뇌졸중 환자의 회전 보행 시 회전 방향이 보행 특성에 미치는 영향

정경만,주민철,정유진,Jung, Kyeoung-Man,Joo, Min-Cheol,Jung, Yu-Jin 한국의료질향상학회 2017 한국의료질향상학회지 Vol.23 No.2

Purpose: The purpose of this study was to determine the effects of rotation direction during curved walking on gait parameters in stroke patients. Methods: A group of thirty subjects with stroke (Berg Balance Scale score${\geq}41$ were fifteen, Berg Balance Scale score${\leq}40$ were fifteen) were enrolled in this study. Testing indications included two directions for rotation in each subject. These indications were for rotation toward the affected and unaffected side in stroke patients. The gait speed, affected side single support duration, affected side double support duration were recorded. The obtained data were analyzed by using paired t-test and Wilcoxon signed rank test in the group that are below and above 40 points of Berg Balance Scale score. Results: There was significant increase affected side single support duration was turned the affected side in stroke patients that presented a Berg Balance Scale score${\geq}41$ (p<.05). There were significant increase gait speed, affected side single support duration, and significant decrease affected side double support duration while subjects were turned the affected side in stroke patients that presented a Berg Balance Scale score${\leq}40$ (p<.05). Conclusion: This result may be effective to rotate in the paralyzed direction to improve the ability of the paralyzed lower limb to gain weight during gait training for stroke patients with a Berg Balance Scale score<40. Therefore, walking training program for hemiplegic patient needs to be suggested in the direction of turning for suitable balance ability.

후방 보행훈련이 급성기 뇌졸중 환자의 균형, 균형 자신감, 낙상 효능에 미치는 영향: 무작위 대조군 예비연구

정경만,Jung, kyeoung-Man 대한물리치료과학회 2021 대한물리치료과학회지 Vol.28 No.2

Background: The requirements for postural and motor control in backward walking training (BWT) may improve balance and walking speed in patients with acute stroke. The aim of this study was to analyze the effect of BWT on balance, balance confidence, and fall efficacy in this population. Design: Randomized controlled pilot trial. Methods: This study included 14 subjects with acute stroke (onset of illness less than one month). They were randomly allocated to a BWT (n=7) or forward walking training (n=7) group and observed five times in a week for a period of two weeks. Measurements were taken before and after the experiment using the Berg balance scale (BBS), Activities-specific balance confidence scale (ABC), and Fall efficacy scale (FES). Results: The BBS, ABC and FES scores obtained in both groups after the experiment were significantly higher than those before the experiment (p<0.05). In addition, the BBS, ABC, and FES scores in the experimental group were significantly higher than those in the control group (p<0.05). Conclusion: These findings indicate that BWT improved balance and balance confidence and decreased the risks of fall in patients with acute stroke. Further study is needed to better understand the effects of backward walking in acute stroke patients.

초기 뇌졸중 환자에서 체간 제한과 결합된 로봇 보조 상지 훈련의 효과: 무작위 대조 예비 연구

정경만 ( Kyeoung-man Jung ),정유진 ( Yu-jin Jung ) 대한신경치료학회 2017 신경치료 Vol.21 No.3

Purpose This study was to determine the effect of robot-assisted upper limb training combined with trunk restraint in early stroke patient. Methods Sixteen inpatients were randomly allocated into the experimental group (n=8), who received robot-assisted upper limb training combined with trunk restraint, and the control group (n=8), who received a robot-assisted upper limb training. Each intervention consisted of a 30 min session once a day, five times a week, for four weeks. To measure the functions of the upper limbs and performance capacities in the activities of daily living, the Fugl-Meyer assessment-upper extremity (FMA-UE), Manual function test (MFT), Korean-modified Barthel index (K-MBI) were used before after the intervention. Results The robot-assisted upper limb training combined with trunk restraint group and control group improved more significantly after intervention in FMA, MFT, K-MBI (p<.05). However, robot-assisted upper limb training combined with trunk restraint group was more effective than control group in increasing the FMA, MFT, K-MBI (p<.05). Conclusion These results suggest that robot-assisted upper limb training combined with trunk restraint is more helpful to improve upper-extremity function than robot-assisted upper limb training only early stroke patients.

