Objective
To investigate the impact of self-efficacy in using one’s upper limbs on the overall wellbeing of stroke patients, we developed the Korean version of the Confidence of Arm and Hand Movement (K-CAHM) scale by modifying the original CAHM to suit Korean cultural conditions.
Methods
This study was conducted from May 2022 to June 2023 at a rehabilitation hospital with 54 stroke patients. Participants with sufficient cognitive and verbal abilities were included, while those with severe comorbidities were excluded. For the translation and cultural adaptation of CAHM into Korean, permission was obtained from the original author. Two translators independently translated the questionnaire, followed by a consensus discussion and expert review to create K-CAHM version 1.0. After back-translation and further review, the final Korean version was completed. Reliability and validity were assessed using Cronbach’s alpha, intraclass correlation coefficient (ICC), exploratory factor analysis, Bland–Altman analysis, and Pearson correlation.
Results
The K-CAHM showed good reliability (Cronbach’s alpha=0.97; ICC=0.895). Bland–Altman plot analysis showed good agreement, indicating test-retest reliability. Moreover, K-CAHM showed good concurrent validity, demonstrated by its correlation with three domains of the International Classification of Functioning, Disability and Health: Fugl-Meyer assessment, the Jebsen-Taylor Hand Function Test, personal hygiene and bathing in the modified Barthel Index, and hand and stroke recovery domain in the Stroke Impact Scale.
Conclusion
The newly developed K-CAHM could complement other outcome measures, facilitating patient-centered rehabilitation in the Korean context.

Objective
To establish and evaluate the validity of the recently developed Korean version of the Oxford Cognitive Screen (K-OCS), this study verified its reliability, validity, and diagnostic accuracy.
Methods
Between November 2021 and December 2023, we recruited 72 patients with stroke from our hospital who agreed to participate in the study. The patients were repeatedly tested using K-OCS by the same or different assessors to estimate inter- and intra-rater reliability. To demonstrate the validity and usability of K-OCS, the test results of screening tools currently used in clinical practice, including the Korean-Mini Mental State Examination and the Korean version of the Montreal Cognitive Assessment, were used in comparison analyses.
Results
The subtests of K-OCS demonstrated excellent inter-rater reliability (intra-class correlation coefficient [ICC]=0.914–0.998) and test–retest reliability (ICC=0.913–0.994). We found moderate-to-strong correlations for convergent validity for the subsets (r=0.378– 0.979, p<0.01), and low-to-moderate discriminant validity correlations. The optimal cut-offs estimated for the subtests of the K-OCS showed a good-to-high range of specificity (94.8%– 100%). The positive predictive value was 58.2%–100% and negative predictive value was 65.6%–98.4%. Sensitivity was estimated at 25.6%–86.9%.
Conclusion
The results of this study indicate that K-OCS is a reliable and valid tool for screening cognitive impairment in patients post-stroke.

Objective
To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients.
Methods
This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips.
Results
The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05).
Conclusion
Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Citations

• Association between bone mineral density and stroke: a meta-analysis
  Peng Zhao, Huaxia Sun
  Frontiers in Neurology.2025;[Epub]     CrossRef

Objective
To culturally adapt the original English Scale for the Assessment and Rating of Ataxia to Thai (SARA-TH) and to evaluate the reliability and validity of the SARA-TH in assessing ataxia in acute ischemic stroke or transient ischemic attack (TIA) patients, as assessed by three healthcare professionals.
Methods
The SARA underwent translation and cross-cultural adaptation to Thai according to established guidelines. Reliability (e.g., internal consistency, intrarater reliability, interrater reliability) and validity (e.g., content validity, convergent validity) were assessed in a sample of 50 participants with ataxia after acute ischemic stroke or TIA. Spearman correlation analysis was used to examine the relationships between the SARA-TH and the Barthel Index (BI-TH), the National Institutes of Health Stroke Scale (NIHSS-TH), and the International Cooperative Ataxia Rating Scale (ICARS) to assess convergent validity. Interrater and intrarater reliability among experienced and novice neurologists, physiotherapists, and occupational therapists were assessed using weighted kappa.
Results
The SARA-TH demonstrated good comprehension and exhibited no significant floor or ceiling effects. It showed excellent internal consistency (Cronbach’s α≥0.776). Significant correlations were found between the SARA-TH score and the BI-TH score (rs=-0.743 to -0.665), NIHSS- TH score (rs=0.404–0.513), and ICARS score (rs=0.859–0.917). The intrarater reliability for each rater ranged from 0.724 to 1.000 (p<0.01), and the interrater reliability varied from 0.281 to 0.927 (p<0.01).
Conclusion
The SARA-TH has excellent internal consistency, validity, and intrarater reliability, as well as acceptable interrater reliability among health professionals with varying levels of experience. It is recommended for assessing ataxia severity in individuals following acute ischemic stroke or TIA.

Objective
To construct a prognostic model for unsuccessful removal of nasogastric tube (NGT) was the aim of our study.
Methods
This study examined patients with swallowing disorders receiving NGT feeding due to stroke or traumatic brain injury in a regional hospital. Clinical data was collected, such as age, sex, body mass index (BMI), level of activities of daily living (ADLs) dependence. Additionally, gather information regarding the enhancement in Functional Oral Intake Scale (FOIS) levels and the increase in food types according to the International Dysphagia Diet Standardization Initiative (IDDSI) after one month of swallowing training. A stepwise logistic regression analysis model was employed to predict NGT removal failure using these parameters.
Results
Out of 203 patients, 53 patients (26.1%) had experienced a failed removal of NGT after six months of follow-up. The strongest predictors for failed removal were age over 60 years, underweight BMI, total dependence in ADLs, and ischemic stroke. The admission prediction model categorized patients into high, moderate, and low-risk groups for removal failure. The failure rate of NGT removal was high not only in the high-risk group but also in the moderate-risk groups when there was no improvement in FOIS levels and IDDSI food types.
Conclusion
Our predictive model categorizes patients with brain insults into risk groups for swallowing disorders, enabling advanced interventions such as percutaneous endoscopic gastrostomy for high-risk patients struggling with NGT removal, while follow-up assessments using FOIS and IDDSI aid in guiding rehabilitation decisions for those at moderate risk.

Objective
To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited.
Methods
The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert’s test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland–Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted.
Results
Ten patients with acute stroke completed the study. Bland–Altman plots revealed good agreements for Albert’s test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively.
Conclusion
The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Citations

• Tablet computer-based cognitive training for visuomotor integration in children with developmental delay: a pilot study
  Jee Hyun Suh, Soo Jeong Han, Sun Ah Choi, Hyesung Yang, Sihyun Park
  BMC Pediatrics.2024;[Epub]     CrossRef

Objective
To generate a Korean version of the Oxford Cognitive Screen (K-OCS) and obtain cutoff scores that determine the impairment of each subdomain. Post-stroke cognitive impairment (PSCI) negatively impacts the rehabilitation process and independence in daily life. Its obscure manifestations require effective screening for appropriate rehabilitation. However, in most rehabilitation clinics, psychological evaluation tools for Alzheimer’s dementia have been used without such considerations. The OCS is a screening assessment tool for PSCI and vascular dementia that can evaluate the cognitive domains most often affected by stroke, including language, attention, memory, praxis, and numerical cognition. It comprises 10 subtasks and enables quick and effective cognitive evaluation.
Methods
The K-OCS, which considers Korea’s unique cultural and linguistic characteristics, was developed with the approval and cooperation of the original author. Enrollment of participants without disabilities was announced at Duksung Women’s University, Yongin Sevrance Hospital, CHA Bundang Medical Center. The study was conducted between September 2020 and March 2022 on 97 male and female participants aged ≥30 years.
Results
All the 97 participants completed the task. In this study, the 5th percentile score was presumed to be the cutoff value for each score, and the values are provided here. The cutoff score for each OCS subtask was similar to that of the original British version.
Conclusion
We suggest the usability of the K-OCS as a screening tool for PSCI by providing the cutoff value of each subtask.

Citations

• Quality of Assessment Tools for Aphasia: A Systematic Review
  Francescaroberta Panuccio, Giulia Rossi, Anita Di Nuzzo, Ilaria Ruotolo, Giada Cianfriglia, Rachele Simeon, Giovanni Sellitto, Anna Berardi, Giovanni Galeoto
  Brain Sciences.2025; 15(3): 271.     CrossRef
• Validation of Korean Version of the Oxford Cognitive Screen (K-OCS), a Post Stroke-Specific Cognitive Screening Tool
  Eunyoung Cho, Sungwon Choi, Nele Demeyere, Rina Kim, Ikhyun Lim, MinYoung Kim
  Annals of Rehabilitation Medicine.2025; 49(1): 5.     CrossRef

Objective
To show the effectiveness of goal-oriented proprioceptive training in subacute stroke for balance, autonomy, and fall risk.
Methods
Out a total of 35 patients, consistent in age (75.31±8.65 years), type of stroke (ischemic, 3 to 11 weeks before), and motor impairment, 18 patients underwent solely proprioceptive rehabilitation, the other 17 dual task exercises. The study assessed autonomy using Barthel Index, fall risk with Timed Up and Go Test (TUG), balance through Berg Balance Scale (BBS) and Tinetti test.
Results
After two months, significant improvements were recorded in Barthel Index, BBS (p<0.0001), Tinetti test (p<0.0001 in dual task group, p=0.0029 in single task group), and TUG (p=0.0052 in dual task group, p=0.0020 in single task group) in both groups. Comparing the two groups, dual task group showed a significant difference in Tinetti balance assessment (p=0.0052), between the total score of Tinetti test and TUG in single (p=0.0271), and dual task (p=0.0235). Likewise, Tinetti gait test was significantly related to TUG in single (p=0.0536), and dual task (p=0.0466), while Tinetti balance test to Barthel Index (p=0.0394), BBS (p<0.0001), and TUG in single (p=0.0219), and dual task (p=0.0196). Lastly, there is a positive correlation of the use of aids with BBS (p=0.0074), and total score of Tinetti test (p=0.0160).
Conclusion
In subacute stroke, goal-oriented proprioceptive training improved balance, but only partially autonomy. Furthermore, the use of aids after dual-task exercises improved recovery of balance, but did not reduced falls.

