Background: This study aims to analyze the trends in research related to the application of whole-body vibration exercise in stroke patients, the methods used, and the effects of such applications. Additionally, it seeks to propose future directions for research on whole-body vibration exercise in stroke patients and provide foundational data for future studies. Objectives: The purpose of this study was to analyze the trends in research on the application of whole-body vibration exercise in stroke patients, focusing on the methods used and the resulting effects. Design: A scoping review. Methods: This is a literature review aimed at identifying trends in whole-body vibration exercise research for stroke patients published in Korea between 2000 and March 2024. The study followed the five stages of the scoping review procedure proposed by Arksey and O’Malley. Results: The remaining one was a comparative study of the effects between vibration frequencies. The main findings from the literature showed statistical significance in 15 studies, excluding 3 articles. Additionally, 13 studies reported that the whole-body vibration exercise group demonstrated more significant improvements than the control group, while 1 study found the control group had more significant effects than the whole-body vibration exercise group. The remaining study compared the effects between different vibration frequencies. Conclusion: Based on the findings of this study, there is a need for more systematic reviews and meta-analyses to evaluate the effectiveness and quality of interventions. These should focus on systematically analyzing the outcomes of vibration exercise programs applied to stroke patients and the relevant dependent variables.

Background: Stroke patients often exhibit excessive kyphosis of the spine and a forward head posture (FHP), which negatively impacts their daily activities. These postural abnormalities not only negatively affect functional movement but also exacerbate musculoskeletal problems. Objectives: This study was conducted to determine the effect of backward walking on FHP in stroke patients. Design: Single-case experimental design (A-B-A’ design). Methods: The study was conducted over a total of 8 weeks, comprising 24 sessions: 3 baseline sessions (A), 18 intervention sessions (B), and 3 regression baseline sessions (A'). No backward walking intervention was performed during baseline (A) and regression baseline (A’). To determine changes in FHP, the craniovertebral angle (CVA) was measured at all sessions. Results: The CVA increased in the intervention (B) and regression baseline (A’) compared to the baseline (A). Conclusion: Backward walking was effective in improving FHP, and the effect was maintained after intervention (B) in patients with stroke. Therefore, backward walking was effective in improving the postural alignment of stroke patients.

Background: Stroke patients commonly experience functional declines in balance and gait due to decreased muscle strength and coordination issues caused by brain damage. Through repetitive training, robot-assisted gait training (RAGT) can aid in promoting neuroplasticity in stroke patients and help them acquire effective gait patterns. Additionally, convalescent rehabilitation hospitals help to ensure rapid recovery through intensive rehabilitation training. Objects: This study investigated the effects of RAGT frequency on gait and balance recovery in stroke patients in convalescent rehabilitation hospitals, providing data to optimize rehabilitation efficiency, enhance functional recovery, and support the development of personalized strategies to ensure safer and more rapid returns to daily life. Methods: This study compared the frequency of RAGT by analyzing a group receiving two units of RAGT per day for 5 days per week with a group receiving two units of RAGT per week as part of a comprehensive rehabilitation program, totaling 16 units daily, in a convalescent rehabilitation hospital. Results: In the 10-minute walking test, statistical significance was observed both within and between groups, whereas the Functional Ambulation Category, Fugl-Meyer Assessment–lower extremities, Berg Balance Scale, and timed up-and-go tests showed significance only within groups. Conclusion: End-effector RAGT and traditional gait training significantly improve gait ability, balance, and lower limb function in stroke patients.

Purpose: This study aimed to integrate and synthesize the recovery experiences of stroke patients through a qualitative meta-synthesis methodology. Methods: By searching through Korean databases(RISS, DBpia, KISS, NDSL), we compared 12 qualitative studies on recovery experiences of stroke patients. The meta-synthesis process was primarily guided by Noblit and Hare’s approach. Results: The common central experience of stroke patients was “reaching the world again”. Findings from the literature reviewed were synthesized into four themes: ‘earnest desire for recovery’, ‘rediscovery of family’, ‘duet of hope and despair’, ‘designing a new life’. Conclusion: The findings of this study provides a deeper understanding of recovery experiences of stroke patients. And this finding will serve as the basis for educational programs for health care personnel and families caring for stroke patients, development of programs to promote recovery of stroke patients, and self-help groups.