컴퓨터보조 인지재활훈련이 초기 뇌졸중 환자의 시지각 기능과 인지에 미치는 효과

정경만 ( Kyeoung-man Jung ),정유진 ( Yu-jin Jung ),노세응 ( Se-eung Noh ) 대한신경치료학회 2016 신경치료 Vol.20 No.3

Purpose This study was aimed at determining the effect of computer assisted cognitive rehabilitation on visual perception and cognition in early stroke patient. Methods Twenty early stroke patients were participated voluntarily and were assigned randomly into experimental group and control group. Participants in the experimental group received computer assisted cognitive rehabilitation (RehaCom program) training (20min) and conventional occupational therapy (20min), but participants in the control group received conventional occupational therapy(40min). Both group received training for three times per week for six weeks. Before and after 6weeks of intervention, an motor_free visual perception test(MVPT), Line Bisection Test(LBT), Mini Mental State Exam_Korean (MMSE_K) were performed and results were analyzed. Results Experimental group and control group improved more significantly after 6 weeks after treatment in MVPT, LBT, MMSE_K(p<.05). However, experimental group was more effective than control group in increasing the MVPT, MMSE_K (p<.05) and decreasing LBT(p<.05). Conclusion we suggest that the computer assisted cognitive rehabilitation(RehaCom program) training may be effective in improving the visual perception function in the early stroke patients

체간 훈련 운동이 만성기 뇌졸중 환자의 균형 및 에너지 소모에 미치는 효과 : 단일사례연구

정경만 ( Kyeoung-man Jung ),정유진 ( Yu-jin Jung ),김희한 ( Hee-han Kim ),박상현 ( Sang-hyun Park ) 대한신경치료학회 2017 신경치료 Vol.21 No.3

Purpose This study was to determine the effect of trunk training exercise on dynamic balance and energy expenditure during walk in chronic stroke patients. Methods This study used a single subject research design. Two chronic stroke patients were participated and received general training five times per week. The trunk training exercise program was modified from preceding studies and composed of trunk muscle strengthening and selective and coordinated movement. The subjects performed exercise program five times a week, forty minute a day, four weeks. Pre base line(A) was only collected participant information without intervention in 5 times. Trunk training exercise(B) was carried out 10 times and 5 times to base lime(A) after intervention. The dynamic balance of was evaluated by Timed Up and Go Test(TUG), the energy consumption was measured by the oxygen cost as the oxygen consumption per unit distance, energy expenditure index(EEI) as the difference of heart rate, in a session. Results The results of the evaluation in each subject were indicated that the dynamic balance test was improved, both oxygen cost and energy expenditure index were decreased during the intervention period. These effects were maintained even during the regression baseline period. Conclusion These results showed that trunk training exercise was effective in the improvement of dynamic balance and decrease energy consumption. This study suggests that trunk training exercise is effective in the improvement of energy efficiency during walk in chronic stroke patients.

체간 안정화 운동이 만성 뇌졸중 환자의 보행속도 및 에너지 소모량에 미치는 효과 : 단일사례연구

정경만 ( Kyeoung-man Jung ),정유진 ( Yu-jin Jung ) 대한신경치료학회 2016 신경치료 Vol.20 No.2

Purpose This study was aimed at determining the effect of trunk stabilization exercises on walk speed and energy consumption during walk in chronic stroke patient. Methods The study used a single subject research design(ABA) and the subject in this study was a 55 year old man with right hemiplegia after stroke. The exercises program were modified from preceding studies and compromised of core muscle strengthening exercise and pelvis tilt exercise. The subject performed exercise program five times a week, one hour a day, four weeks. Pre base line(A) was only collected participant information without intervention in 5 times. Trunk stabilization exercise(B) was carried out 10 times and 5 times to base lime(A) after intervention. The walk velocity of the subject was evaluated by the 10m walking test, the energy consumption was measured by the oxygen cost as the oxygen consumption per unit distance and energy expenditure index as the difference of heart rate, in a session. Results The results of the analysis indicated that the 10MWT, Oxygen cost, Energy expenditure index were improved from 0.38m/s to 0.48 (26.31%), 0.41ml/kg/m to 0.34ml/kg/m(17.07), 0.97beat/min to 0.76beat/min(21.64%), respectively, from the baseline phase to intervention phase. The results indicated that the gait velocity improved and decrease oxygen cost, decrease energy expenditure index. Conclusions Therefore core strength exercise was effective intervention for improving energy efficiency during gait in chronic stroke patient.

