• Title/Summary/Keyword: Functional recovery

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Predictors for Functional Recovery and Mortality of Surgically Treated Traumatic Acute Subdural Hematomas in 256 Patients

  • Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.143-150
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    • 2009
  • Objective : The purpose of this study was to investigate the reliable factors influencing the surgical outcome of the patients with traumatic acute subdural hematoma (ASDH) and to improve the functional outcome of these patients. Methods : A total of 256 consecutive patients who underwent surgical intervention for traumatic ASDH between March 1998 and March 2008 were reviewed. We evaluated the influence of perioperative variables on functional recovery and mortality using multivariate logistic regression analysis. Results : Functional recovery was achieved in 42.2% of patients and the overall mortality was 39.8%. Age (OR=4.91, p=0.002), mechanism of injury (OR=3.66, p=0.003), pupillary abnormality (OR=3.73, p=0.003), GCS score on admission (OR=5.64, p=0.000), and intraoperative acute brain swelling (ABS) (OR=3.71, p=0.009) were independent predictors for functional recovery. And preoperative pupillary abnormality (OR=2.60, p=0.023), GCS score (OR=4.66, p=0.000), and intraoperative ABS (OR=4.16, p=0.001) were independent predictors for mortality. Midline shift, thickness and volume of hematoma, type of surgery, and time to surgery showed no independent association with functional recovery, although these variables were correlated with functional recovery in univariate analyses. Conclusion : Functional recovery was more likely to be achieved in patients who were under 40 years of age, victims of motor vehicle collision and having preoperative reactive pupils, higher GCS score and the absence of ABS during surgery. These results would be helpful for neurosurgeon to improve outcomes from traumatic acute subdural hematomas.

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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Effects of Acupuncture at GB30, GB34, and BL40 on Functional Recovery after Sciatic Crushed Nerve Injury in Rats

  • Lee, Moon-Kyu;Song, Yun-Kyung;Lim, Hyung-Ho
    • The Journal of Korean Medicine
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    • v.31 no.3
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    • pp.66-78
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    • 2010
  • Background: Peripheral nerve injuries are a commonly-encountered clinical problem and often result in a chronic pain and severe functional deficits. Objectives: The aim of this study was to evaluate the effects of acupuncture on the descending pain and the recovery of the locomotor function that follows sciatic crushed nerve injury in rats. Method: In order to assess the effects of acupuncture on the descending pain and functional recovery, we investigated the walking track analysis, brain-derived neurotrophic factor (BDNF) and its receptor tyrosine receptor kinase B (TrkB) expression in the sciatic nerve, and on the expressions of c-Fos and nitric oxide synthase in the paraventricular nucleus (PVN) of the hypothalamus and in the ventrolateral periaqueductal gray (vlPAG) region resulting from sciatic crushed nerve injury in rats. Results: Acupuncture treatment at Huantiao (GB30), Yanglingquan (GB34), and Weizhong (BL40) facilitated functional recovery. C-Fos and nitric oxide synthase expressions in the brain and BDNF and TrkB expressions in the sciatic nerve were decreased by acupuncture treatment. The most potent effects of acupuncture were observed at the GB30 acupoint. Conclusion: It is possible that acupuncture can be used for pain control and functional recovery from sciatic nerve injury.

A Review of Journals on the Functional Recovery of Stroke Patients (뇌졸중(腦卒中) 환자(患者) 기능회복(機能回復)에 대한 최근(最近) 연구동향(硏究動向) 고찰(考察))

  • Song, Yun-Kyung;Lim, Hyung-Ho;Eun, Young-Joon
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.85-110
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    • 2005
  • Stroke is a severe disease in one's life, Many people are suffering from stroke, but there is not a complete recovery therapy. This article aims to review the literature on the Functional recovery of stroke patients, Articles in Medline database between 2003. and 2005. August were review, We classified 176 articles to assessment, therapy and prognosis. and we re-classified them to sub-classifications. We can apply this Informations to our clinic or hospital. And there is few article in relate to Korean-Medicine. It is needed to study about a method of Korean-Medicine on the functional recovery of stroke patients

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Predictors of 30-Day Mortality and 90-Day Functional Recovery after Primary Intracerebral Hemorrhage : Hospital Based Multivariate Analysis in 585 Patients

  • Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.341-349
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    • 2009
  • Objective : The purpose of this study was to identify independent predictors of mortality and functional recovery in patients with primary intracerebral hemorrhage (PICH) and to improve functional outcome in these patients. Methods : Data were collected retrospectively on 585 patients with supratentorial PICH admitted to the Stroke Unit at our hospital between 1st January 2004 and the 31st July 2008. Using multivariate logistic regression analysis, the associations between all selected variables and 30-day mortality and 90-day functional recoveries after PICH was evaluated. Results : Ninety-day functional recovery was achieved in 29.1% of the 585 patients and 30-day mortality in 15.9%. Age (OR=7.384, p=0.000), limb weakness (OR=6.927, p=0.000), and hematoma volume (OR=5.293, p=0.000) were found to be powerful predictors of 90-day functional recovery. Furthermore, initial consciousness (OR=3.013, p=0.014) hematoma location (lobar, OR=2.653, p=0.003), ventricular extension of blood (OR=2.077, p=0.013), leukocytosis (OR=2.048, p=0.008), alcohol intake (drinker, OR=1.927, p=0.023), and increased serum aminotransferase (OR=1.892, p=0.035) were found to be independent predictors of 90-day functional recovery after PICH. On the other hand, a pupillary abnormality (OR=4.532, p=0.000) and initial unconsciousness (OR=3.362, p=0.000) were found to be independent predictors of 30-day mortality after PICH. Conclusion : The predictors of mortality and functional recovery after PICH identified during this analysis may assist during clinical decision-making, when advising patients or family members about the prognosis of PICH and when planning intervention trials.

