• Title/Summary/Keyword: 뇌졸중재활

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The Effect of Optokinetic Stimulation with Smooth Pursuit Eye Movement to Chronic Hemispatial Neglect: A Pilot Study (완곡 추적 안구운동을 동반한 시운동자극이 만성 편측무시에 미치는 영향 : 예비연구)

  • Shin, Jae-Yong;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.81-92
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    • 2016
  • Objective: This study aim is to identify whether 30minutes optokinetic stimulation(OKS) with smooth pursuit eye movement can alleviate chronic hemispatial neglect. Methods: We applied optokinetic stimulation with smooth pursuit eye movement to 2 chronic hemispatial neglect patients. experimental duration was total 4weeks - 1week baseline, 2weeks OKS intervention, 1week 2nd. baseline. The intervention was 10 OKS sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 3 times a week every other day. The OKS was provided on the screen when patient sat in front of the screen(13.5 inch). The OKS video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results: As a result of the OKS for 2weeks, the degree of neglect trends to decrease on both 2 cases compared to baseline A. The degree of the neglect of subject 1 tended to increase the at the baseline A. In contrast, the subject 2 showed that tendency that the degree of the neglect declined additionally at the baseline A. Conclusions: We identified that 30 minutes optokinetic stimulation with sooth pursuit eye movement is effective intervention method for chronic hemispatial neglect.

The Effect of Smooth Pursuit Eye Movement Using Portable Device to Chronic Hemispatial Neglect: A Pilot Study (휴대용 디바이스를 이용한 완곡추적 안구운동이 만성 편측무시에 미치는 영향: 예비연구)

  • Shin, Jae-Yong
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.71-83
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    • 2017
  • Objective : This study aim is to identify whether smooth pursuit eye movement(SPEM) using portable device can alleviate chronic hemispatial neglect. Methods : We applied smooth pursuit eye movement to one chronic hemispatial neglect patient. Experimental duration was total 4weeks - 1week baseline, 2weeks SPEM intervention, 1week 2nd. baseline. The intervention was 10 SPEM sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 5 times a week. The SPEM was provided on the screen when patient sat in front of the screen(8.4 inch tablet pc, distance 40cm). The SPEM video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results : As a result of the SPEM for 2weeks, the degree of neglect tended to decrease compared to baseline A. The degree of the LBT tended to increase the at the baseline A'. In contrast, the SCT showed that tendency which the degree of the neglect maintained at the baseline A'. Conclusion : We identified that SPEM using portable device is effective intervention method for chronic hemispatial neglect.

Study on the Relationship between Family Support and Functional Recovery in Cerebrovascular Accident Patients with Rehabilitation Treatment of Oriental Medicine (한방재활치료를 받은 뇌졸중 환자가 지각한 가족지지와 기능회복에 관한 연구)

  • Kim, Kwang-Joo;Lee, Hyang-Yeon
    • Journal of East-West Nursing Research
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    • v.2 no.1
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    • pp.22-36
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    • 1997
  • Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.

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The Effect of Mental Practice with Task Activities on Upper Limbs Movement Speed and Accuracy of Ideomotor Apraxia Patients : Single Subject Experimental Research (상상연습과 과제활동 병행 치료가 관념운동 실행증 환자의 상지 움직임 속도와 정확성에 미치는 효과: 단일사례 실험연구)

  • Lee, Jae-Hong;Jang, Jong-Sik;Lee, Jae-Shin
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.2
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    • pp.11-22
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    • 2014
  • Objective : The purpose of this study is to investigate the effect of mental practice with task activities through upper limbs movement speed and accuracy in ideomotor apraxia patient. Methods : As a single subject research design with multiple baseline across individuals, the patients were two ideomotor apraxia patients, employed in this study. The employed program included receiving mental practice and task activities, measuring change of the total performance times, time to put down the last cups and amount of water in cups for 4 weeks, including baseline and intervention periods. The subject were measured by Ideomotor apraxia test and MFT were analyzed. The analyses were performed using visually and two-standard deviation band method. Results : All subjects were a reduction in symptoms of apraxia, but noticeable change in upper limbs function was not there. Total time of performance from 376.67 to 355.24 seconds, 391.33 seconds to 434.60 seconds, reduced. Put down the cup of performance time from 15.67 to 13.30 seconds, 20.80 seconds to 10.73 seconds, reduced. The amount of water transferred from 52.38ml to 49.70ml, 50.89ml to 50.09ml, all results were closer to 50ml. Conclusion : As a result of this study, mental practice with task activities can be an effective method to ideomotor apraxia patients. This study would serve a fundamental data on ideomotor apraxia patients to the further studies.