Citations

• A scoping review on the body awareness rehabilitation after stroke: are we aware of what we are unaware?
  Davide Cardile, Viviana Lo Buono, Francesco Corallo, Angelo Quartarone, Rocco Salvatore Calabrò
  Frontiers in Neurology.2025;[Epub]     CrossRef
• Dual tasking as a predictor of falls in post-stroke: A cross-sectional analysis comparing Walking While Talking versus Stops Walking While Talking
  Disha Lamba, Abraham M. Joshua, Vijaya kumar K, Akshatha Nayak, Prasanna Mithra, Rohit Pai, Shivananda Pai, Shyam Krishnan K., Vijayakumar Palaniswamy
  F1000Research.2025; 13: 1395.     CrossRef
• Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
  Kap-Soo Han, Myoung-Hwan Ko
  Geriatrics.2025; 10(1): 23.     CrossRef
• Influence of taping on joint proprioception: a systematic review with between and within group meta-analysis
  Shashank Ghai, Ishan Ghai, Susanne Narciss
  BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
• Application of an Auditory-Based Feedback Distortion to Modify Gait Symmetry in Healthy Individuals
  Le Yu Liu, Samir Sangani, Kara K. Patterson, Joyce Fung, Anouk Lamontagne
  Brain Sciences.2024; 14(8): 798.     CrossRef
• Validez convergente de la escala Tinetti en pacientes con ictus en fase subaguda
  Adrián Arranz–Escudero, Patricia Martín–Casas, Ester Carpio–Calatayud, Ibai López–de–Uralde–Villanueva
  Revista Científica de la Sociedad Española de Enfermería Neurológica.2024; : 500168.     CrossRef
• Time-course for acquiring transfer independence in patients with subacute stroke: a prospective cohort study
  Shin Kitamura, Yohei Otaka, Shintaro Uehara, Yudai Murayama, Kazuki Ushizawa, Yuya Narita, Naho Nakatsukasa, Daisuke Matsuura, Rieko Osu, Kunitsugu Kondo, Sachiko Sakata
  Journal of Rehabilitation Medicine.2024; 56: jrm40055.     CrossRef
• Efficacy and safety of very early rehabilitation for acute ischemic stroke: a systematic review and meta-analysis
  Ying Lou, Zhongshuo Liu, Yingxiao Ji, Jinming Cheng, Congying Zhao, Litao Li
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Challenges in Accessing Community-Based Rehabilitation and Long-Term Care for Older Adult Stroke Survivors and Their Caregivers: A Qualitative Study
  Sining Zeng, Min Wu, Ling Xu, Zining Guo, Shufan Chen, Keyu Ling, Haihan Li, Xiaoli Yu, Xiaoping Zhu
  Journal of Multidisciplinary Healthcare.2024; Volume 17: 4829.     CrossRef
• The Impact of Virtual Reality as a Rehabilitation Method Using TRAVEE System on Functional Outcomes and Disability in Stroke Patients: A Pilot Study
  Claudia-Gabriela Potcovaru, Delia Cinteză, Miruna Ioana Săndulescu, Daniela Poenaru, Ovidiu Chiriac, Cristian Lambru, Alin Moldoveanu, Ana Magdalena Anghel, Mihai Berteanu
  Biomedicines.2024; 12(11): 2450.     CrossRef
• Synergistic effects of combined motor and language interventions on stroke rehabilitation: a holistic approach
  Reihaneh Saber-Moghadam, Afsaneh Zeinalzadeh, Jamshid Jamali, Mohammad Taghi Farzadfard, Davood Sobhani-Rad
  Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
• The importance of recovering body awareness in post-stroke rehabilitation: insights from clinical case reports
  Davide Cardile, Viviana Lo Buono, Francesco Corallo, Simona Cammaroto, Caterina Formica, Angelo Quartarone, Rocco Salvatore Calabrò
  Frontiers in Neurology.2024;[Epub]     CrossRef

Objective
To confirm that the simplified insole does not affect the gait speed and to identify objective sensor-based gait parameters that correlate strongly with existing clinical gait assessment scales.
Methods
Ten participants with gait impairment due to hemiplegic stroke were enrolled in this study. Pairs of insoles with four pressure sensors on each side were manufactured and placed in each shoe. Data were extracted during the 10-Meter Walk Test. Several sensor-derived parameters (for example stance time, heel_on-to-toe_peak time, and toe_peak pressure) were calculated and correlated with gait speed and lower extremity Fugl-Meyer (F-M) score.
Results
The insole pressure sensor did not affect gait, as indicated by a strong correlation (ρ=0.988) and high agreement (ICC=0.924) between the gait speeds with and without the insole. The parameters that correlated most strongly with highest β coefficients against the clinical measures were stance time of the non-hemiplegic leg (β=-0.87 with F-M and β=-0.95 with gait speed) and heel_on-to-toe_peak time of the non-hemiplegic leg (β=-0.86 with F-M and -0.94 with gait speed).
Conclusion
Stance time of the non-hemiparetic leg correlates most strongly with clinical measures and can be assessed using a non-obtrusive insole pressure sensor that does not affect gait function. These results suggest that an insole pressure sensor, which is applicable in a home environment, may be useful as a clinical endpoint in post-stroke gait therapy trials.

Objective
To analyze the changes in muscle mass and quality with time on the paretic and non-paretic sides in subacute stroke patients and identify correlations between the variation of muscle mass and quality and lower limb functions.
Methods
Thirty hemiplegia patients diagnosed with stroke participated in this study. To evaluate poststroke muscle changes, longitudinal measurement of muscle mass and quality was conducted with bilateral lower limbs. The elastic shear modulus was measured using shear wave elastography and muscle thickness (MT) of rectus femoris, vastus intermedius, vastus lateralis (VL), vastus medialis, tibialis anterior, and gastrocnemius (GCM) muscles. Functional evaluation was performed using Berg Balance Scale (BBS), Five Times Sit to Stand Test (FTSST). Follow-up was performed at discharge. The muscle mass and quality were compared according to time. We analyzed whether muscle quantity and quality were related to function.
Results
MT demonstrated no significant change with time. The elastic shear modulus increased significantly in the paretic VL and GCM muscles and did not change significantly in the muscles on the non-paretic side. Correlation analysis detected that elastic shear modulus in the VL has a cross-sectional negative relationship between BBS and positive relationship between FTSST. There were significant correlation between variation of FTSST and the variation of the elastic shear modulus in VL.
Conclusion
Only paretic VL and GCM muscle quality changed in subacute stroke patients and muscle’s property related to lower limb functions. Therefore, the lower extremity requires an approach to muscle quality rather than quantity for subacute stroke patients.

Citations

• Efficacy of robot-assisted gait training on lower extremity function in subacute stroke patients: a systematic review and meta-analysis
  Miao-miao Hu, Shan Wang, Cai-qin Wu, Kun-peng Li, Zhao-hui Geng, Guo-hui Xu, Lu Dong
  Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef

Post-stroke spastic movement disorder (PS-SMD) develops in up to 40% of stroke survivors after a first ever stroke within the first year. Chronic PS-SMD is often associated with severe disabilities and complications, emphasizing the importance of its early recognition and early adequate management. Extensive research has aimed to accurately predict and sensitively detect a PS-SMD. Symptomatic therapies include conventional rehabilitation and local intramuscular injections of botulinum toxin A (BoNT-A). The latter is widely used, but primarily in the chronic phase of stroke. However, recent studies have shown the safety and efficacy of BoNT-A therapy even in the acute phase and early sub-acute phase after stroke, i.e., within three months post-stroke, leading to an improved long-term outcome in stroke rehabilitation. Local BoNT-A injections evolve as the primary approach in focal, multifocal, and segmental chronic or acute/subacute PS-SMD. Patients at high risk for or manifest PS-SMD should be identified by an early spasticity risk assessment. By doing so, PS-SMD can be integral part of the patient-centered goal-setting process of a multiprofessional spasticity-experienced team. The benefit of an early PS-SMD treatment by BoNT-A should predominate putative degenerative muscle changes due to long-term BoNT-A therapy by far. This, as early treatment effectively avoids complications typically associated with a PS-SMD, i.e., contractures, pain, skin lesions. The management of PS-SMD requires a comprehensive and multidisciplinary approach. Early assessment, patient-centered goal setting, early intervention, and early use of BoNT-A therapy prevents from PS-SMD complications and may improve rehabilitation outcome after stroke.

