• Physical Therapy Rehabilitation Science
• /
• v.11 no.3
• /
• pp.344-349
• /
• 2022

Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.

• The Journal of Korean Physical Therapy
• /
• v.31 no.5
• /
• pp.311-316
• /
• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• Journal of the Optical Society of Korea
• /
• v.15 no.4
• /
• pp.373-379
• /
• 2011

Current therapeutic methods for suppressing muscle spasticity are intensive functional training, surgery, or pharmacological interventions. However, these methods have not been fully supported by confirmed efficacy due to the aggravation of the muscle spasticity in some patients. In this study, a combined system was developed to treat with a low-level laser and to monitor the region of the treatment using an optical spectroscopic probe that measures oxygen saturation and deoxygenation during low-level laser therapy (LLLT). The evaluation of the wavelength dependence for LLLT was performed using a Monte Carlo simulation and the results showed that the greatest amount of heat generation was seen in the deep tissue at ${\lambda}$ = 830 nm. In the oxy- and deoxygenation measurements during and after the treatment, oxygen-Hb concentration was significantly increased in the laser-irradiated group when compared to the control group. These findings suggest that LLLT using ${\lambda}$ = 830 nm may be of benefit in accelerating recovery of muscle spasticity. The combined system that we have developed can monitor the physiological condition of muscle spasticity during the laser treatment in real time and may also be applied to various myotonia conditions such as muscle fatigue, back-pain treatment/monitoring, and ulcer due to paralysis.

• Journal of muscle and joint health
• /
• v.25 no.3
• /
• pp.167-175
• /
• 2018

Purpose: The aim of this study was to test the effects of passive exercise on upper extremities muscle spasticity, finger edema, and depression for chronic stroke patients. Methods: A non-equivalent pretest-posttest design was employed for this study. The subjects were 30 elderly patients who were hospitalized to treat chronic stroke. 15 patients were assigned to the experimental and control groups respectively. Passive exercise for 20 minutes per day, five days a week for 8 weeks (total 40 times) was provided for the experimental group. Outcome measurements included manual spasticity test to measure upper extremities' muscle spasticity, the ring measurement method for finger edema and the Korean version of Short-form Geriatric Depression Scale (SGDS-K) for depression. Results: The upper extremities' muscle spasticity (Z=-2.52 p=.012) and the degree of depression (F=5.56, p=.006) in the experimental group were significantly reduced compared to those of the control group. But the degree of finger edema did not significantly differ between the two groups (F=1.46, p=.240). Conclusion: Passive exercise for upper extremities should be encouraged for elderly patients with chronic stroke to enhance the upper extremities' functional capacity as well as depression.

• Journal of Acupuncture Research
• /
• v.27 no.6
• /
• pp.1-10
• /
• 2010

Objectives : The aim of this systematic review was to assess the efficacy of acupuncture and its relevant modality on post-stroke muscle spasticity Methods : We included 7 randomized controlled trials(RCTs) and 1 crossover study on acupuncture on the post-stroke muscle spasticity. Articles searches were performed in various databases in October 2009. Eight studies from 38 articles met the inclusion criteria and were used to assess the quality of clinical trials by means of Jadad scale, STRICTA, CONSORT statement and cochrane-handbook for systematic reviews of interventions. Results : Electrical stimulation such as electroacupuncture and TENS on acupoints was used in five studies. Repeatition of electroacupuncture showed significant decrease of the post-stroke muscle spasticity and persistence of the effect. Only three studies were assessed high quality as the methodological assessment tool(Jadad scale) and none of the studies matched STRICTA recommendations. Conclusions : This systematic review shows that there is beneficial effects of electroacupuncture on the post-stroke muscle spasticity. Further study of large population with high methodological quality will be needed.

• Journal of Korean Academy of Nursing
• /
• v.42 no.6
• /
• pp.783-790
• /
• 2012

Purpose: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. Methods: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. Results: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. Conclusion: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

• Proceedings of the KSME Conference
• /
• 2000.04a
• /
• pp.268-273
• /
• 2000

Velocity-dependent increase in tonic stretch reflexes is one of the prominent characteristics of spasticity. It is very important to evaluate spasticity objectively and quantitatively before and after treatment for physicians. An accurate quantitative biomechanical evaluation for the spasticity which is caused by the disorder of central nervous system is made in this study. A sudden leg dropper which is designed to generate objective testing environment at every trial gives very effective environment for the test. Kinematic data are archived by the 3-dimensional motion analysis system($Elite^{(R)}$, B.T.S., Italy). Kinematic data are angle and angular velocity of lower limb joints, and length and lengthening velocity of lower limb muscle. A program is also developed to analyze the kinematic data of lower limb, contraction and relaxation length of muscles, and dynamic EMG data at the same tim. To evaluate spasticity quantitatively, total 31 parameters extracted from goniogram, EMG and muscle model are analyzed. Statistical analysis are made for bilateral correlations for all parameters. The described instrumentation and parameters to make quantitative and objective evaluation of spasticity shows good results.

• Physical Therapy Korea
• /
• v.2 no.2
• /
• pp.73-84
• /
• 1995

Spasticity has been defined as a motor disorder characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting in hyperexcitability of the stretch reflexes as one component of the upper motor neuron syndrome. Weakness and loss of dexterity, however, are considered to be more disabling to the patient than changes in muscle tone. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakness. This paper considers both the neural and mechanical components of spasticity and discusses, in terms of clinical intervention, the implications arising from recent research. Investigations suggest that the resistance to passive movement in individuals with spasticity is due not only to neural mechanisms but also to changes in mechanical properties of muscle. The emphasis is on training the individual to gain control over the muscles required for different tasks, and on preventing secondary and adaptive soft tissue changes and ineffective adaptive motor behaviours.

• Journal of the Korean Society for Precision Engineering
• /
• v.23 no.7 s.184
• /
• pp.152-158
• /
• 2006

The objective of this work is to develop the knee joint model for representing various pendulum motions and quantifying the spasticity. Knee joint model included the extension and flexion muscles. The joint moment consists of both the active moment from the stretch reflex and the passive moment from the viscoelastic joint properties. The stretch reflex was modeled as nonlinear feedback of muscle length and the muscle lengthening velocity, which is Physiologically-feasible. Moreover, we modeled the spastic reflex as having dynamic threshold to account far the various pendulum trajectories of spastic patients. We determined the model parameters of three patients who showed different pendulum trajectories through minimization of error between experimental and simulated trajectories. The simulated joint trajectories closely matched with the experimental ones, which show the proposed model can predict pendulum motions of patients with different spastic severities. The predicted muscle force from spastic reflex appeared more frequently in the severe spastic patient, which indicates the dynamic threshold relaxes slowly in this patient as is manifested by the variation coefficient of dynamic threshold. The proposed method provides prediction of muscle force and intuitive and objective evaluation of spasticity and it is expected to be useful in quantitative assessment of spasticity.

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