• PNF and Movement
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• v.9 no.4
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• pp.33-40
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• 2011

Purpose : The aims of this study was to identify changes mu rhythm according to familiarity with a stimulus in people with stroke. Methods : Seventeen right-handed participants were asked to observe 2 different stimulus; a non-familiarity stimulus condition (NFSC), and a familiarity stimulus condition (FSC). Electroencephalogram (EEG) signals from electrodes on the participant's scalp were recorded during action observation. The activation of the mirror neuron system was compaired between FSC and NFSC by a paired t-test. An independent t-test was used to compare the difference between right and left hemispheres for the activation of the mirror neuron system during action observation of performing a task with the right hand. Results : The result of paired t-test showed no significantly difference between NFSC and FSC in the activation of the mirror neuron system. The Result of independent t-test also showed no significantly difference in the activation of mirror neuron system between the right and left hemispheres. Conclusion : The familiarity with a stimulus had no signigicant effect on the activation of the mirror neuron system according to the familiarity and in either the right or left hemispheres in people with chronic stroke.

• Korean Journal of Applied Biomechanics
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• v.31 no.1
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• pp.50-58
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• 2021

Objective: This study aimed to determine the effect of wrist and trunk weight loading using sandbags in stroke patients in order to provide the quantitative data for enhancement of gait movement. Method: Twelve stroke patients, who have been diagnosed with hemiplegia over a year ago, were participated in this study. All subjects were asked to perform normal walking [N], wrist sandbag walking [W], wrist & trunk sandbag walking [WT], and both wrist sandbag walking [B] and both wrist & trunk sandbag walking [BT], respectively. Eight infrared cameras were used to collect the raw data. Gait parameters, arm swing, shoulder-pelvic kinematics, and lower extremity joint angle were calculated to examine the differences during walking. Results: As a result, there were no significant differences in the gait parameters, shoulder-pelvis, and lower extremities joint angles, but significant differences were found in the range of motion and the anteversion in arm swing. Conclusion: Wrist and trunk weight loading using sandbags affected the movement of the upper extremities only while it did not affect the movement of the lower extremities. It implies that it can reduce the risk of falling caused by a sudden movement change in lower extremities. In addition, the wrist and trunk weight loading using sandbags can induce changes in movement of the upper extremities independently and contribute to functional rehabilitation through resistance training.

• The Journal of Korean Physical Therapy
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• v.34 no.6
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• pp.326-331
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• 2022

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

• PNF and Movement
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• v.21 no.1
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• pp.119-128
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• 2023

Purpose: Obstacle crossing training is being used to improve the walking ability of stroke patients, but studies on which method is more effective when performing obstacle crossing training with an unaffected limb lead (OCT-ULL) and an affected limb lead (OCT-ALL) are not well known. As such, this study aims to compare the intervention effects of obstacle crossing training using unaffected limb leads (OCT-ULL) and obstacle crossing training using affected limb leads (OCT-ALL). Methods: In total, 25 patients with chronic stroke were studied and assigned randomly to the obstacle crossing training with unaffected limb leads (OCT-ULL) group or the obstacle crossing training with affected limb leads (OCT-ALL) group. A lower extremity strength test, balance and gait test, and fall efficacy test were conducted as preliminary tests, and all patients participated in the intervention for 30 minutes a day, five days a week for four weeks, and the same preliminary tests were conducted post-intervention. Results: Compared with the OCT-ALL group, the OCT-ULL group showed a significant improvement in the strength of the affected hip abductor muscle and in balance and gait, as well as in fall efficacy (p<.05). Conclusion: This study suggested that applying the OCT-ULL training method in the obstacle crossing training of stroke patients is more effective for improving balance and gait functions than OCT-ALL.

