• 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.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.403-410
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• 2020

The purpose of this study was to determine whether olfactory stimulation would improve spasticity, balance ability and quality of life in stroke patients. Twenty-one stroke patients were recruited and were randomly divided into two groups: olfactory stimulation group (n=10) and sham stimulation group (n=11). Participants in both groups received conventional physical therapy for 30 minutes before the intervention. Additionally, subject in the olfactory stimulation group performed olfactory stimulation using lavender oil for 6 minutes (2 minx3 set), five times a week for two weeks, while the sham stimulation group conducted olfactory stimulation using water for the same amount of time. Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors. Dynamic balance was measured using a TUG. Postural-sway distance was measured using a force platform. Quality of life were measured by SF-36. There was no significant difference within group and between the groups in the spasticity. Significant improvement in postural-sway and TUG were observed in the olfactory stimulation group compared to the sham stimulation group (p<0.05). The Mental Componnt Summary of the SF 36 in the olfactory stimulation group improved significantly greater than the sham stimulation group (p<0.05). Our findings indicate that olfactory stimulation is beneficial and effective to improve balance ability and quality of life in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.3
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• pp.277-286
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• 2011

Purpose : This study was to investigate the prevention of spasticity with modified Ashworth scale(MAS) and range of motion(ROM) increase with goniometer in ankle joint by functional electrical stimulation(FES) and exercise for 4 weeks in chronic stroke patients. Methods : 60 chronic stroke patients participated in this study. The subjects were divided into 3 groups, FES group(n=20), FES+exercise group(n=20) and control croup(n=20). After FES application on tibialis anterior muscle by 35Hz for 4 weeks, the change of ankle joint movement was measured by goniometer. Results : The spasticity in ankle joint was decreased greatly in FES and FES+excercise groups(p<.05), and the ROM of ankle joint was increased greatly in FES and FES +exercise groups(p<.05) than control group(p>.05). Conclusion : It shows that FES made the angle of dorsiflexion in spastic ankle joint increase with functional improvement of tibialis anterior muscle in chronic stroke patients. This show that the FES is avaliable for facilitation of ROM and decrease of spasticity as a therapeutic tool.

• Physical Therapy Korea
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• v.9 no.3
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• pp.125-135
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• 2002

In most of the medical literature that discusses the common problem of movement in patients with cerebral lesions. This critical problem is ascribed to a mechanism involving uninhibited neural activity. The goals of neurological physical therapy are focus on reduce of muscle hypertonicity, facilitates muscle activities, and improve of performance in living environment. A variety of studies suggest that spasticity is a distinct problem and separate from the muscle weakness. It has become increasingly recognized that the major functional deficits following brain damage are largely due to negative features such as muscle weakness and loss of performance rather than spasticity. Adequate recruitment of prime mover, not release was able to carry out the movement tasks well. The strengthening exercise of spastic limbs on changes in muscle properties and performance skill, the repeated motor practice has been identified as crucial for motor recovery. This article support the concept that strengthening is an appropriate intervention to improve the quality of physical function in patients with central nervous system lesions. Further studies and therapeutic approaches should be efforts at improving motor neuron recruitment in agonist rather than reducing activity in antagonists while retraining muscle strengthening.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.60-73
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• 2002

Spasticity is the most troublesome problems in the management in cerebral palsy. The purpose of this study was to observe the effect of FES to spasticity. 8 cerebral palsy children were selected for this study. Assessment was carried out before treatment for obtain baseline measurement of spasticity and reassessment were carried out at after 10th., 20th. treatment sessions and 24hours after treatment. The results of this study were as following that MAS scores were significantly reduced after 10th and 20th after treatment compared with pre-treatment. MAS scores were significantly reduced after 20th compared with pre-treatment. These results indicated that FES appears to reduce significantly MAS scores and maintained 24hours after treatment compared with pre-treatment.

