• Journal of Yeungnam Medical Science
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• v.22 no.2
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• pp.119-130
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• 2005

Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.559-567
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• 2010

Purpose : The purpose of this study is to investigate the effects of motor function recovery and change of the heart function factors(ECG & Troponin I) with ischemic stroke patients by different amounts(times) exercise. Methods : Forty-six consecutive chronic hemiparetic patients with cerebral infarct were randomly assigned to two groups: Group 1 (exercise time 60 minutes/day) and Group 2 (exercise time 120 minutes/day). Types of exercise included static bicycle, isokinetic exercise, and standing or gait exercise on a treadmill. Outcome measures included the level of motor recovery (Fugl-Meyer Scale, FMS) and heart function (ECG and Troponin I), and measurements were performed three times: pre-test, 8 weeks and 12 weeks. Results : There was a significantly different change of motor function recovery and ECG between two groups during treatment period. Especially there were significantly change period of pre-test to 8 weeks on ECG and pre-test to 12 weeks on motor function recovery. But Troponin I has no significantly different change between two groups during treatment period. Also there was no significantly different change of motor function recovery and ECG and Troponin I with between two groups during treatment period. Conclusion : The exercise program improved motor function and change ECG without Troponin I in two groups. The result of this study shows that no matter how different amounts of exercise to effect of motor function recovery and heart function test in chronic patients with cerebral infarct.

• Journal of Korean Physical Therapy Science
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• v.7 no.1
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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.

• PNF and Movement
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• v.21 no.3
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• pp.327-335
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• 2023

Purpose: Cerebellar injury can be caused by a variety of factors, including trauma, stroke, and tumor. Cerebellar injury can manifest in different clinical symptoms and signs depending on the size and location of the injury. The purpose of this study was to examine and compare the recovery patterns of each motor function by tracking the motor levels of patients with cerebellar injury. Methods: This study recruited 11 patients with quadriplegia resulting from cerebellar injury. The motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) methods were used to evaluate motor levels. The motor function evaluation was performed immediately after the onset of the condition and at intervals of one month, two months, and six months after onset. Results: The MI values of the upper and lower extremities and hand function (MBC) indicated severe paralysis in the early stages of onset. Compared to the onset time, significant motor function recovery was observed after 1, 2, and 6 months (p < 0.05). In contrast, there was no significant pattern of recovery between 1, 2, and 6 months after onset (p > 0.05). FAC indicated showed significant recovery at one month compared to onset (p<0.05), and there was also a significant difference between 1 and 2 months (p < 0.05). On the other hand, there was no significant difference in FAC between 2 and 6 months (p > 0.05). Conclusion: Patients with cerebellar injury showed significant recovery in functions related to muscle strength and voluntary muscle control one month after onset and gradually recovered further over the next six months. On the other hand, gait function, which is closely related to balance, showed a relatively slow recovery pattern from the beginning of the disease to the six month follow-up.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.53-58
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• 2010

Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

• Physical Therapy Korea
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• v.19 no.2
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• pp.48-58
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• 2012

The objective of this study was to evaluate the effects of mirror therapy on motor function recovery following a stroke through a systemic review and meta-analysis. In total, nine of the 48 studies were identified from search engines between 1997 and 2011, as well as from a review of the reference lists of each identified study. The quality of each study was assessed using Jadad scale, and the effect size was calculated as a Cohen's effect size using MetaAnalyst (Beta 3.13). The overall effect size of the mirror therapy was 2.005 (95% confidence interval=1.041~2.970) in a random-effects model. This finding suggests that mirror therapy is beneficial for improving motor function following a stroke. The results from the subgroup analysis according to categorical variables were as follows: First, the effect size was larger for an onset time of less than 1 year (1.166) than for a duration of 1 year or more (.668). Second, the effect size of unpublished dissertations (1.610) was larger than published articles (1.221). Third, motor recovery of upper extremities (1.609) had a greater effect than motor recovery of lower extremities (.903). The major limitation of this study is the relatively small study population. Therefore, further individual studies of mirror therapy should be conducted in order to generalize the effects. In addition, mirror therapy supervised by a physical therapist should be recognized as a potential approach to manage motor function following a stroke and recommended to patients to improve their motor function.

• Journal of East-West Nursing Research
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• v.2 no.1
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• pp.22-36
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• 1997

Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.