시각적 피드백을 이용한 전신 기울기 운동이 급성기 뇌졸중 환자의 체간 조절, 근력 및 균형에 미치는 효과: 무작위 대조군 예비연구

정경만 ( Kyeoung-man Jung ) 대한물리의학회 2018 대한물리의학회지 Vol.13 No.4

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke. METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment. RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05). CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

회전보행 훈련이 초기 뇌졸중 환자의 균형 자신감, 낙상 효능에 미치는 영향: 무작위 대조 예비 연구

주민철,정경만,정일승,Joo, Min-Cheol,Jung, Kyeoung-Man,Jeong, Il-Seung 한국의료질향상학회 2020 한국의료질향상학회지 Vol.26 No.1

Purpose: This study aimed to determine the effect of curved walking training on balance confidence and fall efficacy in early stroke patients. Methods: The study included 16 early stroke patients who were randomly allocated to a curved walking training group (experimental group, N=8) and a straight walking training group (control group, N=8). Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using the Activities-specific Balance Confidence (ABC) Scale, Fall Efficacy Scale (FES), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. Results: After 3 weeks of training, both groups showed significantly improved ABC, FES, BBS, and TUG (p<.05 in both groups). However, the ABC, FES, BBS, and TUG scores in the experimental group were significantly better than those in the control group (p<.05). Conclusion: These findings indicate that curved walking training may be effective at improving balance confidence and decreasing fall risk in early stroke patients. Therefore, curved walking training can be used as a recommended walking method in early stroke patients.

측방보행 훈련이 급성기 뇌졸중 환자의 균형 자신감, 낙상 효능감, 낙상 위험도에 미치는 영향: 무작위 대조 예비 연구

주민철,정경만,Joo, Min-Cheol,Jung, Kyeoung-Man 한국의료질향상학회 2021 한국의료질향상학회지 Vol.27 No.1

Purpose: The aim of this study was to determine the effect of side walking on balance confidence, falls efficacy and fall risk in acute stroke patients. Methods: The study included 14 patients with acute stroke who were randomly allocated to a side walking group (Experimental group, N=7) and a forward walking group (Control group, N=7). Both groups performed the exercise 5 times a week for 2 weeks. Outcomes were assessed using Korean-Activities-specific Balance Confidence Scale (K-ABC), Korean-Fall Efficacy Scale (K-FES), Korean-Fullerton Advanced Balance Scale (K-FAB). Results: After 2 weeks of training, both groups showed significantly improved ABC, FES, FAB (p<.05 in both groups). However, the ABC, FES, FAB in the experimental group was significantly better than in the control group (p<.05). Conclusion: These findings indicate that side walking training may be effective at improving balance confidence and decreasing fall down risk in early stroke patients. Therefore, side walking training may be recommended as an intervention in reducing the incidence of falls in acute stroke patient.

앉은 자세에서 능동적 체간 훈련이 초기 뇌졸중 환자의 균형과 에너지 소모에 미치는 효과

최종덕 ( Jong-duk Choi ),정경만 ( Kyeoung-man Jung ) 대한물리의학회 2017 대한물리의학회지 Vol.12 No.4

PURPOSE: This study aimed to determine the effect of active trunk training in the sitting position on balance and energy consumption in early stroke patients. METHODS: The subjects of this study were twenty four early stroke patients were recruited and randomly divided into two groups; experimental group (n=12) and control group (n=12). The subjects in the experimental group participated in active trunk training (20 min) and conventional physical therapy (20 min) five times a week for four weeks. The control group conducted general balance exercise (20 min) and conventional physical therapy (20 min) five times a week for four weeks. The outcomes were assessed using the Berg balance scale, Timed up and go test and energy cost and physiological cost index. RESULTS: Both groups showed a significant increase in their Berg balance scale and significant decrease in their Timed up and go test score, and energy cost and physiological cost index (p<.05). Compared to the control group, the experimental group experienced a greater increase in the Berg balance scale (p<.05) and a larger decrease in the timed up and go test score, and energy cost and physiological cost index (p<.05). CONCLUSION: We suggest that active trunk training in the sitting position may be effective in improving balance and energy consumption in early stroke patients. Thus, active trunk training is important for such patients. Further studies are needed to better understand the effectiveness of trunk training in early stroke patients.