• 재활간호학회지
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• 제13권1호
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• pp.23-31
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• 2010

Purpose: The purpose of this study were to describe the level of activities of daily living (ADLs) and fatigue of stroke patients and to identify related factors of ADLs and fatigue. Method: A sample of 132 were used who were recovering from stroke. The face-to-face interviews were conducted to collect data. The levels of ADLs and fatigue were evaluated using the Modified Barthel Index and Kim's fatigue scale respectively. A series of t-test and analysis of variance analyses were conducted to examine study purposes using SPSS 15.0. Results: The levels of fatigue and ADLs were 65.6 (SD=16.52) and 74.6 (SD=22.32) respectively. Significantly poorer ADLs were found: women (t=2.05, p=.001), older people aged ${\geq}$ 70 years (F=2.74, p=.046), the duration of onset (F=4.34, p=.006), the use of assist devices (F=35.64, p<.001), the parts of paralysis (F=4.25, p=.007), the time to attack (F=3.34, p=.039), and accompanying symptoms (F=15.23, p<.001). There was a significant difference in fatigue with patients with lower accompanying symptoms having lower fatigue (F=11.08, p<.001). Conclusion: These findings suggest gender, the duration from onset, the use of assist device, the parts of paralysis, the time to attack and accompanying symptoms were significant factors of the ADLs and fatigue post stroke. These factors should be considered when developing and testing nursing intervention programs for stroke survivors.

• 대한한방내과학회지
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• 제31권2호
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• pp.308-313
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• 2010

Objectives : The weekly variation of ischemic stroke incidence according to the age and sex. Methods : 977 consecutively admitted patients (521 males and 456 females) in a single stroke center from 2006 to 2008. All cases were confirmed with standardized criteria. We used the independent t-test and $x^2$ test in statistical methods. Results : The results demonstrated significant weekly variations of ischemic stroke incidence showing higher incidence on Saturday, Monday and Tuesday and lower incidence on the other days. Difference of ischemic stroke incidence was also shown between transit days, which included the transit days from the weekend to the week and vice versa, and non-transit days. Those aged older than 60 years and females showed more significant differences of weekly variation on transit days than on non-transit days. Conclusions : Ischemic stroke incidence has significant weekly variation, and transit days have higher incidence than non-transit days. Further study is required to identify the general weekly variation by multi-center trial.

• 한국치위생학회지
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• 제18권5호
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• pp.653-664
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• 2018

Objectives: The purpose of this study was to examine the association between two major oral diseases and cardiovascular diseases. Methods: Data from the 6th Korean National Health and Nutrition Examination Survey (2013-2015) were used. The study included 12,754 adults, aged ${\geq}19years$, who participated in the questionnaire survey of health related to hypertension, stroke, myocardial infarction, and angina pectoris as well as completed blood tests, anthropometry, and oral examination. Statistical analyses included complex sample frequency, complex sample general linear, complex sample cross-tabulation, and complex sample logistic regression analyses. Results: With respect to the number of Decayed-Missing-Filled-Teeth(DMFT ), patients with hypertension (DMFT 8.05), stroke (DMFT 8.66), and angina pectoris (DMFT 8.24) showed a DMFT score of >2, compared with those who did not have these diseases (p<0.05). Patients with hypertension, stroke, myocardial infarction, and angina pectoris presented an approximately 2.7, 3.5, 4, and 3 times higher incidence of periodontal diseases, respectively, than those who did not (p<0.05). Based on the analysis of the relationship between the number of DMFT and cardiovascular diseases, patients with cardiovascular diseases had a risk of 1.033 higher DMFT than those who did not (p<0.05). As per the analysis of the relationship between periodontal diseases and cardiovascular diseases, patients with cardiovascular diseases had a 2.969 higher risk of periodontaldiseasesthanthosewithout them (p<0.05). Conclusions: Two major oral diseases were found to be associated with cardiovascular diseases. Therefore, to prevent these major oral diseases in patients with cardiovascular diseases, oral hygiene management must be actively performed.

• PNF and Movement
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• 제12권2호
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• pp.123-132
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• 2014

Purpose: The discovery of mirror neuron system may positively affect functional recovery; therefore, rehabilitation is needed that is practical for use in clinical settings. The purpose of this study was to examine the effect of action observation training on upper motor function in people who had suffered strokes. Methods: Three elderly patients with stroke, aged to years, were recruited from a stroke rehabilitation center. A nonconcurrent, multiple baseline subject approach was taken, with an A-B-A treatment single-subject experimental design, and the experiment was conducted for 3 weeks. The action observation training was repeated 5 times in 5 days during the intervention period. The arm function, including WMFT, BBT, and grip and pinch strength, was evaluated in each subject 5 times during the baseline period, the intervention period, and the baseline regression period. Results: The results of the evaluation for each subject were presented as mean values and video graphs. The WMFT scores of 2 subjects were improved during the intervention period in comparison with the baseline period, and this improvement was maintained even during the regression baseline period. The BBT and the grip and pinch strength were not improved. Conclusion: Based on these results, we suggest that the action observation training for 5 sessions was effective in improving upper limb function of stroke patients but was not effective in improving hand dexterity or grip and pinch strength.