Background: Sarcopenia, characterized by a decrease in physical performance, muscle mass, and strength, is a common complication in patients with stroke, significantly impacting their rehabilitation and quality of life. Objectives: This study aimed to analyze the clinical characteristics associated with sarcopenia in patients with stroke and to identify factors that influence its occurrence. Design: A cross-sectional study. Methods: Data were collected using electronic medical records and assessments, including Korean version of mini-mental state examination (MMSE-K), manual muscle testing, berg balance scale (BBS), functional ambulation category (FAC), and modified barthel index. Sarcopenia was diagnosed based on the Asian working group for sarcopenia 2019 guidelines. Descriptive statistics, chi-square tests, independent t-tests, and logistic regression analyses were used. Results: Of the 82 patients with stroke included in this study, 46 were found to have sarcopenia. Sarcopenic patients had significantly lower body weight, cognitive function (MMSE-K), balance (BBS), walking ability (FAC), and daily living activities (MBI) scores compared to non-sarcopenic patients (P<.05). Logistic regression identified body weight (OR=.852, P=<.001) and cognitive function (OR=.897, P=.035) as significant predictors of sarcopenia. Conclusion: Body weight and cognitive function are crucial in predicting sarcopenia in patients with stroke. These findings suggest the importance of managing body weight and cognitive function to prevent sarcopenia and improve rehabilitation outcomes.

Cerebral ischemia is a serious neurological disorder that can lead to high morbidity and mortality. Baicalin is a naturally bioactive flavonoid derived from Scutellaria baicalensis Georgi, which has neuroprotective activity. Baicalin exerts a neuroprotective effect against hypoxic ischemic injury. In this study, we investigated whether baicalin regulates specific proteins in the cerebral cortex of ischemic stroke animals. Middle cerebral artery occlusion (MCAO) surgery was performed to induce ischemic brain injury, and baicalin (30 mg/kg) or vehicle was injected into the abdominal cavity before MCAO surgery. Neurological behavior tests were performed 24 h after MCAO surgery and proteomics approach was performed using proteins extracted from cortical tissue. Two-dimensional electrophoresis analysis and MALDI-TOF were performed to identify the regulated protein by baicalin. MCAO damage caused severe behavioral disorders, but baicalin treatment improved these behavioral deficits. Baicalin also induced changes in the expression of various proteins in the cerebral cortex of MCAO animals. Proteins changed by baicalin administration are as follow: adenosylhomocysteinase, isocitrate dehydrogenase [NAD] subunit alpha, apolipoprotein A-I, Rab GDP dissociation inhibitor beta, eukaryotic initiation factor 4A, and mu-crystallin. These proteins were involved in metabolism and protein synthesis. The results of this study demonstrated the neuroprotective effects of baicalin by improving behavioral disorders caused by MCAO damage. The results also showed that baicalin regulates the expression of a variety of proteins involved in neuroprotective functions. Therefore, our findings provide evidence that baicalin plays a neuroprotective role in stroke animal models by regulating specific proteins.

