• 제목/요약/키워드: Hemiplegic patient

검색결과 117건 처리시간 0.027초

자세균형제어 시스템의 개발 (Development of Postural Balance Control System)

  • 양길태;김영호;임송학;장윤희;문무성
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.276-279
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    • 1997
  • A simple bio-feedback system was developed to monitor and to analyze patient's postural balance. Two load celIs were used to measure the weight of each side. A specially designed electronic circuit was made to pick up the weight signals and to feed into the data acquisition system. Clinical trials were also made on 20-30 year-old normal subjects and nine hemiplegia patients who had the potential instability in weight bearing. A Microsoft window-based software collected and analyzed the postural balance data. Normal subjects showed only 5% deviations of their body weight. However, hemipegic patients had significant weight shifts toward the healthy limb. With the present system, patients can also exercise their balance and weight bearing. The present system should be of convenience to monitor in real-time and analyze the postural balance control of hemiplegic patients.

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국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석 (Meta-Analysis of Constraint-Induced Movement Therapy in Hemiplegic Stroke Patient in Korea)

  • 박소연;신인수
    • 한국전문물리치료학회지
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    • 제19권2호
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    • pp.59-68
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    • 2012
  • This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

견관절 수부증후군을 가진 편마비 환자의 견관절 동통과 수부부종의 상관관계 연구 (A Study on the Correlation of shoulder Pain and Hand Edema in Hemiplegia with Shoulder-Hand Syndrome)

  • 김병조;안소윤;김수민;배성수
    • The Journal of Korean Physical Therapy
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    • 제12권2호
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    • pp.39-47
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    • 2000
  • The purpose of this study was to evaluate the relationship between shoulder pain and hand edema in stroke patient with shoulder hand syndrome. In this study, 26 hemiplegic patients with the clinical symptom and sign of shoulder hand syndrome were evaluated. Hand volume was measured by hand volumeter, and hand edema was calculated by volume difference of both hands. Shoulder pain was evaluated using VAS (visual analog scale). and spasticity of shoulder was graded by modified Ashworth scale. The relationship among three factors such as shoulder pain. hand edema and shoulder spasticity was evaluated using correlation analysis. Results through correlation analysis among three factors are as follows : 1. Correlation between shoulder pain and hand edema was not significant$(\gamma=-.028)$. 2. Correlation between shoulder spasticity and hand edema was not significant $(\gamma=-.027)$. 3. Correlation between shoulder spasticity and shoulder pain was not significant $(\gamma=-.093)$. As the result of correlation analysis. this study shows that there was no statistically significant difference between shoulder pain and hand edema.

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Stroke 환자에 있어서 MAS(Motor Assessment Scale)를 이용한 운동 능력평가와 각각의 평가 항목과의 상관관계 (Relationship of motor ability evaluation by using MAS and each items of MAS in stroke patient)

  • 김광수
    • 대한물리치료과학회지
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    • 제4권4호
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    • pp.519-528
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    • 1997
  • The purpose of this research were to evaluate the overall capacity of activity in hemiplegic patients caused by stroke, to learn the relationship of the overall capacity of activity with 8 out of 9 subtest of the Motor Assessment Scale (MAS) excluding general tonus subtest, and to use in creation of more efficient rehabilitation program by using Motor Assessment Scale (MAS). Twenty-four stroke patients (14 men and 10 women) were the subjects in this study. Their average age was 59.5 and they received average of 17.88 month of therapy. Collected data analysis was completed by using Statistic Analysis System (SAS). The results were as follows: 1) There was no difference in capacity of activity between right hemiplegia and left hemiplegia. 2) There was no difference in capacity of activity compared therapeutic period and age. 3) In comparing the relationship of the each subtest with the overall capacity of activity, upper arm function showed the highest relation (pearson's r = 0.914), and balance sitting (pearson's r= 0.812) and supine to sitting overside of bed (pearson'sr = 0.746) also showed large relationship. 4) Hand movement (pearson's r = -0.45) and advanced hand activity (pearson's r = -0.401) revealed relationship of general tonus with each subtest. 5) Supine to sitting over side of bed (pearson's r = 0.74), balanced sitting(pearson's r = 0.523), and sitting to standing (pearson's r = 0.723) showed large relationship with walking.

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수지경혈 마사지가 뇌졸중환자의 일상생활동작 수행 능력과 악력반응에 미치는 효과 (The Effects of Hand Acupoint Massages on ADL Ability and Grip Strength of Stroke Patients)

  • 김현미;전은영;최연희
    • 지역사회간호학회지
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    • 제14권3호
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    • pp.424-431
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    • 2003
  • Purpose: The purpose of this study was to explore the effects of hand acupoint massages on ADL ability and grip strength of stroke patients. Method: This study was designed as a quasi-experimental nonequivalent control group for pre and post-test. Twenty-eight patients were assigned to the experimental group and thirty to the control group. The hand acupoint massage was applied to both hands of the experimental group for sixteen minutes each time, a total of 15 times during five weeks. The patient's ADL ability and grip strength were measured before and after the program. The data were analyzed with mean. percent, chi-square, a paired t-test and t-test. Result: The level of ADL ability was significantly higher in the experimental group than in the control group. Also, the level of grip strength was significantly higher in the experimental group of the plegic side than in the control group, but not in the normal side. Conclusion: We have found that the hand acupoint massage helps the stroke patients improve their ADL ability and grip strength. Through this result, the hand acupoint massage could be considered as an effective application for rehabilitation of hemiplegic patients after stroke.

