• Korean Journal of Radiology
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• v.22 no.3
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• pp.324-333
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• 2021

Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

• Physical Therapy Korea
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• v.23 no.1
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• pp.87-93
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• 2016

Background: Posture balance control is the ability to maintain the body's center of gravity in the minimal postural sway state on a supportive surface. This ability is obtained through a complicated process of sensing the movements of the human body through sensory organs and then integrating the information into the central nervous system and reacting to the musculoskeletal system and the support action of the musculoskeletal system. Motor function, including coordination, motor, and vision, vestibular sense, and sensory function, including proprioception, should act in an integrated way. However, more than half of stroke patients have motor, sensory, cognitive, and emotional disorders for a long time. Motor and sensory disorders cause the greatest difficulty in postural control among stroke patients. Objects: The purpose of this study is to determine the effect of visual and somatosensory information on postural sway in stroke patients and carrying out a kinematic analysis using a tri-axial accelerometer and a quantitative assessment. Methods: Thirty-four subjects posed four stance condition was accepted various sensory information for counterbalance. This experiment referred to the computerized dynamic posturography assessments and was redesigned four condition blocking visual and somatosensory information. To measure the postural sway of the subjects' trunk, a wireless tri-axial accelerometer was used by signal vector magnitude value. Ony-way measure analysis of variance was performed among four condition. Results: There were significant differences when somatosensory information input blocked (p<.05). Conclusion: The sensory significantly affecting the balance ability of stroke patients is somatosensory, and the amount of actual movement of the trunk could be objectively compared and analyzed through quantitative figures using a tri-axial accelerometer for balance ability.

• Journal of Acupuncture Research
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• v.28 no.4
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• pp.37-47
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• 2011

Objective : The purpose of this study is to evaluate the effect of sweet bee venom pharmacopuncture on the post-stroke hemiplegic shoulder pain. Methods : 40 patients with post-stroke hemiplegic shoulder pain were randomly divided into 2 groups : study group(sweet bee venom pharmacopuncture treatment group, n=21) and Control group(normal saline treatment group, n=19). They were monitored for 4 weeks, followed up with visual analog scale(VAS), pain rating score(PRS), painless passive shoulder range of movement(PROM) and Fugl-Meyer Motor assessment(FMMA) at before treatment(T0), after 2 weeks(T2) and after 4 weeks(T4). Results : 1. Study group and control group showed pain decrease, but study group showed more significant effectiveness in VAS and PRS than control group. 2. Although there is no significant difference in PROM between study group and control group, both groups showed increase of PROM, and study group had some effectiveness on abduction and flexion as the treatment progresses. 3. There is no significant difference in FMMA between study group and control group. Conclusions : This study suggests that sweet bee venom pharmacopuncture has significant analgesic effect on the post-stroke hemiplegic shoulder pain. And it seems that sweet bee venom pharmacopuncture can be applicable to improve PROM in hemiplegia patients with stroke. Further studies based on larger population and long term follow-up are needed to confirm this suggestion.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.665-678
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• 1999

Stroke is a major cause of death and long-term disability. Because muscle weakness is one of the most prominent consequences of stroke, it was considered important to determine whether exercise in order to improve muscle strength and range of motion could have an effect in limiting the learned disuse of the affected side. The purpose of the study was to identify the effects of an 8 week rehabilitation program on physical and cognitive ability in stroke patients. A total of 18 patients who were admitted to the oriental medicine unit of a K medical center in Seoul were recruited : ten for the experimental group and eight for the control group. The rehabilitation program consisted of three level's of active and passive exercises for prevention of muscle contracture and at range of motion. Muscle strength, flexibility of the upper and lower extremity, perceived balance, functional independence, depression, and quality of life for the two groups were compared at the pretest and 4 and 8 weeks after the rehabilitation program. The results are as follows : 1) When measuring muscle strengths of shoulder abduction and elbow flexion, hip flexion and knee extensor, ankle dorsi-flexor and muscle strength of knee flexor. Muscle strength of knee flexor for the experimental group was significantly higher than the comparison group at the 4 weeks. 2) Muscle strength and flexibility of the ankle dorsi -flexor for the experimental group was significantly better than for the control group at 8 weeks. 3) Functional independence, perceived balance, and Tinetti balance for the experimental group as measured at 4 and 8 weeks were better than for the control group. Also, there were changes over time in physical balance and functional ability, but there was no significant differences between the groups. 4) The experimental group showed a higher quality of life and lower depression than the control group at 8 weeks. 5) Muscle strength and flexibility of ankle dorsi -flexor were significantly changed over time and an interaction between group and time. The findings suggested that the rehabilitation program would improve the physical and psychological status of the stroke patients. Thus, the gains in actual or perceived ability to perform physical activities was marked.

• Journal of Digital Convergence
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• v.14 no.1
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• pp.291-303
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• 2016

The purpose of this study has been done to identify the influencing factors on rehabilitation motive of stroke patients. A sample of 138 stroke patients in Long-term Care and rehabilitation hospitals completed questionnaires through face - to - face interviews. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and Stepwise multiple regression. Rehabilitation motive of stroke pacients was correlated with empowerment (r=.467, p<.001), but not with perceived stress(r=.-.186, p=.029). In a multiple regression, empowerment (${\beta}=.432$, p<.001) and primary care-giver (${\beta}=.175$, p=.023) were associated with rehabilitation motive. These factors attributed to 24% of the total variance in rehabilitation motive. Therefore, the study finding suggests that these significant factors should be considered when developing and implementing convergent care strategies for stroke patients in order to promote their rehabilitation motive.

• PNF and Movement
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• v.16 no.1
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• pp.7-17
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• 2018

Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.

• Korean Journal of Applied Biomechanics
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• v.20 no.2
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• pp.139-148
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• 2010

The purpose of this study was to comparatively analyze the kinematic variables between the squash backhand and racquetball backhand strokes through three-dimensional cinematography. Three expert racquetball players and three expert squash players were involved in the data gathering process. The horizontal, vertical and lateral displacement of racket and trunk segment, intersegmental angular velocity of the wrist, elbow and shoulder joints, and the linear velocity of the racket were descriptively analyzed, and the followings were concluded. The racket of the squash backhand stroke showed an 'U' shaped movement where the racket moved rapidly downward and moved forward to make an impact and followed through to a front-top finish, while the racket of racquetball backhand stroke showed an 'O' shaped movement where the racket showed circular movement through the rear and bottom positions for the impact, and showed rotation through the lower-front and upper front to a upper-rear-ward finish during the follow-through. The peak velocity of racket was found before the impact point in the squash backhand stroke and at the impact point in the racquetball backhand stroke. For the final conclusion, for the squash backhand stoke, instructors might be better to make the racket move downward to make highest velocity before the impact and finished short follow-through, while for the racquetball backhand stroke, to make the racket move forward to make highest velocity at the impact and finished rather long follow-through.

• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.67-73
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• 2019

Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.2
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• pp.160-174
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• 2023

Objective: Carotid artery stenting (CAS) is currently widely used for the treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of CAS performed in a single institution. Methods: We retrospectively analyzed 313 CAS cases from January 2007 to December 2020, including 206 (66%) symptomatic and 107 (34%) asymptomatic cases. Procedure-related morbidity and mortality were assessed. Rates of periprocedural (≤30 days after CAS) and postprocedural ipsilateral strokes (>30 days after CAS) were also assessed. Logistic regression analysis was used to identify risk factors for the periprocedural complication, in-stent restenosis (ISR), and ipsilateral stroke. Results: The success rate of CAS was 98%. Among 313 cases, 1 patient died due to hyperperfusion-related intracerebral hemorrhage (ICH). The CAS-related mortality rate was 0.31%. The overall incidence of periprocedural complications is 5.1%. A risk factor for periprocedural complication was a symptomatic carotid artery stenosis (7.3% vs. 0.9%, p=0.016). Twenty cases of ISR occurred during 63.7±42.1 months of follow-up. The overall incidence of ISR was 10.2% (20/196). A risk factors for ISR were diabetes mellitus (17.6% vs. 5.7%, p=0.008) and patients who used Open-cell stents (19.6% vs. 6.9%, p=0.010). The overall incidence of ipsilateral stroke is 5.6%. A risk factors for ipsilateral stroke was ISR (95% CI, p=0.002). Conclusions: CAS is a safe and effective procedure for carotid artery stenosis. Although the incidence of complications is low, fatal complication such as hyperperfusion-related ICH can occur. To prevent hyperperfusion-related ICH, several methods such as strict blood pressure (BP) control, intentional less widening of stenotic segment should be used. To prevent ISR or stroke occurrence, special attention should be paid to patients who have ISR or ipsilateral stroke risk factors.

• 제어로봇시스템학회:학술대회논문집
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• 1990.10b
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• pp.1312-1315
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• 1990

Nanometer positioning control with high velocity and long stroke is discussed. A one-axis stage mechanism driven by an AC linear motor and guided by a rolling ball guide has been constructed. Coarse and fine position controls are designed by using nonlinear dynamics of the rolling guide. Switching from coarse positioning to fine positioning is studied.