• Title/Summary/Keyword: Post-Stroke

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The Effects of Rehabilitation Excercise Program on Physical Function and Mental Health Status in Patients with Hemiparesis Following Chronic Stroke (재활운동 프로그램이 만성 뇌졸중 편마비 환자의 신체기능과 정신건강상태에 미치는 효과)

  • Park, Jeong-Mo;Lee, Suk-Jeong
    • Research in Community and Public Health Nursing
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    • v.17 no.2
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    • pp.166-175
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    • 2006
  • Purpose: This study was to evaluate the effects of a rehabilitation exercise program on physical function and mental health status in chronic stroke Patients with hemiparesis Method: This study used a single group experimental design with repeated measures. Data collection and intervention were done from August, 2004 to November. 2004 at a community. Participants were fifteen patients (mean age: 68.6), and a 100 meter walking time and box and block tests were conducted at baseline, 4weeks, and post-intervention (8weeks) Activities of daily living and the levels of depression and anxiety were measured by using SCL-90-R at pre and post Intervention. This program consisted of 1 hour individual exercise 3 times a week for 8 weeks, and it focused on stretching, walking, arm and hand exercise, and hand massage. Result: 1. ADL, IADL, and the 100m walking time in the patients were improved compared with baseline. However. box and block tests was not shown significant improvement compared with baseline. 2. Depression and anxiety scores were improved more than that of baseline. Conclusion: The rehabilitation exercise program can be effective in improving physical function and mental health status, and it has a potential for improving Physical health status in Patients with chronic stroke hemiparesis.

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The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients

  • Song, Bo-Kyung
    • The Journal of Korean Physical Therapy
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    • v.23 no.3
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    • pp.71-77
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    • 2011
  • Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

Functional Improvement Following Revision Surgery in a Patient with the Dual Disability of a Complicated Residual Limb and Contralateral Hemiplegia: A Case Report

  • Byun, Ki Hyun;Yang, Dong Seok;Jang, Baek Hee
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.199-203
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    • 2018
  • The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

The Effects of Visual·Auditory Rhythmic Stimulation(VARS) in Static Balance and Dynamic Balance with Chronic Stroke Patients (시·청각리듬자극이 만성 뇌졸중 환자의 정적균형과 동적균형에 미치는 영향)

  • Cho, Namjeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.4
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    • pp.9-14
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    • 2013
  • Purpose : The purpose of this study was to investigate the effect of visual Auditory rhythmic stimulation(VARS) in gait ability and proprioception with chronic stroke patients. Twenty-one persons after six months post stroke participated in pre test-post test control. Method : The subjects were randomly assigned to a visual Auditory rhythmic stimulation(VARS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the FRT(functional reach test) by static balance and TUG(timed up and go test) by dynamic balance. Results : In static balance, FRT distance was significantly different between two group. In dynamic balance, TUG time was significantly different between two group. This study showed that the VARS training increase a balance by postural adjustment of chronic stroke patients more than control group. And so, the VARS training of hemiplegic patients was very important to successive rehabilitation. Conclusion : A continuous examination of VARS training could practical used of physical therapy with exercise.

The Effects of Combined Balance Exercise on Balance in Chronic Stroke Patients (복합적 균형 훈련이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Choi, You-Jin;Ko, Keun-Bum
    • PNF and Movement
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    • v.18 no.2
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    • pp.195-204
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    • 2020
  • Purpose: The study investigated the effect of combined balance exercise using visual feedback and balance pads in rehabilitation of chronic stroke patients. Methods: The participants were 30 patients diagnosed with stroke who met the study selection criteria. Participants were randomly divided into 3 groups of 10: a balance pad exercise (BPE) group, a visual feedback exercise (VFE) group, and a combined balance exercise (CBE) group. All three groups engaged in 30 minutes of exercise, 3 times per week, for 6 weeks. Results: Pre-test and post-test results were analyzed using the functional reach test (FRT), the Berg balance scale (BBS), the timed up & go test (TUG), and the Korean version of the activities-specific balance confidence (K-ABC) scale. The study yielded the following results. Pre- and post-program FRT measures showed significant differences between the BPE and CBE groups (p < 0.05). BBS, TUG, and K-ABC scores showed clear differences in all three groups. Secondly, the CBE group and the BPE group a differed significantly on the BBS before and after the 6-week program (p < 0.05). Finally, the CBE group and the VFE group differed significantly on the BBS before and after the 6-week program (p < 0.05). Conclusion: The study results indicate that combined balance exercise improves balance more effectively than the balance pad and visual feedback exercises. This finding should help to improve rehabilitation in the future.

