Objective : This study was conducted to review about instrument for bilateral upper extremity assessment. Methods : We searched published papers in Medline database. The keywords used in the search were 'upper extremity' and 'motor activity', 'activities of daily living' and 'assessment', 'instrument', 'disability evaluations'. In total of 68 papers, 44 assessment instruments was extracted. We analyzed about numbers, subjects, methods, reliability, validity, responsiveness of assessment instruments about bilateral upper limb function comparing unilateral, combined bilateral and unilateral instruments. Results : The numbers of bilateral measurement tool were 2 in a total of upper extremity measurement tools. Also, subjects were patients with stroke and measurement was based on performance. The reliability, validity and responsiveness of tools were high. Conclusions : Futher study will be needed to development and research about instrument of bilateral upper extremity.
Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.
In the paper, we developed the mobile based rehabilitation system for patients with upper extremity hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built in the smartphone were used to track patients' upper limb motion and the movements was transferred to the tablet PC through bluetooth connection so that the game contents could be interact with the movements. The rehabilitation game contents was based on Brunnstrom stage(B-stage), and was designed to lead accurate movement of upper limb. For the clinical evaluation of the effectiveness, 11 patients were recruited and make them perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The change of upper limb motor function was measured using fugl-meyer assessment(FMA), Brunnstrom stage(B-stage). And the change of quality of life was measured using EuroQoL-5 Dimension(EQ-5D), Beck Depression Inventory(BDI). The results showed significant improvement in upper limb function but not in quality of life. We verified mobile based rehabilitation program could be useful and effective for the clinical use.
The purpose of this study was to know the state of rehabilitation treatment of stroke, to compare treatment with Bobath therapy or not, establish what factors have influence on treatment effect and hospitalization period and to be a great help for guide of treatment and education of patient and family We analyzed 87 stroke patients retrospectively for the patient's age, the subtype of diagnosis, the period at the start of treatment, the duration of treatment, the duration of hospitalization, the speech problem the co-morbid complication and the ambulatory function at discharge These patients visited the department of rehabilitation medicine, Holy Family Hospital, Catholic university of Korea from June 1993 to June 1998. The patients were classified into two groups. One group (47 patients) was treated by Bobath trerapy and the other (40 patients) was not. The results were as follow ; 1) The period at the start of treatment was 15.3 days and the duration of treatment was 32.4 days 2) The shorter the period at the start of treatment, the shorter the duration of admission 3) There was no significant difference between two groups for the duration of hospitalization, seventy two percent of patients with Bobath treatment was walked compared with 25% of patients without Bobath treatment was. 4) There was no relation between the speech problem and the duration of admission, but the group with no speech problem showed better results in ambulation than those with speech problem. On conclusion, as soon as possible early rehabilitation treatment of the stroke patients should be performed in order to reduce the duration of hospitalization. Special(or professonal) treatment with Bobath therapy show more improved funtional recovery than that without Bobath therapy. Therefore actualization of Bobath therapy is also required.
Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.
This study was performed to investigate the clinical pictures and rehabilitation service patterns of stroke patients in cities of kimchon(kumi), jinju. pohwang, jeonju and jeju from January 1,2001 to march. Authors developed structured questionnaire, and distributed it to each physical therapist. Total number of distributed questionnaire was 400, and 301 questionnaire were col looted and analysed finally.1. The occurrence rate of hemorrhagic stroke(60.5%) was higher than that of ischemic stroke(39.5%). The highest incidence of the stroke was noted in the group of 50 years and ratio of male to female 1.3 : 1. 2. The several warning sign is motor deficit(42.5%). headache. dizziness, vomitting(31.9%) and difficulty speaking or understanding(10.6%). 3. The most important contributing factor of stroke was hypertension both hemorrhagic(50.0%) and ischemic stroke(40.3%). 4. In the painful stroke patients(53.2%). the major problems were shoulder pain(51.3%) and shoulder-hand syndrom(31.3%). 5. In hemorrhagic stroke. the seasonal preference was autumn and summer. In ischemic stroke. the seasonal preference was autumn and winter. 6. In the surgery, hemorrhgic stroke(44.5%) was higher than that of ischemic stroke(20.2%). 7 The major impairment were motor deficit(95.3%), psychological deficits(24.4%), hearing and speech deficit(23.4%). vision deficit(14.7%) and perception deficit(12.7%). 8. The rehabilitation services for stroke patients were physical therapy(98.0%), occupational therapy(41.5%), oriental therapy(35.1%), speech therapy(17.5%) and psychological therapy(7.4%). 9. The start of rehabilitation service was different according to surgery. 36.5% of patients started physical therapy in 4 week and 32.0% of patients started in 8 week later in surgery and 53.1% of patients started physical therapy in 2 week in not surgery( P<0.05). 10. The highest frequency of rehabilitation service was six times per week.
