• 제목/요약/키워드: Post-stroke

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뇌졸중 환자의 삶의 질 구조모형 (Structural Equation Modeling on Quality of Life in Stroke Survivors)

  • 서민희;최스미
    • 대한간호학회지
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    • 제40권4호
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    • pp.533-541
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    • 2010
  • Purpose: This study was designed to test structural equation modeling of the quality of life of stroke survivors in order to provide guidelines for development of interventions and strategies to improve their quality of life. Methods: The participants in the study were patients who visited the neurology outpatient department of a tertiary hospital in Seoul between June 25 and October 15, 2009. Data collection was carried out through one-on-one interviews. Demographic factors, functional independence, social support, nutritional status, post-stroke biobehavioral changes and quality of life were investigated. Results: The final analysis included 215 patients. Fitness of the hypothetical model was appropriate (${\chi}^2$=111.5, p=.000, GFI=.926, AGFI=.880, RMSA=.068, NFI=.911, CFI=.953). Functional dependency, social support and post-stroke biobehavioral changes were found to be significant explaining variance in quality of life. Post-stroke biobehavioral changes had the strongest direct influence on quality of life. Nutritional status had an indirect effect on the quality of life. Conclusion: To improve the quality of life of stroke survivors, comprehensive interventions are necessary to manage post-stroke biobehavioral changes, and strengthening social support networks that can contribute to enhancing the quality of life of stroke survivors.

뇌졸중 후 강직에 대한 도침치료: 3 증례보고 (Post-stroke Spasticity Treated by Miniscalpel-Acupuncture: Three Case Report)

  • 윤상훈;조희근;송민영
    • 한방재활의학과학회지
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    • 제28권1호
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    • pp.145-152
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    • 2018
  • Post-stroke spasticity is a common complication that can be deleterious to the daily living function and quality of life of stroke survivor. This case report was conducted to introduce the use of miniscalpel-acupuncture as a novel method for the treatment of post-stroke spasticiy in three patients with chronic stroke. Patients received miniscalpel-acpuncuture treatment for 4~7 session. The flexor digitorum brevis, pronator teres, pronator quadratus, brachioradialis, tibialis posterior, gastrocnemius on the affected side were needled. The main outcome were the Modified Ashworth Scale (MAS) muscle spasticity score and the range of motion. The evaluation indices were measured after the initiation of treatment and after treatment. After miniscalpel-acupuncture session, three patients improved as indicated in the MAS grade and range of motion. This retrospective case report presents miniscalpel-acupuncture as a potentially effective approach in Korean medicine rehabilitation treatment of post-stroke spasticity. Further research is needed to confirm these findings.

중풍 후 강직의 침구치료에 대한 계통적 연구 (A Systematic Review of Clinical Trials on Acupuncture on the Post-stroke Muscle Spasticity)

  • 서병관;백용현;박동석
    • Journal of Acupuncture Research
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    • 제27권6호
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    • pp.1-10
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    • 2010
  • Objectives : The aim of this systematic review was to assess the efficacy of acupuncture and its relevant modality on post-stroke muscle spasticity Methods : We included 7 randomized controlled trials(RCTs) and 1 crossover study on acupuncture on the post-stroke muscle spasticity. Articles searches were performed in various databases in October 2009. Eight studies from 38 articles met the inclusion criteria and were used to assess the quality of clinical trials by means of Jadad scale, STRICTA, CONSORT statement and cochrane-handbook for systematic reviews of interventions. Results : Electrical stimulation such as electroacupuncture and TENS on acupoints was used in five studies. Repeatition of electroacupuncture showed significant decrease of the post-stroke muscle spasticity and persistence of the effect. Only three studies were assessed high quality as the methodological assessment tool(Jadad scale) and none of the studies matched STRICTA recommendations. Conclusions : This systematic review shows that there is beneficial effects of electroacupuncture on the post-stroke muscle spasticity. Further study of large population with high methodological quality will be needed.

Changes of spatio-temporal gait parameters according to experience falls in post-stroke patients

  • Cho, Ki Hun;Lee, Wan Hee
    • Physical Therapy Rehabilitation Science
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    • 제1권1호
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    • pp.22-27
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    • 2012
  • Objective: Falls are defined as contact of the body with the floor after losing balance during activities of daily living. Falls commonly occur among the elderly, and stroke patients in particular are at a high risk of falling. The purpose of this study was to investigate the changes of temporal and spatial gait parameters and gait symmetry according to experience falls in post-stroke patients. Design: Cross-sectional study. Methods: Fifty three patients with stroke were recruited on a voluntary basis from the rehabilitation unit, who currently undergoing physical therapy. All participants were asked to answer questions regarding the frequency of falls in the past 1 year. Fifty-three patients with stroke were allocated 2 groups according to experienced falls: stroke with falls (n=26) during past 1 year and stroke without falls (n=27). The spatial and temporal gait parameters and gait symmetry ratio were measured using GAITRite system. Results: The spatial gait parameters and the temporal gait parameters were significantly different between the stroke with falls group and the stroke without falls group (p<0.05). Furthermore, step length was the only significantly different among symmetry ratio (p<0.05). Conclusions: Experience of falls can lead to impairment of gait ability in stroke patients. This result is expected to be used as a basic data for rehabilitation program development to prevent a fall of post-stroke patients.

