• 제목/요약/키워드: NIH Stroke Scale

검색결과 9건 처리시간 0.022초

건측 위주의 양측자침이 뇌졸중 환자의 NIH Scale상의 기능 회복에 미치는 영향 (Effects of Contralateral Both Side Acupuncture on NIH Scale in Stroke Patients)

  • 서정철;백용현;남동현;서동민;이현종;하지영;우현수;이재동
    • 대한한의학회지
    • /
    • 제22권3호
    • /
    • pp.98-104
    • /
    • 2001
  • Objective : In order to study the effect of contralateral both side acupuncture on recovery of motor disorders in stroke patients, a clinical study was performed. Methods : Thirteen patients with post-stroke hemiplegia were randomized into two groups. Six patients (test group) were treated with contralateral both side acupuncture. The other seven patients (control group) were treated with ipsilateral both side acupuncture. The activity of daily living was measured with a National Institutes of Health (NIH) scale. The therapy was performed once a day for 3 weeks. Results : In terms of score of NIH, the test group showed statistically meaningful increase after I weeks treatment, while the control group showed statistically meaningful increase after 2 weeks (P<0.05). The results showed no statistically meaningful difference after 3 weeks treatment between the groups. Conclusions : These results support that contralateral both side acupuncture therapy has almost the same effectiveness compared with ipsilateral both side acupuncture therapy in improvement of the activity of daily living of post-stroke hemiplegic patients.

  • PDF

일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로- (The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research)

  • 박종구;강명근;이성수;김달래;최서영;한창호;유준상;김민기;김춘배
    • 대한한방내과학회지
    • /
    • 제22권4호
    • /
    • pp.691-702
    • /
    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

  • PDF

뇌졸중 환자의 임상적 검사NIHSS(National Institutes of Health Stroke Scale)와 기능적 예후와의 상관관계 (The Relationship of NIH(National Institutes of Health) Stroke Scale to Functional Improvement in Stroke Patients)

  • 허지영;김지혁;김용권
    • 대한물리치료과학회지
    • /
    • 제9권1호
    • /
    • pp.103-111
    • /
    • 2002
  • The purpose of this study was NIHSS(National Institutes of Health stroke scale) to activities of Daily Living stroke patient. We designed a 17 item neurogic Examination NIHSS use in acute stroke therapy trials. In a study of stroke patient. Assessment were measured by the NIHSS and by the MBI (Modified Barthel Index) to evaluate activities of daily living(ADL). Fifty patients were subject in this study. Collected data analysis were completed by using t-test, ANOVA, correlation analysis and Multiple regression analysis. The following were as follow; Among the test of NIHSS(National Institutes of Health stroke scale) was significantly correlated with changes in MBI(Modified Barthel Index) score in 50 stroke patients. Among the subitems of NIHSS, Pupillary Response, a level of consciousness, best motor arm, best motor leg were the best predictors of functional improvement.

  • PDF

급성 뇌경색 환자에서 예후 추측인자로서의 확산텐서영상 비등방도 (Fractional Anisotropy of Diffusion Tensor Imaging as a Predict Factor in Patient with Acute Cerebral Infarction)

  • 김성길;은성종
    • 한국방사선학회논문지
    • /
    • 제4권3호
    • /
    • pp.13-18
    • /
    • 2010
  • 확산 텐서 영상을 이용하여 뇌경색 환자의 손상된 백질 섬유를 시각화할 수 있게 되었다. 본 연구의 목적은 뇌경색 환자에서 NIHSS와 분할 비등방도의 상관을 평가하고자 하였다. MR 확산영상에서 뇌경색이 확인된 16명(남:11, 여:5, 평균연령 61세) 환자를 대상으로 24방향 DTI를 시행하였다. 뇌경색 발발 후 2주 이내에 증상이 개선된 환자 9명과 증세가 악화된 환자 7명으로 구분하였다. FA값의 정량측정을 위해 병소와 병소 반대측이 통계적으로 유의한 차이가 있음을 확인하였다. 확산강조영상에서는 병소가 고신호로 보였으나, FA값은 정상측 보다 낮게 측정되었다. NIHSS상의 임상증상이 개선된 환자들의 FA값은 0.41, 반대측 정상부는 0.49로 병소측이 15%정도 낮게 측정되었다. 그러나 NIHSS상 증상이 악화된 환자들의 경우 병소측 FA값이 0.28, 반대측 정상부는 0.56으로 큰 차이를 보였다. 결론적으로 DTI에서의 FA값은 뇌경색 환자의 예후를 평가하는데 매우 유용한 지표로 이용될 수 있을 것이다.

