• 제목/요약/키워드: Chronic hemiplegia

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Reasons and Risk Factors for Readmission Following Hospitalization for Community-acquired Pneumonia in South Korea

  • Jang, Jong Geol;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • 제83권2호
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    • pp.147-156
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    • 2020
  • Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

PNF를 이용한 보행 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 영향(단일사례설계) (Effect of Gait Training Using PNF on Balance and Walking Ability in Person with Chronic Stroke(Single Subject Design))

  • 이문규;윤태원;김윤환;임재헌
    • PNF and Movement
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    • 제10권1호
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    • pp.43-52
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    • 2012
  • Purpose : The purpose of this study was to observe the effect of a gait training using PNF on a gait and balance ability of a person with chronic stroke. Methods : The subject was left hemiplegia due to cerebral infarction. The subject participated in PNF gait training session as well as baseline for 30 minutes a day for 4 weeks. we used the 10-meter walking test(10MWT), figure-8-of walk test(F8WT), dynamic gait index(DGI) for measuring the gait ability and four square step test(FSST), Berg balance scale(BBS) for measuring the balance ability through the whole sessions. Results : The gait ability was enhanced compared to first baseline, as measured by 10MWT(27.3%), F8WT(36.6%), DGI(8 points increased). The balance ability was improved compared to first baseline, as measured by FSST(49.1%), BBS(10 points increased). The increase was maintained in second baseline session. Conclusion : The PNF gait training program is helpful to enhance the adaptation of the gait and balance according to the various environmental demands.

수두-대상포진 바이러스의 재활성에 의해 유발되는 다양한 임상질환 (Diverse clinical manifestations caused by varicella-zoster virus reactivation)

  • 박호선
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.1-7
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    • 2016
  • The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.

한의학 고문헌을 통한 오매의 정신의학과 중추신경계 관련 효능 연구 (The Psychiatric and Central Nervous System Effects of Fructus Mume in Medical Classics)

  • 김우영;전원경
    • 혜화의학회지
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    • 제22권1호
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    • pp.71-78
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    • 2013
  • Objectives : Fructus mume(F. mume) has been used as a medicine for thousands of years in East Asia and reported to have effect on cognitive deficits induced by chronic cerebral hypoperfusion. We investigated F. mume's effects on psychiatric and central nervous system in medical classics. Methods : 25 materia medica books and Donguibogam were searched to find psychiatric and central nervous system effects of F. mume. Two Korean Medicine doctors reviewed the effects from the clinical point of view. Results : 安心(relieve psychiatric discomfort), 令人得睡 治不眠(Treat insominia), 去煩悶(relieve chest discomfort) were psychiatric effects and 偏枯不仁(hypoesthesia accompanied with hemiplegia) was central nervous system effect of F. mume. Conclusions : Further studies will be needed to demonstrate F. mume's effects found in medical classics.

Effects of Removable Ankle-Foot Orthosis in Chronic Patients With Hemiplegia During Gait Training: A Pilot Study

  • Kim, Hyung-geun;Oh, Yong-seop
    • 한국전문물리치료학회지
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    • 제22권3호
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    • pp.91-97
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    • 2015
  • This study was conducted to investigate the effects of the removable ankle-foot orthosis (RAFO) which was developed to improve the gait of stroke patients. The subjects of this study were five stroke patients who agreed to participate in this study by signing a written consent form. To verify gait improvement after wearing the orthosis, a Timed Up and Go test and Functional Gait Assessment were performed, and spatiotemporal gait variables such as gait speed, cadence, stride length, double limb support, and the efficient gait test of body sway angle were performed. For every variable, the differences prior to and after wearing the RAFO were compared using the Wilcoxon signed-rank test. Every gait variable improved significantly after wearing the RAFO compared to prior to wearing it. The pilot study will enhance future efforts to evaluate orthotic function objectively during gait in stroke patients.

뇌졸중 후 편마비 환자의 Global Synkinesis 수준이 보행능력에 미치는 영향 (The Effects of Global Synkinesis Level on Gait Ability in Post-Stroke Hemiplegic Patients)

  • 임재헌;임영은;김수현;박경순;김태열
    • The Journal of Korean Physical Therapy
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    • 제20권3호
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    • pp.9-18
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    • 2008
  • Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

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Effects of Slope Changes During Body Weight-Supported Treadmill Training on Gait Characteristics in Patients With Hemiplegia

