• Physical Therapy Rehabilitation Science
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• 제2권1호
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• pp.1-6
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• 2013

Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.

• 대한한방내과학회지
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• 제35권1호
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• 동의신경정신과학회지
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• 제34권4호
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• pp.433-444
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• 2023

Objectives: This case study aimed to provide evidence of the combined use of Korean Medicine treatments, including electroacupuncture (EA) on scalp acupoints, as a useful intervention for post-stroke delirium. Methods: The patient in this study was diagnosed with Cerebral Infarction in Right Corpus Callosum and post-stroke delirium. The patient received eight sessions of EA on scalp acupoints, rehabilitation medicine treatment, and other Korean Medicine treatments such as acupuncture and herbal medicine. Evaluation of treatment effectiveness was done mainly through the Memorial Delirium Assessment Scale Korean (MDAS-K) and Mini-Mental State Examination Korean (MMSE-K). Results: MDAS-K score dropped from 20 to 9 and MMSE-K score increased from 15 to 21 during hospitalization, showing improvement in symptoms. Conclusions: Combined use of Korean medicine treatments including EA on scalp acupoints may be an effective treatment for post-stroke delirium.

• 대한물리치료과학회지
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• 제7권1호
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• pp.333-352
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• 2000

The objective of this study was to identify the effects of the cognitive performance of stroke patients on their motor function recovery after comprehensive rehabilitation management. The subjects of this study were 41 stroke in-patients of the Rehabilitation Hospital, College of Medicine, Yonsei University, hospitalized during the period from September 1, 1997 to May 5, 1998. The cognitive performance was measured using a Mini-Mental State Examination(MMSE) and the motor function recovery using Motor Assessment Scale(MAS). The data were analyzed by the paired t-test, independent t-test, a one way ANOVA, and Pearson's correlation coefficiency. The findings were as follows: 1. There was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 2. There was no significant difference found in relation to sex, age, cause of stroke, laterality of paralysis and the level of spasticity. However, there was a big difference between pre- and post-treatment regarding the treatment period. 3. In line with the cognitive performance level, there was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 4. The correlation between the elements of the cognitive performance and the motor recovery was found to be high in orientation, attention, calculation, and language. Those elements were expected to give larger effects on motor recovery after the comprehensive rehabilitation management. Based on this study, the cognitive performance level was found to play an important role in bringing effects on motor recovery after the comprehensive rehabilitation management of stroke patients. And the evaluation on the motor recovery based on quality would be also expected to be examined, as well as the cognitive performance level test accompanied by Intelligence Quality(IQ) test.

• The Journal of Korean Physical Therapy
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• 제23권3호
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• pp.43-47
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• 2011

Purpose: This study determined the best adjustable height supporter for stroke patients in wheelchairs for the maintenance of a symmetric sitting posture. Methods: Thirty-one stroke participants and 20 age-matched control participants were recruited. The enrolled participants were evaluated by the Force Sensitive Application (FSA) System that was used to assess weight shift and symmetry in wheelchair sitting and assess the symmetric index (SI) of subjects according to 1, 2 and 3 cm height supporters. Results: When a 1 cm height supporter was applied to the paretic side of stroke survivors, sitting postures of stroke patients were significantly more symmetrical (p<0.01). Cross tabulation between the SI of wheelchair sitting and that of the paretic side of stroke patients caused? by a 1 cm supporter showed that 21 SIs of 26 stroke patients were improved by a 1 cm supporter to the paretic side (k=0.26, p<0.01). Conclusion: The findings of the present study demonstrate that stroke patients can maintain a more symmetrical sitting posture (than is possible when simply sitting in a wheelchair seat) if a 1 cm supporter is applied to the paretic side of stroke patients.

• The Journal of Korean Physical Therapy
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• 제21권1호
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• pp.73-80
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• 2009

Purpose: In order to examine difference in the activity of potential of spinal neurons and cortical neurons according to muscle contraction type in post stroke hemiplegic subjects and healthy subjects, the present study conducted an experiment as follows. Methods: The subjects in the experimental group were 17 left-side hemiplegic subjects (9 female, 8 male; mean age, 63.41$\pm$9.86 years) with the right hand as the dominant hand selected among post stroke hemiplegic subjects, and 17 age matched healthy control subjects (10 female, 7 male; mean age, 64.12$\pm$12.07 years). Movement-related cortical potentials (MRCPs) were measured using surface electromyography and electroencephalography while concentric and eccentric movements were made alternately. Results: As to the pattern of the activity of MRCP, which indicates the activity of motor cortical neurons, we found that the amplitude is high (p<0.01), the length of excitement is short (p<0.01) and the ascending gradient of amplitude to the peak increases (p<0.05) in post stroke hemiplegic subjects' lesion sites different from healthy subjects. Conclusion: The activity of cortical neurons was no difference in activity according to contraction type was observed in post stroke hemiplegic subjects' lesion sites. This suggests that there is no distinction in the activity of cortical neurons between concentric contraction and eccentric contraction. Accordingly, if post stroke hemiplegic subjects' activity of motor cortex is analyzed by measuring MRCPs, it is considered useful in research on neural plasticity or as a ground of clinical effects in the area of physical therapy for the central nervous system.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.375-380
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• 2015

