• Title/Summary/Keyword: hemiplegia patients

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The Effect of Neuromuscular Reeducation on the Cognitive and Functional Assessment for Hemiplegic Patients (신경근 재교육이 편마비 환자의 인지와 기능에 미치는 효과)

  • Shin, Hong-Cheul;Kim, Woong-Gak;Lee, So-Joon;Kang, Jeong-Il;Peak, Heon-Hee
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.7-17
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    • 2002
  • 편마비 환자의 인지 기능과 운동 및 신체적 기능에 관련된 변인을 분석하고자 하였다. 본 연구는 인지 기능이 편마비 환자에게 미치는 영향과 인지 영역의 손상이 편마비 환자의 독립적 기능 및 수준 향상의 예언 인자로서의 고려해야 할 개념을 검사나 평가 척도로 비교, 분석 하였다. 연구 대상은 전라북도에 소재한 한방병원에 입원 및 통원하고 있는 52-73세의 연령 범위에 있는 편마비환자 20명 이다. 편마비 환자의 기능적 능력, 운동 회복, 신체적 기능 그리고 인지적 상태를 평가하기 위해 편마비 환자를 위한 임상적 결과 변인 척도, 운동 평가 척도와 바델 척도 그리고 기능적 독립성 측정 척도를 평가도구로 사용하였다. 편마비 환자의 신체적, 운동 그리고 기능적 능력 상태를 평가도구에 의해 측정된 결과를 분석한 바 운동, 신체적 그리고 인지적인 영역과 기능적 독립 측정 척도 및 바델 척도와 관련성이 있음을 보여주고 있다. 편마비 환자의 신체적, 인지적 결함이나 손상 부위, 손상의 본질에 따른 대상의 선정과 운동 조절 형태에 관한 지식 그리고 인지와 신경학적 결함 정도를 심도있게 다루어 기능적 능력 향상의 임상적 효과를 높이고자 하는데 연구의 의의가 있다.

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Changes in the Spinal Motor Neuron Excitability Depending on Postural Changes in Post Stoke Hemiplegics (뇌졸중 후 편마비 환자의 체위변화에 따른 척수운동신경원 흥분성 변화)

  • Park, Young-Hyun;Kim, Yong-Nam;Kim, Su-Hyon;Oh, Seok;Choi, Ji-Ho;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.15-20
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    • 2010
  • Purpose: The purpose of this study was to measure changes in the H-reflex and V wave under loading conditions (e.g. prone and standing position) and to investigate whether postural change would affect the H-reflex and V wave in post stroke hemiplegic patients. Methods: Thirty persons with hemiplegia resulting from stroke (20 males, 10 females) participated in this study. Electromyography (EMG) was used to electrically stimulate and record the soleus H-reflexes and V waves under various loading conditions. The normality of the distribution of each variable (H latency, $H_{max}/M_{max}$ ratio, $V_{max}/M_{max}$ ratio) was tested using the Kolmogorov-Smirnov test. The means of normally distributed continuous data were assessed by independent t-test (${\alpha}$=0.05). Results: There were statistically significant differences in $H_{max}/M_{max}$ ratio (p<0.01), $V_{max}/M_{max}$ ratio (p<0.01), H latency (p<0.01) among the prone and standing position. Conclusion: We found that the H-reflex and V wave in standing position was more active to weight bearing load than prone position.

Decrement and Recovery of Maximal Isometric Contraction by Frequency during NMES (신경근전기자극 주파수에 따른 최대 등척성 수축력의 감소 및 회복)

  • Lim, Sang-Wan;Jeong, Jin-Gyu;Jung, Dae-In;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.2
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    • pp.1-12
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    • 2004
  • The purpose of this study was to determine the effect of muscle fatigue by neuromuscular electrical stimulation(NMES). Using Biodex System 3PRO(Biodex Medical Systems Inc, USA), experiment was conducted as to the normal group(I) composed of fifteen adults and the patient group(II) composed of fifteen patients with spastic hemiplegia. As to each group, maximal tolerated intensity(MTI) and maximal tolerated isometric contraction(MTIC) in electric currents yielded by low rate(20 pps) and high rate(100 pps) neuromuscular electrical stimulation and the aspects of decrease and restoration of the isometric contraction were examined, and their strength decrement index(SDI) and strength recovery index(SRI) were also calculated. 1. As for MTI in NMES, the MTI of the group II was higher than that of the group I in both low rate and high rate NMES. In comparison within group, MTI of group II was significantly higher in high rate NMES rather than in low rate NMES(p<0.05). 2. In comparison of MTIC between groups, the group I showed higher in both low rate and high rate NMES. In comparison within group, MTIC of group II was significantly higher in high rate NMES rather than in low rate NMES(p<0.01). 3. As for SDI, both groups showed highest SDI in high rate NMES, but no significant differences could be observed. 4. As for SRI, both groups showed significantly low SRI in low rate NMES(p<0.01, p<0.05), and comparison between groups showed no significant differences could be observed. These result lead us to the conclusion that muscle fatigue was influenced by frequency, high rate NMES was lower at SDI and higher at SRI on compare to low rate NMES, therefor, a further studies concerning electrical stimulation should consider differences each frequency in response to treatment.

