• 대한물리의학회지
• /
• 제13권2호
• /
• pp.137-145
• /
• 2018

PURPOSE: The purpose of this study was to investigate the effect of action observational physical training with rhythmic auditory stimulation on muscle activity and gait ability in patients with stroke. METHODS: Twenty-six chronic stroke patients participated in this study were assigned into three groups, experimental group 1 (10% faster tempo rhythmic auditory stimulation with action observation training) n=8, experimental group 2 (average tempo rhythmic auditory stimulation with action observation training) n=9, and control group (action observation training) n=9. In this experiment, the corresponding exercise were applied into the subjects of three group for 30 minute a day, 3 time a week during 4 weeks. All participants were measured to muscle activity of lower limb, 10 meter walking test, Figure of 8 walk test, Dynamic gait Index. The collected data were analyzed by using SPSS (version 18.0 for window) and verified that each data was a normal distribution based on Shapiro-Wilk test. Between-group and within-group comparison was analyzed by using One-way ANOVA test, Paired t-test respectively. In all statistical analyses, significance level, ${\alpha}$ was set by .05. RESULTS: The above results revealed that the all experimental group 1 and experimental group 2 and control group were all effective to improve the lower limb muscle activities, gait ability. However more positive effects shown action observational physical training with rhythmic auditory stimulation experimental group. CONCLUSION: This study suggest that action observation physical training with rhythmic auditory stimulation is effective intervention for improvement of muscle activity and walking ability in chronic stroke patients.

• 대한물리의학회지
• /
• 제13권2호
• /
• pp.43-51
• /
• 2018

PURPOSE: Stroke patients have limited ankle range of motion and balance problems. The purpose of this study was to determine the effects of Kaltenborn orthopedic manual therapy, Evjenth-hamberg stretching, and combination of both on ankle dorsiflexion range of motion and dynamic balance ability in stroke patients. METHODS: Thirty patients were placed in three groups, each of which received different treatments: Kaltenborn orthopedic manual therapy (15 mins), Evjenth-hamberg stretching (15 mins), or Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching (30 mins). Each group received three exercise sessions per week during four weeks. To determine its effectiveness of interventions an evaluation was carried out. ankle dorsiflexion range of motion was gauged using a tiltmeter application, and dynamic balance ability was measured using the Berg balance scale. RESULTS: All groups revealed significant improvements in ankle dorsiflexion range of motion, Berg Balance Scale (BBS) score before and after the intervention, and Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching group showed a significant improvement in ankle dorsiflexion range of motion and BBS score in comparison to other groups. CONCLUSION: We found out that each individual method was effective in ankle dorsiflexion range of motion, dynamic balance ability in stroke patients, and the combined method was more effective.

• 대한물리의학회지
• /
• 제15권4호
• /
• pp.47-54
• /
• 2020

PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.

• 대한물리의학회지
• /
• 제9권2호
• /
• pp.223-231
• /
• 2014

PURPOSE: The aim of this study was to investigate the effect of closed and open kinetic exercises on knee extensor strength and balance in patients with early stroke. METHODS: Thirty patients with early stroke participated in the study. Participants were randomly assigned to three groups: an open kinetic chain (OKC) exercise group (n=10), a closed kinetic chain (CKC) exercise group (n=10), and a control group (n=10). All participants received conventional physical therapy for 30 minutes. In addition, the two experimental groups (OKC and CKC) participated in a 30-minute knee strengthening training program. Training for the experimental groups was carried out three times a week for four weeks. Outcomes such as knee extensor strength and balance ability (Tetrax, Functional Reaching Test, Timed Up and Go Test) were measured before and after training. RESULTS: There were significant differences in knee extensor strength and balance ability between the pre- and post-treatment of all groups (p<.05). The improvement of knee extensor strength was significantly higher in the OKC group than in the other groups (p<.05), and the improvement of dynamic balance was significantly higher in the CKC group than in the other groups (p<.05). CONCLUSION: These results showed that both open and closed kinetic chain exercises are effective in the improvement of knee extensor strength and balance ability. This study suggests that open and closed kinetic exercise training is an effective training for strength and balance in patients with early stroke.

• Journal of Korean Neurosurgical Society
• /
• 제45권6호
• /
• pp.360-368
• /
• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• 한국전문물리치료학회지
• /
• 제26권4호
• /
• pp.35-41
• /
• 2019

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

• PNF and Movement
• /
• 제12권2호
• /
• pp.123-132
• /
• 2014

Purpose: The discovery of mirror neuron system may positively affect functional recovery; therefore, rehabilitation is needed that is practical for use in clinical settings. The purpose of this study was to examine the effect of action observation training on upper motor function in people who had suffered strokes. Methods: Three elderly patients with stroke, aged to years, were recruited from a stroke rehabilitation center. A nonconcurrent, multiple baseline subject approach was taken, with an A-B-A treatment single-subject experimental design, and the experiment was conducted for 3 weeks. The action observation training was repeated 5 times in 5 days during the intervention period. The arm function, including WMFT, BBT, and grip and pinch strength, was evaluated in each subject 5 times during the baseline period, the intervention period, and the baseline regression period. Results: The results of the evaluation for each subject were presented as mean values and video graphs. The WMFT scores of 2 subjects were improved during the intervention period in comparison with the baseline period, and this improvement was maintained even during the regression baseline period. The BBT and the grip and pinch strength were not improved. Conclusion: Based on these results, we suggest that the action observation training for 5 sessions was effective in improving upper limb function of stroke patients but was not effective in improving hand dexterity or grip and pinch strength.

