The Posterior Leaf Spring (PLS) has been used for hemiplegic patients in order to help their walking and to increase their balance function. Past studies have mainly focused on the PLS's influence on patients' walking without taking balance function into consideration. The purpose of this study was to identify the immediate effect of PLS on the standing balance in hemiplegic patients. Fifteen hemiplegic patients participated in this study: 10 men and 5 women, with an average age of 53.8 years. Standing balance was measured using a computerized dynamic posturography device under three conditions namely bare-foot standing, standing in shoes without PLS, and standing in shoes with PLS. The results were as follows: 1) The composite equilibrium scores of patients who stood in shoes only and stood in shoes with PLS were higher than those of patients who stood bare-foot. 2) There were no statistical difference in the composite equilibrium scores between the standing condition of patients who stood bare foot and that of patients who stood in shoes with PLS. In conclusion, it is not clear whether or not the PLS affects the standing balance of hemiplegic patients. Further study is required to determine the precise effect of the PLS on standing balance in hemiplegic patients who are not wearing shoes. This is particularly relevant in Korea culture where custom demands the removal of shoes when entering any house or even many restaurants.

The purpose of this study is defined increased active motion utilizing tenodesis splint and vibratory stimulation during functional activities. We selected three left cerebral vascular accident right hand dominance with right hemiplegic patients. who has been actively participating in occupational therapy. Patients participated twice per week from June 1st 1997 until August 30th 1997. According to our study, improvement has been noted in active extension with vibratory stimulation only. No signifinicant improvement was noted with tenodesis splint. Further study is necessary to generalization of stimulation for therapeutic use.

In motor learning, the relative frequency of external feedback is the proportion of external feedback presentations divided by the total number of practice trials. In earlier studies, increasing the percentage of body weight loading on the affected leg of hemiplegic patients, external feedback was continuously produced as the patient attempted to perform a movement. This feedback was produced to enhance the learning effect. However, recent studies in nondisabled populations have suggested that compared with 100% relative frequency conditions, practice with lower relative frequencies is more effective. My study compared the effect of 100% relative frequency conditions with 67% relative frequency conditions to determine what effect they exerted on motor learning for increasing the percentage of body weight loading on the affected lower limbs of patients with hemiplegia. Twenty-four hemiplegic patients were randomly assigned to one of two experimental groups. Each group practiced weight transfer motor learning on a machine. During practice, visual feedback was offered to all subjects. The experiment was carried out with full visual feedback for patients in group one but only 67% visual feedback for patients in group two. The percentage of loading on the affected leg was recorded four times: before learning (baseline value), immediately after learning, 30 minutes after learning, 24 hours after learning. The results were as follows: 1. In the 100% visual feedback group, the percentage of loading on the affected leg increased significantly in all three testing modes over the baseline value. 2. In the 67% visual feedback group, the percentage of loading on the affected leg increased significantly in all three measurements. 3. Immediately after learning, the learning effect was not significantly different between the two groups, but was significantly greater after both the 30 minutes delay and the 24 hours period. These results suggest that the 33% reduction in the provision of visual feedback may enhance the learning effect of increasing the percentage of body weight loading on the affected leg in patients with hemiplegia.

The purpose of this study was to determine the effect of mental practice on biceps brachii muscle strengthening in 3 poststroke hemiplegia patients along with multiple baseline design across subjects. The mental practice adopted for this experiment involved imagery training to practice elbow flexion, which last 12 to 16 sessions with 30 minutes each session. Maximal muscle activities was measured pre- and post-mental practice to evaluate the strength of biceps brachii. The strength of biceps brachii was measured by surface-EMG. The results were: In the subject 1, 73.92 mV (pre-) and 127.56 mV (post-); in the subject 2, 147.60 mV (pre-) and 202.85 mV (post-); and in the subject 3, 20.75 mV (pre-) and 27.92 mV (post-). The results indicate that a simple mental practice is a useful method to strengthen biceps brachii muscle in hemiplegic patients.

