PURPOSE: Strengthening training is effective at improving the function of stroke patients. This study was conducted to compare the effects of exercise intensity on walking, balancing ability, and blood glucose in stroke patients with type 2 diabetes mellitus and to suggest more effective exercise intensity for stroke patients. METHODS: Twenty-two patients with type 2 diabetes mellitus were divided into an experimental group (n=11) and a control group (n=11). In the experimental group, a 40-70% strength of 1RM exercise program was applied for 40 minutes a day, three times a week for 4 weeks. The control group received a 50% intensity of 1RM for the same number and duration of interventions as the experimental group. RESULTS: Both the experimental group and the control group showed significant improvement in the gait function, balance ability, and blood glucose level after the intervention compared to before the intervention. In the FGA (functional gait assessment), the experimental group showed a 52.4% greater increase than the control group, and the fasting blood glucose level was 16.7% greater in the experimental group than the control group. CONCLUSION: The strengthening exercise program, which gradually increases exercise intensity, seems to be effective at improving the function of stroke patients with type 2 diabetes.
■Objectives This case study is to report the effectiveness of Korean medicine in Parkinsonism patient's treatment. ■Methods We used the acupuncture, electro-acupuncture, moxibustion, cupping therapy, herbal medicine, especially Palmulgunja-tang to the Parkinsonism patient with motor disorder such as Postural Instability and Gait Difficulty(PIGD) and aphonia. Unified Parkinson's Disease Rating Scale(UPDRS), analysis of gait pattern, voice dB and self-evaluation of speed and volume were used to assess the change of symptoms. ■Results After treatment, the UPDRS score decreased in overall category and the walking pattern has improved. In addition, the improvement was observed in voice volume and in self assessment of the patient. ■Conclusion This case suggests the effect of Korean medical treatment on motor disorder and aphonia in Parkinsonism.
Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.
Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.
Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.
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.
Objective: This study was conducted for one-hand users including hemiplegic clients currently using general folding manual wheelchairs, so as to analyze their specific problems and recommend solutions regarding usage. Background: Traditional manual wheelchairs require considerable use and control of both hands for operation, thus adaptations become necessary for individuals with asymmetrical use of hands. Method: Thirty hemiplegic clients who were admitted to rehabilitation and convalescent hospitals participated as subjects. The research tools were general folding manual wheelchairs commonly used by people with impaired gait, and the Wheelchair Skills Tests (WST) WST-M/WCU 4.1 version was adopted as the assessment tool. All participants were asked to fill out questionnaires on demographics and wheelchair usage characteristics. Assessment procedures were performed with currently used manual wheelchairs and with/without the use of foot to control the wheelchair. Results: When the participants drove folding manual wheelchairs without the use of foot, even the lowest failure rate among the WST items tested recorded 96.7%. On the contrary, with the use of foot in maneuvering the wheelchairs, failure rates dropped noticeably and success rate among the WST items tested was as high as 86.7%. Conclusion: These findings imply that the use of one-arm (hand) propellable (drivable) wheelchair can be an active and effective solution in resolving problems for hemiplegic clients using existing manual wheelchairs. As such, the government should provide institutional support to further develop and distribute this device or technology, and promote relative research in tandem. For now, the supply of commercially available device to hemiplegic clients is deemed urgent and also a mechanism to provide the devices and relevant services. Application: This study offers viable solutions for hemiplegic clients who rely on existing manual wheelchairs to increase their mobility and occupational performance.
Objective: To investigate the association between one-leg standing ability and postural control for chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Forty individuals who had a first diagnosis of stroke with hemiparesis before six months and over had participated in this study. To analyze the relationship between one-leg standing ability and postural control in the participants, six clinical measurement tools were used for assessment, including the Timed-Up-and-Go (TUG) test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Fugl-Meyer Assessment (FMA), 5 times sit-to-stand (5TSTS) and one-leg standing (OLS). Results: After analyzation, the OLS scores in the more-affected side showed significant positive correlations with BBS scores (r=0.469, p<0.01), DGI scores (r=0.459, p<0.01).and FMA scores (r=0.425, p<0.01). The OLS scores in the more-affected side showed significant negative correlations with TUG score (r=-0.351, p<0.05). The OLS score in the less-affected side showed significant positive correlations with BBS scores (r=0.485, p<0.01), DGI scores (r=0.488, p<0.01) and FMA score (r=0.352, p<0.05). The OLS scores in the less-affected side showed significant negative correlation with TUG scores (r=-0.392, p<0.05) and 5TSTS (r= -0.430, p<0.01). The OLS scores in the more-affected side showed significant positive correlations with the OLS scores in less-affected side (r=0.712, p<0.01). Conclusions: The results of the study suggest that the OLS time may be moderately correlated with static and dynamic postural stabilities and motor recovery following stroke. This study also suggests that the OLS test is as a simple clinical tool for predicting postural control performance for individuals with chronic hemiparetic stroke.
Objective: This study explored the reuse of data captured into an electronic nursing record system using the International Classification for Nursing Practice to support nursing research of inpatient's falls. Methods: Risk factors relevant to inpatients falls ;n an acute setting were identified from the literature review. Four risk assessment tools and two risk identification studies were selected. To examine the availability of coded data in an electronic nursing record system for the identified fall fisk factors, we reviewed 11.319 hospital-day records of 118 patients who were reported by the self-report system. Results: We identified 24 fall risk factors of five categories from the literature review, which were used to identify the standard nursing statements addressing fall risks. One hundred thirty five nursing statements were searched from the hospital's nursing data dictionary of statements and were matched with 14 fall fisk factors. Using the 135 statements. we found that mental status, catheter of drip in situ, abnormal gait, insomnia, surgical procedure. and dizziness/vertigo appeared frequently in the nursing records of inpatients with fall s. Also we found 6 risk factors more through the record review. Conclusion: The electronic records would be a good research source for inpatients' falls. Specifically international classification for nursing practice based nursing record system has the potential for promoting clinical researches.
Objective: This study aims to assess the test-retest reproducibility of the Short Form Berg Balance Scale (SF-BBS) and the Short Form Postural Assessment Scale for Stroke (SF-PASS) among chronic stroke survivors, focusing on their reliability for consistent measurements over time. Design: A cross-sectional study design Methods: Thirty chronic stroke survivors participated in this study, undergoing evaluations with SF-BBS and SF-PASS scales at two different points, separated by a seven-day interval. The analysis focused on test-retest reliability, employing statistical measures such as the Intra-Class Coefficient (ICC2,1), Standard Error of Measurement (SEM), Minimal Detectable Change (MDC), and MDC%, the Bland-Altman plot to assess the limits of agreement and the extent of random measurement error. Results: The study found notable test-retest reproducibility for both SF-BBS and SF-PASS, with ICC values demonstrating strong reliability (0.932 to 0.941, with a confidence interval of 0.889 to 0.973). SEM values for SF-BBS and SF-PASS were reported as 1.34 and 0.61, respectively, indicating low measurement error. MDC values of 3.71 for SF-BBS and 1.69 for SF-PASS suggest that the scales have an acceptable level of sensitivity to change, with reliability metrics falling below 20% of the maximum possible score. Conclusions: The findings suggest that both SF-BBS and SF-PASS exhibit high intra-class correlation coefficients, indicating strong test-retest reliability. The SEM and MDC values further support the scales' reproducibility and reliability as tools for evaluating mobility and dynamic balance in chronic stroke survivors. Therefore, these scales are recommended for clinical use in this population, providing reliable measures for assessing progress in rehabilitation.
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