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Effect of Non-paralyzed side and Paralyzed side of Elastic Band Combined with Proprioceptive Neuromuscular Facilitation Lower Extremity Patterns on Balance in Chronic Stroke Patients (비 마비 측과 마비 측에 적용한 탄력밴드를 결합한 고유수용성 신경근 촉진법 하지패턴이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Lee, Young-Min;Ham, Min-Sik;Kim, Taek-Soo
    • PNF and Movement
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    • v.13 no.4
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    • pp.181-188
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    • 2015
  • Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

Factors Affecting Activity Restriction in the Elderly with Chronic Disease: Using data from the 8th period of the National Health and Nutrition Examination Survey (만성질환 노인의 활동 제한에 영향을 미치는 요인: 국민건강영양조사 제 8기 자료를 활용하여)

  • Hwang, Ho-Sung;Choi, Ji-Hyun;Kim, Su-Kyoung
    • Journal of the Korea Convergence Society
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    • v.12 no.11
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    • pp.359-369
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    • 2021
  • In this study, a complex sample logistic regression analysis was performed to identify the factors affecting the activity restriction of 2,701 normal elderly and chronically ill elderly aged 65 and over using raw data from the 8th period of the National Health and Nutrition Examination Survey. It was found that the elderly with chronic disease felt more restricted in their activities than the normal elderly. Activity limiting factors in stroke and hypertension patients are subjective health status, economic level, stress perception, and moderate-intensity work and leisure. The factors limiting activity in patients with heart disease were subjective health status and economic level, and factors limiting activity in patients with joint disease were subjective health status and high-intensity work and leisure. Activity limiting factors for lung disease patients are education level, high intensity work and leisure, and endocrine system activity limiting factors include subjective health status, stress perception, high intensity work and leisure, and activity limiting factors for cancer patients. is subjective health status, stress perception, moderate-intensity work and high-intensity leisure. Rehabilitation programs and policy support are needed for the continuous participation of the elderly with chronic diseases.

Analysis of Occupational Therapy Intervention Studies for Improvement of Neglect: Single Subject Study (편측무시 개선을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로)

  • Kim, Jin-Yeong;Youn, Sae-Woong;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.9-23
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    • 2023
  • Objective : Among the studies using neglect interventions in the field of occupational therapy, this study was conducted to confirm the contents and characteristics of literature applying single-subject studies, and to analyze the intervention effect and quality level. Methods : This study is a systematic review, and the single subject study published in academic journals for the last 10 years. Results : As a result of the thesis analysis, it was conducted on stroke, and the removal design with seven studies, and two studies were multiple baseline designs. As a result of analyzing the size of the intervention effect applied to neglect, 'highly effective' was found seven times, 'fairly effective' 18 times, 'questionable effective' five times, and 'unreliable effective' six times. As a result of the quality level, there were no studies with low level, with six high level and three medium level. Conclusion : As a result of the study, various methods were applied to neglect interventions. It is thought that this study will provide basic data for evidence-based interventions.