Effects of Combined Functional Electrical Stimulation and Joint Mobilization on Muscle Activation and Mobility of Ankle Joints and Modified Functional Reach Test in Stroke Patient

  • Kim, Su-Jin;Son, Ho-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.2
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    • pp.41-51
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    • 2019
  • PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

Effects of Game-based Postural Vertical Training on Pusher Behavior, Postural Control, and Activity of Daily Living in Patients With Acute Stroke: A Pilot Study (게임 기반의 자세수직 훈련이 급성 뇌졸중 환자의 밀기행동, 자세조절, 그리고 일상생활동작에 미치는 영향: 사전연구)

  • An, Chang-man;Roh, Jung-suk;Kim, Tack-hoon;Choi, Houng-sik;Choi, Kyu-hwan;Kim, Gyoung-mo
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.57-66
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    • 2019
  • Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

Efficacy of Bee-venom Acupuncture on Central Post Stroke Pain -Single-blind Randomized Controlled Trial- (중풍 후 중추성 통증환자에 대한 봉독약침의 임상효과 -단일맹검 무작위배정 환자 대조군 비교연구-)

  • Gwak, Ja-Young;Cho, Seung-Yeon;Shin, Ae-Sook;Lee, In-Whan;Kim, Na-Hee;Kim, Hye-Mi;Na, Byung-Jo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.205-214
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    • 2009
  • Objectives : This study was designed to evaluate objectively the efficacy of bee-venom acupuncture on Central post-stroke patients. Methods : After screening, 25 patients recruited with eligible criteria. Among them 1 dropped out in treatment group, 4 in control group. We applied bee-venom acupuncture 6 points of body($LI_{15}$, $GB_{21}$, $LI_{11}$, $GB_{31}$, $ST_{36}$, $GB_{39}$) 2 times a week for 3 weeks for treatment group, and normal saline for control group in the same way. After 3 weeks treatment and 2 weeks follow up we measured VAS, categorial rating scale as a pain assessment also MBI, Modified Rankin Scale as a stroke recovery. Results : 1. Treatment group showed significant difference in VAS, categorial rating scale after treatment and 2 weeks follow up, compared with baseline. The control group showed significant difference between baseline and after treatment But the 2 weeks follow up, there is no significant difference compared with baseline. Also there's no significant difference in categorial rating scale. 2. MBI showed significant difference in treatment group between baseline and after treatment, but the control group did not have any difference. There's no significant difference in Modified Rankin Scale for treatment group and control group. 3. There's no significant difference between control group and treatment group. This is because of the small sample size in the study, Thus it seems to reflect individual difference strongly. Conclusions : There are positive effect on CPSP patients in pain and stroke recovery treating with bee-venom acupuncture than control group.

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Effects of 5 Weeks Self-Help Management Program on Reducing Depression and Promoting Activity of Daily Livings, Grasping Power, Hope and Self-Efficacy (재가 뇌졸중환자를 위한 5주간의 자조관리프로그램의 효과에 관한 연구)

  • Kim, Keum-Soon;Seo, Hyun-Mi;Kim, Eun-Jeong;Jeong, Ihn-Sook;Choe, Eun-Jeong;Jeong, Sun-I
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.196-211
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    • 2000
  • The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

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A Study on the Educational Effectiveness of Chronic Diseases Among University Students (일부 대학생들의 성인건강 교육의 효과에 관한 연구)

  • Kang, Hee-Sook;Cho, Hyun
    • Journal of the Korean Society of School Health
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    • v.8 no.1
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    • pp.143-154
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    • 1995
  • Korea has been recently reducing the quality of life as well as rising medical cost because of the increase of chronic diseases. But we can prevent those chronic diseases through the improvement of environment or life style. We evaluated the educational effectiveness of chronic diseases(hypertention, diabetes, cancer, stroke and other chronic diseases) designed to increase the knowledge, attitude and practice of chronic diseases among university students. Between August 1994 and November 1994, we implemented chronic diseases prevention instruction in intervention students; unmatched control students were selected in same university. We conducted pre- and post-intervention surveys both intervention and control students with self-reported questionnaires(50 items). We assigned score(0-4 points) to items and conducted a analysis of covariance(ANCOVA) with sex, grade and economic status as the covariate, using the SAS PC computer statistical package. And we culculated odds ratio with safety scores between intervention and control students. The results of this study were followed. 1. In demographic characteristics of subjects both pre- and post intervention, we found no significant differences in intervention and control students at religion, father's education, mother's education, mother's occupation and type of residence(p>0.05), but we found significant differences at sex(p<0.001), grade(p<0.001) and economic status(p<0.05). 2. The sex, grade and economic status-adjusted mean prevention knowledge scores for diabetes and stroke increased from the pre- to post-survey in the intervention students(p<0.001), but control students did not increased(p>0.05). As odds ratios in knowledge were below 1, the knowledge of intervention students were higher than control students. 3. The attitudes for general adult health increased from the pre- to post-survey in the intervention students(p<0.05), but control students did not increased(p>0.05). As odds ratios in attitudes were approximately 1, we can not say effectiveness in intervention students 4. The pratices for cancer and stroke increased from the pre- to post-survey in both the intervention and control students(p<0.001). Also odds ratio of hypertention was 0.91, and that of stroke was 1.14. 5. Health related behaviors did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). But odds ratio of drinking was 0.76 and that of body weight was 1.21. 6. Health status did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). As odds ratio of health status was 1.09, prevention education was not effect in intervention students We would like to recommend as follows; 1. University students must learn about prevention of chronic diseases. Because the knowledge of invetervention students was higher than that of control students. 2. The prevention education of chronic diseases should be taught from primary school. 3. Adult health education for university students must be practiced continuously. Education period(l5 weeks) in this study was not complete. 4. The evaluation of chronic diseases was conducted real measurement(such as BP check) as well as self reported-survey. 5. Educational materials(video tape, pamphlet) related the prevention of chronic diseases should be developed at national level. And we must easely use those materials. 6. The prevention education of chronic diseases should be made through mass media as well as school education.

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