Citations

• How many stroke survivors develop problematic spasticity requiring pharmacological therapy? An international (Europe and USA) observational study protocol
  Richard D Zorowitz, Laura Serrano Barrenechea, Simon Butet, Sergiu Groppa, David Hernández Herrero, Rama Prasad, Susan Sandars, Seema Meloni, Simon Page, Pascal Maisonobe, Alessandro Picelli
  BMJ Open.2025; 15(1): e087404.     CrossRef
• The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis
  Salvatore Facciorusso, Stefania Spina, Alessandro Picelli, Alessio Baricich, Gerard E. Francisco, Franco Molteni, Jörg Wissel, Andrea Santamato
  Toxins.2024; 16(4): 184.     CrossRef
• Botulinum Toxin in Treatments for Abnormal Movements
  María Gabriela González Chico, Xaviera Elizabeth Medina Godoy, Miliana Esperanza Estupiñan Bazurto, María José López Becerra
  Más Vita.2024; 6(2): 82.     CrossRef
• Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing and Machine Learning
  María Jesús Antón, Montserrat Molina, José Gabriel Pérez, Santiago Pina, Noemí Tapiador, Beatriz De La Calle, Mónica Martínez, Paula Ortega, María Belén Ruspaggiari, Consuelo Tudela, Marta Conejo, Pedro Leno, Marta López, Carmen Marhuenda, Carlos Arias-Ca
  Toxins.2024; 16(8): 340.     CrossRef
• Risk factors for post-stroke spasticity: a retrospective study
  Chuanxi Zhu, Lingxu Li, Long Qiu, Guangcheng Ji
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Early is Better, Then, How Early and How to Apply: Practical Approach of Botulinum Toxin Injection
  Joon-Ho Shin
  Annals of Rehabilitation Medicine.2023; 47(6): 439.     CrossRef

Objective
To translate the 22-item Longer-term Unmet Needs after Stroke (LUNS) questionnaire, validate it in the Korean stroke population, and assess the reliability of face-to-face and telephone surveys.
Methods
Sixty-six adult patients with stroke from Seoul National University Bundang Hospital and Kangwon National University Hospital were involved in the validation. Participants were interviewed twice using the LUNS Korean version: first, a face-to-face survey for validation, and second, a telephone survey for test-retest reliability. Participants completed the Frenchay Activities Index (FAI) and Short Form 12 (SF-12) Mental and Physical Component Summary (MCS and PCS) scores at the first interview. For concurrent validity, the differences in health status (FAI, SF-12 MCS and PCS) between the groups that reported unmet needs and those that did not were analyzed for each item. Cohen’s kappa and percentage of agreement between the first and second administrations were calculated for each item to determine the test-retest reliability.
Results
The average age of the participants was 61.2±12.8 years and 74.2% were male. Fifty-seven patients were involved in the second interview. Depending on the unmet needs, SF-12 MCS, PCS, and FAI were significantly different in 12 of 22 items. In the test-retest reliability test, 12 items had a kappa of 0.6 or higher, and two had a kappa of <0.4.
Conclusion
The LUNS instrument into Korean (LUNS-K) is a reliable and valid instrument for assessing unmet health needs in patients with stroke. In addition, telephone surveys can be considered reliable.

Citations

• Psychometric validation of the Chinese version of the longer-term Unmet Needs after Stroke monitoring tool for stroke patients
  Fanling Li, Chang Gao, Yan Qu, Xiaohong Hu, Yue Ma, Wenxuan Ding, Xiaomei Li, Jingjun Zhang
  Disability and Rehabilitation.2024; : 1.     CrossRef

Objective
To investigate the relationship between the torque onset angle (TOA) of the isokinetic test for knee extensors in the paretic side and walking related balance in subacute stroke patients.
Methods
We retrospectively reviewed patients with first-ever strokes who have had at least two isokinetic tests within 6 months of onset. 102 patients satisfied the inclusion criteria. The characteristics of walking related balance were measured with the Berg Balance Scale sub-score (sBBS), Timed Up and Go test (TUG), 10-m Walk Test (10MWT) and Functional Independence Measure sub-score (sFIM). The second isokinetic test values of the knee extensor such as peak torque, peak torque to weight ratio, hamstring/quadriceps ratio, TOA, torque stop angle, torque at 30 degrees, and peak torque asymmetry ratio between paretic and non-paretic limb were also taken into account. Pearson’s correlation, simple regression and multiple regression analysis were used to analyze the correlation between TOA and walking related balance.
Results
TOA of the knee extensor of the paretic limb showed significant correlations with BBS, sBBS, TUG, 10MWT, and sFIM according to Pearson’s correlation analysis. TOA also had moderate to good correlations with walking related balance parameters in partial correlation analysis. In multiple regression analysis, TOA of the paretic knee extensor was significantly associated with walking related balance parameters.
Conclusion
This study demonstrated that TOA of the paretic knee extensor is a predictable parameter of walking related balance. Moreover, we suggest that the ability to recruit muscle quickly is important in walking related balance.

Objective
To determine correlations of alternation motor rate (AMR), sequential motor rate (SMR), and maximum phonation time (MPT) with the severity of dysphagia in subacute stroke patients.
Methods
This was a retrospective chart review study. Data of 171 subacute stroke patients were analyzed. Patient’s AMR, SMR, and MPT data were collected from their language evaluations. Video fluoroscopic swallowing study (VFSS) was done. Data of dysphagia scales including penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, clinical dysphagia scale (CDS), and videofluoroscopic dysphagia scale (VDS) were obtained. AMR, SMR, and MPT were compared between a non-aspirator group and an aspirator group. Correlations of AMR, SMR, and MPT with dysphagia scales were analyzed.
Results
AMR ("ka"), SMR, and modified Rankin Scale were significant associated factors between non-aspirator group and aspirator group, while AMR ("pa"), AMR ("ta"), and MPT were not. AMR, SMR, and MPT showed significant correlations with PAS score, ASHA-NOMS scale, CDS, VDS oral, and VDS pharyngeal scores. The cut-off value for distinguishing non-aspirator group and aspiration group was 18.5 for AMR ("ka") (sensitivity of 74.4%, specificity of 70.8%) and 7.5 for SMR (sensitivity of 89.9%, specificity of 61.0%). AMR and SMR were significantly lower in before-swallow aspiration group.
Conclusion
Articulatory diadochokinetic tasks that can be easily performed at the bedside would be particularly helpful in determining the oral feeding possibility of subacute stroke patients who cannot undergo VFSS, which is the gold standard for dysphagia assessment.

Citations

• Application of B+M-Mode Ultrasound in Evaluating Dysphagia in Elderly Stroke Patients
  Jiaying Shuai, Linping Pian, Li Tian, Linying Wang, Miaomiao Deng, Chen Cheng
  Ultrasound in Medicine & Biology.2025; 51(2): 273.     CrossRef
• Laryngeal and swallowing characteristics in elderly after stroke: a preliminary study
  Jonan Emi Valencia Cardenas, Cris Magna dos Santos Oliveira, Raquel Rodrigues Rosa, Gabriele Ramos de Luccas, Claudia Tiemi Mituuti, Kelly Cristina Alves Silverio, Alcione Ghedini Brasolotto, Giédre Berretin-Felix
  Audiology - Communication Research.2025;[Epub]     CrossRef
• Características laríngeas e de deglutição em idosos pós-acidente vascular encefálico: um estudo preliminar
  Jonan Emi Valencia Cardenas, Cris Magna dos Santos Oliveira, Raquel Rodrigues Rosa, Gabriele Ramos de Luccas, Claudia Tiemi Mituuti, Kelly Cristina Alves Silverio, Alcione Ghedini Brasolotto, Giédre Berretin-Felix
  Audiology - Communication Research.2025;[Epub]     CrossRef
• Comparative analysis of speech assessment tools for individuals with dysarthria in Chile and worldwide
  Marcela Sanhueza-Garrido, Virginia García-Flores, Carlos Rojas-Zepeda, Jaime Crisosto-Alarcón
  Salud, Ciencia y Tecnología.2024; 4: 626.     CrossRef
• Rehabilitation of Patients with Post-Stroke Dysarthria in the Russia and Abroad: a Literature Review
  Olga V. Loginova, Daria I. Bovtyuk
  Bulletin of Rehabilitation Medicine.2023; 22(6): 100.     CrossRef

Objective
To measure muscle activity before and after robot-assisted gait training (RAGT) in patients with stroke and examine the differences in muscle activity changes compared with conventional gait training (CGT).
Methods
Thirty patients with stroke (RAGT group, n=17; CGT group, n=13) participated in the study. All patients underwent RAGT using a footpad locomotion interface or CGT for 20 minutes for a total of 20 sessions. Outcome measures were lower-limb muscle activity and gait speed. Measurements were performed before the start of the intervention and after the end of the 4-week intervention.
Results
The RAGT group showed increased muscle activity in the gastrocnemius, whereas the CGT group showed high muscle activity in the rectus femoris. In the terminal stance of the gait cycle, the gastrocnemius, the increase in muscle activity was significantly higher in the RAGT group than in the CGT group.
Conclusion
The results suggest that RAGT with end-effector type is more effective than CGT to increase the gastrocnemius muscle activity.

Citations

• Effect and optimal exercise prescription of robot-assisted gait training on lower extremity motor function in stroke patients: a network meta-analysis
  Haiping Huang, Xinyi Su, Beisi Zheng, Manting Cao, Yuqian Zhang, Jianer Chen
  Neurological Sciences.2025; 46(3): 1151.     CrossRef
• Efficacy of robot-assisted gait training on lower extremity function in subacute stroke patients: a systematic review and meta-analysis
  Miao-miao Hu, Shan Wang, Cai-qin Wu, Kun-peng Li, Zhao-hui Geng, Guo-hui Xu, Lu Dong
  Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef

Objective
To evaluate the feasibility and usability of cost-effective complex upper and lower limb robot-assisted gait training in patients with stroke using the GTR-A, a foot-plate based end-effector type robotic device.
Methods
Patients with subacute stroke (n=9) were included in this study. The enrolled patients received 30-minute robot-assisted gait training thrice a week for 2 weeks (6 sessions). The hand grip strength, functional ambulation categories, modified Barthel index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go Test, and Short Physical Performance Battery were used as functional assessments. The heart rate was measured to evaluate cardiorespiratory fitness. A structured questionnaire was used to evaluate the usability of robot-assisted gait training. All the parameters were evaluated before and after the robot-assisted gait training program.
Results
Eight patients completed robot-assisted gait training, and all parameters of functional assessment significantly improved between baseline and posttraining, except for hand grip strength and muscle strength test score. The mean scores for each domain of the questionnaire were as follows: safety, 4.40±0.35; effects, 4.23±0.31; efficiency, 4.22±0.77; and satisfaction, 4.41±0.25.
Conclusion
Thus, the GTR-A is a feasible and safe robotic device for patients with gait impairment after stroke, resulting in improvement of ambulatory function and performance of activities of daily living with endurance training. Further research including various diseases and larger sample groups is necessary to verify the utility of this device.