This study was performed to investigate rehabilitation service patterns of stroke patients in metropolis of Korea. Seoul, Taegu. Taejon, Pusan and Kwangju from April-July. 2000. Authors developed questionnair, and distributed it to each physical therapist. Total number of distributed questionnaire was 800, and 622 questionnaire were collected and analysed. 1. The occurrence rate of ischemic stroke$(51.1\%)$ was higher than hemorrage stroke$(48.9\%)$. The highest incidence of the stroke was noted in the group or60 years and ratio of male to female 1.3:1 2. The several warning sign is motor deficit$(50.3\%)$, headache. dizziness. vomitting$(32.6\%)$ and difficulty speaking or understanding$(8.2\%)$. 3. The most important contributing factor of stroke was hypertension both hemorrage stroke$(50.7\%)$ and ischemic stroke$(47.2\%)$. 4. In the painful stroke patients$(53.4\%)$, the major problems were shoulder pain$(55.1\%)$ and shoulder-hand syndrome$(31.9\%)$. There is no clinical method for relieving the pain. 5. The seasonal preference was winter and autumn followed by summer and spring in regardless of diagnosis. 6. In the surgery, hemorrage stroke$(61.2\%)$ was higher than ischemic stroke$(13.5\%)$. 7. The major associated impairment were motor deficit$(99.0\%)$, hearing and speech deficit$(30.9\%)$.perception deficit$(15.9\%)$. psychological deficit$(14.1\%)$ and vision deficit$(10.6\%)$. We need more role of speech pathologist and psychotherapist. 8. The rehabilitation services for stroke patients were given only $15\%$ by onset. 9. Medical doctor did not checking everyday$(41\%)$. 10. Patents said that the physical therapist well understanding$(60.1\%)$ than medical doctor$(36.2\%)$ about their conditions.
Sung Kang Keyng;Hwang Choong Yeon;Lee Sang Kwan;Lee So Young;Cheong Sang Su;Kang Se Young;Lee Jong Deck
Journal of Physiology & Pathology in Korean Medicine
/
v.16
no.3
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pp.609-615
/
2002
A medical treatment of alternating current high-voltage electric field therapy is a method in which we get a healing effect, applying electric field to an organism through an artificial device. In order to estimate the clinical effects of alternating current high-voltage electric field load(HEALTHTRON) on the rehabilitation of stroke patients, improvement of a peripheral blood circulation, and psychogenic symptom, we used BEUNZEUNGHEYNG Instrument, NIHSS(the National Institutes of Health Stroke Scale), FIM(Functional Independence Measure)lnstrument to research BEUNZEUNGHEYNG and recovery of rehabilitative funation. and also we used Thermography, Pulse Meter to measure body temperature and pulse, blood elements, and neuro modulators. We have reached the following conclusions after researching the clinical effects of alternating current high-voltage electric field therapy on the recovery of rehabilitative function and peripheral blood circulation. 1. HEALTHTRON efficiently has increased the volume of peripheral blood circulation in stroke patients. 2. HEALTHTRON rapidly has treated the symptoms of sleeplessness, alertness, and dizziness of stroke patients. 3. HEALTHTRON rapidly has improved rehabilitative function of stroke patients and the adjustment to their activities.
Journal of the Korean Society of Physical Medicine
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v.15
no.4
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pp.163-174
/
2020
PURPOSE: This study examined the effects of Robot Tilt-table Training (RTT) on the lower extremity strength, balance, gait, and satisfaction with rehabilitation, in patients with subacute stroke (less than six months after stroke onset), and requiring intensive rehabilitation. METHODS: A total of 29 subacute stroke patients were divided into an RTT group (n = 14) and a Body Weight Support Treadmill Training (BWSTT) group (n = 15). The mean age of patients was 62 years. RTT and BWSTT were performed for four weeks, three times a week, for 30 minutes. Isometric strength of the lower extremities before and after intervention was compared by measuring the maximal voluntary isometric contraction of the lower extremity muscles. To compare the balance function, the center of pressure (COP) path-length and COP velocity were measured. Timed Up & Go test (TUG) and 10 Meter Walking Test (10 MWT) were evaluated to compare the gait function. A satisfaction with rehabilitation survey was conducted for subjective evaluation of the subject's satisfaction with the rehabilitation training imparted. RESULTS: In the intra-group comparison, both groups showed significant improvement in lower extremity strength, balance, gait, and satisfaction with rehabilitation, by comparing the parameters before and after the intervention (p < .05). Comparison of the amount of change between groups revealed significant improvement for all parameters in the RTT group, except for the 10 MWT (p < .05). CONCLUSION: Both groups are effective for all variables, but the RTT group showed enhanced efficacy for variables such as lower extremity strength, balance, gait, and satisfaction with rehabilitation, as compared to the BWSTT group.
Journal of The Korean Society of Integrative Medicine
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v.8
no.2
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pp.121-130
/
2020
Purpose : The objective of the current study was to evaluate the impact of the Computer-Based Cognitive Rehabilitation Program (CoTras) on the cognitive function and daily living activities of elderly and adult stroke patients. Methods : Twenty stroke patients were divided into two groups comprising 10 elderly stroke patients and 10 adult stroke patients. The CoTras was applied as the intervention for 30 minutes at a time, three times a week, for nine weeks (i.e., a total of 27 times), to both groups. The Neurobehavioral Cognitive Status Examination was used to assess cognitive function, and the Functional Independence Measure was utilized to evaluate daily living activities, prior to, during, and after the intervention. Results : The CoTras was demonstrated to have a statistically significant and positive effect on the cognitive function and daily living activities of stroke patients. However, the effect of the program on the restoration of weight-shifting capacity, as a component of the daily living activities of stroke patients, was without statistical significance. The program had a greater influence on improving the cognitive function and daily living activities of elderly stroke patients than adult stroke patients. Conclusion : This study makes a meaningful contribution to the literature on the topic as the intervention was demonstrated to lead to a more significant recovery of cognitive function and daily living activities in elderly stroke patients, compared to adult patients. Therefore, it is proposed that the CoTras should be used as a clinical intervention for elderly stroke patients. Future studies that evaluate the application of the CoTras, along with other occupation-based intervention programs, are warranted.
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