National Rehabilitation Research Institute

Seoul, South Korea

National Rehabilitation Research Institute

Seoul, South Korea
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Cho S.,National Rehabilitation Research Institute | Lee H.,National Rehabilitation Research Institute | Kim H.,National Rehabilitation Research Institute
International Conference on Control, Automation and Systems | Year: 2016

Stroke patients have reduced kinematic characteristics in gait speed, cadence, step kinematics, and range of motion (ROM). Especially, a drop foot is a common symptom during gait after stroke due to the weakness of ankle dorsiflexor. A few robotic ankle systems have been developed to measure and train pathological ankle movements. However, the previously developed systems use orthogonal ankle axis system which reproduces unnatural human ankle movements. So we have developed a robotic device that considers anatomical ankle axes in order to train ankle muscles and to measure the quantities of ankle ROM, and forefoot and hindfoot ground reaction force. We recruited 10 healthy elderly with no history of neurological disorders. Subjects performed a total of three trials with eight repetitions or more of ankle dorsi-plantarflexion using AMT. To investigate the validity of ankle angle measurements in developed AMT, we compared AMT outputs with output ankle kinematics from VICON motion capturing system. We found similar ankle movement pattern between AMT and VICON during active ankle dorsi-plantarflexion movement. The kinematics measured from AMT ankle ROM had a significant correlation with VICON ankle ROM (r =.958, n = 10, p =.00001). Therefore, we confirmed that the validity of ankle angle measurement in developed AMT. © 2016 Institute of Control, Robotics and Systems - ICROS.


Cho K.H.,National Rehabilitation Research Institute | Lee H.J.,Sungkyunkwan University | Lee W.H.,Sahmyook University
Topics in Stroke Rehabilitation | Year: 2017

Background: Dysfunction of skeletal muscle has been commonly reported in stroke patients. Objective: The purpose of this study was to investigate the intra-and inter-rater reliabilities of measurement of ultrasound imaging (USI) for pennation angle (PA) and muscle thickness (MT) of tibialis anterior muscle in stroke patients. Methods: Thirty-four stroke patients (19 men) participated in this study. USI was used for measurement of PA and MT of the tibialis anterior muscles at rest and during maximum voluntary contraction (MVC). Two examiners acquired images from all participants during two separate testing sessions, seven days apart. Intra-class correlation coefficients (ICCs), confidence interval (CI), standard error of measurement, minimal detectable change, and Bland-Altman plots were used for estimation of reliability. Results: In the intra-rater reliability between measures, for all variables (PA and MT of the paretic and nonparetic sides of tibialis anterior muscles at rest and during MVC), the ICCs ranged between 0.639 and 0.998 and the CI was within an acceptable range of 0.388-0.999. In inter-rater reliability between examiners for the two tests, for all variables, the ICCs ranged between 0.690 and 0.995 and the CI was within an acceptable range of 0.463-0.997. In addition, significant difference was observed between the paretic and non-paretic sides of the tibialis anterior muscle architecture (p < 0.05). Conclusion: These finding demonstrate that measurements of the tibialis anterior muscle using USI can be useful for clinical assessment in stroke patients. In addition, objective and quantitative measurements of tibialis anterior muscle using USI may provide appropriate management for the walking recovery of stroke patients. © 2017 Informa UK Limited, trading as Taylor & Francis Group.


Cho K.,National Rehabilitation Research Institute | Lee W.,Sahmyook University
Journal of Physical Therapy Science | Year: 2014

[Purpose] The purpose of the current study was to investigate the influence of footwear type on postural sway of hemiparetic stroke patients. [Subjects] Thirty-two stroke patients who were undergoing a rehabilitation program were recruited on a voluntary basis from local rehabilitation unit. [Methods] This study had a single-group repeated-measures design. The Good Balance system was used to measure the postural sway velocity (anteroposterior and mediolateral) and velocity moment of the subjects under the eyes open and eyes closed conditions in the standing posture. Postural sway of the subjects in four types of footwear was measured, including barefoot, high heel-collar shoes, flat shoes, or slippers. [Results] The postural sway when wearing the flat shoes or slippers was significantly higher than that when barefoot or wearing high heel-collar shoes. In addition, postural sway velocity and velocity moment of all the footwear types were significantly higher under the eyes closed condition than under the eyes open condition. [Conclusion] Our results reveal that when the subjects wore flat shoes or slippers they had more difficulty than when they wore the high heel-collar shoes in postural control when maintaining standing balance. We believe that this result provides basic information for improvements in postural control and may be useful in balance training to prevent falls after stroke. © 2014 The Society of Physical Therapy Science. Published by IPEC Inc.