Citations

• Changes in body composition, physical fitness and quality of life on robotic gait assisted training in patients with Guillain-Barré Syndrome: a case report
  Moon Jin Lee, Sung Jin Yoon
  Physical Activity and Nutrition.2024; 28(4): 009.     CrossRef
• Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI
  Antonio Fabbrizio, Alberto Fucarino, Manuela Cantoia, Andrea De Giorgio, Nuno D. Garrido, Enzo Iuliano, Victor Machado Reis, Martina Sausa, José Vilaça-Alves, Giovanna Zimatore, Carlo Baldari, Filippo Macaluso
  Healthcare.2023; 11(12): 1805.     CrossRef

Objective
To investigate the relationship between Trunk Impairment Scale (TIS) and lumbar spine bone mineral density (BMD) in subacute stroke patients.
Methods
Twenty-three subacute male stroke patients under the age of 65 were prospectively enrolled to exclude both postmenopausal and senile effects on BMD. The TIS, Berg Balance Scale, the Korean version of the Modified Barthel Index, and manual muscle test were measured at admission and 3 months after stroke onset. BMD of the bilateral lower extremities and lumbar vertebrae was measured by dual-energy X-ray absorptiometry 3 months after stroke onset.
Results
TIS at baseline (TIS_B) and TIS at 3 months after stroke (TIS_3m) showed significant correlations with lumbar BMD (TIS_B, r=0.522; TIS_3m, r=0.517). Through multiple regression analysis, the TIS_B was associated with lumbar BMD (adjusted R2=0.474). However, BMD of the bilateral lower extremities was not correlated with any clinical measurements except body mass index.
Conclusion
We found a relationship between TIS_B and lumbar BMD in subacute young male stroke patients. Stroke patients with poor trunk control in the early subacute stage would have low BMD of vertebral bones at 3 months. The TIS can be useful for estimating bone fragility in the lumbar vertebrae of subacute stroke patients.

Citations

• Effects of shoulder brace usage on postural stability in stroke survivors: A pilot randomized controlled trial
  Giovanni Morone, Alessandro Antonio Princi, Marco Iosa, Rebecca Montemurro, Irene Ciancarelli, Paola Coiro, Danilo Lisi, Riccardo Savo, Matteo Notturno Granieri, Domenico De Angelis, Marco Tramontano
  NeuroRehabilitation.2024; 54(3): 449.     CrossRef

Objective
To investigate the effect of 6 weeks of home-based boxing training on trunk performance, balance, fear of falling, and level of therapy enjoyment in individuals with chronic stroke.
Methods
Eighteen participants with chronic stroke were randomly divided into boxing and control groups (9 patients per group). The boxing group received home-based boxing training for 25 minutes plus balance and trunk exercise training for 15 minutes, while the control group received only home-based balance and trunk exercise training for 40 minutes, three days a week for 6 weeks. The Trunk Impairment Scale (TIS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, and Physical Activity Enjoyment Scale (PACES) were assessed at baseline, and at 2, 4, and 6 weeks post-training. The Wilcoxon signed rank test and Mann–Whitney U-test were used to determine differences between pre- and post-training within and between groups. Statistical significance was set at p<0.05.
Results
The TIS scores significantly increased from 13 to 17 points in the boxing group (p<0.05) compared to an increase from 15 to 17 points in the control group (p<0.05). The Mini-BESTest scores significantly increased from 14 to 22 points in the boxing group (p<0.05) compared to an increase from 17 to 20 points in the control group (p<0.05). There were no differences in the TIS, Mini-BESTest, ABC, and PACES scores between the two groups.
Conclusion
Home-based boxing training with balance and trunk exercise training had a similar training effect compared to home-based balance and trunk exercise training.

Citations

• Therapeutic Intervention for Trunk Control Impairments in Central Nervous System Disorders: A Comprehensive Review of Methods and Efficacy
  Hiroaki Yamashita, Tatsuya Yamaoka, Ryota Shimomura, Sachimori Ichimura, Yuuki Murata, Akihiro Itoh, Tatsuya Mima, Satoko Koganemaru
  Progress in Rehabilitation Medicine.2025; 10: n/a.     CrossRef
• Effects of Taekwondo intervention on balance ability: A meta-analysis and systematic review
  Zhengfa Han, Hanyu Ju, Artur Kruszewski
  PLOS ONE.2025; 20(2): e0317844.     CrossRef
• Interactive Cognitive Motor Training: A Promising Approach for Sustainable Improvement of Balance in Older Adults
  Longhai Zhang, Jiawei Guo, Jing Zhang, Ling Zhang, Yanbing Li, Shutong Yang, Wenfei Zhu, Fei Guo
  Sustainability.2023; 15(18): 13407.     CrossRef

Objective
To investigate the effect of low frequency cerebellar repetitive transcranial magnetic stimulation (rTMS) on balance impairment in patients with cerebral infarction.
Methods
Thirty-two patients were randomly divided into two groups: rTMS group (n=16) and control (n=16). In the rTMS group, treatment was performed five times per week for 2 weeks (10 sessions), and in the control group, a sham coil was used with the sound and sensation of scalp similar to the rTMS coil. Patients in both groups underwent a conventional rehabilitation program. Berg Balance Scale (BBS) was used as the primary outcome measurement. Timed Up and Go test (TUG), 10-m walk test (10mWT), and Activity-specific Balance Confidence scale (ABC) were used as the secondary outcome measurement. All scales were measured at baseline (T0), after 10 sessions of rTMS (T1), and at 4 weeks after treatment completion (T2) by therapists with over 5 years of clinical experience.
Results
There were significant improvements between T0 and T1, and between T0 and T2, for all assessed items in the rTMS group. Whereas there were significant improvements between T0 and T1, and between T0 and T2, for the BBS and 10mWT in the control group. TUG (-4.87±5.05 vs. -0.50±2.97 seconds) and ABC score (8.10±8.33 vs. 0.16±0.97) were observed significant differences in comparison of the changes from T0 to T1 between the two group. BBS score (4.40±3.66 vs. 1.88±3.14), TUG (-4.87±4.56 vs. -0.62±2.96 seconds) and ABC score (8.22±7.70 vs. -0.09±0.86) differed significantly from T0 to T2 between the two groups.
Conclusion
Our findings suggest that low-frequency cerebellar rTMS is helpful for improving balance in patients with cerebral infarction, and maybe a beneficial treatment for these patients.

Citations

• Exploring cerebellar transcranial magnetic stimulation in post-stroke limb dysfunction rehabilitation: a narrative review
  Zhan Wang, Likai Wang, Fei Gao, Yongli Dai, Chunqiao Liu, Jingyi Wu, Mengchun Wang, Qinjie Yan, Yaning Chen, Chengbin Wang, Litong Wang
  Frontiers in Neuroscience.2025;[Epub]     CrossRef
• Effects of cerebellar repetitive transcranial magnetic stimulation on stroke rehabilitation: A systematic review and meta-analysis
  Xin Wang, Guilan Huang, Daoran Wang, Lu Sun, Haobo Leng, Kai Zheng, Xinlei Xu, Guofu Zhang, Caili Ren
  Brain Research Bulletin.2025; 225: 111341.     CrossRef
• Effects of Cerebellar Transcranial Magnetic Stimulation on the Motor Function of Patients With Stroke: A Systematic Review and Meta‐Analysis
  Yongxin Zhu, Juncong Yang, Kun Wang, Xianwen Li, Jiahui Ling, Xie Wu, Lianhui Fu, Qi Qi
  Brain and Behavior.2025;[Epub]     CrossRef
• Efficacy of Cerebellar Transcranial Magnetic Stimulation for Post-stroke Balance and Limb Motor Function Impairments: Meta-analyses of Random Controlled Trials and Resting-State fMRI Studies
  Yuheng Zeng, Zujuan Ye, Wanxin Zheng, Jue Wang
  The Cerebellum.2024; 23(4): 1678.     CrossRef
• Cerebellar transcranial magnetic stimulation for improving balance capacity and activity of daily living in stroke patients: a systematic review and meta-analysis
  Jingfeng Wang, Zhisheng Wu, Shanshan Hong, Honghong Ye, Yi Zhang, Qiuxiang Lin, Zehuang Chen, Liling Zheng, Jiawei Qin
  BMC Neurology.2024;[Epub]     CrossRef
• Effects of Cerebellar Non-Invasive Stimulation on Neurorehabilitation in Stroke Patients: An Updated Systematic Review
  Qi Liu, Yang Liu, Yumei Zhang
  Biomedicines.2024; 12(6): 1348.     CrossRef
• Bilateral Cerebellar Repetitive Transcranial Magnetic Stimulation for Chronic Ataxia After Hemorrhagic Stroke: a Case Report
  Evan Hy Einstein, Juliana Corlier, Cole Matthews, Doan Ngo, Michael K. Leuchter, Cole Citrenbaum, Nikita Vince-Cruz, Bhavna Ramesh, Aaron Slan, Scott A. Wilke, Nathaniel Ginder, Thomas Strouse, Andrew F. Leuchter
  The Cerebellum.2023; 23(3): 1254.     CrossRef

