A content analysis of stroke physical therapy intervention using stroke physiotherapy intervention recording tool.

[Purpose] Physical therapy for recovery of function in people with stroke is known to be effective, but which type of physical therapy intervention is most effective is uncertain because a concrete and detailed record of interventions is done. This study aimed to record, analyze, and describe the content of physical therapy interventions for recovery of function after stroke using stroke physiotherapy intervention recording tool (SPIRIT). [Subjects and Methods] A convenience sample of 23 physical therapists from a rehabilitation hospital in Chung-nam recorded the interventions for 73 patients with stroke who were treated for 30 minutes in 670 treatment sessions. Treatment session contents were recorded using SPIRIT. Descriptive statistics were used to describe the interventions accurately and to investigate the differences according to time since stroke. [Results] Facilitation techniques were the most frequently used interventions (n=1,342, 35.1%), followed by practice (n=1,056, 27.6%), and exercise (n=748, 19.6%) in the physical therapists' clinical practice. [Conclusion] This pattern shows that physical therapists were focused on functional activity. Organizing or teaching patient activities for independent practice interventions (n=286, 7.5%) were used to encourage patient activity and independence outside the treatment sessions. Interventions according to time since stroke were not significantly different.

Effect of body awareness training on balance and walking ability in chronic stroke patients: a randomized controlled trial.

[Purpose] To investigate the effects of body awareness training on balance and walking ability in chronic stroke patients. [Subjects] The subjects were randomly assigned to a body awareness training group (n=6) and a control group (n=6). [Methods] Patients in the body awareness training group received body awareness training for 20 minutes, followed by walking training for 30 minutes a day, 5 days a week for 4 weeks. The control group received walking training for 30 minutes a day, 5 days a week for 4 weeks. [Results] After the intervention, both groups showed significant improvements in the Berg Balance Scale, Timed Up and Go Test, and 10 m walk test compared with baseline results. The body awareness training group showed more significant improvements in the Berg Balance Scale and Timed Up and Go Test than the control group. There was no significant difference in the 10 m walk test between the groups. [Conclusion] The results of this study suggest that body awareness training has a positive effect on balance in patients with chronic stroke.

The effects of cognitive rehabilitation on Alzheimer's dementia patients' cognitive assessment reference diagnosis system performance based on level of cognitive functioning.

[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer's disease (AD) patients' level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.

The effects of computer-assisted cognitive rehabilitation on Alzheimer's dementia patients memories.

[Purpose] The purpose of the present study was to conduct Computer-Assisted Cognitive Rehabilitation (COMCOG) to examine the effects of COMCOG on Alzheimer's dementia patients' memories. [Subjects] Thirty-five patients diagnosed with Alzheimer's dementia received COMCOG for 30 minutes per day, five days per week for four weeks. [Methods] Before and after the COMCOG intervention, subjects' cognitive functions were evaluated using the Cognitive Assessment Reference Diagnosis System (CARDS) and Mini-Mental State Examination-Korea (MMSE-K) test. [Results] According to the results of the evaluation, among the CARDS scores of the subjects who received COMCOG, the scores of the delayed 10-word list, delayed 10-object list, recognition 10-object, and recent memory significantly increased while the scores of recognition 10-word significantly decreased after intervention compared to before intervention. In addition, among the MMSE-K items, the orientation, registration, and recall showed significant increases. [Conclusion] Based on these results, delay in the progress of memory deterioration can be expected when COMCOG is conducted for Alzheimer's dementia patients who show declines in cognitive functions.

Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients.