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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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난치성 간질에 대한 기능적 대뇌반구 절제술 및 Peri-insular 대뇌반구 절제술의 효과 (Surgical Results of Functional Hemispherectomy and Peri-insular Hemispherotomy)

  • 이동걸;이완수;이정교;김정호;고태성;이상암
    • Journal of Korean Neurosurgical Society
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    • 제29권9호
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    • pp.1195-1203
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    • 2000
  • Objective : To confirm the efficacy of functional hemispherectomy and peri-insular hemispherotomy on treatment of intractable epilepsy. Materials & Methods : From April 1997 to February 1999, we performed 1 functional hemispherectomy and 6 peri-insular hemispherotomy in 7 consecutive patients. These procedures result in completely disconnected hemisphere while maintaining the disconnected portion of the hemisphere intact within the surgical cavity. The indications were hemimegalencephaly in 2 cases, infarction with encephalomalacia in 2, Sturge-Weber syndrome in 1, hemiconvulsion hemiplegia epilepsy syndrome in 1, cortical dysplasia with leptomeningeal cyst in 1. Mean follow-up is 15.8 months(range 8-28 months). Results : Among 7 patients, 1 patient died immediately after peri-insular hemispherotomy. Five patients became seizure free with reduced doses of medications. One patient developed rare disabling seizure with medication. In 6 patients, there were improvements in the function of the hemiparetic limbs in the postoperative phase. A 3-year-old boy with infarction and encephalomalacia died few hours after surgery due to postoperative hypothermia. Two patients required shunt after surgery. Two patients developed postoperative brain swelling but were successfully managed with conservative care. Conclusion : In conclusion, functional hemispherectomy and peri-insular hemispherotomy may provide substantial seizure control in selected cases of young hemiplegic patients with intractable epilepsy.

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편측 슬관절 통증을 호소하는 환자의 증상 개선에 따른 보행 척도의 변화 보고: 보행 분석을 중심으로 (A Case Report on Gait Pattern Change of Unilateral Knee Pain Patient Treated by Korean Medicine: Focused on Gait Analysis Results.)

  • 추홍민;김광호;이영웅;박경태;장종원;김선경;임현서;김철현;이상관;성강경
    • 척추신경추나의학회지
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    • 제15권1호
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    • pp.147-155
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    • 2020
  • Objectives : The aim of this study was to analyze changes in the gait pattern of a unilateral knee pain patient after treatment with Korean Medicine therapy. Methods : We conducted gait analysis 4 times over 11 days to analyze changes in gait parameters using gait analysis systems. Results : Velocity, cadence, step length, and stride length were all increased. On the collateral side, both stance phase and double support (%) decreased. These results are similar to those of hemiplegic patients with improvement patterns. Conclusions : Gait analysis could be used as a good evaluation tool for tracking improvements in knee pain.

중풍경직에 전침, TENS 및 신경근 자극기의 효과에 대한 연구 (Antispastic Effects of Electroacupuncture, TENS and NMEs in Stroke Patient)

  • 김용석
    • Journal of Acupuncture Research
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    • 제17권2호
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    • pp.209-220
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    • 2000
  • Spasticity, an abnormal increase in resting muscle tone, is one of the most common symptoms of stroke, and its management is becoming a major issue in rehabilitation. The aims of this study are to determine the effects of electroacupuncture(EA), TENS and neuromuscular electric stimulation(NMES) on spasticity, as well as the possibility of tissue comliance method as a spasticity scale. 45 stroke patients participated in a study of the effects on hemiplegic spasticity of EA, TENS and NMES. Spasticity was measured by modified Ashworth scale on the upper extremity and tissue compliance measurement, penetration mm/kg, on Susamni(LI10) area at just before and after stimulation, and 30 minutes, 1 hour, 2 hours and 24 hours after stimulation. The acupuncture points were applied to Kokchi(LI11), Susamni(LI10), Hapkok(LI4) and Oegwan(TE5) of the affected limb. The electrodes were placed unilaterally on LI11 to LI10 and TE5 to LI4. EA with biphasic wave, 60Hz, 0.4 msec pulse duration and low intensity was applied continuously for 20 minutes. TENS with high frequency, low intensity was applied. NMES was applied with spasticity program for 20 minutes. Each electric stimulation was done on extensor muscles group of forearm for 20 minutes. EA and NMES groups were found to produce a statistically significant decrease(p〈0.05) of spasticity and these effects lasted up to 30 minutes after stimulation. There was no definite correlation between the modified Ashworth scale and tissue compliance measurement. But tissure compliance method was found to be possible as a quantitative measurement on spasticity. There was no significant correlation between the effects of EA and NMES and the characteristics of patient, but significant correlation between the effects of EA and NMES and the modified Ashworth scale.

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추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구 (An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • 대한간호학회지
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    • 제20권2호
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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