cognitive task. The experimental group showed a more significant improvement than the control group on the Berg Balance Scale, the Timed Up and Go Test, the Korean Activities-Specific Balance Confidence Scale, and the Functional Gait Assessment (p<.05). The cognitive task error rates in the final week were significantly less than in the first week in the experimental group (p<.01). These results suggest that dual-task training for chronic stroke patients is effective in improving balance, gait, and cognitive abilities.

• Physical Therapy Rehabilitation Science
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• 제5권4호
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• pp.170-176
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• 2016

Objective: The purpose of this study was to compare the effect of ball kicking dual task gait training with the addition of a cognitive task with general treadmill gait training (TGT) on gait speed, gait endurance, functional gait, balance and balance confidence in patients with chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: Fourteen stroke patients who volunteered to participate in this study were randomly divided into two groups with seven patients in each group: ball kicking dual task training (DTT) group and TGT group. The DTT group received ball kicking DTT with cognitive tasks consisted of three stages and the TGT group received TGT using normal walking speed, respectively, for 30 minutes per day 3 days per week for 4 weeks. Outcome assessments were made with the 10-meter walking test (10MWT), 6-minute walking test (6MWT), functional gait assessment (FGA), Berg balance scale (BBS), timed up and go test (TUG), and the activities-specific balance confidence (ABC) scale. Results: The DTT group showed more significant improvement in the 10MWT, 6MWT, FGA, BBS, TUG, and ABC than the TGT group (p<0.05). In addition, within groups comparison showed significant improvement in all variables (p<0.05). Conclusions: The findings suggest that both ball kicking dual task gait training and TGT improve gait performance and balance in patients with chronic hemiparetic stroke. However, ball kicking dual task gait training results showed more favorable outcomes than TGT for chronic hemiparetic stoke patients.

• 대한물리의학회지
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• 제9권2호
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• pp.213-222
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• 2014

PURPOSE: This study was conducted to determine the effect of patient-selected, task-oriented training on activities of daily living, quality of life, and depression for stroke patients. METHODS: This study included 40 stroke subjects, randomly assigned to either an experimental group or a control group. Both the experimental group and the control group included 20 stroke patients. Patients from the experimental group selected and performed task-oriented training. In the exercise program, the patient chose two categories from six categories and trained for 30 minutes a day, three times a week, for four weeks. Patients from the control group performed conventional task-oriented training. Outcomes were measured using the Korean version of a modified Barthel Index (K-MBI), the Korean Instrumental Activities of Daily Living (K-IADL), the Stroke-specific Quality of Life (SS-QOL), the Short Form 8 (SF-8), and the Beck Depression Inventory (BDI), both before and after training. RESULTS: There were significant differences between the before- and after-intervention data of the K-MBI and the K-IADL (p<.05) for both groups. Also, there were more significant improvements in the experimental group compared to the control group (p<.05) for the SS-QOL, SF-8 and BDI. CONCLUSION: The results of this study showed that patients-selected, task-oriented training had positive effects on stroke patients' activities of daily living, quality of life, and depression.