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Ultrasonographic Findings of Both Knee in Hemiplegic Ambulators with Recent Stroke (초기 편마비 보행 환자에서 양측 무릎의 초음파 검사 소견)

  • Park, Soon-Ah;Yang, Chung-Yong;Kim, Ji-Hee;Lee, Kang-Keun;Shin, Byung-Cheul;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.539-545
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    • 2012
  • To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

Effect of the Mental Practice on the Upper Limb Motor Function Improvement of Hemiplegic Patients (정신훈련이 편마비환자의 상지기능 향상에 미치는 영향)

  • Park, Min-Chull;Ahn, So-Youn;Lee, Hyun-Ok;Koo, Bong-Oh
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.85-98
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    • 2006
  • This study was performed to examine the influences of the mental practice to the hemiplegic upper limb motor function improvement. 20 minute neurologic treatment based on the neurophysiological theory, 10 minute activities of daily living training, and 10 minute mental practice 5 times a week were given in turn to the experimental group(N=11). On the other hand 20 minute neurologic treatment, and 10 minute activities of daily living training 5 times a week were given in turn to the control group(N=11). Both Fugl-Meyer Assessment Scale and Manual Function Test were used to evaluate upper limb motor recovery, upper limb motor function and movement ability. And the Motor Activity Log; Amount of Use and Motor Activity Log; Quality of Movement before training, 2 weeks after training, and 4 weeks after training were measured to assess the upper limb motor quantitatively and qualitatively each. The results are as follows. 1) Considering the interactions of the rate of change on the upper limb motor recovery, motor function, movement ability improvement, and qualitative motor improvement in ADL of experimental group and control group, the change rates of experimental group were found to be greater than those of the control group. 2) In experimental group, the higher the achievements were, the better upper motor recovery was.

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Effects of virtual reality-based core stabilization exercise on upper extremity function, postural control, and depression in persons with stroke

  • Kim, Jee-Won;Kim, Jung-Hee;Lee, Byoung-Hee
    • Physical Therapy Rehabilitation Science
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    • v.9 no.3
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    • pp.131-139
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    • 2020
  • Objective: The purpose of this study was to evaluate the effect of virtual reality (VR)-based core stabilization exercise on upper extremity function, postural control, and depression among persons with stroke with hemiplegia. Design: Randomized controlled trial. Methods: This study was conducted with the inclusion of 24 participants and were randomly assigned to either the VR-based trunk stability exercise group (n=12) or control group (n=12). The VR-based trunk stability exercise group performed core stabilization exercises in a VR environment for 30 minutes. Meanwhile, the control group conducted general core stabilization exercises for 30 minutes. The participants trained 3 times a week for 4 weeks. The manual functional test (MFT), Box and Block Test (BBT), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), the Geriatric Depression Scale (GDS) were used to assess all participants before and after the intervention. Results: The VR-based core stabilization exercise group had a significant improvement in upper extremity function (MFT, BBT) and postural control (BBS) compared with the control group (p<0.05). The VR-based core stabilization exercise showed a significant difference after intervention in the TIS and GDS scores (p<0.05), but they did not significantly differ between the two groups. Conclusions: The result showed that VR-based core stabilization exercise can be effective in improving upper extremity function and postural control among patients with stroke more than the sole application of general physical therapy.

