• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.17-28
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• 2003

The aim of this study was to investigate the effects of treadmill gait training on the functional characteristics and the temporal-distance parameters of gait in hemiplegic patients, as compared with conventional gait training. The subjects of this study were 32 hemiplegic patients who had been admitted or were visited out-patients at Kangdong Sacred Heart Hospital, Hallym University, from March 3 through April 25, 2003. These subjects were randomly divided into treadmill gait training group or conventional gait training group. We evaluated the gait ability, motor functions, muscle strength, spasticity, physiological cost index, and temporal-distance parameters. We analyzed the changes between pre and post training in each groups, and the difference between two groups. Temporal-distance parameters were obtained using the ink footprint method and then energy consumption using physiological cost index. The results were as follows: 1. After a six-week training, treadmill gait training group significantly improved, as. compared to pre-training, in gait ability, motor functions for the leg and trunk and gross function, muscle strength of the lower limb, gait speed, cadence, step length both on the affected and on the unaffected side, step length symmetry, and energy consumption(p<0.05). 2. After a six-week training, conventional gait training group significantly improved, as compared to pretraining, in gait ability, motor functions for the leg and trunk, muscle strength of the lower limb, spasticity the upper limb, gait speed, cadence, step length both on the affected and on the unaffected side, and energy consumption(p<0.05). 3. After a six-week training, the treadmill gait training group significantly improved, as compared to the conventional gait, training, in gait speed and step length on the unaffected side. These results show that treadmill gait training was improved gait speed and step length on the unaffected side of hemiplegic patients, as compared with conventional gait training. Further research is needed to confirm the generalization of these findings and to identify which hemiplegic patients might benefit from treadmill gait training.

• Journal of Korea Entertainment Industry Association
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• v.14 no.7
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• pp.511-518
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• 2020

The purpose of this study was to provide useful data for clinical occupational therapy by examining the correlation between the use of affected and unaffected sides measured using an accelerometer and upper limb function in chronic stroke patients. In this study, accelerometer, Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and Yonsei-Bilateral Activity Test(Y-BAT) was measured on 40 stroke patients who were hospitalized in Won-ju city Y hospital between May 2, 2019 and July 18, 2020. As a result of the study, there was a significant negative correlation between amount of use on the unaffected side and FMA and MAL's Amount of Use(AOU), Quality of Movement(QOM), the quality and satisfaction of performing both hands through Y-BAT. The amount of use on the affected side showed a significant positive correlation with FMA and MAL's AOU, QOM, satisfaction of performing both hands. This study is meaningful in that it suggested the possibility that the actual amount of use on the affected and unaffected side measured using an accelerometer could be used as an evaluation item for upper limb function in stroke patients.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.393-400
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• 2009

Purpose: The purpose of this study was to examine the effects of unilateral sciatic nerve injury on unaffected hindlimb muscles of rats. Methods: Adult male Sprague-Dawley rats were assigned to one of three groups: control(C) group(n=10) that had no procedures, sham(S) group(n=10) that underwent sham left sciatic nerve transection, and sciatic nerve transection(SNT) group(n=9) that underwent left sciatic nerve transection. At 15 days rats were anesthetized, and the soleus, plantaris and gastrocnemius muscles were dissected. Results: Muscle weight of the unaffected plantaris muscle in the SNT group was significantly lower than in the other two groups. Type II fiber cross-sectional areas of the unaffected plantaris and gastrocnemius muscles in the SNT group were significantly smaller than in the other two groups. The decrease of muscle weights and Type I, II fiber cross-sectional areas of the unaffected three muscles in the SNT group were significantly less than that of the affected three muscles. Conclusion: Hindlimb muscle atrophy occurs in the unaffected side after unilateral sciatic nerve injury, with changes in the plantaris and gastrocnemius muscle being more apparent than changes in the soleus muscle. These results have implications for nursing care, in the need to assess degree of muscle atrophy in unaffected muscles as well as affected muscles.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.23-30
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• 2010

Objectives : The second derivative of photoplethysmogram waveform(SDPTG) is a simple, convenient and non-invasive technique for pulse wave analysis. This study was designed to investigate the differences in the SDPTG between the affected side and the unaffected side in hemiparetic patients after stroke, and the effects of acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : To evaluate the differences between the affected side and the unaffected side in hemiparetic patients after stroke, their SDPTG were recorded by using a Cardio Peri SA6000. To evaluate the effects of acupuncture at Palsa(BaXie) in 20 hemiparetic patients after stroke and 20 healthy subjects, their SDPTG were recorded 2 times(pre-acupuncture and post-acupuncture). The SDPTG consists of an a, b, c and d wave in systole and an e wave in diastole. Sano aging index was defined as (b-c-d)/a. Results : 1. The affected side in hemiparetic patients after stroke had higher average b/a ratio(p<0.05)and Sano aging index(p<0.05) than the unaffected side 2. In a comparison of pre-acupuncture and post-acupuncture at the Palsa(BaXie), b/a ratio(p<0.05) and Sano aging index(p<0.05) was decreased significantly in both hemiparetic patients and healthy subjects. Conclusions : These findings suggest that acupuncture at Palsa(BaXie) may be effective method of reverting some of the deleterious effects on vascular function produced by stroke.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.311-319
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• 2021