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뇌졸중후 우울증의 정도와 운동기능의 회복과의 상관관계에 대한 연구 (The correlation between post-stroke depression and the recovery rate of motor functions)

  • 박세진;박상동;이정훈
    • 동의신경정신과학회지
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    • 제13권2호
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    • pp.101-106
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    • 2002
  • Objectives : The degree of post-stroke depression was observed and then correlated to the recovery rate of the motor functions of the above treated stroke patients. Methods : The BDI SCALE(Beck Depression Inventory Scale) and motor grades of 50 diagnosed stroke patients who were hospitalized in Dong-Seo Oriental Hospital between the period of May 2002 to September 2002 were measured. After a 1 month recovery period the BDI SCALE and motor grade of the above mentioned patients were again measured and a correlation was observed. Results : A lower BDI SCALE was observed in patients with a higher motor grade recovery rate. Conclusion : The treatment of post-stroke depression is imperative for positive effects on the motor functions of stroke patients.

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재가 뇌졸중 노인환자에서 자기효능증진 전략을 이용한 자조관리프로그램의 효과 (The Effects of Community-Based Self-Help Management Program by Strengthening Self-Efficacy of Post Stroke Elderly Patients)

  • 유수정;김현숙;김금순;백환금
    • 재활간호학회지
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    • 제4권2호
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    • pp.187-197
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    • 2001
  • The purpose of this study was to determine the effects of self-help management program which strengthens self-efficacy for post stroke elders who attend day care center in Chongju. One group pretest-posttest design was used, and the subjects were 7 post stroke elders with hemiparesis. The self-help management program consisted of 5 sessions and each session included group education on stroke, ROM exercise, recreation and self-care strategies. Those strategies for encouraging and reinforcing self-efficacy provided verbal persuasion, performance accomplishment and vicarious experience. All subjects were questioned before and after the program about ADLs, IADLs, self-efficacy, self-care behavior and depression. The analysis of data revealed that the program was effective to increase the IADLs, self-efficacy and self-care behavior. However, there was no significant difference between pre and post ADLs and depression. The results indicated that this program may be adopted to improve the physical and psychological function of post stroke elderly patients in community settings.

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사회적 지지의 특성에 따른 뇌졸중 환자의 우울 (The Relationship between the Characteristics of Social Support and Post-Stroke Depression)

  • 김인자;서문자;김금순;조남옥
    • 재활간호학회지
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    • 제2권2호
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    • pp.206-214
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    • 1999
  • The effect s of social support on post-stroke depression were investigated. Social support was classified into three categories : primary caregiver's, significant other's, and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at, and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of, frequency they met at, and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the out patient department. The depression was measured using CES-D. Out of the primary caregiver's support, only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary.

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뇌졸중 환자와 정상인의 근 수축 유형에 따른 피질 신경원의 활성도 비교 (Comparison of the Activity of Cortical Neurons According to Muscle Contraction Type between Post Stroke Hemiplegic Subjects and Healthy Subjects)

  • 양가애;김수현;임영은;이동걸;김태열
    • The Journal of Korean Physical Therapy
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    • 제21권1호
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    • pp.73-80
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    • 2009
  • Purpose: In order to examine difference in the activity of potential of spinal neurons and cortical neurons according to muscle contraction type in post stroke hemiplegic subjects and healthy subjects, the present study conducted an experiment as follows. Methods: The subjects in the experimental group were 17 left-side hemiplegic subjects (9 female, 8 male; mean age, 63.41$\pm$9.86 years) with the right hand as the dominant hand selected among post stroke hemiplegic subjects, and 17 age matched healthy control subjects (10 female, 7 male; mean age, 64.12$\pm$12.07 years). Movement-related cortical potentials (MRCPs) were measured using surface electromyography and electroencephalography while concentric and eccentric movements were made alternately. Results: As to the pattern of the activity of MRCP, which indicates the activity of motor cortical neurons, we found that the amplitude is high (p<0.01), the length of excitement is short (p<0.01) and the ascending gradient of amplitude to the peak increases (p<0.05) in post stroke hemiplegic subjects' lesion sites different from healthy subjects. Conclusion: The activity of cortical neurons was no difference in activity according to contraction type was observed in post stroke hemiplegic subjects' lesion sites. This suggests that there is no distinction in the activity of cortical neurons between concentric contraction and eccentric contraction. Accordingly, if post stroke hemiplegic subjects' activity of motor cortex is analyzed by measuring MRCPs, it is considered useful in research on neural plasticity or as a ground of clinical effects in the area of physical therapy for the central nervous system.

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Post-Stroke Oculomotor Nerve Palsy Treated by Traditional Korean Medicine: Three Case Reports

  • Lee, Yoo-na;An, Yu-min;Jang, Woo-seok;Baek, Kyungmin
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1237-1247
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    • 2019
  • Post-stroke oculomotor nerve palsy occurs more frequently than previously reported, but only a few studies of traditional Korean medicine treatments have been reported. The symptoms are severe and difficult to treat, and current treatments are high-cost, short-lasting, insufficient for shortening the therapeutic period and promoting better recovery, or involve the risk of post-operative over-correction or under-correction. Traditional Korean medicine treatments may be comparatively effective at lower cost and less harmful. Thus, we report three cases of post-stroke oculomotor nerve palsy treated with traditional Korean medicine.

뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계 (The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life)

  • 이동진;안승헌
    • 대한물리의학회지
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    • 제6권3호
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    • pp.257-266
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    • 2011
  • Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.