Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient’s activity and should include cognition treatment to allow for a patient’s active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients’ functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight–bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient’s sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (–0.483) and to the unaffected side (–0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

Background: Weakness of the abdominal and mid thoracic muscles the lead to thoracic kyphosis of stroke patients. The trunk muscles activity of stroke patients is significantly related to upper extremity. Objectives: To investigate the effect of seated exercise of thoracic and abdominal muscles on upper extremity function and trunk muscles activity in stroke patients. Design: One-group pretest-posttest design. Methods: A total of 27 stroke patients were recruited. All stroke patient were given seated abdominal exercise (posterior pelvic tilt exercises) and thoracic exercise (postural-correction exercise). All exercises were conducted for 30 minutes, three times a week for four weeks. The manual function test (MFT) and electromyography (EMG) were measured, and EMG electrodes were attached to thoracic paraspinal muscles and lower rectus abdominal muscles. EMG signal is expressed as %RVC (reference voluntary contraction). Results: Experimental group showed significant increases in abdominal muscles, paraspinal muscles activity and MFT total score, items of arm motion (forward elevation of the upper extremity, lateral elevation of the upper extremity, touch the occiput with the palm) in MFT after four weeks. Conclusion: These results suggest that, in stroke patients, seated exercise of thoracic and abdominal muscles contribute to improve trunk muscles activity and upper extremity function in stroke patients.

Background: Recently, the kinesiology taping (KT) method was reported to be effective in improving walking ability in foot drop patients after stroke, but the clinical basis is still unclear. Objectives: The KT method was compared with ankle-foot orthotics (AFO) to investigate gait ability in foot drop patients after stroke. Design: Crossover study design. Methods: In this study, 11 stroke patients with foot drop participated. Walking ability of all subjects for both conditions (KT and AFO) was measured using the GAITRite system. The order of application of the two conditions was determined randomly by drawing lots. Wilcoxon signed-rank test was used to compare walking ability between the two conditions. The level of statistical significance was set at P<.05. Results: There were no significant differences between the KT and AFO methods in terms of velocity, cadence, step length, and stride length (P>.05, all). Conclusion: This study recommends KT as an alternative to the AFO, since KT provides evidence of preventing of foot drops and improving gait ability in stroke patient.

Background: Weakness of the trunk muscles decreases the trunk control ability of stroke patients, which is significantly related to balance and gait. Objectives: To compare the impact of diagonal pattern self-exercise on an unstable surface and a stable surface for trunk rehabilitation on trunk control, balance, and gait ability in stroke patients. Design: Nonequivalent control group design. Methods: Twenty four participants were randomized into the experimental group (diagonal pattern self-exercise while sitting on an unstable surface, n=12) and the control group (diagonal pattern self-exercise while sitting on a stable surface, n=12). All interventions were conducted for 30 minutes, three times a week for four weeks, and the trunk impairment scale (TIS), berg balance scale (BBS), functional gait assessment (FGA), and G-walk were measured. Results: All groups indicated significant increases in all variables (TIS, BBS, FGA, cadence, speed, stride length) after four weeks. The TIS, BBS, FGA, cadence, gait speed, and stride length group-by-time were significantly different between the two groups. Conclusion: We found that, in stroke patients, diagonal pattern self-exercise on an unstable surface is a more effective method for improving trunk control, balance, and gait ability than diagonal pattern self-exercise on a stable surface.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl– Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant betweengroup difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

Background: Motor imagery is the mental representation of an action without overt movement or muscle activation. However, few previous studies have demonstrated motor imagery training effects as an objective assessment tool in patients with early stroke. Objective: To investigate the effect of motor imagery training on Somatosensory Evoked Potentials (SSEP) and upper limb function of stroke patients. Design: A quasi-experimental study. Methods: Twenty-four patients with stroke were enrolled in this study. All subjects were assigned to the experimental or control group. All participants received traditional occupational therapy for 30 minutes, 5 times a week. The experimental group performed an additional task of motor imagery training (MIT) 20 minutes per day, 5 days a week, for 4 weeks. Both groups were assessed using the SSEP amplitude, Fugl-Meyer assessment of upper extremity (FMA UE) and Wolf motor function test. Results: After the intervention, the experimental group showed significant improvement in SSEP amplitude and FMA UE than did the control group. Conclusion: These findings suggest that the MIT effectively improve the SSEP and upper limb function of stroke patients.

