We aimed to explore views of people with stroke regarding aerobic exercise participation during rehabilitation. Qualitative descriptive study informed by a pragmatic worldview. People with stroke attended online or in-person one-on-one semi-structured interviews focused on their general attitudes about aerobic exercise, and their capability, motivation and opportunities to exercise that have or have not been provided during rehabilitation after stroke. Codebook thematic analysis was performed by two independent coders. Thirteen people, 2 to 10 months post-stroke participated in the interviews. Six themes were identified: 1) having an exercise program routine and trusting the physiotherapist during rehabilitation facilitated doing exercise; 2) emotions can make exercise during rehabilitation more or less difficult; 3) limited physical ability post stroke leads to poor exercise self-efficacy and sense of control; 4) knowledge of what exercise is and its benefits affects perseverance in exercising during rehabilitation; 5) personal identity affects perseverance in doing exercises during rehabilitation; and 6) environmental factors facilitate exercise performance (consisting of 2 sub-themes of supportive social environment promotes exercise participation, and more resources (e.g., time, space, staff, other programs) facilitate exercising during and after rehabilitation). People with stroke are more likely to participate in exercises if they are incorporated into their treatment plan. This novel finding could help ensure stroke rehabilitation clinicians prescribe structured exercises within stroke rehabilitation programs.

Pain is a prevalent and complex symptom in neurorehabilitation, with differentiation between neuropathic pain (NP) and musculoskeletal pain (MSK) often proving challenging. This study evaluates the effectiveness of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and Douleur Neuropathique en 4 Questions (DN4) tools in distinguishing NP from MSK pain, aiming to guide appropriate analgesic selection in a rehabilitation setting. Seventy inpatients undergoing active rehabilitation (32 males, 38 females) aged 18-91 years (mean: 67 years) were assessed using LANSS and DN4 scores over a 2-week period. Prescribed analgesia was recorded and correlated with pain classification based on these scores. The results showed that stroke patients exhibited a higher prevalence of NP, reflected in elevated LANSS and DN4 scores. Spinal cord injury (SCI) patients had the highest total scores, often necessitating dual therapy with pregabalin and amitriptyline. Conversely, patients with fractures had the lowest scores, suggesting predominantly MSK pain, with minimal neuropathic features. Pregabalin was prescribed to 29% of stroke patients but only 6% of fracture patients. In conclusion, LANSS and DN4 effectively identified NP, with DN4 proving easier to interpret. Findings underscore the need for targeted analgesic strategies in neurorehabilitation particularly that of NP in stroke and SCI patients. This is still under-researched in literature, compared to conditions like diabetic neuropathy, and future studies are needed to explore tailored pain management protocols in rehabilitation patients.

Apraxia of speech (AOS) is a motor speech disorder that occurs despite the absence of paralysis, weakness, or incoordination of the speech muscles and is characterized by difficulty in planning, programming, and sequencing speech movements. Currently, the Korean language lacks sufficient measures for evaluating AOS, whereas the Apraxia of Speech Rating Scale (ASRS) has been widely used internationally to assess the presence and severity of AOS. This study aimed to translate the Apraxia of Speech Rating Scale into Korean (K-ASRS) and verify its reliability and validity. The translation process comprised four stages: forward and backward translation, expert committee review, and author approval. Thirty native Korean speakers aged 18 years or older with post-stroke aphasia participated. Three speech-language pathologists conducted two assessments over 1 month, and intra- and inter-rater reliability were evaluated using internal consistency and intraclass correlation coefficients. Among the 30 participants, six were diagnosed with AOS. The K-ASRS effectively distinguished the presence of AOS, showing strong internal validity and excellent inter-rater reliability overall, although items five, six, and eight demonstrated only fair agreement. The K-ASRS demonstrated good-to-excellent validity and reliability in patients with post-stroke aphasia and showed high clinical utility because of its short administration time and applicability to both in-person and video assessments.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by neuroinflammation and motor dysfunction. Current treatments primarily provide symptomatic relief. Microcurrent (MC) stimulation has recently emerged as a promising noninvasive technique for Alzheimer's disease; however, its therapeutic potential in PD remains underexplored. This study investigated the effects of MC therapy in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of PD. Female C57BL/6 mice were divided into 3 groups: control, MPTP treated, and MPTP plus MC treated. A step-form waveform (5 V, 7 Hz base frequency with 44 kHz superposition) was applied for 4 weeks. Motor function was evaluated using rotarod and open field tests, and neuropathological changes were assessed by analyzing tyrosine hydroxylase, poly (ADP-ribose) polymerase (PARP), Toll-like receptor (TLR) proteins, caspase-3, and immunohistochemistry. MC therapy significantly improved motor activity in MPTP-treated mice, with increased latency to fall compared to the MPTP-only group. In the substantia nigra, the MC-treated mice had reduced tyrosine hydroxylase neuronal degradation and α-synuclein accumulation. Western blot analysis further revealed that the MC-treated mice had attenuated neuroinflammation by downregulating the TLR4 pathway and reducing PARP and cleaved caspase-3 expression. These findings suggest that MCs preserve dopaminergic neurons by suppressing neuroinflammation in a mouse model of PD, highlighting their potential as a therapeutic modality for PD.

