• Title/Summary/Keyword: Motor Function recovery

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The Relationship Between Postural Control, ADL Function, Muscle Tone, and Functional Improvement in Chronic Stroke Patients (만성 뇌졸중 환자의 자세 조절과 일상생활동작, 근긴장도, 그리고 기능증진과의 관계)

  • An, Seung-Heon;Seo, Young-Jong;Park, Chang-Sik
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.64-73
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    • 2007
  • The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance ($R^2$=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

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Psychosocial Outcome after Head Injury (두부외상후 심리사회적 예후)

  • Park, Ki-Chang;Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.196-202
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    • 2000
  • Objective : This study was designed to evaluate the relationship between the initial neurosurgical or psychosocial factors and the psychosocial outcome. Patients and Methods : We analyzed 123 head-injured patients who were referred to the department of psychiatry for the evaluation of psychosocial function. We analyzed initial neurosurgical variables such as Glasgow Coma scale(GCS) score, skull fracture, CT finding, and psychosocial outcomes with regards to psychosis, personality change, depression, anxiety and IQ on Intelligence Scale. Results : Patients with mild head injury(GCS score 13-15, N=94, 76.4%) had better recovery rate on Glasgow Outcome Scale(GOS), less personality change than those with moderate or severe head injury. However, depression, anxiety and intelligence were not significantly different between two groups. The skull fracture(N=37, 30.1%) did not influence on the psychosocial outcome with reference to personality change, depression, anxiety and intelligence. The patients with abnormal CT findings(N=64, 52%) had lower recovery rate on GOS, more frequent tendency in psychosis, personality change and severe depression, less frequent in anxiety and mild depression, than patients with normal CT finding. However, levels of intelligence were not different between two groups. The patients with industrial accidents(IA) had lower educational level, milder head injury, more delay for the psychiatric evaluation (longer treatment period) than those with motor vehicular accidents(MVA). The psychosocial outcome with reference to personality change, depression, anxiety, intelligence were not different between two groups. Conclusion : These findings indicate that the more severe initial trauma, the poorer psychosocial outcome. However, it was frequently observed that patients with mild head injury suffered from mild anxiety and depression. Therefore mild head injury appeared to be more complicated by psychosocial stressors. The patients with IA, despite the fact that initial head injury was mild, required longer treatment period than MVA.

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Influence of Transcutaneous Electrical Nerve Stimulation and Electroacupuncture on C-fos Expression in Spinal Cord and Functional Recovery After Rat Sciatic Nerve Crush Injury (경피신경전기자극과 전침자극이 흰쥐 좌골신경 압좌손상 후 척수내 c-fos 발현과 기능회복에 미치는 영향)

  • Lee, Hyun-Min
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.187-195
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    • 2009
  • The purpose of this study was to identify the effect of transcutaneous electrical nerve stimulation(TENS) and electroacupuncture(EA) after sciatic nerve crush injury in rats. Subjects were classified TENS group with TENS application, EA group with EA application and Control group which is not applicated electrical stimulation. TENS and EA stimulations were applied post-injury day(PD) 1 to 14 after sciatic nerve injury. This study observed c-fos expression in rat lumbar spinal cord. In addition, the paw withdrawal latency(PWL) and sciatic function index(SFI) were measured. The results were as follows: At PD 1, control group had higher c-fos immunoreactivity than experimental groups. At PD 7 and 14, control group had higher c-fos immunoreactivity than experimental groups. The PWL of experimental groups were significantly lower than control group. The SFI had not significant difference in all groups. But the average of experimental groups were higher than control group. These results suggest that TENS and EA applications increasing sensory and motor nerve recovery while decreasing c-fos immunoreactivity after sciatic nerve crush injury.

