• The Journal of Korean Medicine
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• v.42 no.4
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• pp.75-101
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• 2021

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.1-8
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• 2016

Objective: The present study was to investigate the discrimination capacity of the Performance Oriented Mobility Assessment-Gait Scale (POMA-GS), for predicting falls in stroke survivors. Design: Retrospective cohort study. Methods: Data including the characteristics and number of falls of 52 chronic stroke patients from a rehabilitation center were collected. The number of falls each subject had experienced in the previous year were investigated through interviews. The subjects were divided into two groups depending on the number of falls: if falls occurred twice or more on the basis of the time of study after stroke, they were defined as the falls group and if there was no fall experience or one fall, they were defined as the non-falls group. The subjects were examined with the POMA-GS, and physical functions were examined using by the One Leg Stand Test (OLST), Sit to Stand Test (SST), 10-m Walk Test, Lower Extremity in Fugl-Meyer assessment (FM-LE), and Trunk Impairment Scale (TIS). The validity of POMA-GS for falls prediction was analyzed. Results: In the POMA-GS, which predicts falls in stroke survivors, the cut-off value was 8.5 (sensitivity 72%; specificity 65%) and the area under the curve was 0.75 (95% confidence interval: 0.60-0.90, p<0.007). There was a significant difference in the OLST, SST, FM-LE, and TIS between the subjects with POMA-GS >8.5 and the subjects with POMA-GS ${\leq}8.5$. Conclusions: The POMA-GS could be a useful tool in predicting falls in stroke survivors, as its discrimination capacity and predictive validity is proven satisfactory.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.3
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• pp.515-524
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• 2017

The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.492-501
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• 2007

Objectives : This study was executed in order to evaluate the effects of electroacupuncture on upper-extremity spasticity control in stroke patients. Methods : Eighteen patients with stroke were enrolled and classified into two groups, the study and control group. The control group did not receive any oriental medical treatment. In the study group, the electroacupuncture points were applied to Kokt'aek (PC3) and $Ch'{\u{o}}ch'{\u{o}}n$ (PC2), Naegwan (PC6) and $Ch'{\u{o}}kt'aek$(LU5) of the affected limb. H-reflexl M-response ratio (HIM ratio), modified Ashworth scale (MAS) and Fugl-Meyer motor function assessment (FMA) were used for evaluation of spasticity control before electroacupuncture, within two hours after electroacupuncture, and at two weeks. Results : In MAS, the study group declined more than the control group. but there was no statisticallysignificant consideration. In H/M ratio. the study group was more efficient than the control group. and spasticity decreased successively during the series in the study group. In FMA, motor function in the study group improved more than in the control group and motor function in the study group increased successively during the series. Conclusions : These results showed that electro acupuncture was a useful method to decrease upper-extremity spasticity in patients with stroke. Further studies are needed to explore more cases and the long-lasting carryover effects on upper-extremity spasticity in electroacupuncture.

• Journal of Pharmacopuncture
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• v.9 no.1
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• pp.139-154
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• 2006

Objective : This experiment was conducted to evaluate the effectiveness of Acupuncture, Bee Venom Acupuncture (BVA) and Bee Venom Herbal Acupuncture (BVHA) on post-stroke hemiplegic shoulder pain. Methods : 30 patients were randomly allocated into Acupuncture group, BVA group and BVHA group and was monitored weekly for 4 weeks; initial($T_0$), 1 week($T_1$), 2 weeks($T_2$), 3 weeks($T_3$) and 4 weeks($T_4$). Results : Visual analogue scale of shoulder pain showed significant decrease in BVA and BVHA groups compared to the Acupuncture group at T4 evaluation. Painless passive ROM of shoulder external rotation and Fugl-Meyer Motor Assessment of Upper Limb motor function showed significant increase in all groups. Modified Ashworth scale of the spasticity of upper limb showed no differences between the three groups. Conclusion : BVA & BVHA appears to be an effective in treating post-stroke hemiplegic shoulder pain. Further clinical studies must be done to obtain more concrete findings.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.125-131
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• 2016

PURPOSE: The objective of this research is to investigate the effectiveness of mental practice on function and muscle activation of upper extremity (UE) in stroke patients. METHODS: The mental practice was conducted on 12 subjects for 10 minutes and the related existing work treatment for 20 minutes. The evaluation for the function of UE proceeded with Fugl-Meyer assessment of motor function (FMA) and muscle activity analysis instrument. Furthermore we analyzed patients' reaching activity by two stages, reaching phase and returning to original position phase. RESULTS: According to the research results, the subjects' upper limb function improved in all of the measured items and the total scores after the mental practice (p<.05). In muscle activity, CCR value was used to efficiently analyze the patients' reaching activity in the two stages of reaching stage and returning to the original position phase. While the elbow movement only had a bit of positive change (1.1%) in the reaching stage, both the shoulder (-12.3%) and elbow (-18.2%) movements had a positive change in the returning to original position phase. CONCLUSION: This research confirmed that the mental practice is effective for the enhancement of UE function for stroke patients. The result of this research can contribute to the progress of mental practice in clinical environment.

• Journal of Magnetics
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• v.19 no.4
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• pp.353-356
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• 2014

The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.285-291
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• 2014

PURPOSE: The purpose of this study was to propose clinical criteria to differentiate patients who are able to perform the step-through-step gait pattern in chronic stroke patients. METHODS: Sixty patients with chronic stroke patients participated this study. To differentiate patients who could perform the step-through-step gait pattern, age, gender, and causes of stroke were noted, a Chedoke-McMaster (CM) damage list, Fugl-Meyer (FM) assessment scales and the Berg Balance Scale (BBS) were determined. A 10 meter gait test and Timed Up and Go (TUG) test were conducted to determine the differences in gait speed and dynamic balance between patients walking with or without canes in the step-through-step gait pattern group. RESULTS: There was no significant statistical difference in age, gender, and stroke type between all subjects. There were significant differences in the CM scale for postural and lower extremities, and FM scale for lower extremities and BBS. The dynamic balance ability and gait speed showed significant differences between the subjects in the step-through-step gait pattern with or without a cane during gait. CONCLUSION: CM and FM scales for the lower extremities and postural control, as well as BBS scales, can be used as criteria to differentiate patients who are able to perform the step-through-step gait pattern. These results can also be used to provide beneficial information to patients that are walking with canes.