• Health Policy and Management
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• v.19 no.3
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• pp.92-108
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• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.79-88
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• 2018

Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.194-203
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• 2020

Objectives: This study aimed to compare the gait patterns of cerebellar infarction patients with those of corticospinal tract stroke patients through a follow-up of patients with ataxic gait due to cerebellar infarction and corticospinal tract stroke. Methods: We investigated two cases of patients with cerebellar infarction and two cases each of acute or chronic corticospinal tract stroke who were hospitalized at Wonkwang University Gawangju Medical Center from September 1, 2017 to February 15, 2020 based on medical records and gait analyses. The spatiotemporal gait parameters of each patient were measured three times at 2-week intervals except those of the chronic corticospinal tract stroke patients, which were measured twice at a 1-month interval. Results: Spatiotemporal gait parameters, which include velocity, cadence, step length, stride length, and single support, were consistently increased in the cerebellar infarction patients in comparison to the corticospinal tract stroke patients. The stance phase was decreased in all the patients. Conclusions: The cerebellar infarction patients' gait spatiotemporal parameters were found to consistently improve. Moreover, gait analysis can be used to effectively measure improvement of ataxic gait.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.498-507
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• 2020

The purpose of this study was to examine the effects of thoracic flexibility exercise on sitting balance, static standing balance, gait parameters, and the fall risk of patients with chronic stroke. The participants were randomized into the control (n=12) and thoracic flexibility exercise groups (n=12). Both groups received standard rehabilitation therapy for 30 minutes per session. The subjects in the experimental group performed additional thoracic flexibility exercises 3 times a week for 6 weeks. The trunk impairment scale, static standing balance, gait speed, cadence, and fall risk were assessed for all the participants before and after the intervention. The thoracic flexibility exercise group showed greater improvement than did the control group on the trunk impairment scale (t=-3.57, p=.002), static standing balance (t=5.37, p<.001), gait speed (t=-3.29, p=.003), cadence (t=-2.77, p=.011), and fall risk (t=6.33, p<.001). Furthermore, the thoracic flexibility exercise group significantly improved all the outcomes compared to the baseline values (P<.05). This study showed that the thoracic flexibility exercise improved the functional ability of patients with chronic stroke.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5723-5729
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• 2013

The purpose of this study was to investigate the imbalance of muscle tone and frequent exposure to excessive gait training in patients with chronic spasticity due to stroke, the thickness of the plantar fascia to change and to evaluate. The subjects of this study was in 54 patients with chronic stroke from 18 patients Group I(MAS G0), 18 patients Group II(MAS G1), and 18 patients Group III(MAS G2) were selected. Measurement of clinical symptoms and physical examination, MAS(Modified Ashworth Scale), ultrasonographic, ROM(Range of Motion), VAS(Visual Analogue Scale), TUG(Timed Up and Go test) was measured. The study results were each group between the unaffected side and the affected side on plantar fascia thickness was statistically significantly thicker(p<.001). Each group between the unaffected side and the affected side on ankle dorsiflexion ROM was statistically significantly decrease(p<.001), VAS(p<.001), TUG(p<.001) statistically significantly increase(p<.001). In this study, the plantar fascia pathokinesiology ever presented by the contents of gait training in stroke patients is one of the information that you need to consider when presented.

• Journal of Digital Convergence
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• v.11 no.7
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• pp.281-288
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• 2013

The purpose of this study was to identify the effects of upper and lower limb coordinated exercise for gait ability in stroke patients. Upper and lower limb coordinated exercise method was conducted in two different groups; one is an one leg support group and the other is a non support group. In this study, 14 patients were participated. One leg support group was applied to 7 patients, and non support group was applied to 7 patients. Both group carried out 3 times a week for 30 minutes during 4 weeks. Data were analyzed statistically via Repeated two-way ANOVA, Mann-Whitney U test, and Friedman test. The results of the measurement analysis were summarized as follows: 1. There were significant differences in 10MWT among 2 groups after intervention(p<.05). 2. There were significant differences in F8WT, FSST among 2 groups after intervention(p<.05). According to Bonferroni test, one leg support group had significant increased from pre-intervention to post-4 week. However, there were no significant differences in nonsupport group. In conclusion, improvement of gait ability in chronic stroke patients was effect to upper and lower limb coordinated exercise.