Ko B.-W.,National Rehabilitation Research Institute | Lee H.-Y.,National Rehabilitation Research Institute | Song W.-K.,National Rehabilitation Research Institute
Journal of Physical Therapy Science | Year: 2016

[Purpose] The effects of various rhythmic auditory stimulation tempos on stroke gait pattern changes when training patients with a smartphone-based rhythmic auditory stimulation application were investigated. [Subjects and Methods] Fifteen patients with chronic stroke were included. Cadence during comfortable walking was measured (baseline). After the baseline findings were recorded, rhythmic auditory stimulation with five different tempos (i.e., −10%, −5%, 0%, +5%, and +10% change from baseline. was randomly applied. Finally, comfortable walking without rhythmic auditory stimulation was initiated to evaluate gait pattern changes. [Results] As the tempo increased, the spatiotemporal gait parameters of the stroke patients changed significantly. Gait speed, cadence, and gait cycle duration showed the greatest improvement in the +10% rhythmic auditory stimulation condition compared to baseline. After gait training with rhythmic auditory stimulation, gait speed, cadence, stride length, gait cycle duration, and step length of the affected and unaffected sides improved significantly compared to baseline. [Conclusion] Significant changes in the gait pattern of stroke patients were noted for various tempos after training with rhythmic auditory stimulation. These findings could be used to customize rehabilitative gait training for patients who experience stroke with hemiplegia. © 2016 The Society of Physical Therapy Science. Published by IPEC Inc.


PubMed | National Rehabilitation Research Institute and National Rehabilitation Center
Type: Journal Article | Journal: Annals of rehabilitation medicine | Year: 2017

To investigate the relationship between cognitive perceptual abilities of elderly drivers based on the Cognitive Perceptual Assessment for Driving (CPAD) test and their accident and penalty histories.A total of 168 elderly drivers (aged 65 years) participated in the study. Participant data included CPAD scores and incidents of traffic accidents and penalties, attained from the Korea Road Traffic Authority and Korea National Police Agency, respectively.Drivers mean age was 70.254.1 years and the mean CPAD score was 52.754.72. Elderly drivers age was negatively related to the CPAD score (p<0.001). The accident history group had marginally lower CPAD scores, as compared to the non-accident group (p=0.051). However, incidence rates for traffic fines did not differ significantly between the two groups. Additionally, the group that passed the CPAD test had experienced fewer traffic accidents (3.6%), as compared to the group that failed (10.6%). The older age group (12.0%) had also experienced more traffic accidents, as compared to the younger group (2.4%).Overall, elderly drivers who experienced driving accidents had lower CPAD scores than those who did not, without statistical significance. Thus, driving-related cognitive abilities of elderly drivers with insufficient cognitive ability need to be further evaluated to prevent traffic accidents.


Cho K.,National Rehabilitation Research Institute | Yu J.,Sun Moon University
Journal of Nanoelectronics and Optoelectronics | Year: 2016

This study investigates the changes in the brain wave of stroke patients through neurofeedback training (NFBT) using display. Thirty stroke patients were assigned to two group: 14 patients in the NFBT group, and 16 in the control group. NFBT group played the display game by watching the monitor with the poles attached, and his awakening level was controlled. The training time for this trial was set at 30 minutes, during which a 3-minute training module was conducted 10 times, and trained as five times a week for 6 weeks. Their brain waves were measured pre- and post-training through electroencephalography. In result, the frontal and parietal lobes in particular of NFBT group showed significant differences in activation after the test (p< 0.05). But there were no significant differences between before and after intervention in control group. This study suggests that rehabilitation by NFBT is effective in changing relative beta waves and improving cognitive function. Copyright © 2016 by American Scientific Publishers All rights reserved.


Hwang J.H.,Sungkyunkwan University | Lee C.-H.,Pusan National University | Chang H.J.,Samsung | Park D.-S.,National Rehabilitation Research Institute
Annals of Rehabilitation Medicine | Year: 2013

Objective: To investigate the postural control factors influencing the automatic (reflex-controlled) and attentional (high cortical) factors on dual task. Methods: We used a dual task model to examine the attentional factors affecting the control of posture, subjecting test subjects to vibration stimulation, one-leg standing and verbal or nonverbal task trials. Twenty-three young, healthy participants were asked to stand on force plates and their centers of pressure were measured during dual task trials. We acquired 15 seconds of data for each volunteer during six dual task trials involving varying task combinations. Results: We observed significantly different sway patterns between the early and late phases of dual task trials, which probably reflect the attentional demands. Vibration stimulation perturbed sway more during the early than the late phases; with or without vibration stimulation, the addition of secondary tasks decreased sway in all phases, and greater decreases in sway were observed in the late phases, when subjects were assigned nonverbal tasks. Less sway was observed during the nonverbal task in a sequential study. Conculsions: The attentional and automatic factors were analyzed during a sequential study. By controlling the postural control factors, optimal parameters and training methods might be used in clinical applications. © 2013 by Korean Academy of Rehabilitation Medicine.