목적: 본 연구의 목적은 델파이 조사를 통해 뇌졸중 환자를 위한 인지행동치료 프로그램을 개발하고자 하는 것이다. 연구방법: 델파이 조사 기간은 2023년 3월부터 2023년 6월까지 였으며, 총 3차에 걸쳐 진행되었다. 전문가 구성은 정신보건계열 작업치료 임상경력 3년 이상인 자, 작업치료학과에서 정신사회 작업치료 관련 강의 및 연구 경험이 있는 교수들 중에서 10명을 선정하였다. 근거에 기반한 설문을 구성하기 위해 문헌고찰을 실시하였으며, 1차 델파이 조사는 반개방형 설문을 통해 얻은 전문가들의 답변을 바탕으로 적합한 항목을 추출하였다. 2, 3차 델파이 조사는 각 항목에 대한 적절성을 묻기 위해 리커트 4점 척도를 이용하여 표시하도록 하였으며, 취합된 값을 정리하여 항목별 평균, 표준편차, 내용타당도(Content Validity Ratio: CVR), 각 문항의 타당도(Item-level Content Validity Index: I-CVI), 안정도, 수렴도, 합의도를 산출하였다. 결과: 델파이 조사 결과 각 항목들의 최종 종합 평균은 3.60, 표준편차 0.48, CVR 0.96, I-CVI 0.98, 안정도 0.13, 수렴도 0.43, 합의도 0.77로 항목에 대한 타당도가 높은 것으로 나타났다. 본 연구 결과를 바탕으로 최종 선정된 인지행동치료 프로그램의 구성요소는 ‘인지행동치료에 대한 교육, 인지적 재구조화, 행동적 개입(이완 및 호흡훈련⋅사회기술 훈련⋅행동시행), 활동의 마무리’였으며, 총 16개의 관련 주제가 도출되어 각 주제별 프로그램을 제작하였다. 결론: 본 연구는 전문가들의 응답과 각 항목별 기준에 따라 최종 항목을 도출해 내었으므로 신뢰도와 타당도가 높고, 뇌졸중 환자를 위한 인지행동치료 프로그램의 첫 가이드라인을 제시했다는 것에 의의가 있다.

Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger’s regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger’s regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.

Background: Most patients with chronic stroke have difficulty walking, and various exercise methods are used clinically to improve the disability. Among them, various methods are being applied to improve walking through torso movement. Objectives: This study was conducted to determine the effect of Maitland vertebra joint mobilization exercise and Evjenth trunk muscle stretching exercise on the walking ability of patients with hemiparesis due to chronic stroke. Design: A randomized controlled trial. Methods: In this study, 30 chronic stroke patients with hemiplegia were divided into 15 patients in the Maitland vertebra joint mobilization group (MVJMG) and 15 in the Evjenth trunk muscle stretching exercise group (ETMSEG), and the intervention was conducted for 3 weeks, 5 times a week, 30 minutes a day. After the intervention, walking ability was measured using a gait analyzer. Results: In terms of walking ability, there was a significant increase in walking rate, walking speed, and stride length following the intervention in both the MVJMG and ETMSEG groups (P<.05). When comparing the difference in walking ability between the two groups, there was no significant difference in walking rate. Conclusion: The study found that both Maitland vertebra joint mobilization and Evjenth trunk muscle stretching exercises were effective for improving walking function in chronic stroke patients. However, there was no significant difference in effectiveness between the two interventions.

Background: Treadmill training is an effective intervention method for improving the walking ability of stroke patients, and taping is effective for stabilizing joints. However, taping interventions have not been implemented during treadmill training. Objectives: To examine whether treadmill training with an elastic tape or treadmill training with a non-elastic tape could be more effective in stroke patients. Design: A single blinded, randomized, controlled, comparative study. Methods: 22 stroke patients were randomly allocated to two groups: the elastic group (treadmill gait training with ankle elastic tape on the paretic side) or the non-elastic group (treadmill gait training with non-elastic tape on the paretic side). All participants performed 60 min of comprehensive rehabilitation therapy and treadmill training with an elastic tape or non-elastic tape for 20 min. Results: 10-meter walk test and timed up-and-go test results after training differed significantly from baseline in both groups (P<.05), but significantly larger gains were observed in the elastic group (10-meter walk test, -17.1%; timed up-and-go test, -18.49%; P<.05, respectively). Conclusion: Treadmill gait training with elastic tape on the affected ankle joint might be more effective at improving the walking and balancing abilities of stroke patients.