Objective: To investigate the effect of emphasized initial contact by using a wearable air-pressure insole to provide auditory-feedback with variations of maximum peak pressure (MPP) of the affected side on spatiotemporal gait parameters and gait symmetry of stroke patients Design: A cross-sectional study Methods: Eighteen stroke patients participated in this study. All subjects walked five trials using an air-pressure insole that provides auditory feedback with different thresholds set on the insole. First, subjects walked without any auditory feedback. Then, the MPP threshold on the affected side was set from 70% and increase threshold by 10% after each trial until 100%. They walked three times or more on the gait analyzer for each trial, and the average values were measured. Before starting the experiment, subjects measured body weight, initial gait abilities and affected side MPP without auditory feedback. Results: Temporal and spatial variables were significantly increased in trials with auditory feedback from air-pressure insole except for non-paralyzed single support time and spatial gait symmetry compared to trials without auditory feedback(p<0.05). Among the four different thresholds, the walking speed, unaffected side single support time, affected and unaffected side stride, and affected side step length were greatest at 80% threshold of maximum peak, while affected single support time, temporal gait symmetry, and unaffected step length were greatest at the maximum peak of 100% threshold. Conclusions: These results indicate that auditory feedback gait using air-pressure insoles can be an effective way to improve walking speed, single support time, step length, stride, and temporal gait symmetry in stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.189-199
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• 2024

Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

• Physical Therapy Korea
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• v.16 no.2
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• pp.59-66
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• 2009

This study investigated the irradiation pattern of muscles on the affected side in stroke patients after application of diagonal 2 extension (D2 ex) proprioceptive neuromuscular facilitation in the unaffected upper extremity. Seven stroke patients participated. Electromyographic activities were recorded in the iliopsoas, biceps brachii, and triceps brachii were recorded by surface electrodes at rest, D2 ex with knee extension, and D2 ex with knee 90 flexion, normalized by maximal voluntary isometric contraction (MVIC) values. The medial frequencies of biceps brachii in both sides were also measured to compare muscle type recruited. %MVIC of biceps brachii and triceps brachii were significantly higher in D2 ex than at rest (p<.05). There was no difference in median frequency of biceps brachii between the affected and unaffected side (p>.05). This suggests that proprioceptive neuromuscular facilitation using D2 ex may improve muscle activities of the paretic side and that the irritation pattern of the affected side may respond to maintain body equilibrium according to movement of the sound side.

• Physical Therapy Korea
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• v.9 no.2
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• pp.157-168
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• 2002

The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) approach on the spasticity of affected side in patients with hemiplegia. Three subjects with hemiplegia participated in this study. In single-subject research design (a multiple baseline across individuals) was employed in this study. The intervention program including PNF to the unaffected side was introduced for 30 minutes each day during each intervention phase. Muscle tone of affected side was measured with Tone Assessment Scale, and active hip abduction distance of affected side was taken with the subject supine. And then the muscle tone and the hip abduction distance were measured again 30 minutes later following the intervention. The results showed that the PNF application had some beneficial effects on both muscle tone and active hip abduction. This result suggest that PNF application to non-paretic limb can be effective in reducing muscle tone and improving hip abduction range on paretic limb in persons with hemiplegia. However, further research is needed to prove the effect of PNF application on functional improvement.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.213-219
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• 2023

Purpose: In this study, based on the error augmentation, we performed walking training with increased rhythmic auditory stimulation speed on the affected side (IRAS) and walking training with decreased rhythmic auditory stimulation speed on the unaffected side (DRAS). The purpose of this study was to verify whether motor learning was effective in improving balance ability. Methods: Twenty-eight subjects with chronic stroke were recruited from a rehabilitation center. The subjects were divided into three groups: an IRAS group (10 subjects), a DRAS group (9 subjects), and control group (9 subjects). They received 30minutes of neuro-developmental therapy and walking training for 30minutes, five times a week for three weeks. Static and functional balance ability were measured before and after the training period. Static balance was measured by balancia software. Functional balance was measured by the timed up and go test (TUG) and the berg balance scale (BBS). Results: After the training periods, the IRAS group showed a significant improvement in TUG, BBS, area 95% COP, and weight distribution on the affected side when compared to both the DRAS group and control group (p<0.05). Conclusion: Based on the results of this study, it is possible to consider error augmentation methods of motor learning if rhythmic auditory stimulation is applied to stroke patients in clinical practice. If the affected side is shorter than the unaffected side, the affected side should be adjusted to the increased rhythmic auditory stimulation speed, which is considered to be an effective intervention to improve balance ability.

• PNF and Movement
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• v.16 no.1
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• pp.59-66
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• 2018

Purpose: This study aimed (1) to identify asymmetry observed in electromyography (EMG) activity patterns of lower limb muscles between affected and unaffected sides of stroke patients during sit to stand (STS) movement and (2) to identify the muscles of the paretic lower limb that affected STS performance in stroke patients. Methods: This study consisted of 27 patients (15 males and 12 females) with poststroke hemiparesis. The activation of the rectus femoris (RF), tibialis anterior (TA), and gastrocnemius (GCM) of the affected side and unaffected side during STS movement were recorded using surface EMG. In addition, EMG lower limb muscle activation patterns were measured in the all section, pre-thigh off (pre-TO), and post-thigh off (post-TO) section. All measurements were obtained during five repetitions of the STS (FTSTS) movement. An independent t-test was performed to compare the affected side and unaffected side of the lower limb during the STS movement. A stepwise linear regression analysis was conducted to identify the muscles that affected STS performance. Results: Activation of both the RF and TA significantly affected the lower limb during the STS movement (p<0.05). Two muscles showed a difference on the post-TO section. The results of the stepwise multiple regression analysis showed that the RF and TA muscles of the affected lower limb were affected in FTSTS. Conclusion: These results provide a basis for reinforcement training, focusing on the RF and TA muscles of the affected side of stroke patients to improve asymmetric movement and performance in STS movement.