• Title/Summary/Keyword: 뇌졸중 후

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Effects of Swallowing Training with Biofeedback on Swallowing Function and Satisfaction in Acute Stroke Patients with Dysphagia (생체되먹임을 통한 삼킴훈련이 삼킴장애가 있는 급성기 뇌졸중 환자의 삼킴기능과 만족감에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Gyu-Yong;Won, Young-Sik
    • The Journal of the Korea Contents Association
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    • v.17 no.4
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    • pp.63-71
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    • 2017
  • The purpose of current investigation was identified to the effects of swallowing training with surface electromyography biofeedback on swallowing function and dietary level, satisfaction in acute stroke patients with dysphagia. Sixteen acute stroke patients with dysphagia was participated in our study. All stroke paitents were allocated in randomly to experiemental group(n=8) and control group(n=8). Both group received traditional dysphagia therapy during 30min/day, five per week, for four weeks. experimental group was perfomed swallowing training with surface electromyography biofeedback, additionally 30 min/day, and control group received only swallowing training, additionally 30 min/day. Assessments evaluated Functional Dysphagia Scale(FDS) and Penetration-Aspiration Scale(PAS) for measure of swallowing function, and Functional Oral Intake Scale(FOIS) assessed for measure of dietary level. satisfaction assessed by using Visual Analog Satisfaction Scale(VASS). In results, after intervention both group improved significant on swallowing function, and dietary level, compared to before intervention(p<0.05). After intervention, satisfaction of both group was not significant difference(p>0.05). In comparison of change score between two group, experimental group improved significantly than control group in dietary level(p<0.05). Swallowing training with surface electromyography biofeedback may be a effective dysphagia therapy to improve on dietary level in acute stroke patients with dysphagia.

The Effect of Action Observation Training on Dexterity of Affected Upper Extremity Motor Function and ADL in Stroke Patients (과제지향적 동작관찰훈련이 뇌졸중 환자의 환측 상지기민성과 일상생활활동에 미치는 영향)

  • Eom, Sook;Kim, Su-Kyoung
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.55-66
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    • 2013
  • Objective : The purpose of present study was to determine effects of task oriented action observation training on dexterity of upper limb function after stroke. Training was progressed to imitation and intensive training after observation to required action in ADL. Method : 15 stroke patients were selected and one group pretest-posttest design was applied. Targets observed performance actions of task orientated task through a video and limitated action repeatedly, Training was performed 3 times a week and 20~30 minutes for each round for 3 weeks. Manual function test and 10-second test and Box and block test were performed for a dexterity of upper extremity motor function, Modified Barthel index and Motor activity log were performed for ADL. Result : After the training, a dexterity of affected upper extremity motor function of the target showed significant difference between before and after intervention, ADL showed significant improvement between before and after intervention. Conclusion : Task orientated Action observation lead a positive effect of recovering a dexterity of upper extremity motor function and ADL. Therefore, this study suggest a action observation training as one strategy of an intervention type of th e occupational therapy.

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Effects of Training on Sit to Stand on Various Seat Heights on the Balance in Stroke Patients (다양한 좌석 높이에서 일어서기 훈련이 뇌졸중 환자의 균형에 미치는 영향)

  • Kim, Hyun-Sung;Seo, Byoung-Do
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.12
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    • pp.253-260
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    • 2020
  • This study aimed to compare the effects of sit-to-stand training, or training to stand up from sitting positions at various seat heights, on the balance recovery among stroke patients. This study included 20 stroke patients who were randomly divided into two groups. Each group was trained for six weeks, three times a week from March to June 2019. Static balance and dynamic balance were measured, and the variations were analyzed using the paired t-test and the independent t-test. There were significant changes observed in both static and dynamic balance (p<.05) before and after training. However, no significant changes were seen in the static balance in the standing posture with eyes closed (p>.05). This study confirmed that there was a significant effect of training on the balance of stroke patients, especially when progressively lower seat heights were used during the training. This suggests new directions for treatment during rehabilitation for balance recovery of stroke patients. Further studies will need to apply this training to a larger number of subjects, and use various training methods such as randomization of seat height to enable the generalization of the results of this study and application in clinical practice.