• Physical Therapy Korea
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• v.18 no.1
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• pp.93-103
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• 2011

This study was implemented to verify the feasibility of motor function recovery and the appropriate period for therapy. The research began with spinal laminectomy of 40 white rats of Sprague-Dawley breed and induced them spinal crush injury. Following results were obtained by using the modified Tarlov test (MTT), Basso, Beattle, Bresnahan locomotor rating scale (EBB scale) and modified inclined plate test (MIPT). First, the measurement using the MTT confirm that the most severe aggravation and degeneration of functions are observed two days after induced injury, and no sign of neuromotor function recovery. Second, better scores were achieved by open-ground movement group on BBB locomotor rating scale test, and weight-bearing on inclined plate group show better performance on MIPT. Third, both BBB and MIPT scale manifested the peak of motor function recovery during 16th day after the injury and turn into gradual recovery gradient during 16th to 24th. Fourth, the control group showed functional recovery, however, the level of recovery was less significant when compared with group open-ground movement group and weight-bearing on inclined plate group. Hence, it was clearly manifested that the lumbar region of the spinal cord had shown the best performance when its functions were measured after the execution of specific physical training; therefore it indicated the possibility of learning specific task even in damaged lumbar regions. Thus it is expected to come out with better and more effective functional recovery if concentrated physical therapy was applied starting 4 days after the injury till 16 days, which is the period of the most active recovery.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.267-272
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• 2006

Objective : There have been recent reports that mesenchymal stromal cells that are harvested from adipose tissue are able to differentiate into neurons. In the present study, we administered adipose tissue derived stem cells in rats with cerebral infarction in order to determine whether those stem cells could enhance the recovery of motor function. Methods : Cerebral infarction was induced by intraluminal occlusion of middle cerebral artery in rats. The adipose tissue-derived mesenchymal stem cells were harvested from inguinal fat pad and proliferated for 2 weeks in DMEM media. Approximately $1{\times}10^6$ cells were injected intravenously or into subdural space of the peri-lesional area. The rotor rod test was performed at preoperative state[before MCA occlusion], and 1, 2, 3, 4, 6, 8 and 10 weeks after the cell therapy. Results : The motor functions that were assessed by rotor rod test at 1 week of the cell therapy were nearly zero among the experimental groups. However, there was apparent motor function recovery after 2 weeks and 4 weeks of cell injection in intravenously treated rats and peri-lesionaly treated rats, respectively, while there was no significant improvement till 8 weeks in vehicle treated rats. Conclusion : These results demonstrate that the adipose derived stem cell treatment improves motor function recovery in rats with cerebral infarction.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.2
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• pp.45-60
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• 2008

Objectives : Sopung-tang(Shufeng-tang) is a famous herbal prescription that treated ischemic brain injury. This study was designed to evaluate the effects of Sopung-tang(Shufeng-tang) on congnition and motor function recovery after ischemic brain injury in rats. Methods : Male rats were divided into 4 groups. Those rats caused ischemic brain injury by occlusion of MCA as Longa method. Control group I was per os normal saline for 7 days after ischemic brain injury. Control group II was per os normal saline for 14 days after ischemic brain injury. Experimental group I(Ex I) was taken with Sopung-tang(Shufeng-tang) for 7 days after ischemic brain injury. Experimental group II(Ex II) was taken with Sopung-tang(Shufeng-tang) for 14 days after ischemic brain injury. The author carried out neurological, cognitive motor behavior tests and histological assessment. Neurological motor behavior tests consist of limb placement test, beam-walking test and horizontal wire test. Morris water maze test was used for cognitive motor behavior test. In the histological assessment test, TTC(2,3,5-triphenylteterazolium chloride) staining, Hematoxylin & Eosin staining and immunohistochemical staining were experimented. Results : 1. In neurological motor behavior tests, motor function recovery was significantly increased in the experimental groups as compared with control groups(p<0.05). Especially Ex II was significantly increased as compared with Ex I(p<0.05). 2. In Morris water maze test, congnitive motor function recovery was significantly increased in the experimental groups as compared with control group(p<0.05). Especially Ex II was significantly increased as compared with Ex I(p<0.05). 3. In the immunohistochemical staining for the expression of BDNF in hippocampus, more immune reaction was investigated in the experimental groups as compared with control groups. Especially most immune reaction was experimented in the EX II. Conclusions : According to the above results, Sopung-tang(Shufeng-tang) can treat on the congnition and motor function recovery after ischemic brain injury in rats. And it is effective method in expression of BDNF in hippocampus.