[Purpose] This study aimed to determine the effect of mirror therapy (MT) with transcranial direct current stimulation (tDCS) on the recovery of the upper extremity function of chronic stroke patients. [Subjects] Twenty-seven patients at least 6 months after stroke onset were divided randomly into an experimental group (14 patients) and a control group (13 patients). [Methods] All subjects received tDCS for 20 min followed by a 5 min rest. Then the experimental group received MT while the control group conducted the same exercises as the experimental group using a mirror that did not show the non-paretic upper extremity. The groups performed the same exercises for 20 min. All subjects received this intervention for 45-min three times a week for 6 weeks. [Results] After the intervention, the experimental group showed significant improvements in the box and block test (BBT), grip strength, and the Fugl-Meyer assessment (FMA), and a significant decrease in the Jebsen-Taylor test. The control group showed a significant increase in grip strength after the intervention, and a significant decrease in the Jebsen-Taylor test. Comparison of the result after the intervention revealed that the experimental group showed more significant increases in the BBT and grip strength than the control group. [Conclusion] These results show that MT with tDCS has a positive effect on the functional recovery of the upper extremity of stroke patients, through activating motor regions in the brain, and thus plays an important role in recovery of neuroplasticity.

Effects of body awareness training on mild visuospatial neglect in patients with acute stroke: a pilot randomized controlled trial.

[Purpose] This study aimed to investigate the effects of body awareness training (BAT) on mild visuospatial neglect in patients following acute stroke. [Subjects] The subjects were 12 stroke patients randomly assigned to either the experimental group (n1=6) or control group (n2=6). [Methods] The experimental group underwent BAT for 15 minutes and then task-oriented training for 30 minutes a day, five times a week for three weeks. The control group underwent task-oriented training for 30 minutes a day, five times a week for three weeks. Assessments were made using the Motor-free Visual Perception Test (MVPT), Line Bisection Test (LBT), and modified Barthel index (MBI). [Results] Following the interventions, the experimental group showed a significant change in MVPT, LBT, and MBI scores. [Conclusion] The results of this study suggest the feasibility and suitability of BAT with task-oriented training for mild visuospatial neglect in patients with acute stroke.

The effect of ground tilt on the lower extremity muscle activity of stroke patients performing squat exercises.

[Purpose] The purpose of this study was to determine the effect of ground tilt on the lower extremity muscle activity of stroke patients performing squat exercises. [Subjects] Fifteen hemiparetic patients volunteered to participate in this study. [Methods] The subjects performed squat exercises at three different ground tilt angles: 15° plantar flexion, a neutral position, and 15° dorsiflexion. A surface electromyogram (sEMG) was used to record the electromyographic activities of the leg extensor muscle in the vastus lateralis (VL), vastus medialis (VM), gastrocnemius lateralis (GL), and gastrocnemius medialis (GM). The sEMG activity was analyzed using a one-way repeated measures ANOVA and a post hoc Bonferroni correction. [Results] The results of this study are summarized as follows. Significant differences were noted for the VL and the GL when the angle of the ankle joint was between the 15° plantar flexion and neutral positions during squat exercises involving the VL and when the angle of the ankle joint was between the neutral position and 15° dorsiflexion during squat exercises involving the VM. [Conclusion] In this study, sEMG showed that the VL and GL changed significantly during squat exercises according to the ground tilt angle of hemiparetic patients. Therefore, squat exercises with different ground tilt angles can be used to improve VL and GL strength.

Effects of the nerve mobilization technique on lower limb function in patients with poststroke hemiparesis.

[Purpose] The purpose of the study was to determine the effects of a sciatic nerve mobilization technique on improvement of lower limb function in patient with poststroke hemiparesis. [Subjects] Twenty- two stroke patients participated in this study. [Methods] They were randomly selected based on selection criteria and divided into two groups. In the subject group (n=10), sciatic nerve mobilization with conventional physical therapy was applied to patients. In the control group (n=10), only conventional physical therapy was applied to stroke patients. [Results] There were significant differences between the two groups in pressure, sway, total pressure, angle of the knee joint, and functional reaching test results in the intervention at two weeks and at four weeks. [Conclusion] The present study showed that sciatic nerve mobilization with conventional physical therapy was more effective for lower limb function than conventional physical therapy alone in patient with poststroke hemiparesis.