급성기 뇌졸증 환자의 상태와 기능회복도와의 상관관계 (The Correlation Between Early Clinical State and Functional Outcome in Acute Stroke Patients)

  • 최은정;이원철
    • 동국한의학연구소논문집
    • /
    • 제6권2호
    • /
    • pp.167-190
    • /
    • 1998
  • 최근 뇌졸중 예후에 관한 연구 경향을 살펴보면 방사선 소견에 예후인자를 살펴보는 방법과, 방사선 소견을 배제한 환자의 상태, 즉 의식이나 인지, 지각, 운동, 언어기능, 대소변 장애 등의 여부와 예후와의 상관관계를 연구하는 방법으로 크게 나누어 볼 수 있다. 전자의 경우는 비교적 객관적인 검토가 가능하지만, 후자의 경우는 연구방법에 있어 어려움이 있었다. 이에 저자는 후자의 방법으로 어떠한 요인들이 뇌졸증의 예후에 영향을 미치는지와, 그 중 가장 영향력 있는 요인이 무엇인지 밝히고자 다음과 같은 통계연구를 하였다. 연구대상은 동국인천한방병원 내과에 일원한 환자 중 뇌졸중 증상발현 48시간 이내에 입원하였으며, 4주간의 추적검사가 가능하였고, 방사선 검사에서 뇌혈관 질환으로 판단된 환자 32명이었다. 연구방법은 입원 시 각 환자의 임상기록지에 기능평가방법의 하나인 FIM, NIH scale, CNS 점수를 기록하고 그 각각의 sub-item 중에서 의식, 인지, 지각, 운동, 언어기능과 대소변 장애에 해당하는 항목을 골라 4주후 MBI로 평가한 기능회복도와의 상관관계를 살펴보았다. 또 각 항목 중에서 가장 영향력 있는 요인을 알아보기 위하여 다중회귀분석을 이용하였고, FIM, NIH scale, CNS의 총점을 다중회귀 분석하여 어느 기능 평가도가 예후에 가장 많은 영향을 미쳤는지도 알아보았다. 의식, 인지, 지각, 운동, 언어, 대소변 항목에 해당하는 FIM, NIH scale, CNS의 각 sub-item에서 점수별로 상, 중, 하위의 군을 나누어 4주후 MBI 평균점수를 살펴본 결과 모두 항목에서 유의성 있는 차이를 보여 이러한 요인들이 예후에 영향을 미친것을 알 수 있었다. 또 MBI 점수의 독립성을 기준으로 해서 5군으로 나누어 각 Sub-item과의 상관성을 살펴본 결과 의식과 지각기능 중 Lim-ataxia 항목을 제외한 나머지 항목에서는 통계적으로 유의성이 있는 것으로 나타났다. 각 Sub-item을 다중회귀 분석한 결과 인지기능이 예후에 가장 큰 영항을 미쳤으며, 지각기능 중 sensory항목과 대변장애가 다음으로 영향을 미쳤다. FIM, NIH scale, CNS의 총점을 나누어 다중회귀 분석하여 본 결과 가장 영향력 있는 평가도는 FIM이었고, 다음은 CNS였다.

  • PDF

뇌졸중환자의 연하장애에 관한 임상적 연구 (1) (Clinical Study of Dysphagia in Stroke Patients (1) (Preliminary paper))

  • 고성규
    • 대한한방내과학회지
    • /
    • 제18권1호
    • /
    • pp.62-68
    • /
    • 1997
  • Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

  • PDF

동씨침(董氏鍼)을 가미(加味)한 치료(治療)가 중풍환자(中風患者)의 NIH Stroke Scale과 MBI상의 기능 회복에 미치는 영향 (Effects of Added Tong's Acupuncture on NIB Stroke Scale and MBI in Stroke Patients)

  • 조태성;손인석;김철홍;서정철;윤현민;장경전;송춘호;안창범
    • Journal of Acupuncture Research
    • /
    • 제19권5호
    • /
    • pp.35-45
    • /
    • 2002
  • Objective : The aim of this study was to investigate the effect of tong's acupuncture on recovery of motor disorders in stroke patients. Methods : Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-tong's acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NlHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results: In terms of score of NIHSS. the test group showed statistically meaningful decrease after 2 week treatment. but the control group showed statistically meaningful decrease after I week(p<0.05). And in terms of score of MBI. the test group showed statistically meaningful increase after 2 week treatment. but the control group showed statistically meaningful increase after I week(p<0.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions: These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.

