• Journal of Digital Convergence
• /
• v.10 no.3
• /
• pp.233-240
• /
• 2012

This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

• Therapeutic Science for Rehabilitation
• /
• v.3 no.2
• /
• pp.71-81
• /
• 2014

Objective: The purpose of this study is to ob serve effects of CPM(Continuous Passive Motion) on hand functional and upper-extremity muscular strength rehabilitation for stroke patients. Method: Objects of this study, three patients have the symptoms of hemiplegia due to stroke. These are acute patients, within a 18 months after treatment and correspond in Brunnstrom stage 4~6. This study used single subject (A-B) design for three patients with a stroke and the effect of CPM was measured using Jebsen-Taylor hand function test, Purdue Pegboard test, hand muscular strength test. They received CPM for 3 weeks, 2 per day, 30 minutes for each, total 30 times. Results: Two patients' results of fingertip grip test in hand strength measurements did not change. Results of Jebsen-Taylor hand function test, Purdue Pegboard test and other hand muscular strength test were improved. To validate statistical results nonparametric statistical method, Wilcoxon signed ranks test was performed. P-Values are greater than 0.05 so difference between be fore and after treatment is not statistically significant result. Conclusion: Despite of limitation of short program period and fewer participants, CPM which has been conducted for stroke patients showed the effect on improvement of hand function and muscle strength. This study shows that CPM which is mainly used to treate lower-extremity rehabilitation can be use to improve performance of hand function and strength for patients with stroke.

• The Journal of the Korea Contents Association
• /
• v.16 no.3
• /
• pp.149-161
• /
• 2016

The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

• Journal of Digital Convergence
• /
• v.17 no.9
• /
• pp.271-278
• /
• 2019

The aim of this study was to investigate the effects of virtual reality training on upper extremity function and activities of daily living in patients with sub-acute stroke. The present study enrolled 18 patients with sub-acute stroke. All subjects were assigned into either the experimental group (n=9) or control group (n=9). Both groups received conventional occupational therapy for 30 minutes/day, 5 times a week, for 4 weeks. Additionally, the experimental group performed virtual reality training in each session for 30 minutes/day, and the control group conducted conventional occupational therapy in each session for 30 minutes/day. The outcome measures were performed through the Fugl-Meyer Assessment (FMA) and the Korean-modified Barthel Index (K-MBI) before and after intervention. In results, the experimental group showed significant improvements in the scores of FMA and K-MBI after intervention (p<.05). The control group showed significant improvements in the shoulder/elbow/forearm, wrist, and hand sub-domains of the FMA and K-MBI (p<.05). After intervention, the experimental group showed significantly greater improvements in the total score and in the wrist and hand sub-domains of the FMA than control group (p<.05). These findings suggest that virtual reality training may have positive effects on the improvements of upper extremity function in patients with sub-acute stroke.

• Journal of Korean Critical Care Nursing
• /
• v.14 no.3
• /
• pp.73-86
• /
• 2021

Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

• Journal of Digital Convergence
• /
• v.11 no.8
• /
• pp.235-242
• /
• 2013

This study aimed to evaluate the effectiveness of imagery training on upper limb function and activities of daily living in subacute stroke patients. This study included 16 voluntary participants with subacute stroke. Subjects were randomly assigned to either experimental or control group, with 8 in each group. Imagery training group performed imagery training during 30 minutes and then task-oriented training 30 minutes a day, 5 times a week for 4 weeks. Control group performed task-oriented training during 30 minutes during a day, 5 times a week for 4 weeks. Assessments were made using the Wolf Motor Function Test (WMFT) and Fugl-Meyer motor function assessment (FMA) to evaluate the changes of upper function. And modified Barthel Index (MBI) was measured to evaluate the activities of daily living. The results showed that imagery training group was more significant increase than control group in WMFT, FMA, and MBI (p<.05). Small to huge effect sizes of 1.59, 2.02, 0.37 were observed for WMFT, FMA, and MBI, respectively. This study indicated that imagery training may be helpful in improving the upper limb function and activities of daily living for subacute stroke patients, and support the clinical feasibility of the imagery training.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.8 no.2
• /
• pp.109-118
• /
• 2014

The purpose of this study was to compare the effectiveness of rehabilitation therapy with natural recovery in patients who had dysphagia due to stroke. Swallowing functions were examined on a total of 98 patients with stroke-caused dysphagia based on a videofluoroscopic swallowing study (VFSS) for 8 weeks. The each group was evaluated with DOSS, DSS and FOSS to assess swallowing ability in the first week and re-evaluated in the $8^{th}$ week during the session for investigating the recovery status. The author compared the above initial data and follow-up data using a Mann-Whitney U test, Kruskal-Wallis test and Wilcoxon's Signed Rank test, ANCOVA to confirm statistically controlling for the effects of other continuous variables, performed by IBM SPSS Statistics 20.0 for windows. There was statistically significant recovery in the experimental group except measure of DOSS (p>0.05). In the control group, it showed improvement in all the scales(p<0.05). After terminating each session, the comparison of the two group of patients showed statistical significant differences in DSS and FOSS(p<0.05). These results suggest that possibility of natural neurologic recovery has positive effects on early stage of dysphagia caused by stroke.

• The Monthly Diabetes
• /
• s.210
• /
• pp.11-13
• /
• 2007

당뇨는 고혈압, 고지혈증, 흡연과 함께 관상동맥질환을 일으키는 4대 주요한 위험요인 중의 하나이다. 당뇨를 가지고 있으면 관상동맥질환, 뇌졸중, 말초동맥질환을 비롯한 동맥경화성 심혈관질환에 걸릴 위험이 증가한다. 관상동맥질환은 당뇨병환자에서 높은 유병율을 가지며 당뇨병환자의 사망원인의 75%는 죽상동맥경화와 관련이 있고 그 중 75%는 관동맥질환이다. 과거에 관동맥질환이 없는 당뇨병환자에서 급성심근경색의 발생위험은 현재 관동맥질환이 있는 환자와 같으며, 특히 여성에서 관동맥질환 사망위험도는 비당뇨여성의 5$\sim$8배로 현저히 높다. 치료법의 현저한 발전으로 관동맥질환의 사망률이 많이 줄어들었지만 당뇨병환자에서는 여전히 높은 상태이다.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.12 no.1
• /
• pp.10-19
• /
• 2018

The present study was to investigated the effects of motion-based virtual reality training on cognitive function and activities of daily living in patients with stroke. This study was participated in forty one patients with acute stroke. All subjects were randomly assigned into either the experimental group(n=20) or the control group(n=21). The both groups received the conventional occupational therapy during 30 min a day, 5 a week, 4 a weeks. Additionally, experimental group performed motion-based virtual reality training on each session during 30 min/day, and control group conducted conventional occupational therapy on each session during 30 min/day. The outcome measures were the LOTCA(Loewenstein Occupational Therapy Cognitive Assessment), TMT(Trail Making Test), VM(Visual Memory), K-MBI(Korean Modified Barthel Index). In comparison of change score of cognitive function, the experimental group showed a significantly greater improvements in attention and visual working memory than the control group(p<.05). As a result for change score of activities of daily living, the experimental group showed a significant greater improvement in self care than the control group(p<.05). Our findings suggest that motion-based virtual reality training may have a effects of the improvements of cognitive function and activities of daily living than conventional therapy in patients with acute stroke.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.11
• /
• pp.126-136
• /
• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.