Objective
To characterize the repetitive transcranial magnetic stimulation (rTMS) induced changes in angiogenic mechanisms across different brain regions.
Methods
Seventy-nine adult male Sprague-Dawley rats were subjected to a middle cerebral artery occlusion (day 0) and then treated with 1-Hz, 20-Hz, or sham stimulation of their lesioned hemispheres for 2 weeks. The stimulation intensity was set to 100% of the motor threshold. The neurological function was assessed on days 3, 10, and 17. The infarct volume and angiogenesis were measured by histology, immunohistochemistry, Western blot, and real-time polymerase chain reaction (PCR) assays. Brain tissue was harvested from the ischemic core (IC), ischemic border zone (BZ), and contralateral homologous cortex (CH).
Results
Optical density of angiopoietin1 and synaptophysin in the IC was significantly greater in the low-frequency group than in the sham group (p=0.03 and p=0.03, respectively). The 1-Hz rTMS significantly increased the level of Akt phosphorylation in the BZ (p<0.05 vs. 20 Hz). Endothelial nitric oxide synthase phosphorylation was increased in the IC (p<0.05 vs. 20 Hz), BZ (p<0.05 vs. 20 Hz), and CH (p<0.05 vs. 20 Hz and p<0.05 vs. sham). Real-time PCR demonstrated that low-frequency stimulation significantly increased the transcriptional activity of the TIE2 gene in the IC (p<0.05).
Conclusion
Low-frequency rTMS of the ipsilesional hemisphere in the early subacute phase of stroke promotes the expression of angiogenic factors and related genes in the brain, particularly in the injured area.

Citations

• Novel emerging therapy for erectile dysfunction: efficacy and safety of flat magnetic stimulation
  Daniel Galimberti, Agustina Vila Echague, Ery A. Ko, Laura Pieri, Alessandra Comito, Irene Fusco, Tiziano Zingoni
  Archivio Italiano di Urologia e Andrologia.2024;[Epub]     CrossRef
• Determining the Optimal Stimulation Sessions for TMS-Induced Recovery of Upper Extremity Motor Function Post Stroke: A Randomized Controlled Trial
  Yichen Lv, Jack Jiaqi Zhang, Kui Wang, Leilei Ju, Hongying Zhang, Yuehan Zhao, Yao Pan, Jianwei Gong, Xin Wang, Kenneth N. K. Fong
  Brain Sciences.2023; 13(12): 1662.     CrossRef

Objective
To evaluate the efficacy and safety of Daewoong botulinum toxin type A (NABOTA) after its launch in South Korea.
Methods
This prospective, multicenter, open-label phase IV clinical trial included 222 patients with stroke. All patients visited the clinic at baseline and at weeks 4, 8, and 12 after injection of upto 360 units of NABOTA into the wrist, elbow, and finger flexor muscles at the first visit. The primary outcome was the change in Modified Ashworth Scale (MAS) score for the wrist flexor muscles between baseline and week 4. The secondary outcomes were the changes in MAS, Disability Assessment Scale (DAS), and Caregiver Burden Scale (CBS) scores between baseline and each visit, and the Global Assessment Scale (GAS) score at week 12.
Results
There was a statistically significant decrease in the MAS score for the wrist flexors between baseline and week 4 (-0.97±0.66, p<0.001). Compared with baseline, the MAS, DAS and CBS scores improved significantly during the study period. The GAS was rated as very good or good by 86.8% of physicians and by 60.0% of patients (or caregivers). The incidence of adverse events was 14.4%, which is smaller than that in a previous trial.
Conclusion
NABOTA showed considerable efficacy and safety in the management of upper limb spasticity in stroke patients.

Objective
To investigate the effect of antigravity treadmill gait training (AGT) on gait function, balance, and fall risk in stroke patients.
Methods
This study included 30 patients with stroke (mean age, 73 years). All subjects were randomly divided into two groups. The intervention group (n=15) performed AGT for 20 minutes, five times per week for 4 weeks. The control group (n=15) received conventional gait training for the same duration. To assess fall risk, the Tinetti Performance-Oriented Mobility Assessment (POMA) was measured. The Berg Balance Scale (BBS), Timed Up and Go test (TUG), and 10-m walk test (10mWT) were measured to assess dynamic balance. All scales were measured before intervention (T0) and at 4 weeks (T1) and 12 weeks (T2) after intervention.
Results
Results showed that the total POMA score, BBS, and 10mWT scores improved significantly (p<0.05) at T1 and T2 in both groups. The POMA gait score (4.20±1.37 at T1, 4.87±1.36 at T2) and TUG (4.52±4.30 at T1, 5.73±4.97 at T2) significantly improved (p<0.05) only in the intervention group. The changes in total POMA score and BBS of the intervention group (7.20±2.37, 7.47±3.07) improved more significantly (p<0.05) between T0 and T2 than the control group (2.53±2.10, 2.87±2.53).
Conclusion
Our study showed that AGT enhances dynamic balance and gait speed and effectively lowers fall risk in stroke patients. Compared to conventional gait therapy, AGT would improve gait function and balance in stroke patients more effectively.

Citations

• Reporting of Adverse Events in Studies Involving Treadmill Gait Training After Stroke: A Systematic Review
  Jesimiel Missias de Souza, Daiane Carla Rodrigues Cardoso, Stephano Tomaz da Silva, Josicleide Araújo de Azevedo, Samara Katiane Rolim de Oliveira, Lorenna Raquel Dantas de Macedo Borges, Larissa Araújo Gomes, Maria Amanda Ferreira Quirino, Tatiana Souza
  NeuroRehabilitation: An International, Interdisciplinary Journal.2025; 56(3): 274.     CrossRef
• Effectiveness of Anti-Gravity Treadmill Exercise After Total Knee Arthroplasty: Protocol for a Randomized Controlled Trial
  Elina Jääskeläinen, Mikko Manninen, Heikki Hurri, Mikko Rantasalo, Yun Zhou, Hannu Kautiainen, Leena Ristolainen
  JMIR Research Protocols.2025; 14: e59935.     CrossRef
• Optimizing Rehabilitation Outcomes for Stroke Survivors: The Impact of Speed and Slope Adjustments in Anti-Gravity Treadmill Training
  Jung-Ho Lee, Eun-Ja Kim
  Medicina.2024; 60(4): 542.     CrossRef
• Increased trailing limb angle in hemiplegic patients after training with a knee orthosis: A randomized controlled trial
  Shun Ito, Hiroaki Abe, Toru Okanuka, Kosuke Nanka, Takuma Nagasawa, Kazuto Oki, Yoshimi Suzukamo, Shin-Ichi Izumi
  NeuroRehabilitation.2024; 54(3): 485.     CrossRef
• General Treatments Promoting Independent Living in Parkinson’s Patients and Physical Therapy Approaches for Improving Gait—A Comprehensive Review
  Dae-Hwan Lee, Bong-Sik Woo, Yong-Hwa Park, Jung-Ho Lee
  Medicina.2024; 60(5): 711.     CrossRef
• Effect of water-based exercise with or without external buoyancy devices in influencing balance improvement in stroke: scoping review
  Ribka Theresia, Farid Rahman
  Fizjoterapia Polska.2024; 24(3): 350.     CrossRef
• Simulating space walking: a systematic review on anti-gravity technology in neurorehabilitation
  Mirjam Bonanno, Maria Grazia Maggio, Angelo Quartarone, Alessandro Marco De Nunzio, Rocco Salvatore Calabrò
  Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef
• The Safety and Feasibility of Lower Body Positive Pressure Treadmill Training in Individuals with Chronic Stroke: An Exploratory Study
  Sattam M. Almutairi, Moodhi M. Alfouzan, Taghreed S. Almutairi, Hatem A. Alkaabi, Misoon T. AlMulaifi, Marzouq K. Almutairi, Faisal K. Alhuthaifi, Chad Swank
  Brain Sciences.2023; 13(2): 166.     CrossRef
• The Effectiveness of Lower-Body Positive Pressure Treadmill Gait Training on Mobility Function and Quality of Life in Individuals with Chronic Stroke: Prospective Cohort Study
  Sattam Almutairi
  Middle East Journal of Rehabilitation and Health Studies.2023;[Epub]     CrossRef
• A robotic treadmill system to mimic overground walking training with body weight support
  Jongbum Kim, Seunghue Oh, Yongjin Jo, James Hyungsup Moon, Jonghyun Kim
  Frontiers in Neurorobotics.2023;[Epub]     CrossRef
• Lower body positive pressure treadmill gait training for neurological patients: a systematic review
  Sattam M. Almutairi
  Bulletin of Faculty of Physical Therapy.2023;[Epub]     CrossRef

Objective
To develop an objective and quantitative clinical evaluation tool that can be used for diagnosis and severity assessment of dysarthria in patients with stroke.
Methods
A prototype test comprising 23 items was developed to test the function of each speech organ. The scoring of the prototype test was based on the analysis of the result values obtained from 50 healthy individuals. The test was performed for 50 patients with stroke who were suspected to have dysarthria. For evaluating the correlation between each prototype test item and the Urimal Test of Articulation and Phonation (U-TAP), the odds ratio was obtained for each result, based on which the final test items for composing the Korea Dysarthria Test (KDT) were selected. The validity of the test was evaluated using the receiver operator characteristic (ROC) curve and the area under the curve. We used the intraclass correlation coefficients to quantify inter- and intra-rater reliability. The Spearman correlation coefficient was used for examining the correlation between the KDT and the Speech Mechanism Screening Test and U-TAP.
Results
Among the 23 prototype test items, 16 exhibiting significant results were finally selected as the KDT. The higher score of the KDT is reflected the better speaking function. The sensitivity and specificity of the KDT were shown to be high at the cutoff value of 76.50 point.
Conclusion
KDT is a useful evaluation tool for dysarthria, showing a significant correlation with SMST and U-TAP.