Kim M.,Sahmyook University | Cho K.,National Rehabilitation Research Institute | Lee W.,Sahmyook University
Tohoku Journal of Experimental Medicine | Year: 2014

Stroke patients live with balance and walking dysfunction. Walking is the most important factor for independent community activities. The purpose of this study was to investigate the effect of a community walking training program (CWTP) within the real environment on walking function and social participation in chronic stroke patients. Twenty-two stroke patients (13 male, 50.45 years old, post stroke duration 231.64 days) were randomly assigned to either the CWTP group or the control group. All subjects participated in the same standard rehabilitation program consisting of physical and occupational therapy for 60 min per day, fve times a week, for four weeks. In addition, the CWTP group participated in CWTP for 30 min per day, five times a week, for four weeks. Walking function was assessed using the 10-m walk test (measurement for 10-meter walking speed), 6-min walk assessment (measurement of gait length for 6-minutes), and community gait assessment. Social participation was assessed using a social participation domain of stroke impact scale. In walking function, greater improvement was observed in the CWTP group compared with the control group (P < 0.05). In addition, social participation improved more in the CWTP group compared with the control group (P < 0.05). These fndings demonstrate the effcacy of CWTP on walking function and social participation in chronic stroke patients. Therefore, we suggest that CWTP within the real environment may be an effective method for improving walking function and social participation of chronic stroke patients when added to standard rehabilitation. © 2014 Tohoku University Medical Press.


Jung D.-W.,National Rehabilitation Research Institute | Park D.-S.,National Rehabilitation Research Institute | Lee B.-S.,National Rehabilitation Hospital | Kim M.,National Rehabilitation Hospital
Annals of Rehabilitation Medicine | Year: 2012

Objective: To examine the cardiorespiratory responses of patients with spinal cord injury (SCI) paraplegia using a motor driven rowing machine. Method: Ten SCI patients with paraplegia [A (n=6), B (n=1), and C (n=3) by the American Spinal Injury Association impairment scale] were selected. Two rowing techniques were used. The first used a fixed seat with rowing achieved using only upper extremity movement (fixed rowing). The second used an automatically moving seat, facilitating active upper extremity movement and passive lower extremity movement via the motorized seat (motor rowing). Each patient performed two randomly assigned rowing exercise stress tests 1-3 days apart. The work rate (WR), time, respiratory exchange ratio (R), oxygen consumption (VO 2), heart rate (HR), metabolic equivalents (METs), and rating of perceived exertion (RPE) were recorded. Results: WR, time, VO 2, and METs were significantly higher after the motor rowing test than after fixed motor rowing test (p<0.05). HR after motor rowing was significantly lower than fixed rowing (p<0.05). Conclusion: Cardiorespiratory responses as VO 2, HR and METs can be elicited by the motor rowing for people with paraplegic SCI. © 2012 by Korean Academy of Rehabilitation Medicine.


Lee J.,National Rehabilitation Research Institute | Kim K.,National Rehabilitation Research Institute | Kim J.,National Rehabilitation Research Institute | Song W.-K.,National Rehabilitation Research Institute
2012 9th International Conference on Ubiquitous Robots and Ambient Intelligence, URAI 2012 | Year: 2012

Innovative assistive rehabilitation robots are being developed with the participation of user candidates and clinical experts during the entire robot-development process. The purpose of this study is to obtain feedback from users and clinical experts during a demonstration of the first prototype of both the smart mobile walker and the upper extremity assistive robot. In the case of the smart mobile walker, safety is crucial for all users. The system's weight is another important factor for users who are elderly or fragile. In addition, people with spinal cord injuries require ease of accessibility between a wheelchair and the smart mobile walker. For the upper extremity assistive robot with spinal cord injuries require assistance to use their fine motor skills, i.e., finger movements. Different fine motor skills are assisted depending on the disability of the user. Overall, the walker needs to have the capability of being customizable while retaining its safety. In addition, the upper extremity assistive robot requires a suitable handle, a pleasant appearance, and a grasping function. This feedback will contribute to the development of a pragmatic rehabilitation robot. Copyright © 2012 IEEE.

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