목적: 본 연구의 목적은 뇌졸중 환자들을 대상으로 사회연결망 분석을 활용하여 일상에서 수행되는 작업의 연결망 구조를 분석하는 것이다. 연구방법: 본 연구의 대상은 뇌졸중 환자 40명이다. 작업연결망의 구조 분석은 사회연결망 분석을 기반으로, 네트워크 분포와 중심성, 그리고 응집구조에 대한 분석이 수행되었다. 작업수행은 대상자들이 일상생활 활동 중에서 가장 만족한 활동으로 설정하였고, 통계청 생활시간조사의 일상생활 활동수행의 45문항을 활용하여 조사되었다. 활동에 대한 강도는 10점 척도로 평정하도록 하였고, 연결망의 강도로 분석하였다. 결과: 연결정도 중심성, 매개 중심성, 위세중심성이 높은 활동은 personal health care로 나타났다. 응집구조 분석결과 작업연결망은 3개의 하위 커뮤니티로 구성되었다. 결론: 본 연구의 결과는 뇌졸중 환자들의 작업연결망의 구조를 관계형태로 이해하는 데 가치와 의미를 지니며, 작업수행의 관계와 패턴에 대한 지식적 체계를 제공한다. 게다가, 본 연구의 결과는 임상적으로 치료적 접근과 중재, 교육의 과정에서 작업을 활용하고, 연계하여 확장하는 데 중요한 통찰력을 제공한다. 이에, 본 연구의 결과는 뇌졸중 환자를 대상으로 중재계획을 수립하고 목표를 설정하는 데 중요한 지침으로 활용될 수 있다.

목적: 본 연구는 뇌졸중 환자를 대상으로 적용한 인지기반 작업수행(Cognitive Orientation to daily Occupational Performance, CO-OP) 중재에 대한 조건, 형태 및 효과에 대하여 체계적 고찰을 하고자 하였다. 연구방법: 2014년부터 2023년까지의 PubMed, CINAHL, EMBASE, SCOPUS, Web of Science와 한국학술 지인용색인(Korea Citation Index)에 게재된 문헌을 대상으로 체계적 분석을 시행하였다. 검색어는 (Cognitive Orientation to daily Occupational Performance OR CO-OP) AND (Stroke OR Cerebrovascular accident)이며, 총 164편 중 선정 및 배제기준에 따라 뇌졸중 환자를 대상으로 CO-OP 중재를 시행한 실험 문헌 9편을 최종 선택하여 문헌에 대해 분석하였다. 결과: 분석한 문헌 중 무작위 대조실험 연구는 6편(66.67%)으로 질적 수준이 비교적 높았다. 대상자는 뇌졸중 후 1~6개월이 가장 많았으며, 선별조건으로는 인지 및 의사소통 능력이 중요 요소임을 확인할 수 있었다. 대상자가 선택한 중재 활동 영역으로는 기본적 일상생활활동(Basic Activities of Daily Living)과 수단적 일상생활활동(Instrumental Activities of Daily Living)이 가장 많았으며, 중재기간은 4주 또는 7주, 10회기, 각 주당 3회 미만이 가장 많이 실시되고 있었다. 모든 문헌에서 작업수행 향상에 초점을 두고 있었으며, 상지기능 및 건강 상태 같은 다른 영역의 효과를 제시하고 있었다. 종속변인 평가도구는 주로 작업수행 관련이 나타났으며, 그중 캐나다작업수행측정(Canadian Occupational Performance Measure) 과 Performance Quality Rating Scale이 가장 많이 사용되고 있었다. 결론: 본 연구에서는 CO-OP 중재를 적용한 뇌졸중 환자의 특성, 선별조건, 중재 활동, 중재 효과 및 형태, 종속변인 평가도구 및 실험연구의 근거 수준을 확인하였고, 이는 뇌졸중 환자를 대상으로 한 CO-OP 중재의 연구와 교육 방향에 기초자료로 활용될 수 있을 것이다.