Patients with brain injury often experience accompanying disabilities that can make it challenging for them to use tools or perform complex tests. Therefore, Korean Mini-Mental State Examination (K-MMSE) is widely used in clinical practice as an alternative to the computerized neurocognitive test (CNT) or Wechsler Adult Intelligence Scale tests to assess cognitive function in these individuals. This study aimed to investigate the correlation between the K-MMSE and CNT in brain injury patients to evaluate the and clinical usefulness of K-MMSE. A total of 120 patients were assessed using both tests, and a significant correlation was observed between the total scores of K-MMSE and CNT. The orientation component of K-MMSE was significantly correlated with CNT components, indicating that individuals who perform well on orientation tasks are likely to have better cognitive abilities overall. While K-MMSE has limitations in evaluating specific cognitive domains, it is a useful tool in clinical practice for evaluating cognitive impairment, especially in patients who have difficulty using more complex cognitive tests.

ClinicalTrials.gov Identifier: NCT01953549.

This study analyzed the impact of post-stroke fatigue (PSF) on functional recovery in acute and subacute stroke patients during inpatient rehabilitation. Medical records of 177 patients were retrospectively reviewed. PSF was assessed using the Fatigue Severity Scale (FSS)-9. Patients were classified into two groups: a PSF group (mean FSS ≥ 4) and a non-PSF group (mean FSS < 4). Stroke severity was measured with the National Institutes of Health Stroke Scale, and functional outcomes were evaluated using Functional Ambulation Category (FAC), Berg Balance Test, Korean version of the Modified Barthel Index (K-MBI), and Mini-Mental State Examination-Korean version (MMSE-K). Statistical significance was set at p < 0.05. The prevalence of PSF was 52.5%. The repeated measures of analysis of variance showed significant "time" effects on FAC (F = 29.726, p < 0.001) and K-MBI (F = 15.348, p < 0.001). A significant "group" effect was observed on MMSE-K (F = 4.571, p = 0.035), and a "time × group" interaction on only K-MBI (F = 4.284, p = 0.041). Multivariable logistic regression analysis showed that improvements in K-MBI scores were independent of initial severity, depression, and age (p = 0.043). PSF affects the recovery of activities of daily living (ADL) in stroke patients, suggesting that regulating early fatigue after stroke positively affects functional recovery.

This study investigated the differences in the effect of repetitive transcranial magnetic stimulation (rTMS) between patients with and without the involvement of Broca's area (IBA). The medical records of 20 stroke patients treated with rTMS for non-fluent aphasia were reviewed. Patients completed the Korean version of the Western Aphasia Battery (K-WAB) pre- and post-rTMS. Magnetic resonance T1-weighted images of the brain were analyzed using SPM12 software. Montreal Neurological Institute templates and Talairach coordinates were used to determine Broca's area involvement and segregate patients into 2 groups: IBA and non-IBA (NBA) groups. All statistical analyses were performed using the SPSS software. Twenty subjects were included in the study. The K-WAB scores revealed improvements in the total subjects and IBA and NBA groups. There were no statistical differences between the IBA and NBA groups in the ΔK-WAB scores of aphasia quotient, fluency, comprehension, repetition, and naming. The rTMS was positive for non-fluent aphasia patients, but there was no significant difference in effectiveness depending on the IBA. Further research with a larger number of patients is needed to identify the differences in the effect of rTMS on the IBA.

This study aimed to develop a short version of the International Classification of Functioning, Disability, and Health (ICF) core set and verify functioning levels of patients for stroke rehabilitation in Korea. Using the Delphi technique, a 3-round consensus process was conducted. Thirty multidisciplinary rehabilitation experts from different hospitals completed the consensus study. The questionnaire for this study adopted the comprehensive ICF core set for stroke developed by the Geyh group. A 7-point Likert-type scale was used by participants to weigh the impact of each category on activities of daily living or rehabilitation after a stroke. The consensus of ratings was assessed with Spearman's rho and inter-quartile range indices. A core set to assess functioning levels of patients with stroke was developed from those categories. A short version of ICF core set to assess and verify functioning levels of patients with stroke was developed for 12 categories, including 3 categories (consciousness, muscle power, and attention) from body functions, 1 (structure of brain) from body structures, 5 (eating, walking, moving around, changing basic body position, and carrying out daily routine) from activities and participation, and 3 (individual attitudes of immediate family members, immediate family, and personal care providers/personal assistants) from environmental factors. This preliminary study developed a Delphi consensus process, gathering statistical evidence and expert commands based on the short version of ICF core set for rehabilitation of stroke patients in Korea.

The aim of this study is to investigate the changes in functional independence and their associated factors during the first 6 months to 1 year after stroke onset. This study is the interim results of the Korean Stroke Cohort for Functioning and Rehabilitation. A total of 1,011 participants were included and classified into 3 subgroups according to changes in the Korean version of Modified Barthel Index (K-MBI) scores that occurred between 6 months to 1 year after stroke onset: the improved group (IG), with scores that increased 5 points or more; the stationary group (SG), with the K-MBI score changes ranging from -4 to +4 points; and the declined group (DG), with the K-MBI scores that decreased 5 points or more. Ordinal logistic regression analyses were used to assess the factors influencing changes in the K-MBI score. Among 1,011 patient, 436 patients (43.1%), 398 patients (39.4%) and 117 patients (17.5%) were classified into the IG, SG, and DG, respectively. Obesity and Geriatric Depression Scale score were significant influencing factors for changes in the K-MBI scores. Obesity showed a positive influence on the K-MBI score, while depression showed a negative influence.