• Physical Therapy Rehabilitation Science
• /
• 제7권3호
• /
• pp.114-118
• /
• 2018

Objective: The left and right sides of the brain has different roles. This study investigated the differences in cognitive driving ability between stroke survivors with damage to the left brain and right brain. Therefore, the purpose of this study was to compare the driving cognitive ability of left and right hemispheric drivers following stroke. Design: Cross-sectional study. Methods: The Stroke Drivers' Screening Assessment (SDSA) from the UK was translated to the Korean Stroke Drivers' Screening Assessment (K-SDSA) to meet the specific traffic environments of Korea. The SDSA is composed of 4 tasks :1) a dot cancellation task that measures concentration and visuospatial abilities necessary for driving, 2) a directional matrix task to measure spatio-temporal executive function required for driving, 3) a compass matrix task to measure accurate direction determination ability required for driving, and 4) recognition of traffic signs and reasoning ability to understanding traffic situation. The SDSA assessment time is about 30 minutes. The K-SDSA was used to compare the cognitive driving abilities between 15 stroke survivors with left and 15 stroke survivors with right brain damage. Results: There were significant differences between the persons with stroke patients with left brain lesions (right hemiplegia) compared to the persons with stroke with right brain lesions (left hemiplegia) (p<0.05). It was found that the cognitive driving ability of those with right brain damage was lower than that of the group of left brain damage. Conclusions: This research investigated the driving cognitive ability of persons with stroke. The therapists can use this information as basis for the driving test and training purposes. It could also be used as a basis to understanding if the cognitive ability of not only stroke survivors but also those with brain damage is adequate to actually drive.

• 한국전문물리치료학회지
• /
• 제19권3호
• /
• pp.98-104
• /
• 2012

The aim of this study was to examine the effects of repeated passive movement (RPM) of different velocities on the improvement of knee joint position sense (JPS) in post-stroke patients with hemiplegia, thereby investigate the possibility of clinical application in the initial stage of rehabilitation for patients with post-stroke hemiplegia. Thirteen hemiplegic patients participated in this study. For the subjects' knee JPS tests, a passive angle reproduction test and an active angle reproduction test were performed prior to and after the intervention, which involved 30 repetitions of passive full-range-of-motion flexion and extension exercise of the knee joints at randomized degrees of $0^{\circ}/s$, $45^{\circ}/s$, and $90^{\circ}/s$. Paired t-test analysis was done in order to compare changes in the pre- and post-intervention knee JPS. One-way repeated analysis of variance was used in order to compare changes in JPS after intervention at three different movement velocities. The level of significance was set at .05. The result was that the subjects' post-intervention knee JPS significantly improved after the RPM exercise at a $45^{\circ}/s$ and a $90^{\circ}/s$ relative to the RPM exercise $0^{\circ}/s$ (p<.05). JPS changes with RPM intervention at the rapid velocity of $90^{\circ}/s$ were most increased, suggesting the most effective enhancement in knee JPS is with intervention at the velocity (p<.05). Therefore, RPM intervention at a half or higher velocity improved stroke patients' knee JPS. During the initial stage of rehabilitation for patients with post-stroke hemiplegia, the efficient application of the RPM exercise at a half or higher velocity will be possible.

• 대한물리치료과학회지
• /
• 제18권1호
• /
• pp.79-84
• /
• 2011

Background: The purpose of this study was to investigate differences in balancing ability and weight bearing between paretic and non-paretic. Methods: Subjects of the study were consisted of 30 acute hemiplegia patients(paretic 15, non-paretic 15) who were receiving rehabilitation therapy in hospital. Weight shifting was quantitatively evaluated to determine the ability of patients to and during conscious weight shifting on the Gaitview. Independent t-test was utilized to detect the mean difference between the groups. Results: 15 patients with stroke were able to shift more weight onto the paretic leg. And pressure ratio of right hemiplegia was significantly difference on the nonparetic leg, pressure ratio of left hemiplegia was significantly difference onto the paretic leg. Conclusions: Patients with left hemiplegia who was cortical lesions in the right hemisphere were able to shift more body weight onto their paretic leg. These patients should be encouraged to practice shifting their weight towards their non-paretic leg to improve their balance.

• 대한의용생체공학회:의공학회지
• /
• 제31권1호
• /
• pp.50-55
• /
• 2010

Gait initiation is a transitional process from the balanced upright standing to the beginning of steady-state walking. Dysbalanced gait initiation often causes stroke patients to fall. The net center of pressure, measured by two triaxial force plates from twenty healthy subjects and two stroke patients, was investigated to assess asymmetry of gait initiation in hemiparetic subjects. The time interval and distance of the net center of pressure(CoP) moved from the initiation point to the toe off(S1) and from the toe off to the initial contact(S2) were calculated during gait initiation of normal and stroke patients. When the patient with right hemiplegia(A) initiated his gait with right foot, the time interval and the distance of the net CoP in S1 and S2 were smaller than that of normal subjects' values. However, he initiated the gait with left foot(unaffected side) the time interval and the distance of net CoP in S1 were larger than normative values. Differently, the patient with left hemiplegia(B) has shown that larger time interval and distance in S1 and smaller time interval and distance in S2 in both sides. His asymmetry(with which side the gait initiated) was not significant. It is too early to conclude that these results could be general characteristics of the stroke patients because the variations were large and moreover, the level of motor recovery of the patients was different. However, it is expected that these trials could help to set up the strategy of the therapy for the rehabilitation or prevention of fall in stroke patients.

