• PNF and Movement
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• v.5 no.1
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• pp.37-47
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• 2007

Objective : A large proportion of stroke survivors have to deal with problems in gait. Proper evaluation of gait must be undertaken to understand the sensorimotor impairment underlying locomotor disorders post stroke. Methods : The characteristics of gait pattern with post stroke are reviewed in this paper. In particular, temporal distance parameters, kimematics, kinetics, as well as energy cost, EMG are focused. Results : The technology for gait analysis is moving rapidly. The techniques of 3D kinematic and kinetic analysis can provide a detailed biomechanical description of normal and pathological gait. This article reviews gait analysis method and characteristics of post stroke. Finally current method of gait analysis can provide further insight to understand paretic gait and therapeutic direction.

• The Journal of Korean Medicine
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• v.36 no.1
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• pp.1-8
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• 2015

Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.1-8
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• 2009

Purpose: This study examined the effect of EMG-stim related to the functional recovery of the upper extremity in chronic stroke patients with an intensive massed practice protocol. Methods: The subjects were assigned randomly to either the EMG-stim group (n=10) or sham treatment group (n=10). Both groups received conventional physical therapy, occupational therapy and FES, five times per week over a four week period. In the EMG-stim group, EMG-stim was applied to the hemiplegic wrist and finger extensors for 2 sessions for 30 minutes per day, 5 times per week over a 4 week period. As the pre- and the post-test, the following four motor tests were assessed as the function of the upper extremity clinical functional test: extensor digitorum strength test, Box and Block test, Fugl-Mayer Assessment, and Jebson-Taylor Hand Function Test. Results: In the Box and Block test and Fugl-Mayer Assessment, there were statistically significant differences between both groups as well as between pre- and post-test. The extensor digitorum and wrist extensor strength were similar in both groups. In the Jebson-Taylor Hand Function Test, there was a significant difference in simulated page turning but not in the other subtests. Conclusion: Intensive massed practice with EMG-stim intervention applied to the hemiplegic upper extremity is an effective therapeutic method for chronic stroke patients. However, a variety of intervention methods designed for stroke patients in clinical settings are needed.

• Journal of Acupuncture Research
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• v.41 no.2
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• pp.75-86
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• 2024

A review of randomized controlled trials (RCTs) using electroacupuncture (EA) to treat patients with foot drop was performed to analyze the effectiveness of EA for this condition. Relevant studies (n = 183) from 7 databases (Cochrane Library, Excerpta Medica Database, PubMed, China National Knowledge Infrastructure, Korean Studies Information Service System, Research Information Sharing Service, and Oriental Medicine Advanced Searching Integrated System) were selected based on the inclusion and exclusion criteria, and 12 RCTs met the selection criteria. In all 12 studies, EA showed significantly positive changes. In most indicators, positive changes were observed in the EA group compared with that in the control group. Significant increases were confirmed in muscle strength-related indicators such as the Fugl-Meyer motor scale, surface electromyography, active range of motion, and gait-related indicators such as the Tinetti score, maximum walking speed, and Berg balance scale. No notable adverse events were reported. EA is suggested as an effective treatment for post-stroke foot drop; however, more RCTs are required.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2365-2369
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• 2021

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.3
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• pp.55-64
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• 2023

PURPOSE: Examine the effects of auditory feedback and functional electrical stimulation on balance, walking ability, and lower extremity function of subacute stroke patients. METHODS: Twenty-seven subjects diagnosed with subacute stroke within six months were randomly divided into three groups: test group 1, which performed walking exercises with auditory feedback and functional electrical stimulation; test group 2, which performed walking exercises only with functional electrical stimulation; control group applied only functional electrical stimulation, with nine subjects each. RESULTS: There were significant pre- to post-intervention differences in BBS in the gait training group with auditory feedback and functional electrical stimulation treatment, and significant pre- to post-intervention differences in BBS, sit-to-stand time, and average step speed in the gait training group with functional electrical stimulation, but no statistically significant differences in between-group comparisons. CONCLUSION: Gait training with auditory feedback and functional electrical stimulation can improve the balance and gait performance in stroke patients. Therefore, in the future, gait training with auditory feedback and functional electrical stimulation therapy may be suggested as a gait rehabilitation training tool for stroke patients.

• Physical Therapy Rehabilitation Science
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• v.1 no.1
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• pp.17-21
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• 2012

Objective: To investigate the effect of long-term water exercise on gait parameters in the elderly post stroke patients. Design: One group pretest-posttest design. Methods: Twenty elderly post stroke patients (age: $56.5{\pm}10.1$ years, height: $168.6{\pm}5.8cm$, body mass: $69.3{\pm}6.9kg$, handicapped level: $2.5{\pm}0.8$) participated in this study. Participants took part in gait training of 1 hour per day, three days per week, for three months. Participants' gaits were analyzed to find the effect of 3 months water exercise by a 3-D motion analysis with 8 infrared camera and 1 force plate (sampling frequency: 100 and 1,000 Hz, respectively). A paired t-test was used to find the significance with significant level as 0.05. Results: Gait velocity, step length & step width significantly increased, and asymmetric index for gait parameters significantly decreased after the water exercise (p<0.05). Conclusions: The water exercise effectively affect on patients' gait ability and electromyography analysis will be needed further study.

• The Journal of Internal Korean Medicine
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• v.33 no.4
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.1
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• pp.61-72
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• 2022

Objectives This study aimed to the application of Chuna manual therapy in patients with stroke where much evidence is not available. Methods Domestic databases (KOREANTK, OASIS, RISS, KISS, and KMBASE) were queried for literature showing application of Chuna manual therapy in stroke patients. Additionally, insufficient evidence was supplemented with expert consensus using the Delphi method. Based on the literature review and expert consensus, the academic committee of the Korean Society of Chuna Manual Medicine reviewed and summarized the Chuna technique recommendations that can be applied to stroke patients. Results There were six studies on Chuna manual therapy in stroke patients, and Chuna therapy was applied for pelvic, shoulder, and elbow joint spasticity. The expert Delphi survey did not agree with the application of the nine of the 69 standard Chuna techniques and deliberated on matters to be considered when applying Chuna manual therapy to stroke patients. Finally, based on clinical research literature and expert opinions, Chuna technique was recommended for patients with post-stroke spasticity. Conclusions The application of Chuna therapy to non-muscular skeletal disorders, including stroke is recommended and should be applied while taking the necessary precautions.