• Title/Summary/Keyword: Post stroke

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Effects of Functional Electrical Stimulation on the Balance of Hemiplegic Patients (기능적 전기자극 치료가 편마비 환자의 균형에 미치는 영향)

  • Kim, Yong-Cheol;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.97-111
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    • 2004
  • This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

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The Effects of Education According to Constitution & Character of Patients Who have Stroke (뇌졸중 환자의 체질별 건강통제위 성격별 자가간호에 대한 교육의 효과)

  • Kang Hyun-Sook;Lee Jung-Min;Choi Eun-Sun;Jeon Eun-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.7-18
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    • 1995
  • This study was designed to explore the effectiveness of education to improve self-care of stroke patients with three types of charactor health locus of control and constitution. A total of 56 patients were selected by convenience sampling at one oriental hospital. The teaching of self-care was conducted by the researcher. The self-care performance was measured for 10 days. The data were analyzed using t-test, ANOVA and Scheffe method as post hoc test. The results of this study are as follows : 1. The self-care performance by patients' characteristics : Age and education had impact on the self-care performance. The level of self-care performance of young and high educated patients was high, gender, religion, occupation, monthly income, and the paralyzed side, however, didn't have influence on the self-care performance. 2. The self-care performance of patients with three types of constitution : There was no statistical significance on the self-care performance of patients group by constitution. However, average score of self-care performance of patients with So-Um was high. 3. The self-care performance of patients with three types of health locus of control : There was no statistical significance on self-care performance of patient group by health locus of control. 4. The correlation between the constitution and the health locus of control : There was no statistical significance on the introverted and chance health locus of control of patients with three types of constitution. However, there was a statistically significant relationship between the powerful others health locus of control and So-Yang. Even though there was no statistically significant self-care performance of patients with So-Um, there was a clinical significance on the high score of self-care performance of patients with So-Um as compared with the self-care performance of the patients. The health locus of control didn't have influence on the self-care performance of patients. There was a statistically significant relationship between the powerful others health locus of control and So-Yang. Therefore, this study suggest the need to develop the nursing intervention to improve the self-care of stroke patients with the powerful others health locus of control and So-Yang, Furthermore, the longitudinal research is needed to determine the effectiveness of training to imp

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A Improved Case of Post Cerebral Infarction Dizziness and Gait Discomfort after Treated with Korean Medicine Treatment and Vestibular Rehabilitation Practice (한의복합치료와 전정재활운동을 병행하여 뇌졸중 후 어지러움과 보행불안 증상이 개선된 증례 보고)

  • Chu, Hongmin;Lim, Hyeon-Seo;Kim, Kwangho;Lee, Young-Ung;Park, Kyungtae;Jang, Jongwon;Ryu, Ho-sun;Kim, Su-hak;Kim, Cheol-hyun;Lee, Sangkwan;Sung, Kang-keyng
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.179-186
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    • 2020
  • The aim of this study was to report the effect of Korean medicine treatments and vestibular rehabilitation practice on an stroke patient with dizziness. The patient received Korean medicine treatments, such as acupuncture and herbal medication, and vestibular rehabilitation practice. The effects of treatments were assessed with the Korean dizziness handicap inventory, Korean activities-specific balance confidence scale, Korean vestibular disorders activities of daily living scale. Researchers conducted gait analysis for evaluation patient's gait disturbance's improvement during treatments. The intensity of dizziness were significantly reduced after the complete treatment. After treatment with traditional Korean medicine and vestibular rehabilitation practice, the patient showed significant improvements in symptoms and gait parameters. This case proved that combined therapy of Korean medicine treatment and vestibular rehabilitation practice can be useful for stroke patients who suffered from dizziness. however, studies of larger populations are required in the future.

Occupational Therapy for Community Mobility in Stroke Patients : Systematic review (뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰)

  • Jo, Eun-Ju;Kam, Kyung-Yoon;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.77-89
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    • 2018
  • Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.

Post-stroke Visual Impairment Treated with Korean Medical Treatment: A Case Series (한의 복합 치료를 통해 개선된 뇌졸중 후 시야 장애 환자 2례 증례보고)

  • Lee, Young-ung;Kang, Geonhui;Kim, Kwangho;Kim, Cheol-hyun;Kang, Sunny;Lee, Sangkwan
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1035-1044
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    • 2021
  • Objective: This study investigated two cases of Korean medical treatment for visual field impairment after stroke: Case 1, a 56-year-old male with a posterior cerebral artery infarction and right homonymous hemianopsia, and Case 2, a 46-year-old male with an intracerebral hemorrhage in the left parietal lobe and right homonymous hemianopsia. Methods: Case 1 was treated with acupuncture, electroacupuncture, and herbal medicine (Mangeum-tang) for two months, and Case 2 was treated with acupuncture, electroacupuncture, and herbal medicine (Oryeong-san) for 40 days. Results: Following treatment, for Case 1, the Humphrey visual field test showed improvement. The visual field indexes (VFIs) for the left and right eyes improved from 44% to 55% and 49% to 64% respectively, and the mean deviations (MDs) for the left and right eyes improved from -21.11 dB to -19.91 dB and -17.45 dB to -13.89 dB, respectively. The mean visual sensitivities (MVSs) of the left and right eyes also improved from 8.67 dB to 11.33 dB and 1.67 dB to 9.67 dB, respectively, with no side effects. For Case 2, the VFI for the left eye improved from 36% to 64% and that for the right eye remained unchanged. The MDs for the left and right eyes also improved from -22.02 dB to -14.47dB and -22.11 dB to -21.34 dB, respectively, with no side effects. Conclusions: This study suggests that Korean medical treatment may improve visual impairment after stroke, but further research is needed.

Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms

  • Cho, Min-Soo;Kim, Min-Su;Chang, Chul-Hoon;Kim, Sang-Woo;Kim, Seong-Ho;Choi, Byung-Yon
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.131-134
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    • 2008
  • Objective: The surgical approach for anterior choroidal artery (AChA) aneurysm is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result. can result in postoperative ischemic complications. The purpose of this study was to clarify the risk of clip-induced ischemic complication in AChA aneurysm and to get the benefits for helping decision making. Methods: We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself. J type from junction of AChA and ICA and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory. Results: Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (r=0.005) Conclusion: AChA aneurysm surgery carries a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.

Cost-Effectiveness of Carotid Endarterectomy versus Carotid Artery Stenting for Treatment of Carotid Artery Stenosis

  • Kim, Jong Hun;Choi, Jong Bum;Park, Hyun Kyu;Kim, Kyung Hwa;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.20-25
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    • 2014
  • Background: Symptomatic or asymptomatic patients with significant carotid artery stenosis (range, 70% to 99%) generally undergo either carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) to prevent stroke. In this study, we evaluated the cost effectiveness of these two treatment modalities. Methods: A total of 47 patients (mean age, $67.1{\pm}9.1$ years; male, 87.2%) undergoing either CEA (n=28) or CAS (n=19) for the treatment of significant carotid artery stenosis were enrolled in this study. Hospitalization costs were subdivided into three parts, namely pre-procedure, procedure and resource, and post-procedure costs. Results: Total hospitalization costs were similar in both groups of CEA and CAS (6,377 thousand won [TW] vs. 6,703 TW, p=0.255); however, the total cost minus the pre-procedure cost was higher in the CAS group than in the CEA group (4,948 TW vs. 5,941 TW, p<0.0001). The pre-procedure cost of the CEA group was higher than that of the CAS group (1,429 TW vs. 762 TW, p<0.0001). However, the procedure and resource cost was higher in the CAS group because the resource cost was approximately three times higher in the CAS group than in the CEA group. The post-procedure cost was higher in the CEA group because hospital stays were approximately two times longer. Conclusion: The total hospitalization cost was not different between the CEA and the CAS groups. The pre-procedure cost was high in the CEA group, but the cost from procedure onset to discharge, including the resource cost, was significantly lower in this group.

A clinical case study of chronic inflammatory anemia in post-symptom period resulting Stroke of Soeumin patient (소음인환자(少陰人患者)의 중풍후유기(中風後遺期)에 병발(倂發)한 만성(慢性) 염증성(炎症性) 빈혈(貧血)에 대한 증례(症例))

  • Park, Eun-kyung;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.377-383
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    • 1999
  • The anemia which is accompanied with chronic primary diseases has been showed most frequently in the clinic. The purpose of this study is to give an account of the effects of the Korean herbal medicine therapy which is based on the constitutional medicine for the patient who has suffered from mild anemia, pneumonia and general depressed condition in the chronic stage of post-cerebellar hemorrhage. The subject is a 75-year-old woman who has had the symptoms caused by hemorrhage, which are headache, dizziness, walking disturbance, dysphasia, and general weakness and so forth. Therefore, she has normocytic normochromic anemia in the hematomancy. We have diagnosed her as Soeumin(少陰人) Ulkwangjeung(鬱狂症) and have prescribed Palmulgunjatang(八物君子湯) in accordance with the principle of Seungyangikgi(升陽益氣). The consequence is that the accompanied anemia and genseal depressed condition have improved.

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Effects of Korean Medicine on Patients with Idiopathic Parkinson’s Disease: A Retrospective Study (특발성 파킨슨병 환자에 대한 한의치료의 효과 : 후향적 연구)

  • Yang, Seung-bo;Kim, Yeon-jin;Lee, Hyung-min;Lee, Hyun-joong;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.37 no.4
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    • pp.653-660
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    • 2016
  • Objectives: The purpose of this study was to investigate the effects of Korean medicine on patients with idiopathic Parkinson’s disease.Methods: The charts of 47 patients diagnosed with idiopathic Parkinson’s disease in the Department of Internal Korean medicine, Stroke and Neurological Disorders Center, Kyung Hee University Hospital, Gangdong between August 2012 and July 2016 were reviewed. The Unified Parkinson’s disease rating scale (UPDRS) was administered before and after treatment with Korean medicine.Results: Thee average UPDRS Ⅱ+Ⅲ, UPDRS Ⅱ, and UPDRS Ⅲ of the 47 patients decreased significantly from 22.26±15.15, 10.19±7.53, and 12.06±8.35, respectively, pretreatment to 16.96±13.63, 7.47±6.44, and 9.49±7.73, respectively, post-treatment. The average postural instability and gait difficulty (PIGD), tremor, and bradykinesia also significantly improved post-treatment.Conclusions: These results provide evidence that Korean medicine can improve the activities of daily living and motor function of patients with idiopathic Parkinson’s disease. In particular, Korean medicine may be effective for the treatment of PIGD, tremor, and bradykinesia.

Acoustic Voice Analysis in Patients with Penetration/Aspiration Via Videofluoroscopic Swallowing Study (비디오투시조영검사를 통한 침습/흡인에 따른 음성의 음향적 분석)

  • Kang, Young Ae;Jee, Sung Ju;Koo, Bon Seok
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.60 no.9
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    • pp.454-462
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    • 2017
  • Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders.