Background: Stroke often results in impaired postural control and asymmetric weight distribution, which negatively affect balance and functional mobility. Previous research has demonstrated that balance training interventions incorporating proprioceptive stimulation and visual feedback can enhance postural stability in stroke survivors. However, there remains debate regarding the relative effectiveness of these two approaches. While proprioception-based training emphasizes sensory input from mechanoreceptors to improve postural control, visual feedback-based training leverages external cues to facilitate balance adjustments. Objectives: To investigation the effects of proprioception-based trunk exercise and visual-auditory feedback-based trunk exercise on sitting balance in patients with chronic stroke. Design: Randomized controlled trial. Methods: A total of 24 participants diagnosed with chronic stroke were randomly assigned to two groups: the proprioception-based trunk exercise group (PTG, n=10) and the visual-auditory feedback-based trunk exercise group (VTG, n=11). Both groups participated in a 6-week intervention program, five sessions per week, lasting 25 minutes per session. Outcome measures included the Limitation of Stability (LOS), the Korean version of the Trunk Impairment Scale (K-TIS), and the Postural Assessment Scale for Stroke (PASS). Pre- and post-intervention assessments were analyzed using paired t-tests and independent t-tests to evaluate within-group and between-group differences. Results: Both PTG and VTG groups demonstrated significant improvements in LOS, K-TIS, and PASS scores following the intervention (P<.05). However, there were no statistically significant differences between the two groups in the amount of change observed. Conclusion: The findings suggest that both proprioception-based and visualauditory feedback-based trunk exercises are effective in improving sitting balance in chronic stroke patients. The lack of a significant difference between the groups indicates that both approaches provide comparable benefits. Future research should explore long-term effects and investigate potential differences in various functional domains beyond sitting balance.

Background: Functional sarcopenia, a subcategory of sarcopenia, has recently been introduced. It is defined by muscle weakness and reduced physical performance, regardless of muscle mass reduction, and may potentially affect overall rehabilitation outcomes in patients. Objectives: This study aimed to classify stroke patients into two groups based on the presence or absence of functional sarcopenia and to compare changes in balance and gait ability after receiving the same rehabilitation intervention. Design: A quasi-experimental design. Methods: A total of 44 stroke patients participated in this study and were classified into functional sarcopenia (n=22) and non-functional sarcopenia groups. Physical function tests were used to assess balance (Timed Up and Go, Berg Balance Scale) and gait (10-Meter Walk Test, Functional Ambulation Category). All participants underwent a four-week convalescent rehabilitation program, receiving five sessions per week, with each session lasting four hours per day. Results: After four weeks of convalescent rehabilitation, both groups showed significant improvements in all outcome measures (P<.05). However, when comparing the pre-post changes, no significant differences were found between the two groups in the changes of balance and gait outcomes (P>.05). Conclusion: These findings suggest that stroke patients with functional sarcopenia can achieve a similar level of functional recovery as those without functional sarcopenia when provided with appropriate rehabilitation interventions.

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.

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.

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.

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: 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: 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.

Background: As ways to optimize the mobilization of postural stability muscles for sitting up motions, arm reaching motions and head raising motions have important effects. Objectives: This study was conducted to investigate the effects of reaching to sit-up training on the trunk muscle activity, postural ability, and balance ability of patients with hemiplegia due to stroke. Design: Randomized controlled trial. Methods: This study was conducted with 18 stroke patients who met the selection criteria divided into two groups: a study group of 9 patents and a control group of 9 patients. The study group carried out reaching to sit-up training, which can promote trunk muscles and improve control through trunk interactions. The control group received general physical therapy intervention Results: The activity of the trunk muscle was significantly different before and after intervention in study and control group. The functional reaching test showed significant changes in both the study group and the control group. The timed up and go test showed a significant change in the study group. Conclusion: Reaching to sit-up training for 4 weeks showed increases in trunk muscle activity in stroke patients and was effective in improving balance ability.

Background: ErigoPro enables acute stroke patients to carry out stable weight-bearing training with gradual verticalization. Study on the effectiveness of robotic assisted treatment equipment for chronic patients is insufficient. Objectives: This study aims to investigate the effect of dynamic vertical posture training using ErigoPro on trunk alignment and balance in chronic stroke patients. Design: Randomized controlled trial. Methods: The subjects of this study were 30 patients were randomly assigned to a study group of 15 patients and a control group of 15 patients. The study intervention was carried out for 50 minutes per day consisting of 30 minutes of general neuro-physiotherapy and 20 minutes of ErogoPro training, 3 times a week for 8 weeks. Results: The study group showed difference in trunk inclination (P<.05), kyphotic angle (P<.05), lateral deviation of the spine (P<.05), thoracic angle (P<.01), timed up and go test (P<.01), Berg balance score (P<.01). There was a significant difference between the groups in the trunk inclination (P<.05), timed up and go test (P<.01), Berg balance score (P<.05). Conclusion: It could be seen that the treatment combined with ErigoPro training for 8 weeks was effective in restoring trunk alignment and improving balance ability in chronic stroke patients.

Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were “Stroke”, “Hemiplegia”, “Taping”, “Tape”, “Balance”, and “Gait” with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and nonelastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.

Background: Studies using Smovey and Vibration foam rollers are mostly conducted with normal adults, breast cancer patients, and athletes. However, there are not many studies applied to stroke patients to date. Objectives: The purpose of this study is to investigate the effect of vibration exercise on the range of motion of the shoulder and knee joints in stroke patients. Design: A randomized controlled trial. Methods: A total of 36 stroke patients, with 12 in the Smovey and Vibration foam roller group (SVG), 12 in the Smovey and Non-Vibration foam roller group (SNVG), and 12 in the control group (CG) were randomly assigned to exercise three times a week for 6 weeks. The range of motion of the shoulder and knee joints was measured for each group before and after 6 weeks of exercise. For joint range of motion, shoulder flexion and extension and knee flexion and extension were measured using BPMpro. Results: In terms of the difference in time, the flexion and extension of the shoulder and the flexion and extension of the knee on the paretic side were significant in the SVG and SNVG. The CG was not significant. Shoulder flexion and extension and knee flexion and extension on the unaffected side were all insignificant. The differences between each group were significant between the SVG and the CG and the SNVG and the CG. SVG and SNVG were not significant. Conclusion: It was found that vibration exercise had a positive effect on the range of motion of the shoulder and knee joints. Therefore, it is thought that vibration exercise can be provided as a clinical intervention method for shoulder and knee range of motion.