Background: Mobilization with movement (MWM) is an effective intervention for increasing range of motion (ROM) and function without pain. Objectives: The purpose of this study is to comprehensively characterize the functional effects of MWM applied to the ankle joint in patients with stroke. Design: Systematic Review and Meta-analysis. Methods: International electronic databases, CINAHL, Embase, MEDLINE, PubMed, and Google scholar were included and identified after review by two investigators in July 2023 according to PRISMA guidelines. Data were synthesized using software provided by Cochran and analyzed using a random effects model with reweighting to account for heterogeneity between participants. Results: After excluding duplicate studies, 14 of the 19 articles screened through the abstracts were excluded, resulting in a total of five studies involving 109 participants with stroke. MWM showed significant differences in ankle ROM [overall effect (Z=3.27, P=0.00)], gait speed [overall effect (Z=3.33, P=0.00)], and cadence [overall effect (Z=2.49, P=0.01)]. Conclusion: The results of the meta-analysis confirmed that MWM is effective in improving ankle ROM and gait parameters in patients with stroke.

Background: The reduction in physical activity in stroke patients weakens their health and lowers their quality of life. There is a need for the development of effective exercise programs to enhance the physical activity of chronic stroke patients. Objectives: The purpose of this study is to investigate the effects of a rehabilitation sports program using Proprioceptive Neuromuscular Facilitation (PNF) on the body composition, physical function, and quality of life of stroke. Design: Single group study. Methods: This study was conducted on 9 chronic stroke patients. The exercise program, which applied PNF, was carried out in group sessions twice a week for 50 minutes each over 8 weeks. Participants were assessed before and after the exercise program using InBody, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Grip Strength, 10-Meter Walk Test (10MWT), Timed Up and Go Test (TUG), Functional Reach Test (FRT), and completed the 36-Item Short Form Health Survey (SF-36) questionnaire. Statistical analysis was performed using paired t-tests for pre- and post-exercise comparisons and the Wilcoxon signed-rank test for evaluating the effects of the exercise program. Results: The results of this study showed differences in weight (P>.05), BMI(P>.05), body fat (P>.05), FMA-UE (P<.05), Grip Strength (P<.05), 10MWT (P<.05), TUG (P<.05), FRT (P<.05), SF-36 (P<.05). Conclusion: This suggests that the rehabilitation sports program using PNF can be used as an exercise program to enhance physical activity, improving physical function and quality of life in chronic stroke patients.

Background: Among the various rehabilitation methods for stroke patients, one method involves the use of vibration. Recently, vibration foam rollers, combining vibration with foam rolling, have been developed and are widely used. Objectives: The purpose of this study was to investigate the effects of vibration foam rolling on ankle range of motion (ROM), and gait speed in patients with stroke. Design: A randomized controlled trial. Methods: Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the non-vibrating foam roller group (n=15). Active dorsiflexion ROM, and 10-meter walk (10MW) were used to evaluate ankle ROM, and gait speed before and after each exercise. The two groups performed a 30-minute foam roller exercise program. The non-vibrating foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Results: The within-group change in active dorsiflexion ROM after the exercise was significant for both the vibrating foam roller group and the non-vibrating foam roller group (P<.05). The within-group change in 10MW after the exercise was significant for the vibrating foam roller group (P<.05), while it was not significant for the non-vibrating foam roller group (P>.05). Additionally, there was no significant difference in active dorsiflexion ROM and 10MW between the vibrating foam roller group and the non-vibrating foam roller group (P>.05). Conclusion: This study confirmed that a vibrating foam roller exercise program immediately improves ankle ROM and gait speed in stroke patients.