Citations

• Correlation Between Articulatory Diadochokinetic Parameters and Dysphagia Parameters in Subacute Stroke Patients
  Back Min Oh, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Su Jung Park, Beom Jin Kim, Hyun Jung Kim
  Annals of Rehabilitation Medicine.2023; 47(3): 192.     CrossRef
• Destruction of Vowel Space Area in Patients with Dysphagia after Stroke
  Min Kyu Choi, Seung Don Yoo, Eo Jin Park
  International Journal of Environmental Research and Public Health.2022; 19(20): 13301.     CrossRef

With rapid aging, the number of stroke survivors with disabilities in Korea is increasing even if mortality is declining. Despite coordinated efforts for quality improvement of stroke rehabilitation in Korea, the statistics of stroke rehabilitation were not well reported. This review aimed to provide contemporary and comprehensive statistics and recent changes in stroke rehabilitation in Korea. The Clinical Practice Guideline for Stroke Rehabilitation in Korea was developed in 2009 and updated in 2012 and 2016. Additionally, the representative databases for stroke rehabilitation include the Korean Brain Rehabilitation Database and the Korean Stroke Cohort for functioning and rehabilitation. These nationwide databases provided current information on stroke rehabilitation. Among Korean stroke survivors, one in three had motor impairment, one in four had cognitive impairment, one in three had speech impairment, one in four was dependent in ambulation, one in six had swallowing difficulty, and one in four was dependent in activities in daily living at 5 years after stroke. Comprehensive inpatient rehabilitation following transfer to the department of rehabilitation medicine significantly decreased stroke-related mortality and long-term disability. This review provides an improved understanding of stroke rehabilitation and guidance to implement timely, coordinated, evidence-based stroke rehabilitation services to relieve the socioeconomic burden of stroke.

Citations

• Elevated risk of end-stage kidney disease in stroke patients: A population-based observational study
  Sohyun Chun, Kyungdo Han, Bongseong Kim, Dagyeong Lee, In Young Cho, Hea Lim Choi, Jun Hee Park, Junseok Jeon, Hye Ryoun Jang, Dong Wook Shin
  International Journal of Stroke.2025; 20(4): 461.     CrossRef
• Two stroke education programs designed for older adults
  Jeongha Sim, Chanam Shin
  Geriatric Nursing.2024; 55: 105.     CrossRef
• Changes in dementia treatment patterns associated with changes in the National Policy in South Korea among patients with newly diagnosed Alzheimer’s disease between 2011 and 2017: results from the multicenter, retrospective CAPTAIN study
  Young Jin Kim, Ki-Youn So, Hyo Min Lee, Changtae Hahn, Seung-Hoon Song, Yong-Seok Lee, Sang Woo Kim, Heui Cheun Park, Jaehyung Ryu, Jung Seok Lee, Min Ju Kang, JinRan Kim, Yoona Lee, Jun Hong Lee
  BMC Public Health.2024;[Epub]     CrossRef
• Health-Related Quality of Life of Post-Stroke Patients in a Public Hospital
  Mijung Jang, Heedong Park, Miyoung Kim, Galam Kang, Hayan Shin, Donghyun Shin, KyooSang Kim
  Brain & Neurorehabilitation.2024;[Epub]     CrossRef
• Predictors of Burden for First-Ever Stroke Survivor’s Long-Term Caregivers: A Study of KOSCO
  Jin-Won Lee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, So Young Lee, Junhee Han, Jeonghoon Ahn, Yun-Hee Kim, Min-Keun Song, Won Hyuk Chang
  Medicina.2024; 60(4): 559.     CrossRef
• Association between the Thickness or Area of the Temporal Muscle and Skeletal Muscle Mass in Bioimpedance Analysis
  Jee Myung Han, Du Hwan Kim, Byung Chan Lee
  Gerontology.2024; 70(8): 823.     CrossRef
• Association between Height and Functional Outcomes of Patients 6 Months after a Stroke: A Multicenter Prospective Observational Cohort Study
  Nae Yoon Kang, Sung-Hwa Ko, Yong-Il Shin, Ji Hong Min, Mi Sook Yun, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Gyung-Jae Oh, Yang Soo Lee, Min Cheol Joo, So Young Lee, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Yun-Hee Kim, Won Hyuk Chang
  Journal of Personalized Medicine.2024; 14(6): 610.     CrossRef
• Impact of Interprofessional Collaborative Practice on Functional Improvements Among Post-Acute Stroke Survivors: A Retrospective Cross-Sectional Study
  Tsen-Pei Chen, Ying-Jia Lin, Yu-Lin Wang, Li-Min Wu, Chung-Han Ho
  Journal of Multidisciplinary Healthcare.2024; Volume 17: 3945.     CrossRef
• Association Between Frequency of Rehabilitation Therapy and Long-Term Mortality After Stroke: A Nationwide Cohort Study
  Je Shik Nam, Seok-Jae Heo, Yong Wook Kim, Sang Chul Lee, Seung Nam Yang, Seo Yeon Yoon
  Stroke.2024; 55(9): 2274.     CrossRef
• Functional Recovery in Acute and Subacute Stroke Patients With or Without Post-stroke Fatigue
  Juwon Lee, Gowun Kim
  Brain & Neurorehabilitation.2024;[Epub]     CrossRef
• The Safety and Efficacy of Balance Training on Stroke Patients With Reduced Balance Ability: A Meta-Analysis of Randomized Controlled Trials
  Yong Wook Kim, Seo Yeon Yoon
  Brain & Neurorehabilitation.2024;[Epub]     CrossRef
• Discordance Between Spine-Hip and Paretic-Nonparetic Hip Bone Mineral Density in Hemiplegic Stroke Patients: A Multicenter Retrospective Study
  Seung Don Yoo, Tae-Woo Kim, Byung-Mo Oh, Seung Ah Lee, Chanwoo Kim, Ho Yeon Chung, Jung Eun Son, Ji Yeon Lee, Hyunji Lee, Hoo Young Lee
  Annals of Rehabilitation Medicine.2024; 48(6): 413.     CrossRef
• Geographic Distribution of Central Nervous System Rehabilitation Treatment in Korea and Its Associated Factors
  Dong-Gyun Sohn, Jaehong Yoon, Jun-Soo Ro, Ja-Ho Leigh
  Journal of Korean Medical Science.2023;[Epub]     CrossRef
• Response to Letter to the Editor on “Chronic Phase Survival Rate in Stroke Patients With Severe Functional Limitations According to the Frequency of Rehabilitation Treatment”
  Dougho Park, Hyoung Seop Kim
  Archives of Physical Medicine and Rehabilitation.2023; 104(7): 1157.     CrossRef
• Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study
  Suk Won Bae, Junhyun Kwon, Hyung-Ik Shin
  Frontiers in Neurology.2023;[Epub]     CrossRef
• Poststroke rehabilitation using repetitive transcranial magnetic stimulation during pregnancy: A case report
  Joongho JO, Hyojong KIM
  World Journal of Clinical Cases.2023; 11(19): 4707.     CrossRef
• Predictors of quality of life at 6 months in patients with mild stroke: A prospective observational cohort study
  Mu Su Kim, Ji Hong Min, Yong-Il Shin, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Gyung-Jae Oh, Yang Soo Lee, Min Cheol Joo, So Young Lee, Min-Keun Song, Junhee Han, Jeonghoon Ahn, Yun-Hee Kim, Sung-Hwa Ko, Won Hyuk Chang
  Journal of Stroke and Cerebrovascular Diseases.2023; 32(10): 107302.     CrossRef
• Risk Factors and Prognosis of Stroke in Gynecologic Cancer Patients
  Ji Young Kwon, Kena Park, Jeong Min Song, Seung Yeon Pyeon, Seon Hwa Lee, Young Shin Chung, Jong-Min Lee
  Cancers.2023; 15(19): 4895.     CrossRef
• A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia
  Zbigniew Guzek, Wioletta Dziubek, Małgorzata Stefańska, Joanna Kowalska
  Journal of Clinical Medicine.2022; 11(12): 3478.     CrossRef
• Efficacy and Safety of Botulinum Toxin Type A (NABOTA) for Post-stroke Upper Extremity Spasticity: A Multicenter Phase IV Trial
  Wonjae Hwang, Seong Min Kang, Sang Yoon Lee, Han Gil Seo, Yoon Ghil Park, Bum Sun Kwon, Kwang Jae Lee, Deog Young Kim, Hyoung Seop Kim, Shi-Uk Lee
  Annals of Rehabilitation Medicine.2022; 46(4): 163.     CrossRef

Objective
To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.
Methods
Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).
Results
The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.
Conclusion
There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

Citations

• Inter-rater and Intra-rater Reliability of the Videofluoroscopic Dysphagia Scale with the Standardized Protocol
  Ingi Min, Hyeonseong Woo, Jae Yoon Kim, Tae-Lim Kim, Yookyung Lee, Won Kee Chang, Se Hee Jung, Woo Hyung Lee, Byung-Mo Oh, Tai Ryoon Han, Han Gil Seo
  Dysphagia.2024; 39(1): 43.     CrossRef
• Tongue diagnostic parameters-based diagnostic signature in coronary artery disease patients with clopidogrel resistance after percutaneous coronary intervention
  Bo Liang, Rui Li, Jia Lu, Xiao-Jie Tian, Ning Gu
  EXPLORE.2023; 19(4): 528.     CrossRef
• Correlation Between Articulatory Diadochokinetic Parameters and Dysphagia Parameters in Subacute Stroke Patients
  Back Min Oh, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Su Jung Park, Beom Jin Kim, Hyun Jung Kim
  Annals of Rehabilitation Medicine.2023; 47(3): 192.     CrossRef

