• Title/Summary/Keyword: Post-Stroke

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The Effect of Rehabilitation Training Programs on the Kinetic and Kinematic Parameters During Sit-To-Stand in Chronic Stroke Patients (만성편마비 환자의 재활 운동 유형이 일어서기 동작의 운동학 및 운동역학적 변인에 미치는 영향)

  • Yu, Yeon-Joo;Yoon, Te-Jin;Eun, Seon-Deok
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.121-134
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    • 2006
  • The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.

The Effect of Shoe Lift of the Paretic Limb on Gait Patterns in Hemiplegics (환측 신발 높이기가 편마비 환자의 보행 특성에 미치는 영향)

  • Yoon, Jung-Gyu;Park, Jeong-Mee;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.83-96
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    • 2002
  • The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

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The Effect of Core Program Exercise on Dynamic Balance of the Patient with Post-Stroke Hemiplegia (코어프로그램이 편마비환자의 동적 균형 감각에 미치는 영향)

  • Kim, Kwang-Soo;Seo, Hyun-Du;Lee, Byoung-Hee;Kim, Seong-Yeol;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.79-87
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    • 2010
  • Objectives : The purpose of this study is to analyze and to compare the difference and the change between dynamic balance exercise group and dynamic balance exercise with core program exercise group. Also, based on this data, to prescribe effective exercises for hemiplegic patients and the pubis in order to achieve more effective dynamic balance exercise rehabilitation and better dynamic balance exercise in the field of therapeutical exercise. Methods : Twenty subjects(Core program exercise plus Dynamic balance exercise group, CP: 10, Dynamic balance exercise group, NCP: 10) were chosen among hemiplegic patients. Measurements of dynamic balance were evaluated at initial presentation(pretest) and after 4, 8, 12 weeks'. Paired t-test and Repeated measured ANOVA was utilized to detect the mean difference between the groups. Results : Firstly, after 4 weeks' and 8 weeks' and 12 weeks' CP exercise and NCP exercise, there were all significant difference to increase dynamic balance (p<0.05). secondly, after 4 weeks' and 8 weeks' and 12 weeks' CP and NCP exercise, there was significant difference to increase dynamic balance more CP group than NCP group. Lastly, among 4 weeks' and 8 weeks' and 12 weeks' CP exercise, there was progressively significant difference to increase dynamic balance(p<0.05). Conclusions : This study showed that dynamic balance exercise with core program exercise is an effective treatment strategy for hemiplegic patients than dynamic balance exercise rehabilitation.

Effect of Acupuncture at PC6(Neiguan) and SP4(Gongsun) points on Autonomic Nervous System in Healthy Adults (내관(內關)(PC6).공손(公孫)(SP4) 자침이 정상인의 자율신경계에 미치는 영향 연구)

  • Rheu, Kyoung-Hwan;Im, In-Hwan;Kim, Dong-Hyun;Na, Byong-Jo;Lee, Beom-Jun;Park, Seong-Uk;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.698-705
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    • 2006
  • Objectives : This study was designed to investigate the effect of PC6 and SP4 on autonomic nerve system in healthy adults. Methods : 22 healthy adults were recruited and randomized into the study group or control group. The study group (real acupuncture group) was acupuncturcd on PC6 and SP4. The control group (sham acupuncture group) was acupunctured superficially near PC6 and SP4 but not the exact points. The subjects rested for 10 minutes, and were then acupunctured. After 15 minutes, acupuncture needles were removed and the subjects rested for another 15 minutes. Heart rate variability(HRV) was continuously measured during the study period by FM-150 (digital Holter ECG recorder). Results : In the real acupuncture group. LF(low frequency) significantly decreased during the acupuncture period(p<0.05). LF/HF ratio also had a significant decrease during acupuncture period and the decrease was maintained during the post-treatment period as compared with the pre-treatment period. In the sham acupuncture group. LF significantly increased during the acupuncture period but LF/HF ratio had no significant changes. Conclusions : The results suggest that acupuncture on PC6 and SP4 can increase parasympathetic activity and balance autonomic nervous system.

