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[Purpose] The purpose of this study was to examine the effects of task-specific plantar flexor training on walking ability indices in a patient with a paretic ankle. [Subject and Methods] The subject was a 65-year-old male patient with right hemiplegia due to a left medullary ventral infarction. An ABA' single-subject design was adopted. The independent variable was a task-specific plantar flexor training exercise, similar to that during walking, targeting the paretic ankle. The dependent variables were the isometric ankle plantar flexor strength, maximum walking speed, step length, and trailing limb angle in the paretic terminal stance phase. The B study phase was divided into B1 and B2 phases. A two standard-deviation-band method was used to evaluate improvement. [Results] Improvements in the paretic plantar flexor strength, maximum walking speed, step length, and trailing limb angle in the B2 phase were observed. The improvements in the maximum walking speed, step length, and trailing limb angle were sustained in the A' study phase. [Conclusion] These results suggest that task-specific plantar flexor training exercise is efficacious in improving the walking ability index of a paretic ankle.

[Purpose] The purpose of this study was to investigate the effects of hand strength on upper extremity function and activities of daily living in patients with right hemiplegia, as well as to provide important fundamental data for rehabilitation after stroke. [Subjects and Methods] This study was conducted from May 1 to December 30, 2013, at the Department of Rehabilitation of P Hospital in Seoul and included subjects hospitalized with a diagnosis of stroke. Patients with right hemiplegia were selected, and their hand strength, upper extremity function, and activities of daily living were evaluated. Hand strength was measured by grip, lateral pinch, and three-point pinch strength. [Results] The effects of hand strength on upper extremity function were evaluated. The results showed that all types of hand strength significantly influenced upper extremity function. However, only grip strength influenced activities of daily living. [Conclusion] In rehabilitation of stroke patients, it is necessary to first improve their general physical condition and basic activities of daily living, and then improve hand movement and hand muscle strength for instrumental activities of daily living training, which requires detailed hand movements.

[Purpose] The purpose of this study was to investigate the effects of mirror therapy on the upper extremity functions of stroke patients. [Subjects] The subjects of this study were 14 hemiplegia patients (8 males, 6 females; 9 infarction, 5 hemorrhage; 8 right hemiplegia, 6 left hemiplegia) who voluntarily consented to participate in the study. [Methods] The Korean version of the manual function test (MFT) was used in this study. The test was performed in the following order: arm movement (4 items), grasp and pinch (2 items), and manipulation (2 items). The experiment was conducted with the subjects sitting in a chair. The mirror was vertically placed in the sagittal plane on the desk. The paretic hand was placed behind the mirror, and the non-paretic hand was placed in front of the mirror so that it was reflected in the mirror. In this position, the subjects completed activities repetitively according to the mirror therapy program over the course of four weeks. [Results] There were significant increases in the grasp-and-pinch score and manipulation score. [Conclusion] In conclusion, the grasp-and-pinch and manipulation functions were improved through mirror therapy.

[Purpose] This study was performed to investigate the balance of the stance limb of hemiplegic stroke patients during the crossing of obstacles of different heights. [Subjects] Twenty stroke patients (right hemiplegia) crossed obstacles of different heights (0 cm, 10 cm, 20 cm). [Methods] Stance time and muscle activity of the stance limb were measured during obstacle crossing. Two-way ANOVA was used to compare the stance time and muscle activities of the stance limb at the various obstacle heights. [Results] The results show that the stance time of the unaffected lower limb was significantly longer than that of the paretic lower limb and obstacle height increased, the stance time of the unaffected lower limb increased significantly. The participants exhibited increase in electromyography of the unaffected limb with increasing obstacle height. Particularly, the rectus femoris and gastrocnemius of the unaffected limb showed significant increases, and the tibialis anterior of the unaffected limb showed a significant difference between heights of 10 cm and 20 cm. Finally, the tibialis anterior and gastrocnemius showed significant difference between paretic and unaffected limb at all obstacle hights. [Conclusion] The results suggest that training the gastrocnemius of the paretic limb is an effective therapy for hemiplegic stroke patients.

[Purpose] The purpose of this study was to investigate the plantar foot pressure distribution of stroke patients while crossing obstacles of different heights. [Subjects] Eight subjects (right hemiplegia) participated in this study. [Methods] Plantar foot pressure was recoded by a RS-scan system (RS scan Ltd., German). One-way ANOVA was used to compare foot data of the various heights. [Results] The peak plantar pressure values of the paretic lower limb during the stance phase showed significant differences among the T1, M1, M2, M3 and M4 regions. However, the peak plantar pressure values of the non-paretic lower limb showed significant differences only in the T1, MF, HM and HL regions. [Conclusion] This study found that when stroke patients attempted to cross an obstacle, crossing the obstacle with the non-paretic lower limb while supporting the body with the paretic lower limb was a more stable and efficient obstacle crossing strategy.

To study the recovery of walking in an 85 year old man who had right hemiplegia after suffering a cerebral infarction, electromyograms (EMGs) were recorded from his leg muscles. We used signs for instability that we derived from EMG patterns seen in the developmental process of normal infants. The myoelectric activity at one month after the stroke showed many patterns indicative of unstable walking, closely resembling activity patterns seen in very unstable independent gait of a one year old baby in the first month of learning to walk. Seven months later, these patterns indicating unstable gait tended to have decreased or disappeared, although some marked activity betraying instability still remained. However, when the patient walked with the support of a hand cart and was able to hold his trunk upright, these excessive muscular activities decreased or disappeared, closely resembling the stable adult walking pattern. We recommend further study of the evaluation of recovery of walking after stroke by comparing the patient’s EMG patterns to those not only of normal adult human gait, but also of the development of human walking in early childhood.