Background: Kinesio taping is being applied to improve ankle dorsiflexion in stroke patients. Currently, the elasticity of kinesio taping is applied in various ways. Objectives: To investigated the effect of tibialis anterior kinesio taping elasticity level on gait speed in stroke patients. Design: A randomized cross-over pilot study. Methods: A total of 12 study subjects were allowed to experience three conditions within a single group. The three conditions are strong elastic taping condition, weak elastic taping condition, and non-elastic taping condition. Study subjects were randomly assigned to each condition sequentially. For the evaluation, gait variables (cadence, gait speed, stride length) were measured 24 hours after applying the taping appropriate for each condition. Results: The strong elastic taping condition significantly increased gait variables compared to the weak elastic taping and non-elastic taping conditions (P<.05). Weak elastic taping significantly increased gait variables compared to non-elastic taping (P<.05). Conclusion: As tibialis anterior kinesio taping elasticity increased, gait variables significantly improved in stroke patients.

Background: Most studies targeting stroke patients have confirmed improvements in balance and walking using immersive and non-immersive virtual reality training programs. However, to date, there are not many studies targeting brain activation enhancement for the two training programs. Objectives: The purpose of this study is to investigate the effect of a virtual reality training program on the EEG of stroke patients according to differences in immersion. Design: A randomized controlled trial. Methods: A total of 20 stroke patients, with 10 in an immersive virtual reality training programs group (IVRG) and 10 in a non-virtual reality training programs group (NVRG) were randomly assigned to exercise three times a week for 6 weeks. EEG was measured for 2 minutes using DSI-24. Results: The intra-group difference in relative alpha waves of brain waves was not significant for both groups, and the between-group difference was not significant. Differences in EEG relative beta waves in the experiment group were significant in the Fp1, Fp2, Cz, C3, C4, P3, and O2 in the experiment group, and significant in the Cz and O2 in the control group. As a result of comparing the differences between each group before and after, there was a significant difference in the Fp1 area. Conclusion: Virtual reality training programs based on differences in immersion were found to have a positive effect on EEG. Therefore, it is believed that a virtual reality training program based on differences in immersion can be provided as a clinical intervention method for EEG.

Background: Stroke patients experience a variety of physical problems due to neurological problems, including difficulties with trunk control. Trunk taping is used to improve gait in stroke patients. Objectives: To investigated the immediate effect of thoracic and abdominal elastic taping on gait parameters (the dynamic balance and gait speed) in stroke patients. Design: Quasi experimental study. Methods: A total of 24 study subjects were randomly assigned to the experimental group (thoracic and abdominal taping, 12 people), and the control group (sham taping, 12 people). All subjects had timed up and go (TUG) test and 10 meter walk test (10MWT) measured before and after taping. Results: After taping, the TUG test and 10MWT results were significantly reduced only in the study group (P<.05). The TUG test and 10MWT results of the study group were significantly decreased compared to the control group. Conclusion: The thoracic and abdominal taping was found to improve trunk control in stroke patients, thereby improving dynamic balance and walking speed.

Background: Hemiparesis not only affects the affected side but also exerts an impact on the unaffected side. Stroke patients endure muscular weakness attributable to hemiparesis, resulting in asymmetry of muscular strength between the paralyzed and non-paralyzed sides. Objectives: To investigate the correlation between lower limb muscle strength asymmetry and functional factors in patients with stroke. Design: A cross-sectional study. Methods: A total of 58 stroke patients participated in this study. After measuring the muscle strength of both lower limbs using manual muscle testing, the asymmetry was calculated. Functional factors such as berg balance scale (BBS), timed up and go (TUG), 10-metre walk (10MW), and modified barthel index (MBI) were measured. Results: The BBS showed positive correlations with hip, knee, and ankle strength asymmetry (P<.05). The TUG showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The 10MW showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The MBI showed positive correlations only with hip strength asymmetry (P<.05). Conclusion: We were found that there is a more pronounced lower limb muscle strength asymmetry in the lower extremity of stroke patients, which is associated with BBS, TUG, and 10MW.