The objective of this study was to identify the effects of pelvic tilting exercise on gait patterns of hemiplegic patients. The subjects of this study were 31 hemiplegic in- and out-patients of the Rehabilitation Hospital, Yonsei University Medical Center, from September 24, 1997 through November 5, 1997. Pre- and post-treatment change in gait patterns were measured using a ink foot-print. The data were analyzed by the paired t-test, one-way ANOVA, and independent t-test. The findings were as follows: The difference in gait patterns between pre- and post-treatment was statistically significant, with an increase in gait velocity to 7.98 cm/sec post-treatment; an increase in cadence to 7.29 steps/min; a narrowing of the base of support to 1.33 cm; an increase in step length of 3.92 cm on the less affected side and 3.73 cm on the more affected side; an increase in stride length of 5.82 cm on the less affected side and 5.92 cm on the more affected side(statistically not significant in foot angle). In relation to sex, age, cause of stroke, and laterality of paralysis, the difference in gait patterns between pre- and post-treatment was not statistically significant. Where there was no significant difference of the effects of pelvic exercise regarding the degree of spasticity, the presence of a decrease in proprioception, and the duration of treatment. In conclusion, hemiplegic pelvic tilting exercise was found to have transmitting positive effect in improving gait patterns.

We assessed the function of the both hands and arms of the hemiplegic patients by MFT(Manua1 Function Test) and ADL score of the hemiplegic patients by FIM(Func- tional Independence Measure) and investigate its significance. The subjects of this study were 34 patients who had been hospitalized Rehabilitation Hospital, Yonsei University College of Medicine. The results are as follows ; 1. MFS(Manua1 Function Score) of both uninvolved upper limbs and involved upper lim- bs were significantly correlated with total FI M score. 2. The shoulder abduction, touch hand to the back , pegboard sub-items of MFT on the uninvolved upper limbs were significantly correlated with total FIM score. 3. The all sub-items of MFT on the involved upper limbs were significantly correlated with total FIM score. 4. The function of both uninvolved upper limbs and involved upper limbs by MFT were significantly correlated with self care, mobility, locomotion. According to the above results, MFT shows the functional status of the hemiplegic patients relatively well.

The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.

Weight bearing training on the involved leg is impotant for ambulation and activities of daily living in ambulatory hemiplegic patients. Traditionally, physical therapists have relied on exercise therapy and subjective evaluation. The goal for this study was to measure lower extremity weight distribution in standing with ten hemiplegic pations(M:8, F:2) and to determine the traing effect on symmetrical standing posture using a "Limloader". The Limloader is a machine designed for training symmetrical weight bearing posture. The results showed that the ability to keep the center of gravity within the limits for balance was improved significantly but the ability to adjust weight bearing on the involved leg was not (p<0.05). This study demostrated that hemiplegics can improved their symmetrical weight bearing ability using sensory biofeedback.

Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was , , respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

본 연구의 목적은 16주간의 수중운동이 만성 편마비 환자들의 정신건강 및 신체적 자아 효능감에 미치는 영향을 구명하여, 이 환자들의 삶의 질 향상에 도움이 되는 재활 운동프로그램을 제공하는데 있다. 연구대상은 서울특별시 P복지관 만성 편마비 환자 16명(실험집단 8명, 통제집단 8명)으로 하였으며, 공변량분석을 통해 측정된 자료의 유의성 검증을 하여 다음과 같은 결론을 얻었다. 첫째, 수중운동은 만성 편마비 환자들의 긴장, 분노, 피로, 활력과 같은 정신건강 요인에는 긍정적인 변화를 주었으나, 우울과 혼동 같은 요인에는 통계적으로 유의한 영향을 주지 않았다. 둘째, 신체적 자아 효능감 요인인 신체 능력과 자기표현 자신감의 변화에도 긍정적인 영향을 미쳤다. 따라서 환자의 특성을 고려한 적절한 수중운동은 만성 편마비 환자뿐만 아니라 다른 장애인의 정신적 재활에 도움이 될 것으로 기대된다.