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Identification of Differentially-Methylated Genes and Pathways in Patients with Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage

  • Kim, Bong Jun;Youn, Dong Hyuk;Chang, In Bok;Kang, Keunsoo;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.4-12
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    • 2022
  • Objective : We reported the differentially methylated genes in patients with subarachnoid hemorrhage (SAH) using bioinformatics analyses to explore the biological characteristics of the development of delayed cerebral ischemia (DCI). Methods : DNA methylation profiles obtained from 40 SAH patients from an epigenome-wide association study were analyzed. Functional enrichment analysis, protein-protein interaction (PPI) network, and module analyses were carried out. Results : A total of 13 patients (32.5%) experienced DCI during the follow-up. In total, we categorized the genes into the two groups of hypermethylation (n=910) and hypomethylation (n=870). The hypermethylated genes referred to biological processes of organic cyclic compound biosynthesis, nucleobase-containing compound biosynthesis, heterocycle biosynthesis, aromatic compound biosynthesis and cellular nitrogen compound biosynthesis. The hypomethylated genes referred to biological processes of carbohydrate metabolism, the regulation of cell size, and the detection of a stimulus, and molecular functions of amylase activity, and hydrolase activity. Based on PPI network and module analysis, three hypermethylation modules were mainly associated with antigen-processing, Golgi-to-ER retrograde transport, and G alpha (i) signaling events, and two hypomethylation modules were associated with post-translational protein phosphorylation and the regulation of natural killer cell chemotaxis. VHL, KIF3A, KIFAP3, RACGAP1, and OPRM1 were identified as hub genes for hypermethylation, and ALB and IL5 as hub genes for hypomethylation. Conclusion : This study provided novel insights into DCI pathogenesis following SAH. Differently methylated hub genes can be useful biomarkers for the accurate DCI diagnosis.

Translation and Content Validity of the Korean Version of the Motor Activity Log (한국어판 운동활동일지(Korean Version-Motor Activity Log) 번안과 내용타당도 연구)

  • Kim, Sujin;Hwang, Sujin
    • PNF and Movement
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    • v.20 no.2
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    • pp.263-273
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    • 2022
  • Purpose: Translation and adaptation involve cross-cultural and conceptual aspects; they are not simply based on linguistic equivalence. This study aimed to produce a conceptually equivalent Korean version of the motor activity log (K-MAL) for the upper extremities that can be applied across the Korean population and its cultures. Methods: Following the procedures used in the translation of other cross-cultural evaluation tools, and the five steps of the translation process, the motor activity log (MAL) was translated into Korean (K-MAL). We then examined the content validity of the K-MAL. Twenty-two rehabilitation professionals (11 males and 11 females, mean length of clinical career = 101.54 months) assessed the content validity of the K-MAL. The content validity ratio and content validity index were used to verify the content validity. Results: There were inconsistencies found in three sub-items in the MAL during the forward translation process. These inconsistencies were corrected, and the complete K-MAL was produced. The exact critical values of the content validity ratio and the content validity index of the K-MAL were 0.45-0.95 and 0.77-1.00, respectively. Conclusion: The K-MAL was successfully developed using a systematic methodology, which included translation, adaptation, and evaluation of the content validity. We expect that stroke rehabilitation professionals working in both clinical and research settings will apply the K-MAL when evaluating the amount and quality of use of the upper extremities in post-stroke patients in Korea.

Effects of Proprioceptive Neuromuscular Facilitation Combined with Auricular Acupuncture on Activation of the Leg Muscles of Strok e Patients (이침을 병행한 고유수용성신경근촉진법이 뇌졸중 환자의 다리 근활성도에 미치는 영향)

  • Jeong-Il Kang;Ji-Wei Li
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.1
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    • pp.1-8
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    • 2023
  • PURPOSE: This study analyzed how proprioceptive neuromuscular facilitation (PNF) combined with auricular acupuncture affected the activation of the leg muscles of stroke patients and measured the effects of this combination to provide clinical data. METHODS: The subjects were divided randomly into experimental group I, which received PNF combined with auricular acupuncture, and experimental group II, which received PNF alone. Each group had ten members. A 30-minute intervention was performed four days a week for six weeks. Before the six weeks of intervention, pre-tests were conducted to measure muscle activation in the legs. After six weeks, post-tests were also conducted to measure muscle activation in the legs. RESULTS: Experimental group I showed a statistically significant difference in muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus. Experimental group II also showed a statistically significant difference in the muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus (p < .05). In a between-group comparison of the changes, a statistically significant difference was observed between the two groups in terms of muscle rectus femoris, muscle biceps femoris, muscle tibialis anterior, and muscle soleus (p < .05). CONCLUSION: Intervention in experimental group I increased the activation of the leg muscles more effectively because auricular acupuncture was applied to various spots on the ear corresponding to the spleen, liver, kidney, pelvis, knee, ankle, and toe. Auricular acupuncture is expected to be used more widely in the future because it is a safe way of stimulating muscle activation.