• The Journal of Korean Physical Therapy
• /
• 제32권1호
• /
• pp.1-6
• /
• 2020

Purpose: This study examined the effects of action observational training to improve the gait function for patients with stroke. Methods: The participants were divided into two groups: right hemiplegia group (n=12) and left hemiplegia group (n=12). All groups received conventional therapy for five sessions for 30 minutes, each for three weeks. Left and right hemiplegia group practiced additional action observational training for five sessions for 20 minutes each for three weeks. They participated in three weeks of action observational training coupled with immediate physical practice (intervention), followed by a final assessment. The duration of each action observation video sequence was 10 minutes, followed immediately by practice of the observed motor skill (10 minutes). The gait velocity, cadence, swing time, step length, and BOS (base of support) were examined using the GAITRite system. Results: The results of this study showed significant improvement in the gait function. The outcomes of the gait abilities from gait velocity, cadence, swing time, step length of the affected side, and BOS (base of support) were improved significantly in the right hemiplegia group (p<0.05). In the left hemiplegia group, there was no significant improvement in the gait velocity, cadence, and BOS except for the swing time and step length of the affected side. The left and right group comparisons between the groups were not significant (p<0.05). Conclusion: Action observation training improves the gait function. These results suggest that action observational training is feasible and suitable for stroke patients.

• The Journal of Korean Physical Therapy
• /
• 제30권5호
• /
• pp.199-203
• /
• 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.

• 신경치료
• /
• 제22권3호
• /
• pp.31-36
• /
• 2018

Purpose The purpose of this study was to investigate the effects of contact handorientation response(CHOR) during sit-to-stand(STS) in people with stroke. Methods The subjects of the study were Thirty hemiplegia participated (Rt. hemiplegia/Lt. hemiplegia: 15/15, mean age: $65.82{\pm}8.53$) in this study. The analysis of muscles activation (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) distribution was conducted by the EMG, and the analysis of foot pressure distribution was conducted by the resistive pressure sensor. Hemiplegic stroke patients were instructed to perform STS three times with the non-affected side hand and affected side hand on the table. Results There was a significant positive correlation between rectus femoris, tibialis anterior muscle activation and affected side hand contact during STS(p<0.05). The STS correlated with the foot pressure in the affected side hand contact(p<0.05). Conclusion AS a result, CHOR during STS is related to muscle activation and the characteristics of foot pressure. This information was observed in the affected side hand contact on the table, suggestion that rehabilitation programs should be implemented.

• 대한한의학회지
• /
• 제22권4호
• /
• pp.158-163
• /
• 2001

Clinical symptoms of acute stroke include loss of consciousness, aphasia, dysphagia, hemiplegia, without urination or defecation, headache, dizziness, chest discomfort, etc. As methods of oriental medical treatment at acute stroke state, acupuncture, fumigating, emetic, sternutatory therapy etc. were known. We treated a 69-year-old female patient who was unconscious after acute stroke with acupuncture and herbal medicine. Also, we chose Croton seed (Crotonis Fructus) Tansy (Artemisiae Argi Folium)-hwan for treatment and fumed it on the patient's nose once a day. After 7 days of treatment with fumigating therapy, we observed improvement in consciousness on the Glasgow coma scale, and other symptoms (aphasia, dysphagia, hemiplegia, without urination or defecation)

• 대한물리의학회지
• /
• 제14권1호
• /
• pp.139-150
• /
• 2019

PURPOSE: This study was conducted to determine the effects of treadmill gait training with obstacle-crossing on the static and dynamic balance ability of patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into three groups as: treadmill gait training with obstacle-crossing (TOG, n=7), treadmill gait training without obstacle-crossing (TGG, n=7) and a control (CON, n=7). TOG and TGG performed exercise for 20 minutes, three times a week for 8 weeks. Static balance ability (stability typical, ST; weight distribution index, WDI; fourier harmony index, FHI; and fall index, FI) and dynamic balance ability (berg balance scale, BBS and timed up and go test, TUG) were measured before and after 8 -weeks in each exercise group. Statistical analyses were conducted using two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Tukey's HSD. RESULTS: FHI and BBS were significantly increased at TOG (p<.01) and TGG (p<.05) after 8-weeks compared to before treadmill gait training with obstacle-crossing. FHI and BBS were significantly increased at TOG compared with CON and TGG (p<.05). CONCLUSION: Treadmill gait training with obstacle-crossing was more effective than that without obstacle-crossing to improve posture control and independent daily life performance of hemiplegia patients.

• 대한간호학회지
• /
• 제36권5호
• /
• pp.792-802
• /
• 2006

Purpose: The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke. Method: For this study, the grounded theory method was utilized. Results: After constant comparative analysis, the core category emerged as 'rebuilding the body which was ruined'. In addition, the causal conditions were 'restriction of physical function', and 'loss of roles'. The adjustment process consisted of the 'facing reality phase', 'overcoming depression phase', 'overcoming physical limits phase' and 'reestablishing roles phase' The main strategies in the facing reality phase were 'holding on to a glimmer of hope', 'getting away from the harsh reality' and 'facing up to the reality'. The main strategies in the overcoming depression phase were 'soothing oneself', 'Self-introspection' and 'restoring self-esteem'. In addition, the main strategies in the self-initiative overcoming physical limits phase was 'discovering personal strategies and striving to recover'. The main strategies in the reestablishing roles phase were 'reestablishing a parents' role', 'reestablishing a spouse's role' and 'reestablishing social roles'. Conclusion: In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.