The Effects of Difumarate Salt S-15176 after Spinal Cord Injury in Rats

  • Erdogan, Hakan;Tuncdemir, Matem;Kelten, Bilal;Akdemir, Osman;Karaoglan, Alper;Tasdemiroglu, Erol
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.445-454
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    • 2015
  • Objective : In the present study we analyzed neuroprotective and antiapoptotic effect of the difumarate salt S-15176, as an anti-ischemic, an antioxidant and a stabilizer of mitochondrial membrane in secondary damage following spinal cord injury (SCI) in a rat model. Methods : Three groups were performed with 30 Wistar rats; control (1), trauma (2), and a trauma+S-15176 (10 mg/kg i.p., dimethyl sulfoxide) treatment (3). SCI was performed at the thoracic level using the weight-drop technique. Spinal cord tissues were collected following intracardiac perfusion in 3rd and 7th days of posttrauma. Hematoxylin and eosin staining for histopatology, terminal deoxynucleotidyl transferase dUTP nick end labeling assay for apoptotic cells and immunohistochemistry for proapoptotic cytochrome-c, Bax and caspase 9 were performed to all groups. Functional recovery test were applied to each group in 3rd and 7th days following SCI. Results : In trauma group, edematous regions, diffuse hemorrhage, necrosis, leukocyte infiltration and severe degeneration in motor neurons were observed prominently in gray matter. The number of apoptotic cells was significantly higher (p<0.05) than control group. In the S-15176-treated groups, apoptotic cell number in 3rd and 7th days (p<0.001), also cytochrome-c (p<0.001), Bax (p<0.001) and caspase 9 immunoreactive cells (p<0.001) were significantly decreased in number compared to trauma groups. Hemorrhage and edema in the focal areas were also noticed in gray matter of treatment groups. Results of the locomotor test were significantly increased in treatment group (p<0.05) when compared to trauma groups. Conclusion : We suggest that difumarate salt S-15176 prevents mitochondrial pathways of apoptosis and protects spinal cord from secondary injury and helps to preserve motor function following SCI in rats.

A study of facial nerve grading system (구안와사(口眼喎斜)의 평가방법(評價方法)에 대한 고찰(考察))

  • Kim, Jong-In;Koh, Hyung-Kyun;Kim, Chang-Hwan
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.1-17
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    • 2001
  • Background and Objetive : Lack of uniformity in reporting facial nerve recovery in patients with facial nerve paralysis has been a major disadvantage in comparing treatment modalities. The objective evaluation of facial nerve function is a complex procedure. The House and Brackmann grading system, the Yanagihara grading system has been recommend as a universal standard for assessing the degree of facial nerve palsy. However, clinical studies for treatment of facial palsy have rarely used this universal standard in oriental medicine. That is the reason for analysing this facial nerve grading system. Material and Method : We choose 10 scales reported from 1955 till 1995. These facial nerve grading systems may be classified as Gross system, Regional system and Specific system. Result and Conculsion : The scales of Botmann and Jonkees, May, Peitersen, and House and Brackmann are the gross facial nerve grading systems with which we grossly assess the facial motor dysfunction and the secondary defect. Among these scales, H-B scale is the most widespred The scales of Yanagihara(若杉文吉), Smith, Adour and Swanson, Jassen, FEMA are the regional facial nerve grading system in which we weight, or unweight the facial motor dysfunction and the secondary defect. For example, the scales of Yanagihara(若杉文吉) and Smith are the unweighted regional scale, the scale of Adour and Swanson, Jassen, FEMA are the weighted regional grading system. The scale of Stennert is the Specific facial nerve grading system in which we respectively assess the grade of facial dysfunction at rest, in motion and the secondary defect. For the objective evaluation of the oriental medicine treatment for facial palsy, we must use the universal standard scale, i.e. the H-B scale, the Yanagihara scale.

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Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

  • Cho, Ki Hun;Song, Won-Kyung
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.93-98
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

Complex Regional Pain Syndrome on Post-Stroke Patients with Korean Medicine: A Case Series of Three Patients (뇌졸중 후 발병한 복합부위 통증증후군 환자의 한방치료로 호전된 치험 3례 보고)

  • Byun, Sung-Bum;Yun, Jong-Min;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.573-584
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    • 2014
  • Objectives: This study was performed to evaluate the efficacy of Korean Medicine on post-stroke patients with upper limb pain due to complex regional pain syndrome diagnosed by three-phase bone scan, digital infrared thermal imaging, and International Association for the Study of Pain diagnostic criteria Methods: To evaluate the effectiveness of the treatments, visual analogue scale, medical research council grade, Brunnstrom stage of motor recovery, modified Ashworth scale, and Korean modified Barthel index were used. Results: After Korean medical treatments like acupuncture, herb medication, bee-venom therapy and rehabilitation therapy for 4 weeks, upper limb pain was considerably less and function of upper limbs was improved. Conclusions: Korean medical treatments have some good effects on post-stroke patients with complex regional pain syndrome.