Recovery State of Hemorrhagic Stroke Patients: Exploratory Comparison of Recovery State between Spontaneous Intracerebral Hemorrhage(s-ICH) and Spontaneous Subarachnoid Hemorrhage(s-SAH) (출혈성 뇌졸중 환자의 회복: 자발성 뇌출혈(s-ICH) 환자와 자발성 지주막하 출혈(s-SAH) 환자의 회복 정도에 대한 탐색적 차원의 비교 연구)

  • Oh, Hyun-Soo;Seo, Wha-Sook;Cho, Hwa-Yeon;Kim, Mi-Og;Kim, Mi-Ran;Mo, Jin-A
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.600-612
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    • 2008
  • Purpose: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. Methods: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. Results: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. Conclusion: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.

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Study of the planarian phototaxis during brain regeneration

  • Inoue, Takeshi;Kumamoto, Hiroshi;Cebria, Frances;Kobayashi, Chiyoko;Agata, Kiyokazu
    • Journal of Photoscience
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    • v.9 no.2
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    • pp.287-289
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    • 2002
  • Planarians show negative phototaxis and have extensive regenerative ability, including the ability to regenerate the brain. Recently the process of regeneration of the planarian brain has been divided into three steps based on the expression of neural markers. In this study, we have analyzed the process of recovery of the light response during head regeneration. Although morphological observations indicated that regeneration of the eyes and optic nerves appeared to be completed by the fourth day, the recovery of the evasion behavior against light was not recovered within 4 days after amputation. Functional recovery of the evasion behavior could be detected starting 5 days after amputation and then gradually recovered. We previously identified genes which are specifically expressed in the brain after the recovery of morphological structures. This characteristic suggested that these genes may be involved in functional recovery of the brain. To investigate the function of these genes, we performed gene knockout analysis using the RNA interference method. The results clearly indicated that these genes are involved in the functional recovery of the visual system.

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The Effects of Exercise Intensity and Initial Timing on Functional Recovery after Sciatic Nerve Crush Injury in Rats

  • Cai, Junyan;Na, Sang-su;Hwangbo, Gak
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.3
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    • pp.1-7
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    • 2015
  • PURPOSE: The aim of this study was to investigate the effects of exercise intensity and initial timing on functional recovery following sciatic nerve injury in rats. METHODS: Total of 80 Sprague-Dawley rats was used and randomly divided 6 groups. Under deep anesthesia, the sciatic nerve was nipped by adapted hemostatic tweezers for 30 seconds and the injured nerve was transparent under naked eyes. Acute exercise groups was applied treadmill after sciatic nerve crush injury during 5days with three type intensity. Late exercise groups was also applied treadmill during 5 days with three type intensity after 5 days break. Values of sciatic functional index were measured and analyzed in each group after exercise period. RESULTS: The sciatic functional index values between control groups 1, acute low-intensity group, acute middle-intensity group in acute phase showed statistical significant (p<.05). The sciatic functional index values between control groups 2, late low-intensity group, late middle-intensity group and late high-intensity in late phase showed statistical significant (p<.05). The comparison in acute and late phase, sciatic functional index values of each low-intensity group and each high-intensity group showed statistical significant (p<.05). CONCLUSION: Whether at acute or late phase, treadmill exercise as a therapy obtained beneficial effects of functional recovery and exercise training at low speed is more beneficial effects on the recovery of motor function in acute phase.

The Effects of Pulsed Electromagnetic Field on Functional Recovery and Expression of GAP-43 after Incomplete Spinal Cord Injury in Rats (맥동전자장이 불완전 척수손상 흰쥐의 기능회복과 GAP-43의 발현에 미치는 영향)

  • Bang, Hyun-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.3
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    • pp.349-356
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    • 2012
  • Purpose : This study was designed to investigate the effects of pulsed electromagnetic field on functional recovery and expression of GAP-43 after incomplete spinal cord injury (SCI) in rats. Methods : To confirm the damage of SCI and effects of pulsed electromagnetic field, 20 Sprague-Dawley male rats were used and divided randomly 2groups (SCI, PEMF). Incomplete SCI was induced by using modified NYU drop model. After operation, functional recovery test, immunohistochemistry and western blot analysis were measured at 1, 2, 3 weeks. Pulsed electromagnetic field were apply three weeks (one times a day, five days a week and twenty minutes a session). Results : In the this study, applications of pulsed electromagnetic field after incomplete SCI induced the significant improvement in functional recovery and expression of neurotrophic factor. The results were as follows; Foot print test, PEMF were significantly decreased than the SCI (p<.05). Expression of GAP-43, PEMF were significantly increased than the SCI at 2 and 3 weeks (p<.05). Conclusion : In conclusion, pulsed electromagnetic field were positive effect in functional recovery and expression of GAP-43 after incomplete SCI in rats.

Motor Recovery in Stroke Patients (뇌졸중의 운동신경기능 회복)

  • Jang, Sung-Ho;Kwon, Yong-Hyun
    • Yeungnam University Journal of Medicine
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    • v.22 no.2
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    • pp.119-130
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    • 2005
  • Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

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