Background: Ankle instability usually occurs after stroke, and contributes to unsafe walking and associated risk of falling in the affected patients. Objective: To investigate the effects of kinesiology taping (KT) on gait and balance ability (center of pressure, CoP) in patients with ankle instability after stroke. Design: One group, pre-post design. Methods: A total of 11 patients with ankle instability after stroke were enrolled. In all subjects, the gait and balance ability were assessed under 2 conditions: KT and barefoot. Gait and balance ability was assessed using GAITRite system and FDM-S platform. Results: Comparison between KT and barefoot condition, KT condition was significantly higher in velocity, cadence, step length, and stride length than barefoot condition (P<.05). KT condition was significantly lower in CoP path length and sway speed than barefoot condition (P<.05). Conclusion: KT indicated potential as a helpful method for walking and balancing ability in patients with ankle instability after stroke. Therefore, this study recommends KT as an option applicable to the stroke with ankle instability.

목적 : 본 연구는 지역사회에 거주하여 작업치료를 받고 있는 뇌졸중 환자를 대상으로 지역사회 참여정도가 삶의 질에 미치는 영향에 대하여 알아보고, 상관성 및 인과관계에 따른 설명력을 알아보고자 한다. 연구방법 : 뇌졸중 환자 117명을 대상으로 하였다. 지역사회 참여지표를 통하여 지역사회 참여도를 조사 하였고, 뇌졸중 환자의 삶의 질 측정을 사용하여 삶의 질을 평가하였다. 삶의 질과 사회참여와의 상관관계를 분석하기 위하여 피어슨 상관분석을 실시하였으며, 그에 따른 인과관계를 알아보기 위하여 회귀분석을 실시하여 분석하였다. 결과 : 지역사회 참여에 영향을 미치는 요인으로 질병의 정도가 심할수록 참여정도가 낮았으며, 선거에 참여할수록 참여정도가 높았다. 삶의 질에 영향을 미치는 요인으로 참여 주도권, 사회적 유대 및 관계, 참여의 의의가 높을수록 사회적 위축이 낮을수록 높은 상관관계를 보였다. 지역사회 참여 요인 중 삶의 질에 가장 큰 영향을 주는 변인으로는 질병의 정도와 참여주도권이 나타났다. 결론 : 뇌졸중 환자의 삶의 질에 미치는 영향은 질병의 정도와 선거참여 정도, 지역사회 참여 4가지 요인(참여 주도권, 사회적 유대 및 관계, 참여의 의의, 사회적 위축)이 중요한 변인으로 분석되었다. 뇌졸중 환자의 삶의 질을 증진시키기 위한 방안으로 사회 참여요인을 적용하여 의미 있는 작업치료 기초자료로 사용되길 기대한다.

Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients’ high motivation and committed participation. Patients’ motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients’ participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients’ level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients’ participation at early intervention were important determinants of functional outcome. These findings suggest that patients’ participation should be encouraged in order to achieve successful stroke recovery.

Background: Foot drop is a common symptom after stroke and causes walking disorders. Therefore, its proper treatment is important for improving the walking ability of patients with foot drop. Objective: This study aimed to investigate the effects of electrostimulation during walking on the walking ability of patients with foot drop after stroke. Design: Quasi-experial study. Methods: The study enrolled 18 patients with foot drop after stroke. All subjects were assigned to the experimental or control group. The experimental group underwent electric stimulation during walking, while the control group used ankle foot orthoses. Both groups received treatment 20 minutes a day 5 times a week for 4 weeks. Outcome measures were assessed for walking and balance ability using the 10-m walking test (10MWT), 6-min walking test (6MWT), and Timed Up and Go test (TUG) Results: After the intervention, both groups showed significant improvements in 6MWT and TUG results. However, the experimental group showed significantly better improvement on all tests than the control group. Conclusion: The foot drop stimulator effectively improved the walking and balance ability of patients with foot drop after stroke.

Background: Walking is a complex activity. The main components of walking include balance, coordination, and symmetrical posture. The characteristics of walking patterns of stroke patients include slow walking, measured by gait cycle and walking speed. This is an important factor that reflects post-stroke quality of life and walking ability. Objective: This study aimed to examine the effect of deep lumbar muscle stabilization exercise on the spatiotemporal walking ability of stroke patients. Design: Quasi-experial study Methods: The experiment was conducted 5 times per week for 4 weeks, with 30 minutes per session, on 10 subjects in the experimental group who performed the deep lumbar muscle stabilization exercise and 10 subjects in the control group who performed a regular exercise. Variables that represent the spatiotemporal walking ability (step length, stride length, step rate, and walking speed) were measured using GAITRrite before and after the experiment and were analyzed. Results: There was a significant difference in the pre- and post-exercise spatiotemporal walking ability between the two groups (p<.05). Furthermore, there was a significant difference in the step rate and walking speed between the two groups (p<.05). Conclusions: Deep lumbar muscle stabilization exercise is effective in improving the walking ability of stroke patients. Therefore, its application will help improve the spatiotemporal walking ability of stroke patients.