Effectiveness of Combined Korean Medicine on Traumatic Spinal Cord Injury: A Case Report

  • Choi, Ji-Won;Bae, Ji-Min;Kim, Jae-Kyu;Lee, Byung-Ryul;Yang, Gi-Young
    • The Journal of Korean Medicine
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    • v.38 no.4
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    • pp.110-117
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    • 2017
  • Objectives: This study aims to evaluate the clinical effectiveness of a Korean medicine treatment on a traumatic spinal cord injury. Metohds : A 44-year-old male patient who had suffered a traumatic spinal cord injury was treated for two months. The effectiveness of complex Korean medicine treatments was measured using the Numeric Rating Scale (NRS) and the Manual Muscle Test (MMT). Result : We found that the NRS of pain caused by numbness was decreased from 7 to 0-1, and the overall motor measured by the MMT was also improved. The patient's walking state was changed from wheelchair ambulation to walker ambulation. Conclusion : Based on this finding, complex Korean medicine treatments may be effective in treating patients' pain, controlling paresthesia, and aiding the recovery function of activities in daily living. However, because of the limitation of our study, further high-quality research should be conducted.

DEVELOPMENT OF AN OPERATION STRATEGY FOR A HYBRID SAFETY INJECTION TANK WITH AN ACTIVE SYSTEM

  • JEON, IN SEOP;KANG, HYUN GOOK
    • Nuclear Engineering and Technology
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    • v.47 no.4
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    • pp.443-453
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    • 2015
  • A hybrid safety injection tank (H-SIT) can enhance the capability of an advanced power reactor plus (APR+) during a station black out (SBO) that is accompanied by a severe accident. It may a useful alternative to an electric motor. The operations strategy of the H-SIT has to be investigated to achieve maximum utilization of its function. In this study, the master logic diagram (i.e., an analysis for identifying the differences between an H-SIT and a safety injection pump) and an accident case classification were used to determine the parameters of the H-SIT operation. The conditions that require the use of an H-SIT were determined using a decision-making process. The proper timing for using an H-SIT was also analyzed by using the Multi-dimensional Analysis of Reactor Safety (MARS) 1.3 code (Korea Atomic Energy Research Institute, Daejeon, South Korea). The operation strategy analysis indicates that a H-SIT can mitigate five types of failure: (1) failure of the safety injection pump, (2) failure of the passive auxiliary feedwater system, (3) failure of the depressurization system, (4) failure of the shutdown cooling pump (SCP), and (5) failure of the recirculation system. The results of the MARS code demonstrate that the time allowed for recovery can be extended when using an H-SIT, compared with the same situation in which an H-SIT is not used. Based on the results, the use of an H-SIT is recommended, especially after the pilot-operated safety relief valve (POSRV) is opened.

Operation Performance of a Polymer Electrolyte Fuel Cell Cogeneration System for Residential Application (가정용 고분자연료전지 시스템의 운전 방법에 따른 성능 비교)

  • Lee, W.Y.;Jeong, K.S.;Yu, S.P.;Um, S.K.;Kim, C.S.
    • Transactions of the Korean hydrogen and new energy society
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    • v.16 no.4
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    • pp.364-371
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    • 2005
  • Fuel cell systems(FCS) have a financial and environmental advantage by providing electricity at a high efficiency and useful heat. For use in a residence, a polymer electrolyte fuel cell system(PEFCS) with a battery pack and a hot water storage tank has been modelled and simulated. The system is operated without connection to grid line. Its electric conversion efficiency and heat recovery performance are highly dependent on operation strategies and also on the seasonal thermal and electric load pattern. The output of the fuel cell is controlled stepwise as a function of the state of the battery and/or the storage water tank. In this study various operation strategies for cogeneration fuel cell systems are investigated. Average fuel saving rates at different seasons are calculated to find proper load management strategy. The scheme can be used to determine the optimal operating strategies of PEFCS for residential and building applications.