Significance of Dexamethasone Suppression Test in Patients with Stroke (뇌졸중 환자에서 Dexamethasone 억제검사의 의의)

  • Kim, Wook-Nyeon;Kim, Seong-Min;Kee, Beung-Su;Park, Mee-Young;Hah, Jung-Sang;Byun, Yeung-Ju
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.63-71
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    • 1994
  • The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. These tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control(p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results(p<0.01) 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Sinificantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

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An Application of Constraint-Induced Therapy in Patients With Chronic Hemiparesis After Brain Injury (뇌 손상 후 편부전마비 환자에서의 억제-유도 치료의 적용)

  • Park, Ji-Won;Kim, Jong-Man;Kim, Yun-Hee
    • Physical Therapy Korea
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    • v.8 no.4
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    • pp.91-99
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    • 2001
  • 뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환측 상지를 사용하게 하여 기능을 반복 학습하게 함으로써 기능을 증진시키는 방법이다. 이미 여러 연구자들이 경두개 자기자극(transcranial magnetic stimulation), 움직임 관련 피질전위(movement-related cortical potential), 기능적 자기공명 영상기법(functional magnetic resonance imaging) 등을 통하여 억제-유도 치료 후 운동피질영역에서의 재조직화를 보고함으로써 기능 증진과 관련된 회복 기전을 뒷받침하고 있다. 억제-유도 치료의 영역은 확대되어 뇌졸중, 척수손상, 고관절 치환술 후로 하지에서의 기능증진을 위하여 연구가 진행되고 있으며 특히 뇌졸중 후 실어증 환자에서 새로운 방법으로 제시되고 있다. 따라서, 억제-유도 치료는 신경학적인 손상 후 움직임의 재활에 있어서 치료-유도를 통한 중추신경계의 회복에 효과적으로 작용할 수 있다.

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A Study on Factors in Quality of Life of Patients with Acute Cerebral Infarction One Year after Diagnosis (급성기 뇌경색 발생 환자의 1년 후 삶의 질 관련요인)

  • Shin, Seung-Ok;Ryu, So Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.1
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    • pp.274-282
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    • 2014
  • This study aimed to investigate the general characteristics of patients with acute cerebral infarction, the characteristics of its treatment and its correlation with stroke rating scale and to analyze the factors that affect patient's quality of life. The subject of this study was 576 patients who survived more than a year after they were diagnosed with cerebral infarction that occurred within 7 days and discharged from a study center. Their quality of life was investigated through phone interview. The average age of subjects was $65.8{\pm}12.4$ years old and male subjects took up 62% among all subjects. The mean of quality of life showed $0.77{\pm}0.29$. There was statistically significant difference in factors such as gender, age, hypertension, atrial fibrillation, stroke history and smoking. The result of multiple regression analysis showed the quality of life was lower in females than in males and it was significantly low in older subjects or those with stroke history. Also high stroke scale was related to significantly low quality of life. As such, hospitalized patients due to stroke should receive appropriate intervention during the hospitalization and after their discharge and the development of program is required to prevent relapse.

The Effects of Virtual Reality Program on Fall Efficacy and Activities of Daily Living for Patients with Stroke (가상현실 프로그램이 뇌졸중 환자의 낙상 효능감과 일상생활활동에 미치는 영향)

  • Lee, Jong-Min;Kim, Dong-Hee;Song, Seung-Il
    • The Journal of Korean society of community based occupational therapy
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    • v.2 no.2
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    • pp.25-35
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    • 2012
  • Objective : The purpose of this study was to investigate the effect of virtual reality program on fall efficacy and activities of daily living(ADL) for patients with stroke. Method : Twenty stroke patients were participated voluntarily and were assigned randomly into the control and the experimental groups. Both control and experimental groups were given same basic rehabilitation treatment while only the experimental group was given virtual reality program. The fall efficacy of both groups was assessed using fall efficacy scale(FES) and ADL performance ability was assessed by functional independence measure(FIM). Result : Fall efficacy and ADL performance ability showed a statistically meaningful difference for both experimental and control groups(p< .05), the fall efficacy and ADL performance ability of the experimental group improved meaningfully in a statistical way than that of the control group(p<. 05). Conclusion : It was found that carrying out virtual reality program with occupational therapy has an effect on fall efficacy and ADL performance ability of patients with stroke. Therefore, virtual reality program can be a way of treatment for patients with stroke to improve their fall efficacy and ADL performance ability, and the program can also be applied in clinics as well as occupational therapy.