  • Hwang, Young-In;An, Duk-Hyun
    • 한국전문물리치료학회지
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    • 제15권4호
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    • pp.10-17
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    • 2008
  • The purpose of this study was to determine the therapeutic effect of slope changes of the treadmill with body weight-supported training on gait characteristics in patients with hemiplegia. The volunteered subjects were divided into 3 groups based upon slope changes: control group ($0^{\circ}$ incline), $7^{\circ}$ group ($7^{\circ}$ incline), $12^{\circ}$ group ($12^{\circ}$ incline), They were trained the body weight-supported treadmill training (BWSTT) for 8 weeks. All subjects were supported up to 40% of their body weight on the treadmill training and the support was gradually decreased to 0~10% as the subjects were adapted to the training. There were significant improvements of walking velocity, step length of the affected side, the asymmetry ratio of step length in $7^{\circ}$ group (57.80 cm/s, 67.25 cm, .14), $12^{\circ}$ group (71.00 cm/s, 71.00 cm, .11) than control group (40.62 cm/s, 55.00 cm, .74) (p<.05): there were no differences between $7^{\circ}$ group and $12^{\circ}$ group in the all outcomes (p>.05). Both $7^{\circ}$ group and $12^{\circ}$ group scored higher than the control group in those outcomes and finally the effects of slopes changes of the treadmill were effective on gait characteristics of patients. But it s till remains undetermined what degree on the treadmill might be better to train the hemipareric patients. Therefore, more studies are required to look into minutely the changes of slopes of the treadmill influencing on gait characteristics.

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동작관찰훈련이 뇌졸중 환자의 마비측 상지기능에 미치는 영향: 단일사례연구 (The Effect of Action Observation on Motor Function of Paretic Upper Extremity in Stroke Patients: Single Subject Study)

  • 정우식;윤태원;최연정;이홍균
    • 대한물리의학회지
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    • 제8권2호
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    • pp.271-280
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    • 2013
  • PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.

뇌졸중 환자의 상지부종에 대한 정량적 감각 평가 (Quantitative sensory Testing on Edema of Upper Extremity for Stroke Patients)

  • 이영신;정대인;김경윤
    • 한국콘텐츠학회논문지
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    • 제13권12호
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    • pp.851-859
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    • 2013
  • 본 연구는 뇌졸중 편마비 환자를 대상으로 비마비측과 상지부종이 있는 마비측의 정량적 감각 평가(QST)를 비교함으로서 부종 관리 및 치료에 대한 기초자료를 제공하고자 하였다. 연구의 목적에 맞는 아급성기 뇌졸중 환자I군(n=15)과 만성기 뇌졸중 환자II군(n=17)을 대상으로 비마비측과 마비측에 대한 상지용적의 차이, 기계적 동통 역치(MPT), 냉감역치(CST), 온감역치(WST), 냉통증역치(CPT), 온통증역치(WPT), 진동감각 역치(VST)에 대한 정량적 감각 평가(QST)를 실시하였다. 그 결과, 각 군내 비교 시 모든 측정 항목에서 유의한 차이가 나타났고(p<.001), I군과 II군의 군간 마비측 감각 평가 비교에서는 기계적 동통 역치(MPT)를 제외한 모든 측정 항목에서 유의한 차이가 나타났다(p<.05). 아급성기에는 만성기에 비해 상지부종으로 감각역치 증가로 인한 감각저하가 초래되었음을 확인할 수 있었다. 뇌졸중 환자의 부종에 따른 감각적 특성 차이를 정량적 평가를 통해 알아보고자 하였다.

동작관찰 과제지향훈련이 만성 뇌졸중환자의 균형 및 보행능력에 미치는 효과 (Effects of Action-observational training Program on Gait and Balance of Patients with Hemiplegia)

  • 김해리;우성희;이효정
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2018년도 춘계학술대회
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    • pp.576-579
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    • 2018
  • 본 연구는 만성뇌졸중 환자에게 적용한 동작관찰 과제지향 훈련이 균형 및 보행능력에 미치는 영향을 알아보고자 하였다. 연구에 동의한 만성 뇌졸중환자 30명중 동작관찰 과제지향훈련을 시행한 실험군 15명과 일반 과제지향훈련을 시행한 대조군 15명에게 총 6주간 하루 30분씩 훈련하였다. 훈련효과를 알아보기 위해 훈련전 균형은 BT4로 검사를 시행하였고 보행능력은 10M검사를 실시하였다. 이에 동작관찰 과제지향 훈련군이 일반과제 지향훈련군에 비해 균형과 보행능력에서 유의미한 차이를 보였다. 이에 동작관찰 과제지향훈련이 만성뇌졸중환자의 균형 및 보행능력에 효과적인 프로그램임을 알 수 있다.

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