• Title/Summary/Keyword: Post-Stroke

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Application of Segmental Phase Angle for Assessment of Post-Stroke Complex Regional Pain Syndrome (뇌졸중 후 복합부위통증증후군에서 부위별 위상각을 이용한 평가)

  • Park, Se-Heum;Kim, Woo-Jin;Jo, Geun-Yeol;Kwon, Jun-Koo
    • Clinical Pain
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    • v.19 no.1
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    • pp.23-27
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    • 2020
  • Our objective is to evaluate the applicability of segmental phase angle (PhA) via bioelectrical impedance analysis (BIA) for post-stroke complex regional pain syndrome (CRPS). Due to its noninvasiveness and convenience, various studies have used BIA in clinical conditions. We measured segmental PhA in 4 patients at the time of CRPS diagnosis and repeated 4 weeks after 2 weeks of steroid pulse therapy. In 3 cases, the affected-to-unaffected ratio of the upper limb PhA decreased at the time of diagnosis. In 2 cases with improvement of more than 5 points in the CRPS severity score (CSS), increased ratios were observed. In other 2 cases with improvement of less than 4 points in the CSS, no remarkable changes in the ratios were found. We suggest that the segmental PhA can be helpful in assessment of post-stroke CRPS and its recovery.

Study on Asymmetrical EMG Activation Pattern of Selected Trunk and Thigh Muscles on Gait Velocity of Individuals With Post-Stroke Hemiparesis During Sit-to-Stand Movement (일어서기 동작시 편마비 환자의 보행 속도에 따른 체간과 하지 근 활성 형태의 비대칭성에 관한 연구)

  • Park, Hyun-Ju;Oh, Duck-Won;Choi, Sung-Jin;Jang, Hyun-Jeong;Sim, Sun-Mi;Cho, Hyuk-Shin
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.29-38
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    • 2012
  • This study aimed to identify the asymmetry observed in the electromyography (EMG) activity patterns of selected trunk and thigh muscles between the affected and unaffected sides during the sit-to-stand movement in ambulatory patients with post-stroke hemiparesis. This study included 20 patients with post-stroke hemiparesis. The differences between stroke fast walkers (${\geq}8m/s$, 11 subjects) and stroke slow walkers (<8 m/s, 9 subjects) were compared. The activation magnitude and onset time of the multifidus, lumbar erector spinae, hamstrings, and quadriceps during the sit-to-stand movement were recorded through surface EMG. Moreover, the EMG activation magnitude and onset time ratios of each bilateral corresponding muscle from the trunk and leg were measured by dividing the relevant values of the unaffected side by those of the affected side. In all the subjects, the activation magnitudes of the multifidus, hamstring, and quadriceps on the affected side significantly decreased compared to those on the unaffected side (p<.05). The onset time of muscle activity in the affected side was markedly delayed for the multifidus and quadriceps during the task (p<.05). The activation magnitude ratios of the quadriceps were markedly decreased in the stroke slow walkers as compared to those in the stroke fast walkers. These findings indicate that the asymmetry in the multifidus, hamstring, and quadriceps muscle activation patterns in patients with post-stroke hemiparesis may be due to the excessive muscle activation in the unaffected side to compensate for the weakened muscle activity in the affected side. Our findings may provide researchers and clinicians with information that can be useful in rehabilitation therapy.

Effects of Scalp Acupuncture on Short-term NIHSS and MBI in Stroke Patients (두침이 중풍환자의 단기간 NIHSS와 MBI에 미치는 영향)