• Physical Therapy Korea
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• v.5 no.1
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• pp.44-50
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• 1998

The purpose of this case study was to introduce botulinum toxin A injection in cerebral palsy. Spasticity can be managed using a variety of methods. Eliminating aggravating sources, promoting stretching and bracing, and positioning are the least invasive methods of treatment. Botulinum toxin A injection is a relatively recent method of spasticity management in children with cerebral palsy. A 3-year old boy was evaluated for possible botulinum toxin injection to promote left side function. The patient had left hemiparetic cerebral palsy. He walked with bilateral intoning, much worse on the left than on the right and with excessive plantar flexion on the left. Botulinum toxin A was injected into the left medial gastrocnemius, with the goals of improving quality of gait. Finally, botulinum toxin treatment of would improve the motor function and ambulatory status in cerebral palsy by hypertonicity, spasticity, dynamic contracture and athetoid movement.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.39-47
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• 2000

The purpose of this study was to evaluate the relationship between shoulder pain and hand edema in stroke patient with shoulder hand syndrome. In this study, 26 hemiplegic patients with the clinical symptom and sign of shoulder hand syndrome were evaluated. Hand volume was measured by hand volumeter, and hand edema was calculated by volume difference of both hands. Shoulder pain was evaluated using VAS (visual analog scale). and spasticity of shoulder was graded by modified Ashworth scale. The relationship among three factors such as shoulder pain. hand edema and shoulder spasticity was evaluated using correlation analysis. Results through correlation analysis among three factors are as follows : 1. Correlation between shoulder pain and hand edema was not significant$(\gamma=-.028)$. 2. Correlation between shoulder spasticity and hand edema was not significant $(\gamma=-.027)$. 3. Correlation between shoulder spasticity and shoulder pain was not significant $(\gamma=-.093)$. As the result of correlation analysis. this study shows that there was no statistically significant difference between shoulder pain and hand edema.

• The Journal of Korean Physical Therapy
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• v.14 no.2
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• pp.51-64
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• 2002

Spasticity is the most troublesome problems in the management in cerebral palsy. The purpose of this study was to observe the effect of the FES and FIR to spasticity.8 cerebral palsy children were selected for this study. Assessment was carried out before treatment for obtain baseline measurement of spasticity and reassessment were carried out at after 10, 20 treatment sessions and 24hours after treatment. The results of this study were as fellowing : 1. MAS scores were significantly reduced after 10th and 20th after treatment compared with pre-treatment. 2. MAS scores were significantly reduced after 20th and maintained 24hours after treatment compared with pre-treatment These results indicated that FES and Far infrared appears to reduce significantly MAS scores and maintained 24hours after treatment compared with pre-treatment.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.3
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• pp.1-11
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• 2024

PURPOSE: This study examined the effects of high-intensity (HI) muscle strength training and stretching exercises on muscle strength, spasticity, postural alignment, and participation in the activities of daily living (ADL) in an adolescent with cerebral palsy (CP). METHODS: The study used a single-subject design with a 16-week follow-up. After a three-week intervention-free period, a participant underwent five data collection sessions for the baseline measurements. Subsequently, stretching and HI strength training occurred three times weekly for 48 sessions, with the outcome measures collected weekly post-treatment. Final measurements were taken the day after the last session, and a follow-up assessment occurred six weeks post-study to assess the learning effects. RESULTS: After 16 weeks of treatment, the participant exhibited improved targeted muscle strength and postural alignment without increased spasticity. On the other hand, no significant change in participation in the ADL was observed. CONCLUSION: The research findings suggest that HI strength training and stretching exercises may contribute to improvements in muscle strength and body alignment without increased spasticity in an adolescent with CP, but it may not have a significant impact on participation in ADL.

• Annals of Clinical Neurophysiology
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• v.1 no.1
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• pp.19-25
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• 1999

Background & Objectives : In cerebral palsy, spastic paraplegia is one of the most crippling motor manifestations. Reducing the spasticity may improve gait and decrease the incidence of lower-extremity deformities. The spasticity may result from abnormally increased afferent signals via dorsal roots onto interneurons and anterior horn and spreading of reflex activation to other muscle groups. To assess the influence of dorsal rhizotomy to spasticity, the authors analyzed five cerebral palsy patients with spastic paraplegia. Methods : The operation entailed and L1-2 laminectomy, ultrasonographic localization of conus medullaris and identification of lumbosacral dorsal roots. The innervation patterns of each dorsal root were examined by electromyography (EMG) responses to electrical stimulation. Tetanic stimulation was applied to individual rootlets of each root after reflex threshold was determined. the reflex responses were graded and rootlets producing high grade response were selected and cut. Short-term postoperative evaluations were performed. Results : Intraoperative EMG monitoring was satisfactorily performed in all five cases. One month after the operations, all patients showed greatly reduced spasticity which was measured by the instrumental gait analysis. Bilateral knee and ankle jerks were normalized and tip-toe gait with scissoring disappeared in all patients. Conclusion : Intraoperative EMG monitoring seems useful for the selective dorsal rhizotomy to reduce spasticity.