• Journal of Chest Surgery
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• 제57권3호
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• pp.242-251
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• 2024

Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

• 한국임상약학회지
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• 제32권1호
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• pp.37-46
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• 2022

Background: Non-valvular atrial fibrillation (NVAF) is associated with ischemic stroke risk in the aging population. Observational studies have indicated beneficial effects of direct-acting oral anticoagulant (DOAC) against ischemic stroke compared to warfarin. This study aimed to investigate ischemic stroke incidence and bleeding risk in patients on DOAC therapy. Methods: Using the database of Korean Health Insurance Review and Assessment-Aged Patient Sample 2015, we conducted a retrospective cohort study. Study subjects with NVAF diagnosis and prescribed anticoagulants were enrolled. Propensity score (PS) matching by age, sex, comorbidities, and medications were used. The clinical outcomes were major adverse cerebro-cardiovascular events (MACCEs, ischemic stroke/systemic embolism, myocardial infarction, cardiac death) and bleeding events. A cox proportional hazard model analysis was performed to compare the outcomes with hazard ratio (HR) and 95% confidence interval (CI). Results: Total 4,773 elderly patients with NVAF were initially included. Four PS-matched groups including rivaroxaban vs. warfarin-only (n=1,079), dabigatran vs. warfarin-only (n=721), rivaroxaban vs. dabigatran (n=721), and switchers of warfarin to rivaroxaban vs. warfarin-only (n=287) were analyzed. Every group showed statistically similar results of MACCEs and bleeding events, except for the group of rivaroxaban vs. dabigatran. Rivaroxaban users showed higher risks of bleeding events than dabigatran users (HR 2.25, 95% CI 1.01-4.99). Conclusion: In the elderly patients with NVAF, efficacy and safety outcomes among oral anticoagulants including DOACs and warfarin were similar, while rivaroxaban are more likely to have higher bleeding risks than dabigatran. Further research using large size sample is needed.

• 대한물리의학회지
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• 제10권3호
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• pp.47-55
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• 2015

PURPOSE: Stoke is one of most common disabling conditions and it is still lacking of measuring patient's functioning level. The aim of the study was to develop Korean language version of stroke impact scale 3.0. METHODS: Korean version of stroke impact scale 3.0 was developed in idiomatic modern Korean with a standard protocol of multiple forward and backward translations and an expert reviews to achieve equivalence with the original English version. Interviews with clinicians who were currently managing patients with stroke were also conducted for language evaluation. A reliability test was performed to make final adaptation using a pre-final version. To assess the reliability of the translated questionnaire, the intraclass correlation coefficient (ICC) was calculated for each domain of the scale. RESULTS: Thirty subjects (16 male, 14 female) aged from 20 to 75 years old participated to review the translated questionnaire. Reliability of each domain of the questionnaire was found to be good in strength (ICC=0.74), ADL (ICC=0.81), mobility (ICC=0.90), hand function (ICC=0.80) and social participation (ICC=0.79), communication (ICC=0.77) with total (ICC=0.76). However, domains of memory and thinking (ICC=0.66), and emotion (ICC=0.27) and showed poor reliability. CONCLUSION: This study indicates that the Korean version of SIS 3.0 was successfully developed. Future study needed for obtaining the validity of the Korean version of SIS 3.0.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.12-19
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• 2005

The purpose of this study was to investigate the possibility of virtual moving surround (VMS) on static balance in the patients with balance dysfunction. Eighty three subjects who were admitted or treated as an outpatient, or a family member, at the department of rehabilitation unit of university hospital were recruited to participate. Subjects were three groups based on their overall medical status: healthy, diabetic neuropathy and stroke. Each group was tested for static balance with a forceplate during static standing with VMS. The virtual movement was simulated with a head mounted display. The parameters for static balance were total sway path. In this study, the parameters of postural control for patients with diabetic neuropathy and stroke subjects were significantly increased in conditions elicited with the VMS. In the healthy elderly participants, the total sway path was not significantly different under virtual movement conditions. Therefore, VMS could be used in the evaluation and treatment of the patients with balance dysfunction.

• 대한간호학회지
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• 제45권1호
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• pp.46-53
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• 2015

Purpose: This study was conducted to examine the effect of oral care with an aroma solution on oral status and oral cavity microorganism growth in elderly patients with stroke. Methods: A non-equivalent control group, with a pretest-posttest design was used in this study. The participants were assigned to the experimental group (n=30) that received oral care with an aroma solution or the control group (n=31) that received 0.9% saline solution. To identify the effect of the experimental treatments, objective/subjective assessments of oral status and oral cavity microorganism growth were performed using the oral assessment guide, oral perception guide, and oral swab culture. Data were analyzed using Chi-square test, Fisher's exact test, and t-test with the SPSS version 21.0 program. Results: The objective oral status was significantly lower in the experimental group than in the control group (t= -3.64, p<.001). There was no significant difference between the subjective oral status of the experimental group and control groups (t= -1.24, p=.109). Oral microorganism growth was significantly lower in the experimental group than in the control group (t= -7.39, p<.001). Conclusion: These findings indicate that special mouth care using an aroma solution could be an effective oral health nursing intervention for elderly patients with stroke.

• PNF and Movement
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• 제20권1호
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• pp.115-123
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• 2022

Purpose: The aim of this study was to investigate the effects of sit-to-stand training with various foot positions combined with visual feedback on muscle onset time and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned into three standing groups: one with a symmetrical foot position (SSF; n = 10), one with an asymmetrical foot position with the affected foot at the rear (SAF; n = 10), and one with visual feedback and an asymmetrical foot position (SVAF; n = 10). Sit-to-stand training with different foot positions was performed for 30 minutes a day, 5 times a week, for a total of 4 weeks. The effects on muscle onset time and balance were assessed. Results: In a comparison of the onset time of muscle contraction, the onset time of the affected side tibialis anterior and less-affected side gastrocnemius muscle and tibialis anterior was significantly shortened in the SAVF group. And onset time of the less-affected side tibialis anterior was shortened in the SAF group. There was a significant difference in the result of functional reach testing in the SVAF group. Conclusion: VRG was effective in improving muscle activity and balance in elderly women aged 65 and older. In this study, sit-to-stand training with visual feedback and asymmetrical foot position showed significant functional improvement.