  • PDF

급성기 뇌경색의 위험인자와 NIH stroke scale에 관한 임상적 연구 (Clinical Study on Risk Factors of Acute Brain Infarction And NIH stroke scale)

  • 김도경;정현윤;손호영;이재욱;이영준;최상옥;김경민;김영균;권정남
    • 동의생리병리학회지
    • /
    • 제25권3호
    • /
    • pp.573-581
    • /
    • 2011
  • This study was done to examine the risk factors between controls group and acute brain infarction patients group, and to compare high risk group with low risk group through NIHSS(National Institutes of Health stroke scale). We compared the risk factors between acute brain infarction patients group(N=180) and controls group(N=93). And according to risk factors, we analyzed 1st NIHss, after 3 weeks improved extent within acute brain infarction patients group. The results were as follows. 1. Among the risk factors, HTN, DM, the blood levels of HCY were significantly higher and the blood levels of HDL-C was significantly lower in patients group than controls group. 2. In scale analysis according to risk factors, 1st NIHss were significantly higher in Hypo-HDL-cholesterolemia, Obesity, High-Homocysteine, HTN, DM, previous CVA history group than low risk group within acute brain infarction patients group. 3. In after 3 weeks improved extent analysis according to risk factors, improved extent were lower in Hyperlipidemia, HTN, DM, previous cardiac history, older age group than low risk group within acute brain infarction patients group. The above results suggest that significant risk factors of acute brain infarction, and shows the High risk group that had risk factor of brain infarction recognized from the former research tends to have higher 1st NIHss. Also the High risk group tends to have lower improved extent, but the results are not statistically significant. Furthur research on subject is needed.

급성 허혈성 뇌졸중에 수반된 연하장애에 관한 임상적 고찰 (Clinical Review about Dysphagia associated with Acute Ischemic Stroke)

  • 한명아;김동웅
    • 대한한의학회지
    • /
    • 제22권3호
    • /
    • pp.42-50
    • /
    • 2001
  • Objectives : Dysphagia is common and severe problems of acute stroke determining the prognosis of stroke only second to mental change, and results in secondary fatal complications such as aspiration pneumonia, malnutrition, dehydration, etc. Therefore, we were to investigate the clinical characteristics of dysphagia accompanied by acute ischemic stroke. Methods : We selected subjects through clinical notes retrospectively, whose main problems included dysphagia resulted from acute stroke within 72 hours from onset who were admitted to the Internal Medicine Department of Wonkwang Oriental Medicine Hospital from Jan. 2000 to Apr. 2001. We assessed the severity of dysphagia from admission to discharge using a staging method : stage 0 is normal without dysphagia, stage 1 is nearly normal except for intermittent dysphagia, stage 2 is compensated abnormal swallowing requiring adjusted diets or delayed feeding time, stage 3 is uncompensated abnormal swallowing resulted in weight loss down to 10% of initial and daily aspiration, coughing, and vomiting, stage 4 is uncompensated abnormal swallowing resulting in weight loss beyond 10% and recommended for non-oral feeding, and stage 5 is 100% non-oral feeding by L-tube, or gastrostomy or NPO state. Results : Dysphagia was improved statistically significantly from the mean stage of $3.6{\pm}0.29$ on admission to $1.88{\pm}0.32$ on discharge (P<0.05). On average $7.1{\pm}1.48$ days were required for improving more than one stage level. As patients were older and the stage of dysphagia was worse on admission, severity of dysphagia was more difficult to improve (correlation coefficiency was 0.55 and 0.77 respectively, P<0.05). Aspiration pneumonia was complicated in 13 patients of the total 25 at mean dysphagia stage of $3.36{\pm}0.37$. However, any specific values such as lesion size, lesion site, sex, age, past history and NIH Stroke Scale on admission did not affect it (P>0.05). Conclusion : Clinical course of dysphagia was determined about I week from the onset. Aspiration pneumonia was mainly complicated during oral feeding periods. If there were no improvement of dysphagia over 2-3 weeks, then non-oral feeding such as Levin tube or gastrostomy must be considered.

  • PDF