Correlation of Mental State with Resilience of Stroke Patients during Rehabilitation (뇌졸중 환자의 재활치료 중 정서 상태와 회복 탄력도와의 관련성 연구)

  • Kyeong-Jin Ko;Ji-Eun Oh;Ha-Min Lee;Hyung-Won Kang;Sun-Ho Shin;Yeoung-Su Lyu
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.2
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    • pp.163-175
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    • 2024
  • Objectives: To investigate the relationship between rehabilitation treatment, mental state and resilience of stroke patients undergoing rehabilitation by examining the correlation between The Core Seven Emotions Inventory-Short Form (CSEI-s) and the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). Methods: All 104 participants (44 diagnosed with stroke who were receiving rehabilitation and 60 without stroke or psychiatric history) completed the CSEI-s, K-CD-RISC, and Questionnaire for stroke symptoms. All data were analyzed using by Statistical Package for the Social Sciences (SPSS) ver. 27.0. Descriptive statistics, chi-square test, t-test, Mann-Whitney U test, Kruskal-Wallis H test, and Pearson correlation coefficient were used for data analysis. Results: As a result of the CSEI-s, compared to the control group, the stroke group showed significantly lower Joy (喜) scores and significantly higher scores for Depression (憂) and Sorrow (悲). With a morbidity period of 12 months or less, the Thought (思) score was significantly higher. The Fear (恐) score was significantly higher when the rehabilitation was initiation more than 4~8 weeks after than that when the treatment was started immediately. Meanwhile, the K-CD-RISC score was significantly higher when rehabilitation was started immediately. In the stroke group, the K-CD-RISC score was positively correlated with Joy (喜) but negatively correlated with Depression (憂) and Fear (恐). In the control group, K-CD-RSIC showed a positive correlation with Joy (喜) but negative correlations with Depression (憂), Sorrow (悲), and Fear (恐). Conclusions: In addition to early rehabilitation treatment, mental approach through Korean medicine psychotherapy is crucial for enhancing the resilience of stroke patients.

The Reliability and Convergent Validity of the 180 ° Turn Test in Stroke Patients and the Effects of Turn Direction on Time and Step Count (뇌졸중 환자의 180 ° 회전 검사의 신뢰도와 수렴 타당도 및 회전 방향이 소요시간과 걸음 수에 미치는 효과 )

  • Sung-Heon An;Byoung-Kwon Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.189-199
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    • 2024
  • Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 m/s) were unaffected by turning direction, while slower speeds (<0.58 m/s) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

The relationship of cognitive function and physical recovery stage on quality of life in stroke patients (뇌졸중 환자의 인지기능과 신체회복단계가 삶의 질에 미치는 영향)

  • Yeoil Jeon;Sangwoo Kim;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.3
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    • pp.51-65
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    • 2024
  • Background: The patients common have side effects of cognitive and function dysfunction after a stroke. According to specific factors which influence quality of life(QoL), the QoL of stroke survivors are impacted resulting from diverse interactions. Therefore, This study aims to suggest that we determines the relationship between cognitive function and stage of physical recovery and the quality of life as well as the degree of recovery by cluster analysis of the relationship between the degree of physical recovery and the quality of life Design: Randomized Methods: The following tests were used in this study to evaluate cognitive function, recovery stages and quality of life respectively: Cognitive function was measured using Korea-Mini Mental State Examination(K-MMSE). For evaluation of recovery stages, Brunnstrom Rrecovery Stage(BRS), quality of life was measured using Stroke Specific -Quality Of Life(SS-QOL). The sample size of this study was calculated using G*Power Version 3.1.9.7 (Franz Faul, University kiel, Germany, 2020). Based on moderate effect size of 0.15, a significance level (α) of 0.05, and power of 0.90 in the two-sided test, the calculation revealed that 88 patients were required for questionnaires. Results: The results of this study showed significant positive correlation(p<0.05). As a result of cluster analysis, in the case of the physical recovery stage, the degree of physical recovery improves from cluster 1 to cluster 3 and in the case of the quality of life, the quality of life improves from cluster 1 to cluster 3. However, it was confirmed that the change in the quality of life of cluster 1 and cluster 2 was not significant. These results show that the degree of physical recovery has a greater impact on the quality of life in the late stages of physical recovery, while the degree of physical recovery does not have a significant effect on the quality of life in the early and mid-term of the physical recovery stage. Conclusion: This study confirms that cognitive function, recovery stages and quality of life have significant correlations, and the recovery status has impacted on quality of life.