Radiological Projection for Diagnosis of Shoulder Subluxation in Patients with Post-Stroke Hemiplegia (편마비 환자에서의 견관절 아탈구 진단에 유용한 촬영법)

  • Cho, Kwang-Ho;Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.253-259
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    • 2009
  • Purpose : The purpose of this study was to find out useful radiological projection of shoulder subluxation in patients with post-stroke hemiplegia. Methods : A total of 33 patients with post-stroke hemiplegia were included(20 men and 13 women, mean age 62.3 years) and having the subluxed shoulder over one finger breath. The shoulder subluxation was determined as the ratio of the radiographic vertical and horizontal distance. The vertical distance was determined by measuring the distance between the most inferolateral point of the acromion and the central point of the humeral head. The horizontal distance was determined by measuring the distance between the central point of the glenoid fossa and the central point of the humeral head. To measure of the shoulder subluxation, the shoulder AP, axial and transthoracic lateral projections were taken on both affected and unaffected shoulders. We analyzed the difference of subluxation distance by t-test. Results : When patients was in sitting position, the average time of being shoulder subluxation was 123 second. There was significant difference between supine($49.90{\pm}13.6\;mm$) and sitting position($60.72{\pm}16.3\;mm$) in the vertical distance of shoulder anterior-posterior projection. Also, there was significant difference on transthoracic lateral projections, Affected $35.92{\pm}6.2\;mm$, Unaffected $28.76{\pm}5.4\;mm$. But in case of shoulder axial projection(supine position), there was no significant difference (Unaffected and affected was $23.01{\pm}9.0\;mm$, $22.45{\pm}8.2\;mm$ each). Conclusion : Radiological projection of shoulder subluxation has diagnostic value when it goes after check out the process of subluxation through finger breadth test. For this, patients must be in sitting and shoulder neutral position about 2 minutes. In addition, Shoulder anterior-posterior and transthoracic projection were significant to diagnose subluxation. But in axial projection, there wasn't meaningful differences.

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The Effects of LI4, TE3, TE5 and LI11 Moxibustion on Radial Artery Blood Flow and Heart Rate Variability in Stoke Patients with Hemiplegia (합곡.중저.외관.곡지 뜸치료가 뇌졸중 편마비 환자의 환측 요골동맥 혈류 및 심박변이도에 미치는 영향)

  • Yoon, Seung-Kyou;Kwon, Seung-Won;Seo, Yu-Ri;Park, Joon-Young;Im, Jin-Wook;Park, Joo-Young;Cho, Seung-Yeon;Jung, Hwan-Yong;Park, Sung-Wook;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Sang-Hoon;Bae, Young-Min
    • The Journal of Korean Medicine
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    • v.32 no.5
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    • pp.50-65
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    • 2011
  • Objectives: Moxibustion has been used for various post-stroke symptoms and has also been known to have effect on peripheral blood flow. This study investigated the effect of moxibustion on radial artery blood flow by Doppler ultrasound and on heart rate variability in post-stroke hemiplegia patients. Methods: Moxibustion was applied on the points of LI4, TE3, TE5 and LI11 on the affected side, and blood flow of the radial artery was measured using the Minimax-Doppler-K device. Blood flow velocity and pulsation index were analyzed before, during, and after moxibustion. Simultaneously LF, HF, and LF/HF as variables for HRV were measured by FM-150. Results: The mean value of blood flow velocity in all patients (n=23) showed significant increase between before and after moxibustion, but there was no significant difference in pulsation index and LF, HF, LF/HF ratio between before and after moxibustion. In Yin (n=9) and Yang (n=14) groups, both showed significant increase of blood flow velocity between before and after moxibustion, but there was no significant difference in pulsation index and LF, HF, LF/HF ratio between before and after moxibustion. In Deficiency (n=14) and Fullness (n=9) groups, only the Deficiency group showed significant increase of blood flow velocity between before and after moxibustion, while the Fullness group showed no significant difference in blood flow velocity between before and after moxibustion, and also there was no significant difference in pulsation index and LF, HF, LF/HF ratio between before and after moxibustion. Conclusions: This study suggests that moxibustion on LI4, TE3, TE5 and LI11 on the affected side of stroke patients increase the peripheral blood flow in the affected arm, which was most remarkable in those with Yin and Deficiency pattern.

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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