Objective
To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.
Methods
The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.
Results
There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.
Conclusion
The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

Citations

• Stroke and associated comorbidities in Southeast Asian countries
  Aishika Datta, Soumya Akundi, Kaveri Wagh, Gangadhar Bhurle, Deepaneeta Sarmah, Arvind Sharma, Sudhir Shah, Anupom Borah, Shailendra Saraf, Pallab Bhattacharya
  Neuroprotection.2025; 3(1): 29.     CrossRef
• Stroke in the Patient With Type 2 Diabetes
  Terri W. Jerkins, David S.H. Bell
  Endocrine Practice.2025; 31(4): 547.     CrossRef
• Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management
  Anush Barkhudaryan, Wolfram Doehner, Nadja Jauert
  Clinical Autonomic Research.2025;[Epub]     CrossRef
• Stress hyperglycemia increases short-term mortality in acute ischemic stroke patients after mechanical thrombectomy
  Bing Yang, Xuefang Chen, Fangze Li, Junrun Zhang, Dawei Dong, Huiyue Ou, Longyan Lu, Niu He, Xiaohong Xu, Xiufeng Xin, Jingchong Lu, Min Guan, Hongyu Qiao, Anding Xu, Huili Zhu
  Diabetology & Metabolic Syndrome.2024;[Epub]     CrossRef
• Implications of fasting plasma glucose variability on the risk of incident peripheral artery disease in a population without diabetes: a nationwide population-based cohort study
  Hye Soo Chung, Soon Young Hwang, Jung A. Kim, Eun Roh, Hye Jin Yoo, Sei Hyun Baik, Nan Hee Kim, Ji A. Seo, Sin Gon Kim, Nam Hoon Kim, Kyung Mook Choi
  Cardiovascular Diabetology.2022;[Epub]     CrossRef
• The Role of Nondiabetic Hyperglycemia in Critically Ill Patients with Acute Ischemic Stroke
  Hung-Sheng Shih, Wei-Sheng Wang, Li-Yu Yang, Shu-Hao Chang, Po-Huang Chen, Hong-Jie Jhou
  Journal of Clinical Medicine.2022; 11(17): 5116.     CrossRef
• A Path to Precision Medicine: Incorporating Blood-Based Biomarkers in Stroke Rehabilitation
  Byung-Mo Oh
  Annals of Rehabilitation Medicine.2021; 45(5): 341.     CrossRef

Objective
To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA).
Methods
We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS).
Results
The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items.
Conclusion
The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

Citations

• Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial
  Myeong Sun Kim, Hyunju Park, Ilho Kwon, Kwang-Ok An, Hayeon Kim, Gyulee Park, Wooseok Hyung, Chang-Hwan Im, Joon-Ho Shin
  Journal of NeuroEngineering and Rehabilitation.2025;[Epub]     CrossRef
• Additional Effects of Facilitatory Cerebellar Repetitive Transcranial Magnetic Stimulation on Inhibitory Repetitive Transcranial Magnetic Stimulation over the Unaffected Contralesional Primary Motor Cortex for Motor Recovery in Subacute Ischemic Stroke Pa
  Sungwon Kim, Ho Seok Lee, Heegoo Kim, Dae Hyun Kim, Won Hyuk Chang
  Journal of Clinical Medicine.2025; 14(7): 2315.     CrossRef
• Resistive versus active assisted robotic training for the upper limb after a stroke: A randomized controlled study
  Sun Young Jeon, Myung Ki, Joon-Ho Shin
  Annals of Physical and Rehabilitation Medicine.2024; 67(1): 101789.     CrossRef
• Validity and reliability of selective control of upper extremity scale (SCUES) in patients with chronic stroke
  Didem Boz Sönmez, Esra Giray, Arzu Atıcı, Özge Gülsüm Illeez, Pınar Akpınar, Feyza Ünlü Özkan, Ilknur Aktaş
  Disability and Rehabilitation.2024; 46(20): 4813.     CrossRef
• Rehabilitative effects of Baduanjin in Chinese stroke patients: A systematic review and meta-analysis
  Xi Cheng, Yanling Gao, Xiaofeng Chen, Jinhua Lu, Qingyue Dai, Jinghui Lai
  Preventive Medicine Reports.2024; 41: 102703.     CrossRef
• Effect of Hwanggigyejiomul-tang on Postoperative Breast Cancer-related Lymphedema (BCRL): A Systematic Review and Meta-analysis
  Yeong-seo Lee, Ye-seul Kim, Young-kyun Kim, Kyoung-min Kim
  The Journal of Internal Korean Medicine.2024; 45(1): 31.     CrossRef
• Effects of high-intensity interval robot-assisted gait training on cardiopulmonary function and walking ability in chronic stroke survivors: A multicenter single-blind randomized controlled trial
  Junghwa Do, Woo-Taek Lim, Dae Yul Kim, Eun Jae Ko, Myoung-Hwan Ko, Geon Woo Kim, Ji Hye Kim, SooBin Kim, Hwal Kim
  Journal of Back and Musculoskeletal Rehabilitation.2024; 37(5): 1309.     CrossRef
• No Additional Effects of Sequential Facilitatory Cerebral and Cerebellar rTMS in Subacute Stroke Patients
  Ho Seok Lee, Sungwon Kim, Heegoo Kim, Seung-min Baik, Dae Hyun Kim, Won Hyuk Chang
  Journal of Personalized Medicine.2024; 14(7): 687.     CrossRef
• Effectiveness of mixed reality-based rehabilitation on hands and fingers by individual finger-movement tracking in patients with stroke
  Yeajin Ham, Dong-Seok Yang, Younggeun Choi, Joon-Ho Shin
  Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef
• Research trends and hotspots of post-stroke upper limb dysfunction: a bibliometric and visualization analysis
  Qingqing Tang, Xinyue Yang, Mengmeng Sun, Min He, Ren Sa, Kaiqiang Zhang, Bing Zhu, Tie Li
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Protocol for a single-blind randomized controlled clinical trial to investigate the feasibility and safety of in-bed self-exercises based on electromyography sensor feedback in patients with subacute stroke
  Jung Hyun Kim, Byung-Mo Oh, Han Gil Seo, Sung Eun Hyun, Jong tae Han, Dae hee Kang, Woo Hyung Lee, Mehrnaz Kajbafvala
  PLOS ONE.2024; 19(12): e0310178.     CrossRef
• Efficiency and usability of a modified pegboard incorporating computerized technology for upper limb rehabilitation in patients with stroke
  Yeajin Ham, Joon-Ho Shin
  Topics in Stroke Rehabilitation.2023; 30(4): 333.     CrossRef
• Intra- and inter-rater reliability of the Italian Fugl-Meyer assessment of upper and lower extremity
  Ines Hochleitner, Leonardo Pellicciari, Chiara Castagnoli, Anita Paperini, Angela Maria Politi, Silvia Campagnini, Silvia Pancani, Benedetta Basagni, Filippo Gerli, Maria Chiara Carrozza, Claudio Macchi, Margit Alt Murphy, Francesca Cecchi
  Disability and Rehabilitation.2023; 45(18): 2989.     CrossRef
• Correlation of the Fugl Meyer assessment, Motricity Index and Barthel Index scales in the assessment of rehabilitation in post-stroke patients
  Duong Thi Huong Nguyen, Dieu Thuong Thi Trinh
  MedPharmRes.2023; 7(4): 1.     CrossRef
• Motor and cognitive function according to level of physical activity in stroke patients
  Jeong Ja Kim, Jong Won Lee
  The Journal of Korean Academy of Physical Therapy Science.2023; 30(4): 29.     CrossRef
• Urdu translation and cross-cultural validation of the Fugl-Meyer assessment in people with stroke
  Mehwish Ikram, Syed Shakil ur Rehman, Katharina S. Sunnerhagen, Margit Alt Murphy
  Disability and Rehabilitation.2022; 44(25): 8048.     CrossRef
• Assessment of Lower Limb Motor Function, Ambulation, and Balance After Stroke
  Yeun Jie Yoo, Seong Hoon Lim
  Brain & Neurorehabilitation.2022;[Epub]     CrossRef
• Assessment of Upper Extremity Function in People With Stroke Based on the Framework of the ICF: A Narrative Review
  Hanna Kim, Joon-Ho Shin
  Brain & Neurorehabilitation.2022;[Epub]     CrossRef
• European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews, clinical practice guidelines and expert consensus
  Gerdienke B. Prange-Lasonder, Margit Alt Murphy, Ilse Lamers, Ann-Marie Hughes, Jaap H. Buurke, Peter Feys, Thierry Keller, Verena Klamroth-Marganska, Ina M. Tarkka, Annick Timmermans, Jane H. Burridge
  Journal of NeuroEngineering and Rehabilitation.2021;[Epub]     CrossRef

Objective
To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke.
Methods
This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated.
Results
There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively.
Conclusion
In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

Citations

• Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review
  Yijing Li, Zhihua Xu, Xu Zhang, Dongfei Ma, Xiangfei Meng, Mengting Zhang, Jiao Sun
  Journal of Clinical Nursing.2023; 32(11-12): 2533.     CrossRef
• “Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes”: Commentary
  Jonathan Willman, Brandon Lucke-Wold
  World Journal of Gastrointestinal Pharmacology and Therapeutics.2023; 14(1): 1.     CrossRef
• Association between successful weaning from nasogastric tube feeding and thoracic muscle mass in patients with aspiration pneumonia
  Hyun Woo Lee, Dong Hyun Kim, Kwang Nam Jin, Hyo-Jin Lee, Jung-Kyu Lee, Tae Yeon Park, Deog Kyeom Kim, Eun Young Heo
  Medicine.2023; 102(30): e34298.     CrossRef
• Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease
  Giuseppe Cosentino, Massimiliano Todisco, Carla Giudice, Cristina Tassorelli, Enrico Alfonsi
  Current Opinion in Neurology.2022; 35(6): 741.     CrossRef

Objective
To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients.
Methods
This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders.
Results
Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028).
Conclusion
The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.