Purpose: The purpose of this study was to evaluate the impact of differences in computer-aided cognitive rehabilitation aimed at stroke patients on cognitive function and daily life. Methods: The study subjects were Gwangju, Jeonnam including the attention group (group I), memory group (group II), and visual perception group (group III), who were randomly placed in each of a 10 by one problem solving group (group IV). The PSSCogRehab was applied to all subjects who underwent eight weeks once a week after 20 minutes in each group by strengthening mediation 10 minutes 30 minutes total, with a five minute break in the middle. Results: Cognitive function and activities of daily living is security and inter-group differences before intervention, and post-test results in the memory training group II, the intervention group I, III, IV and more on cognitive function and activities of daily living compared to it was effective. Conclusion: The results of computer-aided cognitive rehabilitation measuring cognitive function and ADL in patients with stroke in accordance with the group I, III, and IV group cognitive function and activities of daily living compared to IV showed that it was more effective.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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• pp.257-262
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• 2021

Objective: Patients with stroke generally diminished ankle range of motion, which decreases balance and walking ability. This study aimed to determine the effect of ankle self-mobilization with movement (s-MWM) on ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in patients with chronic stroke. Design: Randomized controlled trial design Methods: Twenty-four post-stroke patients participated in this study. The participants were randomized into the control (n = 12) and self-MWM groups (n = 12). Both groups attended standard rehabilitation therapy for 30 minutes per session. In addition, self-MWM group was performed 3 times per week for 8 weeks. All participants have measured ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index in before and after the intervention. Results: After 8 weeks of training, self-MWM group showed greater improvement in ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index than in the control group (p<0.05). Further, self-MWM group had significantly improvement in all dependent variables compared to the pre-test (p<0.05). Conclusions: Our investigation demonstrates that self-MWM is beneficial for improving functional ability. Also, self-MWM was superior to control with respect to improving ankle dorsiflexion passive range of motion, timed up and go test, and dynamic gait index.

• PNF and Movement
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• 제8권2호
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• pp.17-24
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• 2010

Purpose : The purpose of present study was to determine effects of a visual feedback training on balance ability in poststroke hemiparetic subjects. Methods : Fourteen chronic stroke patients participated. Participants were randomly divided into either visual feedback training group(7 experimental group, 7 control group). All of participated were inpatients at local rehabilitation center and had been receiving a traditional rehabilitation program, five days a week. Exprimental group have additionally undergone for four weeks, three days a week, the visual feedback training but control group was not received any additional program except the traditional rehabilitation program. The Berg Balance Scale(BBS), the FICSIT-4, the MTD-balance system to measure a balance ability were carried out twice before and after training. Results : After participation in the program, subjects of visual feedback training demonstrated a significant improvement in the scores of the BBS, the FICSIT-4, the MTD-Balance system. The control group had no change on the any tests. After the training, the result to improve significantly in visual feedback training group compared to post-test of control group were the score of BBS and the FICSIT-4 and the MTD-Balance system. Conclusions : The present study suggests that the visual feedback training program may become a useful strategy for enhancing balance ability in the rehabilitation of stroke patiens.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.32-42
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• 2022

Objective: This study was conducted to verify the effectiveness of a cognitive rehabilitation program consisting of physical exercises and mental activities for patients with chronic stroke with mild cognitive impairment (MCI). We aimed to investigate how this cognitive rehabilitation program affects patients' cognitive ability, depression, and sleep quality. Design: One group pretest-posttest design Methods: The study was conductedon 12 patients who participated in thecognitive rehabilitation complex exercise program for 16 weeks. The Korean version of the Montreal Cognitive Assessment (MoCA-K), Hamilton Depression Rating Scale (K-HDRS), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the measured variables before and after study participation. The cognitive rehabilitation complex exercise program included 30 minutes of cognitive exercise and 30 minutes of Brill Exercise. The Wilcoxon signed-rank test was used to compare the variables before and after program participation. Cronbach's ɑ was used to assess the reliability of the test variables. Results: The post-program assessment showed a statistically significant increase in the MoCA-K score, which measures cognitive function (Z=-2.628, P=0.009). For depression ratings, there was a statistically significant decrease in the K-HDRS score (Z=-2.041, P=0.041). For sleep quality, although there was a numerical increase in the PSQI score, the difference was not statistically significant (Z=-0.702, P=0.483). The reliability test confirmed that all the individual test variables exhibited high reliability (cognitive function, 0.859; depression, 0.872; sleep, 0.822). Conclusions: We found that cognitive rehabilitation program used in this study had a positive effect on the cognitive function and depression in patients with chronic stroke with MCI.