목적 : 본 연구는 뇌졸중 환자의 편의성과 안전성을 고려하여 목욕 활동의 효율성을 증진 시킬 수 있는 목욕의자 개발과 이의 효과성 검증에 목적을 두었다. 연구방법 : 대상자는 광역시 소재 재활병원에 입원 중인 뇌졸중 환자 20명을 대상으로 하였다. 연구도구로서 전문가집단을 대상으로 델파이 조사와 뇌졸중환자의 개선사항에 대한 의견수렴을 거쳐 개발한 목욕의자 프로 토타입을 사용하였다. 평가도구는 Rapid Entire Body Assessment (REBA), 설문(사용성 평가, 개방형설문), Korean version of Quebec User Evaluation of Satisfaction Assistive Technology (K-QUEST 2.0)를 활용하였다. 통계분석으로 목욕의자 프로토타입 사용 전·후에 대해 t-test 분석을 실시하였다. 결과 : 목욕의자 프로토타입 사용 전·후 평과결과, 목욕용품사용과 샤워기사용 자세에 대한 REBA의 조 치수준이 ‘높음’에서 각각 ‘보통’과 ‘낮음’으로 낮아졌으며, 사용성 평가항목인 편리성은 ‘적절’, 그 외 7개 항목에서는 ‘보통’, 사용 후 만족도는 효과성에서 ‘만족’, 그 외 7개 항목에서는 ‘보통’이라는 의견을 제시 하였다. 결론 : 본 연구에서 개발한 목욕의자가 뇌졸중 환자의 목욕활동에 대한 편의성과 안전성을 높이는데 효과 적일뿐만 아니라 신체적 부담도 줄일 수 있는 보조기로서 역할을 기대한다.

목적 : 본 연구에서는 뇌졸중 환자를 대상으로 Tablet PC 기반 인지 평가도구와 MMSE-K, MoCA-K를 비교하여 공인타당도와 Tablet PC 기반 인지 평가도구의 검사-재검사를 시행하여 신뢰도를 알아보고자하였다. 연구방법 : 본 연구는 2018년 6월 18일부터 2018년 9월 16일까지 시행하였으며, 울산에 소재한 종합병 원에 입원하여 작업치료를 받는 67명의 아급성 뇌졸중 환자를 대상으로 하였다. 평가는 MMSE-K, MoCA-K, Tablet PC 기반 인지 평가도구를 사용하였다. 공인타당도와 검사-재검사 신뢰도는 Pearson 상관분석을 사용하였다. 결과 : 공인타당도를 분석한 결과 Tablet PC 기반 인지 평가도구와 MMSE-K의 상관계수는 r=.85(p<0.01), MoCA-K의 상관계수는 r=.86(p<0.01)로 높은 공인타당도를 보였다. 신뢰도는 r=.97(p<0.01)로 검증 되었다. 결론 : 본 연구를 통해 Tablet PC 기반 인지 평가도구의 공인타당도와 신뢰도를 검증하였으며, Tablet PC 기반 인지 평가도구가 임상에서 인지 평가도구로서 사용될 수 있는 근거를 제시하였다.

목적 : 본 연구는 뇌졸중 환자가 거주하고 있는 가정환경에서 작업치료사가 실시하는 가정 기반 중재의 방법과 효과에 대하여 국외 연구들을 중심으로 체계적 고찰을 실시하고자 한다. 연구방법 : 자료 검색을 위해 MEDLINE, CINAHL, Pubmed의 데이터베이스를 사용하여 관련된 연구를 검색하였다. 최종 분석에 포함된 연구는 총 13편이었으며, 분석 대상에 포함된 연구를 바탕으로 비뚤림 평가와 PICO 방법을 적용하여 자료를 추출하고 분석하여 체계적으로 정리하였다. 결과 : 분석 대상에 포함된 13편의 연구에서는 작업치료사가 가정 기반 중재에 참여하고 있었다. 가정 기반 중재에서 작업치료사는 단독으로 개입하는 중재 혹은 다학제 재활 팀에 구성되어 중재가 이루어지고 있었다. 작업치료사는 가정환경을 배경으로 뇌졸중 환자의 일상생활, 의미 있는 활동 그리고 목표활동을 선정하고, 이를 개선하기 위한 역할을 수행하고 있었다. 결론 : 뇌졸중 환자의 가정 기반 중재에서 작업치료사는 대부분 활동 및 참여영역을 촉진시키기 위해 대상자 중심의 중재 방법을 적용하고 있었다. 본 연구를 통하여 국내 실정에 적합한 가정 기반 중재를 적용하기 위해 작업치료사의 역할에 대한 근거로 활용될 수 있을 것으로 기대한다.