  • 조태성;손인석;박인범;김상우;서정철;윤현민;장경전;송춘호;안창범
    • The Journal of Korean Medicine
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    • v.24 no.1
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    • pp.65-73
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    • 2003
  • Objective: The aim of this study was to investigate the effect of scalp acupuncture on recovery from motor disorders in stroke patients. Methods: Twenty-two patients with post-stroke hemiplegia were randomized into two groups. Ten patients (test group) were treated by 2 methods: scalp acupuncture and general acupuncture. The other twelve patients (control group) were treated only with general acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale (NIHSS) and Modified Barthel Index (MBI). The therapy was performed once a day for 2 weeks. Results: In terms of NIHSS score, the test group showed statistically meaningful decrease after 2 weeks treatment, while the control group showed statistically meaningful decrease after 1 week (p<0.05). And in terms of score of MBI, the test group did not show statistically meaningful increase but the control group showed statistically meaningful increase after 1 week (p<0.05). There was no statistically meaningful difference after 1 and 2 weeks treatment between the groups. Conclusions: These results support that the test group has almost same the effectiveness compared with the control group in improvement of the activity of daily living of post-stroke hemiplegic patients.

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A Study of the Clinical Utility of the Four Square Step Test for Predicting Falls in Stroke Patients (뇌졸중 환자의 낙상 예측을 위한 Four Square Step Test의 활용에 관한 연구)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.1-6
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    • 2010
  • Purpose: This study was designed to evaluate the clinical utility of the Four square step test (FSST) for predicting falls in stroke patients, to compare the ability of the FSST test to discriminate between subgroups of fallers, and to determine if the test has any predictive value in identifying stroke patients who will fall. Methods: Stroke patients (N=37) who could walk at least 50 m with minimal assistance were recruited consecutively when attending a physical therapy session during their rehabilitation. Dynamic standing balance was measured using the FSST. The main outcome measures were FSST time and fall number. Numbers of falls were compared with FSST scores. Differences between the groups in FSST scores were examined using a t-test and 1-way analysis of variance. Post hoc analysis using the Tukey B procedure was used to identify specific group differences. Alpha was set at 0.05. Results: A total of 15 participants (40.5%) reported falls 6 had recurrent falls (2 falls) and 9 fell once. The mean FSST time differed significantly between groups with zero and multiple falls. A cutoff score of greater than 17 seconds on the FSST was associated with a sensitivity of 83% and a specificity of 84% for the identification of subjects with multiple risk factors for falls. Conclusion: The FSST is a feasible and valid clinical test of dynamic standing balance and can predict falls in post-stroke patients.

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

  • Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.62-68
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    • 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.

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A Scoping Review of Acupuncture Points for Post-Stroke Sequelae: Focusing on the Electroacupuncture (뇌졸중 증상별 경혈 활용에 대한 주제범위 문헌고찰: 전침을 중심으로)

  • Lee, Hwa Yeon;Kim, Song-Yi;Choi, Su-Hyeon;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.4
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    • pp.197-208
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    • 2021
  • Objectives : The aim of this study was to conduct a scoping review focusing on acupuncture points information applied in experimental studies using electroacupuncture for stroke. Methods : First, we set the research question of this study to identify which acupuncture points were studied for various symptoms of post-stroke sequelae in clinical and animal experiments. For this purpose, among the records searched through EMBASE, experimental studies including acupuncture points used in electroacupuncture treatment for stroke were selected as inclusion criteria for this study. The acupoints information used in each experiment was extracted from the included studies according to the type of study design and symptoms of stroke sequelae, and quantitative analysis was performed. Results : A total of 973 studies using acupuncture treatment, of which 429 papers including electroacupuncture were analyzed. Most of the animal experiments were conducted on general conditions instead of specific symptoms of stroke, and in clinical studies, electroacupuncture studies were conducted on symptoms such as hemiplegia and spasticity, cognitive and mental problems, dysphagia, shoulder problems, and depression that occur after stroke. Acupuncture points such as GV20, ST36, LI11, and LI4 were mainly used regardless of stroke symptoms. Except for these acupuncture points, GV26, GV14, GV16, and GV24 were frequently used in animal experiments, and TE5, LI15, LI10, and LR3 were widely used in clinical studies. Conclusions : Although this study extracted and analyzed only the frequent acupuncture points in the electroacupuncture study for stroke. However, in the future, it is necessary to be able to secure the evidence for acupuncture treatment elements through comparative studies between different acupuncture points or other elements constituting electroacupuncture.

