• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.109-115
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• 2009

Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.

• 대한한방내과학회지
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• 제38권5호
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• pp.658-667
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• 2017

Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.

• 재활간호학회지
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• 제3권2호
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• pp.169-181
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• 2000

The purpose of this study was to identify the effect of follow-up care for stroke survivors on primary caregivers' quality of life. Quasi-experimental research was conducted in which an experimental group and a control group-each of 15 stroke survivors and their primary caregivers-were consecutively sampled. Data collected from July to September, 1999 by interview using a structured questionnaire with both the experimental and the control groups. After a month, the two groups were given the same questionnaire. The experimental group was also given a telephone follow-up every week for a month, as well as a home visit. The survey instruments used in this study were Saha and Cooper's "Modified Barthel Index" (11 items) for checking the stroke survivors' level of activities of daily living, and a modified form of Jeong's "Quality of life" (18 items) for primary caregivers' QOL level. The obtained data were analyzed by percentage, t-test, $X^2$-test, Kruscal-Wallis test, Spearman correlation coefficient by SAS/PC program. The results were as follows: 1. There was no significant difference in the stroke survivors' ADL level, though the level of the experimental group was higher than that of the control group. 2. There was a statistical difference in the before and after treatment of the primary caregivers' QOL level. In conclusion, the follow-up care program had a useful effect on the quality of life of primary caregivers.

• 혜화의학회지
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• 제29권2호
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• pp.1-11
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• 2020

Objectives : The aim of this study was to report the effectiveness of Combined Korean Medicine treatment on a intracerebral hemorrhage patient with hemiplegia and gait disturbance. Methods : A 56-year-old, female patient with hemiplegia and gait disturbance was treated by Korean Medicine including acupuncture, moxibustion and herbal medicine. The effect of the treatment was evaluated by Manual Muscle Test(MMT), Modified Rankin Scale(MRS), Korean version of Modified Barthel Index(K-MBI). The gait of the patient was evaluated by 10m walk test, Timed Up&Go Test(TUG), Functional Ambulatory Category(FAC), GAITRite and Symmetry Criterion(SC). Results : After treatment, MMT, MRS, K-MBI, gait parameters and gait symmetry were improved. Conclusions : This study suggests that Combined Korean Medicine treatment might be effective for a intracerebral hemorrhage patient with hemiplegia and gait disturbance.

• 대한한방내과학회지
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• 제42권5호
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• pp.1131-1141
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• 2021

Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

• PNF and Movement
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• 제16권3호
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• pp.451-460
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• 2018

Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

• 대한한방내과학회지
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• 제43권2호
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• pp.175-183
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• 2022

Objective: The aim of this study is to report the improvement of a basal ganglia infarction patient with left hemiplegia and gait disturbance after treatment with Korean medicine. Methods: The patient was treated using acupuncture, moxibustion, and herbal medicine. 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. Results: After 118 days of treatment, scores for all three scales improved. Conclusion: Treatment with Korean medicine appears to be effective for improving the clinical symptoms of basal ganglia infarction with hemiplegia and gait disturbance, but further research is needed to verify this.

• 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.

• 대한물리치료과학회지
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• 제31권1호
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• pp.98-109
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• 2024

Background: The purpose of this study is to investigate changes in physical and cognitive function according to the level of independence in performing activities of daily living in stroke patients. Design: Retrospective study. Method: This study is a retrospective study analyzing medical records. This study utilized data collected from 123 stroke patients at admission in a local rehabilitation hospital between 2019 and 2022. Stroke patients were classified into 5 groups based on the scores of the Korean Modified Barthel index (K-MBI) evaluated at the time of hospitalization at a rehabilitation hospital, and investigated the change in physical (spasticity (modified Ashworth scale), muscle strength (manual muscle test), gait ability (functional ambulation category), upper extremity function (manual function test), and balance function (berg balance scale)) and cognitive function (Korean mini mental status examination) according to the level of independence in performing activities of daily living. Result:: As a results, significant differences were observed in the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive functions of stroke patients according to the level of independence in performing activities of daily living (p<0.05). However, there was no significant difference in upper and lower extremities spasticity. Conclusions: Through the results of this study, we found that the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive function were influenced by the level of independence in performing activities of daily living in stroke patients.

• 대한한방내과학회지
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• 제38권2호
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• pp.118-124
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• 2017

Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.