• 대한통합의학회지
• /
• 제10권2호
• /
• pp.105-113
• /
• 2022

Purpose: The purpose of this study is to investigate the effect of non-invasive transcranial direct current stimulation (tDCS) on muscle activity, including 10 m WT, TUG, and BBS, in hemiplegic stroke patients. Methods: This study was conducted on 42 inpatients diagnosed with hemiplegia due to stroke at hospital B in Daejeon for more than 6 months. Walking training was conducted for six weeks, five times a week for 30 minutes, with a general walking group (14 people), tDCS walking group (14 people), and tDCS (sham) walking group (14 people). Results: As a result of the study, the change in the muscle activity before and after tDCS intervention was significantly increased in the tibialis anterior muscle in the CG group. In the EG group, the erector spine (lumbar), rectus femoris, and tibialis anterior muscles significantly increased. In the SEG group, significant increases were observed in the rectus femoris and tibialis anterior muscles. Significant differences were found in the rectus femoris and tibialis anterior muscles in the comparison between groups after intervention according to tDCS application. Also, 10 m WT, TUG, and BBS were significantly increased in the CG, EG, and SEG groups after intervention, and there were significant differences in 10 m WT, TUG, and BBS in comparison between groups after intervention according to tDCS application. Conclusion: As a result, tDCS is an effective in improving the walking ability of stroke patients, and in particular, it effectively increases the muscle activity of the rectus femoris and tibialis anterior muscles, which act directly on walking, and also improves the speed and stability of walking. It is considered being an effective method to increase the gait of stroke patients by combining it with the existing gait training.

• 대한물리의학회지
• /
• 제17권4호
• /
• pp.93-101
• /
• 2022

PURPOSE: This study sought to investigate the effects of treadmill gait training combined with a thoracic mobility exercise on gait and balance in patients with stroke. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 20 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (treadmill gait training combined with a thoracic mobility exercise, n = 11) or control group (treadmill gait training without the thoracic mobility exercise, n = 9). All the participants underwent comprehensive rehabilitation therapy (5 × /week for 4 weeks). Additionally, the experimental group underwent 20 min of treadmill gait training combined with 10 min of a thoracic mobility exercise (3 × / week for 4 weeks) and the control group underwent the former but not the latter. Gait and balance were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the 10-m walking test (10 MWT), timed up-and-go (TUG) test, center of pressure (COP) velocity, and COP length in the experimental group (p < .05). This group also showed a larger decrease in the 10 MWT and COP velocity than the control group (10 MWT, -3.02 sec vs. -1.68 sec, p < .05; COP velocity, -.07 mm/sec vs. .08 mm/sec, p < .05). CONCLUSION: Treadmill gait training, combined with the thoracic mobility exercise, could be effective in improving the gait and balance of stroke patients. It could also be more effective in improving walking speed and static balance than the treadmill gait training alone.

• 대한물리의학회지
• /
• 제17권2호
• /
• pp.53-62
• /
• 2022

PURPOSE: This study was conducted to investigate the effect of a real-time pressure feedback provided during gait training on the weight weight distribution of the inner part of mid-foot in paralyzed side and gait function in stroke patients. METHODS: A total of 24 patients with hemiplegic stroke in a rehabilitation hospital were randomly assigned to the experimental and control group. All participants (n = 24) performed 15 min of comprehensive rehabilitation therapy 5 times a week for a period of 4 weeks. Additionally, the experimental group and control group underwent gait training with a real time feedback and general gait training, respectively, for 15 min five times a week for 4 weeks. Weight distribution and gait function were measured before and after the 4-week training. RESULTS: Significant increases in the weight distribution (WD), stance time (ST) and step length (SL) of the paralyzed side, and a significant decrease in the 10 m walking test (10 MWT) observed after training in the two groups (p < .05). The experimental group showed larger changes in the all variables than the control group (WD, +10.5 kg vs. +8.8 kg, p < .05; ST, 12.8 s vs. 4.9 s, p < .05; SL, 4.9 cm vs. 1.7 cm, p < .05; 10 MWT, -3.5 s vs. -1.0 s, p < .05, respectively). CONCLUSION: Gait training with a real-time feedback might be effective in improving the normalization of weight bearing of the paralyzed lower extremity and gait function of stroke patients, and be considered to be a more effective gait training for improving the abilities than the general gait training.