A Case of homonymous Hemianopia after Occipital-Parietal Lobe Hemorrhage Treated with Combined Korean Medical Treatment (동측 반맹을 호소하는 후두엽-두정엽 뇌출혈 환자에 대한 복합 한의치험 1례)

  • Seong Hoon, Jeong;In Hu, Bae;Geun Young, Kim;Ki-Ho, Cho;Sang-Kwan, Moon;Woo-Sang, Jung;Seungwon, Kwon;Han-Kyul, Lee
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.65-72
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    • 2022
  • ■Background Overall prevalence of visual field loss after stroke was estimated at 31%, ranged from 5.5- 57%. Among them, homonymous hemianopia is the most common symptom of post-stroke visual field loss and leads to a decrease in the quality of life and therapeutic effect. However, standard treatment has not been established. ■Case report A 48-year-old male with right side homonymous hemianopia by a left occipital-parietal lobe hemorrhage was treated with Qu-Ji-Du-Huang-Wan, acupuncture and electroacupuncture for 20 days. We used confrontation visual field exam, automated perimetry and visual analog scale for evaluating symptoms. Following treatment, confrontation visual field exam and the subjective discomfort was improved. ■Conclusions The present case report suggests that combined Korean medicine treatment might be an effective treatment of post-stroke homonymous hemianopia. A number of follow up studies should be conducted to clarify the effectiveness of treatment.

An Unconventional Approach Considering Flexor Spasticity and Flexion Synergies of the Upper Extremity Following a Stroke: A Randomized Double-blind Pilot Study

  • Rha, Young Hyoun;Lee, Keun Hee;Shin, Jun Bum;Park, Kang Hui;Kim, Byung Sun;Ha, Jae Chan
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.147-155
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    • 2022
  • Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (np2 = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

The Effects of Combined Complex Exercise with Abdominal Drawing-in Maneuver on Expiratory Abdominal Muscles Activation and Forced Pulmonary Function for Post Stroke Patients (복합운동과 복부 끌어당김 조정 훈련의 병행이 뇌졸중 환자의 호기 시 복부근육 활성도 및 노력성 폐기능에 미치는 영향)

  • Yun, Jeung-Hyun;Kim, Tae-Soo;Lee, Byung-Ki
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.4
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    • pp.513-523
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    • 2013
  • PURPOSE: The purpose of this study was to investigate characteristics of the forced pulmonary function test effect and abdominal muscles activation by combined complex exercise with abdominal drawing-in maneuver training of chronic stroke patients. METHODS: 14 post stroke patients(10 males and 4 females) involved voluntary this study and we divided two groups into CEG(complex exercise group) and CEAG (complex exercise and abdominal drawing-in maneuver group).(n=7, per goup). Each groups implicated the 2 times, 30minute exercises for 6 weeks a day. The CEAG performed the complex exercise 15 minutes and 15 minutes of abdominal drawing-in maneuver. For data analysis, the mean and standard deviation were estimated; non-parametric independent t-test was carried out. RESULTS: According to the study, in the combined complex exercise with abdominal drawing-in maneuver group, FVC and activation of transversus abdominis/internal oblique were statistically significant difference compared to the complex exercise group. CONCLUSION: These results indicate that the combined complex with abdominal drawing-in maneuver was efficient in enhancing abdominal muscles activation and pulmonary function of chronic stroke patients.

Effect of Robot-Assisted Hand Rehabilitation on Hand Function in Chronic Stroke Patients (손 재활 로봇의 적용이 만성 뇌졸중 환자의 손 기능 향상에 미치는 영향)

  • Park, Jin-Hyuck
    • The Journal of Korea Robotics Society
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    • v.8 no.4
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    • pp.273-282
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    • 2013
  • The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(Amadeo(R)) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in Amadeo(R), and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of Amadeo(R), finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.