Effects of Treadmill Training on Gait of Stroke Patients : A Systematic Review (트레드밀운동이 뇌졸중 환자의 걷기기능향상에 관한 문헌연구)

  • Kang, Kwon-Young;Ko, Tae-Sung
    • Journal of Korean Physical Therapy Science
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    • v.15 no.3
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    • pp.73-79
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    • 2008
  • Background : Treadmill training has been proposed as a useful adjunct to conventional physical therapy to restore ability to walk after stroke. The purpose of this study to inform clinical practise by evaluating the research evidence for the effectiveness of treadmill training after stroke. Methods : We searched to the effectiveness of any form of intervention for effect of treadmill training by Dankook University electronic library databases of Medline, Embase, Cinahl, Amed and PEDro combined with a hand search of papers published in relevant peer-reviewed journals. Any type of study relevant to the topic published in English during time period from 1980 to 2007 was included. Results : The literature search identified 35 studies. The included studies enrolled a total of 374 subjects. 1. Treadmill retraining without partial body weight support might be more effective than no treatment at improving gait velocity, get up and go time, gait endurance and step length symmetry. 2. Treadmill retraining with partial body weight support might be more effective than no treatment in improving step length symmetry, gait velocity, gait endurance and balance. 3. Treadmill retraining might be more effective with partial body weight support than without it at improving gait velocity and motor improvement as measured by The Stroke Rehabilitation Assessment of Movement(STREAM). 4. Treadmill retraining without partial body weight support may be no different from physiotherapy and increase gait velocity to conventional gait therapy. 5. Treadmill retraining with partial body weight support may be no different from physiotherapy for gait velocity, motor recovery and balance. Conclusion The review suggests that although treadmill training of gait, especially with partial body weight support, might Improve gait parameters and functional mobility, unless treadmill training is directed at Improving gait speed it might be no more effective than conventional physical therapy at improving gait parameters.

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The Effects of Performing a One-legged Bridge with Hip Abduction and Unstable Surface on Trunk and Gluteal Muscle Activation in Healthy Adults

  • Bak, Jong-Woo;Cho, Min-Kwon;Chung, Yi-Jung
    • The Journal of Korean Physical Therapy
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    • v.28 no.3
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    • pp.205-211
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    • 2016
  • Purpose: This study investigated the influence of muscle activity of the trunk and lower limb during a bridge exercise using a unstable surface and during one-legged bridge hip abduction in healthy adults. Methods: Nineteen healthy participated in this study (12 males and 7 females, aged $29.0{\pm}5.0$). The participants were instructed to perform the bridge exercises under six different conditions. Trunk and lower limb muscle activation, such as the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO), was measured using surface electromyography. The six different bridge exercise conditions were conducted randomly. Data analysis was performed by using the mean scores after three trials of each condition. Results: On the ipsilateral side, muscle activity of the IO, EO, and ES during the hip abduction condition (Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction, Bridge with use of a sling and single-leg hip abduction) was significantly higher than those during Unstable surface (Bridge with use of a ball, Bridge with use of a sling) and General bridging exercise (p<0.05). In the contralateral side, activities of the GM and EO during Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction and Bridge with use of a sling and single-leg hip abduction was significantly higher than that during Bridge with use of a ball, Bridge with use of a sling and General bridging exercise (p<0.05). Conclusion: This study demonstrated that performing a bridge exercise with use of a sling and single-leg hip abduction had an effect on trunk and gluteal muscle activation. The findings of this study suggest that this training method can be clinically effective for unilateral training and for patients with hemiplegia.

A Case Report on Hemiplegia in a Patient with an Intracerebral Hemorrhage of the Basal Ganglia of the Corona Radiata Treated with Traditional Korean and Western Medicine (기저핵-대뇌부챗살 뇌출혈로 인한 반신부전마비에 대한 한·양방 병행 치험 1례)

  • Jung, Da-hae;Kil, Bong-hun;Kim, Dong-won;Youn, Hye-soo;Lee, Eun-chang;Jo, Hye-mi;Han, Da-young;Son, Ah-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1131-1141
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    • 2021
  • Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

Effectiveness of Focal Muscle Vibration on Upper Extremity Spasticity and Function for Stroke Patients : A Systematic Review (뇌졸중 환자의 상지 경직 감소와 기능 향상을 위한 국소 진동자극의 효과에 대한 체계적 고찰)

  • Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.23-33
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    • 2018
  • Objective : This systematic review aimed to investigate the effect of focal muscle vibration in patients with post-stroke spastic hemiplegia. Methods : We searched literature published between April 2009 and October 2017 using PubMed and RISS databases. The main search terms were Vibration therapy, Focal vibration, Somatosensory, Upper limb, and Spasticity after stroke. Based on inclusion/exclusion criteria, 6 articles were selected. Results : Articles on focal muscle vibration intervention ranged from evaluation of application-only vibration to muscle vibration with task-oriented activity. Intervention effects on upper extremity spasticity and function and activities of daily living were assessed. There were significant effects on upper extremity spasticity, function, and cortical excitability. Conclusions : This study can provide information on focal muscle vibration for use by clinical therapists. However, further studies are needed to identify the optimal stimulation site and frequency/amplitude of application to maximize the effects of focal muscle vibration.