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The Effects of Lower Extremity Strengthening Program on Balance, Gait and Upper Limb Function in Patients with Stroke (뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과)

  • Kim, Ju-O;Lee, Byoung-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.6
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    • pp.114-123
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    • 2020
  • The purpose of this study was to determine the effect of lower extremity strengthening program on balance, gait and upper limb function in patients with stroke. This study was a hospital-based with Central nerve system lesion patients, randomized controlled trial with a blinded assessor. Twenty four hemiparetic stroke patients were divided into two groups: a Lower extremity strengthening program group (LESPG)(n=12) and a Treadmill training group (TTG)(n=12). The LESPG performed a Lower extremity strengthening program on the affected side. The TTG exercised on a treadmill for 30 minutes a day. Assessment tools included the Timed Up and Go test (TUG), the Functional Gait Assessment (FGA) and the Manual Function Test (MFT). There was a significant difference in TUG, FGA, and MFT scores between the two groups in the LESPG for the balance, gait, and upper limb function than for the TTG(p<.01). Results of the present study indicated that the effect of lower extremity strengthening program for 4 weeks had an effect on balance, gait and upper limb function of hemiplegic patients after stroke.

Effects of Inspiratory Muscle Training on Diaphragm Thickness, Pulmonary Function, and Chest Expansion in Chronic Stroke Patients (흡기근 저항훈련이 만성 뇌졸중 환자의 횡격막 두께와 폐기능에 미치는 효과)

  • Jung, Ju-Hyeon;Kim, Nan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.1
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    • pp.59-69
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    • 2013
  • 연구목적: 본 연구는 만성 뇌졸중 환자를 대상으로 흡기근 저항훈련이 횡격막 두께와 폐기능 및 흉곽 확장에 미치는 효과를 알아보고자 수행하였다. 연구방법: 연구 대상자는 총 29명(남자 17명, 여자 12명)으로 흡기근 저항훈련군(15명)과 대조군(14명)으로 분류하였다. 모든 대상자는 6개월 이상된 만성 뇌졸중 환자로 일반적인 신경발달치료를 받고 있으며, 같은 기간 동안 흡기근 저항훈련군에 역치부하 흡기근육 단련기(threshold IMT device)를 제공하고 주 3회${\times}$1회 20분씩 6주간 시행하였다. 마비측과 비마비측 횡격막 두께측정을 위해 초음파의 7.5MHz linear probe를 사용하여 최대 흡기시(Tdi.con)와 휴식시(Tdi.rel)의 두께를 측정하고 수축률(TR)을 계산하였다. 또한 폐 활량계를 사용하여 노력성 폐활량을 측정하였으며, 줄자를 사용하여 흉곽 확장을 측정하였다. 연구결과: 6주간 중재 후 흡기근 저항훈련군에서 최대흡기시 횡격막 두께(Tdi.con)와 수축률(TR)은 유의한 증가를 보였다(p<.05). 1초간 노력성 호기량 ($FEV_1$)과 최대 호기 속도(PEF)도 유의한 증가를 보였으나(p<.05), 노력성 폐활량(FVC)과 1초간 노력성 호기량의 노력성 폐활량에 대한 비($FEV_1$/FVC), 흉곽 확장은 유의한 증가는 보이지 않았다(p>.05). 결론: 본 연구는 만성뇌졸중 환자를 대상으로 흡기근 저항훈련의 적용이 횡격막의 수축력과 폐기능 및 흉곽 확장력을 향상시켜 호흡근의 협응력을 증가시키고, 비활동성으로 인해 감소된 운동내성을 증가하게 함으로써 향후 재활에서 만성 뇌졸중 환자에게 2차적인 기능향상에 도움을 줄수 있을 것으로 보여진다.

A Convergence Study on the Effects of functional electrical stimulation with mirror therapy on balance and gait ability in chronic stroke patients. (기능적 전기자극을 병행한 거울치료가 만성 뇌졸중 환자의 균형 및 보행능력에 미치는 영향에 관한 융합적 연구)

  • Kim, Dong Hoon;Kim, Kyung Hun
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.109-120
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    • 2018
  • The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with mirror therapy on balance and gait ability in chronic stroke patients. Thirty-five subjects who met the inclusion criteria were randomly allocated into three groups: the functional electrical stimulation with mirror therapy group(FMT group, n=11), mirror therapy group(MT group, n=12), and control group (n=12). The exercises were conducted for 30 min per day, five, per week for four weeks. Balance and gait ability were examined at baseline and after 4 weeks of intervention. After training, the FMT group showed significant improvement in berg balance scale (BBS), center of pressure (COP) length, affected step length (ASL), Cadence and average gait speed (AGS) compared MT group and control group(p<0.05). This findings show that FES and MT convergence can be an effective intervention for stroke patients balance and gait ability. Continued development of convergence interventions for stroke patients with balance and gait ability in practice, are suggested.