• 제목/요약/키워드: Hemiplegia patient

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주 조절점 핸들링이 편마비 환자의 한발서기 자세적응에 미치는 영향 - 보바스의 신경발달치료 중심 - (The Effect of Key Point Control Handling for One-leg Standing Postural Adaptation in Hemiplegia)

  • 김대영
    • 대한물리치료과학회지
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    • 제8권2호
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    • pp.1059-1064
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    • 2001
  • This study is aimed at diagnosing transmutation aspect with the respective of hemiplegia patient's static adaptation of posture which is influenced by anti-gravity excercise, center of gravity shifting movement and segmental movement adaption of the legs and arms by key-point control in the process of Bobatli's treatment approach. The patients for the investigation of this study were selected as a total 17 patients who were doing the physical-therapy in Tae-gu Rehabilitation Center, and diagnosed as hemiplegia patients by Rehabilitation Medicine department in Kyung-buk University hospital. And also, there investigated into temporal transition that keep the attitude with one-leg standing on the ground concerning static attitude adaption on the basis of the before of anti-gravity movement and the after of 4-weeks movement. The findings of this study were as follows: With the respective the time to keep standing pose by one-leg at static attitude transmutation, affected side showed meaningful differences as a l.86/sec, 2.62/sec at 4 weeks later considering the before and after of this experiment.(p<0.01), non-affected side at the aspect of attitude keeping time, but there didn't showed meaningful differences statistically.

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발의 위치가 편마비 환자의 의자에서 일어서기에 미치는 영향 (The Effects of Varying Foot Placement on Sit-to-stand in Patients with Hemiplegia)

  • 김종만;노정석
    • 한국전문물리치료학회지
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    • 제4권1호
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    • pp.30-38
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    • 1997
  • The patients with hemiplegia show different body weight distribution as compared to normal subjects. These patients load their body weight more on sound leg than affected leg. The purpose of this study was to examine the effect of foot placement under three conditions: forward, intermediate, and backward placement, on body weight distribution and time needed to rise while assuming sit-to-stand. Fourteen patients with hemiplegia participated in the study. Their body weight distributions during sit-to-stand under the three different conditions were measured by a limb loader and time needed to rise was measured by a stopwatch. The data were analysed by the repeated measure of one-way ANOVA. Statistical Analysis demonstrated that body weight distribution was less asymmetric in backward foot placement. The difference of body weight bearing rate between sound leg and affected leg was significantly decreased as foot placement moved from forward to backward. These results show that backward foot placement during sit-to-stand make patient with henuplegia distribute their body weight more evenly on the lower extremity.

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뇌졸중 편마비환자의 견관절 아탈구 예방에 관한 고찰 (Review of Prevention of Hemipelegic Shoulder Subluxation After Stroke)

  • 한진태;권오현;신형수
    • 대한물리의학회지
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    • 제2권2호
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    • pp.243-250
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    • 2007
  • Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

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편마비 환자의 보행에 대한 외회전 감소운동의 효과 (The Effect of External-rotation Reducing Exercise on the Gait of Patient with Hemiplegia)

  • 김아람;박철주;유인정;최정욱;현주협;조남정;유병국;정종희;이호준
    • 대한임상전기생리학회지
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    • 제6권1호
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    • pp.69-79
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    • 2008
  • In this paper, the effects of the external-rotation exercise on the gait of hemiplegia was investigated. 26 patients with hemiplegia due to cerebrovascular accident participated in this study. Subjects were randomly assigned to experimental group(n=12) and control one(n=14). 12 subjects of the experimental group were received the external rotation reducing exercise on the mat with seating and supine posture after the general therapeutic exercise for hemiplegia. 14 subjects of the control group were received only general therapeutic exercise. The effects of external rotation reducing exercise were evaluated by measurements of gait velocity, cadence, stride length, step length and foot angle using ink-foot prints. The collected data were analyzed statistically based on Wilcoxon, Mann-Whitney and correlation analysis. After treatment of three weeks, it turned out that external rotation reducing exercise has the significant effect on foot angle(p<0.01). However the exercise has no statistically significant direct effect on the gait velocity, cadence, stride length and step length.

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Assessment of Body Fluid Alteration Using Bioelectrical Impedance in Stroke Patients with Hemiplegia Caused by Cerebral Hemorrhage and Cerebral Infarction

  • Shin, Yong Il;Kim, Gun Ho;Hwang, Young Jun;Baik, Seung Wan;Kim, Jae Hyung;Jeon, Gye Rok
    • 센서학회지
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    • 제26권3호
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    • pp.160-167
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    • 2017
  • Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body composition in paretic and non-paretic regions. In this study, the body fluid alteration in the paretic and non-paretic regions of stroke patients with hemiplegia caused by cerebral hemorrhage and cerebral infarction was analyzed using bioelectrical impedance analysis (BIA). Alterations in body fluids were investigated to assess the physical status of the paretic and non-paretic regions of 20 stroke patients with hemiplegia caused by cerebral hemorrhage (7 patients) and cerebral infarction (13 patients). Extracellular water (ECW), intracellular water (ICW), ICW/ECW, total body water (TBW), ECW/TBW, and TBW/fat-free mass were utilized to evaluate the functional status of the paretic and non-paretic regions. Compared with the non-paretic region, the paretic region had high ECW and low ICW. Due to the loss of motor function and nutritional imbalance caused by the stroke, the amount of fat increased while the muscle quantity and quality significantly decreased in the paretic region. Thus, BIA can be a useful tool for quantitatively assessing paretic and non-paretic regions in stroke patients with hemiplegia.