Citations

• Usefulness of body composition assessment by bioelectrical impedance vector analysis in subacute post-stroke patients in rehabilitation
  Alessandro Guerrini, Mariacristina Siotto, Carola Cocco, Marco Germanotta, Valeria Cipollini, Laura Cortellini, Arianna Pavan, Stefania Lattanzi, Sabina Insalaco, Yeganeh Manon Khazrai, Irene Giovanna Aprile
  Scientific Reports.2025;[Epub]     CrossRef
• Indirect calorimetry directed feeding and cycling in the older ICU population: a pilot randomised controlled trial
  Ng Shu Hui Elizabeth, Tan Yanni, Leong Siaw May, Tiong Hui Fen, Li Xuanhui Janice, Kwan Peijun, Ong Sze Pheng, Toh Shi Jie, Loh Ne Hooi Will
  BMC Anesthesiology.2024;[Epub]     CrossRef
• Effects of Brunnstrom movement therapy versus mirror therapy on hand function in post-stroke hemiplegic population
  Nimra, Ayesha Zulifiqar, Muhammad Umair Javaid, Reham Ali Mohamed Ali Ahmed
  Journal of Musculoskeletal Surgery and Research.2024; 8: 389.     CrossRef
• Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease
  Thanapon Keawon, Narongkorn Saiphoklang
  Therapeutic Advances in Respiratory Disease.2024;[Epub]     CrossRef
• Trunk Impairment Scale for Predicting Lumbar Spine Bone Mineral Density in Young Male Patients With Subacute Stroke
  Yeon Hee Cho, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Hyun Jung Kim
  Annals of Rehabilitation Medicine.2023; 47(2): 98.     CrossRef
• Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia
  Ruihong Yao, Liqing Yao, Changli Yuan, Bu-Lang Gao
  Frontiers in Neurology.2022;[Epub]     CrossRef
• Natural aging course of lumbar extensor muscle mass and strength in community-dwelling older women: a 1-year prospective observational study
  Dong Hyun Kim, Jinhee Park, Chang Won Lee, Sang Yoon Lee
  Aging Clinical and Experimental Research.2022; 34(9): 2099.     CrossRef
• Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients
  Iasmin Matias Sousa, Camila Ferri Burgel, Flávia Moraes Silva, Ana Paula Trussardi Fayh
  Nutrients.2022; 14(11): 2207.     CrossRef
• Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials
  Sang Yoon Lee, Hyun Jeong Lee, Jae-Young Lim
  Archives of Gerontology and Geriatrics.2022; 102: 104758.     CrossRef
• Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data
  Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara, Irene Aprile
  Nutrients.2022; 14(22): 4825.     CrossRef
• Handgrip Strength: An Irreplaceable Indicator of Muscle Function
  Sang Yoon Lee
  Annals of Rehabilitation Medicine.2021; 45(3): 167.     CrossRef

Objective
To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke.
Methods
Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated.
Results
There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group.
Conclusion
Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

Citations

• A protocol to optimize non-invasive brain stimulation for post-stroke rehabilitation
  Ayesha Juhi, Manul Das, Dinesh Bhatia, Suman Dhaka, Rajesh Kumar, Deepak Kumar, Shreya Sharma, Pritam Kumar Chaudhary, Chanchal Goyal, Md Asif Khan, Himel Mondal
  MethodsX.2025; 14: 103209.     CrossRef
• Comparison of the efficacy of different protocols of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function, activities of daily living, and neurological function in patients with early stroke: a systema
  Xueyi Ni, Zinan Yuan, Ruimou Xie, Xiaoxue Zhai, Xiang Cheng, Yu Pan
  Neurological Sciences.2025;[Epub]     CrossRef
• A Multi-Electrode Transcranial Direct Current Stimulator (ME-tDCS): Design considerations and safety aspects
  Cassandra Solomons, Vivekanandan Shanmugasundaram, Sivasakthi Murugan Velayutham
  Heliyon.2025; 11(7): e43039.     CrossRef
• Non-invasive brain stimulation for functional recovery in animal models of stroke: A systematic review
  Antonio Rodríguez, Laura Amaya-Pascasio, María Gutiérrez-Fernández, José García-Pinteño, Margarita Moreno, Patricia Martínez-Sánchez
  Neuroscience & Biobehavioral Reviews.2024; 156: 105485.     CrossRef
• The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review
  Benedetta Capetti, Lorenzo Conti, Chiara Marzorati, Roberto Grasso, Roberta Ferrucci, Gabriella Pravettoni, J. Michael Wyss
  Neural Plasticity.2024; 2024: 1.     CrossRef
• Gamma oscillations induced by 40-Hz visual-auditory stimulation for the treatment of acute-phase limb motor rehabilitation after stroke: study protocol for a prospective randomized controlled trial
  Wang Fu, Xiaoming Yu, Minghui Lai, Yuanli Li, Yingting Yang, Yong Qin, Min Yu, Feng Wang, Cong Wang
  Trials.2024;[Epub]     CrossRef
• Molecular Changes in the Ischemic Brain as Non-Invasive Brain Stimulation Targets—TMS and tDCS Mechanisms, Therapeutic Challenges, and Combination Therapies
  Aleksandra Markowska, Beata Tarnacka
  Biomedicines.2024; 12(7): 1560.     CrossRef
• Repetitive Transcranial Magnetic Stimulation Coupled With Visual‐Feedback Cycling Exercise Improves Walking Ability and Walking Stability After Stroke: A Randomized Pilot Study
  Yixiu Wang, Xiaoming Chen, Menghuan Wang, Yingying Pan, Shiyi Li, Mengfei He, Feng Lin, Zhongli Jiang, Zhiyong Zhao
  Neural Plasticity.2024;[Epub]     CrossRef
• Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis
  Yung-Jiun Chien, Chun-Yu Chang, Meng-Yu Wu, Yung-Chen Chien, Hsin-Chi Wu, Yi-Shiung Horng, Saskia F. A. Duijts
  European Journal of Cancer Care.2023; 2023: 1.     CrossRef
• Exploring the Potential of Transcranial Direct Current Stimulation for Relieving Central Post-Stroke Pain: A Randomized Controlled Pilot Study
  Ji-Soo Baik, Jung-Hyun Yang, Sung-Hwa Ko, So-Jung Lee, Yong-Il Shin
  Life.2023; 13(5): 1172.     CrossRef
• Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation
  Qian Duan, Wenying Liu, Jinhui Yang, Ben Huang, Jie Shen, Laura Baroncelli
  Neural Plasticity.2023; 2023: 1.     CrossRef
• A blended neurostimulation protocol to delineate cortico-muscular and spino-muscular dynamics following neuroplastic adaptation
  Filip Stefanovic, Julian A. Martinez, Ghazala T. Saleem, Sue Ann Sisto, Michael T. Miller, Yaa A. Achampong, Albert H. Titus
  Frontiers in Neurology.2023;[Epub]     CrossRef
• Non-invasive Brain Stimulation Techniques for the Improvement of Upper Limb Motor Function and Performance in Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis
  Ishtiaq Ahmed, Rustem Mustafaoglu, Simone Rossi, Fatih A. Cavdar, Seth Kwame Agyenkwa, Marco Y.C. Pang, Sofia Straudi
  Archives of Physical Medicine and Rehabilitation.2023; 104(10): 1683.     CrossRef
• Investigation of the efficacy of low-frequency repetitive transcranial magnetic stimulation on upper-limb motor recovery in subacute ischemic stroke without cortical involvement: a protocol paper for a multi-center, double-blind randomized controlled tria
  Hee-Mun Cho, Seungwoo Cha, Min Kyun Sohn, Sungju Jee, Won Kee Chang, Won-Seok Kim, Nam-Jong Paik
  Frontiers in Neurology.2023;[Epub]     CrossRef
• Non-invasive brain stimulation associated mirror therapy for upper-limb rehabilitation after stroke: Systematic review and meta-analysis of randomized clinical trials
  Qingqing Zhao, Hong Li, Yu Liu, Haonan Mei, Liying Guo, Xianying Liu, Xiaolin Tao, Jiang Ma
  Frontiers in Neurology.2022;[Epub]     CrossRef
• Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery
  Helene Luise Walter, Anton Pikhovych, Heike Endepols, Steffen Rotthues, Johannes Bärmann, Heiko Backes, Mathias Hoehn, Dirk Wiedermann, Bernd Neumaier, Gereon Rudolf Fink, Maria Adele Rueger, Michael Schroeter
  Neurorehabilitation and Neural Repair.2022; 36(10-11): 701.     CrossRef
• Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
  Tao Xue, Zeya Yan, Jiahao Meng, Wei Wang, Shujun Chen, Xin Wu, Feng Gu, Xinyu Tao, Wenxue Wu, Zhouqing Chen, Yutong Bai, Zhong Wang, Jianguo Zhang
  Journal of Clinical Medicine.2022; 11(20): 6162.     CrossRef