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic (n1= 15) and ground (n2=15) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

목적 : 본 연구에서는 국내 뇌졸중 환자에게 가상현실프로그램의 효과를 분석하여 국내 작업치료 임상에서의 가상현실프 로그램의 사용에 대한 연구현황에 따른 앞으로의 활용방안을 제안하고자 하였다. 연구방법 : 자료의 검색을 위해 RISS, KISS의 데이터베이스를 이용하였다. 주요 용어는 “가상현실”, 뇌졸중”으로 관련 연구를 검색하였다. 선정기준에 적합한 총11편의 연구를 대상으로 질적 수준, PICO를 사용하여 연구주제에 따른 자료를 분석하였다. 결과 : 총 11편이 선정되었으며 무작위 실험-대조군 논문(Randomized Controlled Trail; RCT)이었다. 그 중 인지기능 관련 연구 5편, 정신기능 관련 4편, 신체기능 관련 2편 이었다. 사용한 중재 프로그램은 HMD odyssey, RAPAEL Smart Glove, Joystim, Finger-training Application, Virtual Reality of Driving Program, Wii, X-box가 사용 되었다. 모든 프로그램 중재 후 인지, 정신, 신체 기능의 증진을 확인할 수 있었다. 결론 : 본 연구는 국내 작업치료 연구 중 뇌졸중 환자 대상의 가상현실기반의 중재를 분석하였고 중재방법과 효과 그리고 가능성을 제시하였다. 가상현실기반 프로그램은 뇌졸중 환자의 인지, 정신, 신체기능에 효과가 있었으며 추후 연구에선 많은 대상자에게 치료 후 지속성에 대한 연구를 통해 가상현실 훈련의 적용 가능성과 효과를 입증 한 연구들이 이루어져야 할 것이다.

Background: Although there are interventions available for the improvement of arm functions of patients with stroke, measuring changes in global synkinesis (GS) according to changes in the muscle activity of paretic and nonparetic side muscles is an important factor and studies to investigate such potential factors are evaluated necessary. Objective: To examine the correlation between the affected arm muscle activity and GS changes in patients with stroke. Design: Randomized controlled trial Methods: In order to measure muscle activities of 30 stroke patients, anterior deltoid, posterior deltoid, biceps brachii and triceps brachii of the affected arms were measured using surface electromyography (EMG) and for analyzing GS, biceps brachii and triceps brachi of the affected arms were measured using the same instrument. Results: When the correlations between the muscle activity and GS of the affected arm were analyzed, the results showed significant correlations between the posterior deltoid and the triceps brachii(p < .01) and between the triceps brachii and GS(p < .05). Conclusion: : The results of this study suggest that the efficient movements of the affected arms of stroke patients, it is possible to increase extensor activity by improving smooth antagonism of the arm.

Background: Stroke patients require arm movement exercising for various stimulations in standing position for various stimulations rather than in a sitting position because they require integrated skillful movements, such as stretching, holding, and controlling. Objective: This study was conducted to provide foundational clinical data about lower limb global synkinesis in stroke patients using arm movements in a standing position. Design: Randomized controlled trial. Methods: The subjects were divided into a control group (n = 10) and an experimental group (n = 10), and a pre-test was conducted to evaluate leg global synkinesis (GS) and balance. Intervention method is stretching an arm to hold a ball, repeating supination and pronation of the hand only while maintaining the arm extended as much as possible, repeating shoulder abduction and adduction while holding the pegboard. This was followed by a three-week intervention during which re-measurement was conducted in the same way as was done for the pre-test. Results: The control group showed a significant difference in GS and balance during plantar flexion (p<.05), and the experimental group showed a significant difference in GS and balance during all movements (p<.05, p<.01, respectively). There was a significant difference in GS and balance between the two groups during dorsiflexion (p<.05, p<.01, respectively). Conclusion: The findings demonstrate that human arm movements in a standing position can reduce GS in the affected limb, and balance can be improved by stimulating the surrounding tissues of the affected limb and changing them positively.