Functional Improvement Following Revision Surgery in a Patient with the Dual Disability of a Complicated Residual Limb and Contralateral Hemiplegia: A Case Report

  • Byun, Ki Hyun;Yang, Dong Seok;Jang, Baek Hee
    • The Journal of Korean Physical Therapy
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    • 제30권5호
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    • pp.199-203
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    • 2018
  • The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

수행에 대한 지식의 상대적 빈도가 편마비 환자의 균형 재훈련에 미치는 영향 (Effects of Relative Frequency of Knowledge of Performance on Balance Retraining in Patients With Hemiplegia)

  • 오동식;최흥식;김택훈;노정석
    • 한국전문물리치료학회지
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    • 제8권1호
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    • pp.9-19
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    • 2001
  • During therapy sessions, feedback is often provided concurrently by the physical therapist as the patient attempts to perform a movement and after the movement attempt. This feedback is provided to enhance the patient's balance abilities. However, recent studies in nondisabled populations have suggested that frequent feedback may be detrimental to retention or learning of motor skills. This study compared the effects of 100% relative frequency of knowledge of performance (KP) with 66% relative frequency of KP for motor learning on balance retraining in patients with hemiplegia. Twenty patients with hemiplegic were randomly assigned to one of two experimental groups. The acquisition phase consisted of 16 blocks of 5 trials for 2 days (80 total practice trials). The retention phase consisted of 2 blocks of a short-term retention test, one day after the end of the acquisition phase and a long-term retention test, one week after the end of the short-term retention test. In the 100% feedback condition, participants received feedback after every practice trial. A faded KP schedule was used in the 66% condition. No significant differences were found between the two groups during all experimental phases (acquisition and retention phases), (p>.05). However, there were significant decreases in balance index for both groups of acquisition phase (p<.05). These results suggest that 66% relative frequency of KP is not more effective than 100% relative frequency of KP with respect to retention over time when hemiparetic patients attempt to learn balance.

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자음건비탕가녹용을 비롯한 한방치료로 호전된 편마비를 동반한 뇌출혈 환자 1례 (A Case Report of Intercranial Hemorrhage with Hemiplegia Improved by Jayumkeonbi-tang with Deer Antler and Other Korean Medicine Treatments)

  • 강지윤;신주은;백지수;김윤식;설인찬;유호룡
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.791-802
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    • 2023
  • Objective: This study reports on the effectiveness of Korean medicine treatment in a patient with intracerebral hemorrhages with symptoms of hemiplegia, personality change, and aphasia. Case presentation: The patient was treated using Korean medicine, including Jayumkeonbi-tang with deer antler as herbal medicine, acupuncture, moxibustion, and a limb activation exercise. To evaluate the effect on clinical symptoms, a manual muscle test, the Modified Functional Ambulation Classification, and the Korean version of the Modified Barthel Index were used. After 84 days of treatment, the MMT grade of the right upper and lower limbs improved from Gr. 2+/2- to Gr. 4/3~4 on average, and personality change and aphasia were gone. Conclusion: A complex treatment that includes Jaeumkunbi-tang, acupuncture, moxibustion, and limb activation exercises can be effective following an intracerebral hemorrhage resulting in hemiplegia and personality change. However, more research is needed.

편마비 환자를 위한 착용형 보행 로봇 제어 알고리즘 개발 (Control Algorithm of a Wearable Walking Robot for a Patient with Hemiplegia)

  • 조창현
    • 로봇학회논문지
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    • 제15권4호
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    • pp.323-329
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    • 2020
  • This paper presents a control algorithm for a wearable walking aid robot for subjects with paraplegia after stroke. After a stroke, a slow, asymmetrical and unstable gait pattern is observed in a number of patients. In many cases, one leg can move in a relatively normal pattern, while the other leg is dysfunctional due to paralysis. We have adopted the so-called assist-as-needed control that encourages the patient to walk as much as possible while the robot assists as necessary to create the gait motion of the paralyzed leg. A virtual wall was implemented for the assist-as-needed control. A position based admittance controller was applied in the swing phase to follow human intentions for both the normal and paralyzed legs. A position controller was applied in the stance phase for both legs. A power controller was applied to obtain stable performance in that the output power of the system was delimited during the sample interval. In order to verify the proposed control algorithm, we performed a simulation with 1-DOF leg models. The preliminary results have shown that the control algorithm can follow human intentions during the swing phase by providing as much assistance as needed. In addition, the virtual wall effectively guided the paralyzed leg with stable force display.