• Title/Summary/Keyword: Rehabilitation after stroke

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Effect of tDCS Stimulation for Improving Working Memory on Stroke Patients' EEG Variation (작업기억의 향상을 위한 tDCS 자극이 뇌졸중 환자의 뇌파변화에 미치는 영향)

  • Bae, Si-Jeol;Jeong, Woo-Sik;Lee, Hong-Gyun;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.261-272
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    • 2012
  • This study was conducted so as to examine which change tDCS (Transcranial Direct Current Stimulation) for improving working memory can make on the EEC of stroke patients. Among the patients who suffered for more than 6 months by hemiparalysis caused by stroke, 20 patients selected by MMSE and DST were randomly divided into I group (10 patients) fulfilled by only CCT and II group (10 patients) fulfilled by both tDCS and CCT for total 4 weeks, 30 minutes per a day, three times per a week. For examining EEC variation, the absolute spectrum power was calculated by three bands (${\theta}$; 4~8 Hz, lower ${\alpha}$; 8~10.5 Hz, upper ${\alpha}$;10.5~13 Hz) during the task of words, photos and mental calculation with EEC test, before the arbitration, after 2 weeks and after 4 weeks, so the rate of increase and decrease (%) for the reference EEC was obtained. As the results, the first, particular aspects different one another in three bands were detected according to the measuring period and task. The second, in the forth week, there was only a significant difference in lower ${\alpha}$-power of all tasks. Therefore, through the procedure measuring EEC of this study, the degree of working memory's damage can be expressed by numerical value and tDCS should be additionally helpful for brain damaged patients' perception rehabilitation.

The Effects of Electro-Acupuncture the Rat with Induced MCAO

  • Choi, Jung-Hyun;Kim, Ji-Sung;Kim, Dong-Il;Kim, Bo-Kyoung;Kim, Soon-Hee;Song, Chi-Won
    • The Journal of Korean Medicine
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    • v.30 no.3
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    • pp.70-78
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    • 2009
  • Objectives : This study was aimed at examining the effects of the application of EA (electroacupuncture) at GV20 and LI4 in the early cerebral ischemia on the size of cerebral infarction, COX-2 and IL-6. Methods : For this experiment, 21, six-week-old male S-D (Sprague - Dawley) rats weighting 160g to 200g were selected and randomly classified into 3 groups, seven rats in each group. Brain ischemia was simulated using a modified Koizumi method which was performed on each rat. In the GV20 group, the GV20 of the SD rats was stimulated for thirty minutes with acupunctural electrode low frequency stimulator five hours after inducement of ischemia. For the LI4 group, the LI4 was stimulated as above, while for the Ischemia group, no stimulation was applied. Twenty-four hours after the experiment, stained cerebral tissues were examined and an immuno-histological test was done to examine inflammatory reaction Results : Out of the three groups, the LI4 group showed the smallest size of cerebral infarction and the Ischemia group showed the highest COX-2 (cyclooxygenase-2) expression value in the cortex of the cerebrum. In addition, the LI4 group showed the lowest COX-2 expression value in unknown putamen out of the three groups. Conclusions : We infer that EA, applied at LI4 and GV20 in early ischemia, is effective in delaying the expression of IL-6 (interleukin-6) and COX-2, the inflammatory agents manifested from stroke. In addition, application at LI4, rather than GV20, can lower the expression value of the inflammatory agents. Further, EA can be an effective way to block early inflammatory reaction in stroke.

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Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients (수정된 연하곤란사정도구와 비디오 연하영상 조영술의 흡인 위험 예측비교)

  • Moon, Kyung-Hee;Sohn, Hyun-Sook;Lee, Eun-Seok;Paek, Eun-Kyung;Kang, Eun-Ju;Lee, Seung-Hee;Han, Na-Ri;Lee, Meen-Hye;Kim, Deog-Young;Park, Chang-Gi;Yoo, Ji-Soo
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.359-366
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    • 2010
  • Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

A Literature Study of Gait (보행(步行)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Kim, Bum-Chol;Keum, Dong-Ho;Lee, Myeong-Jong
    • The Journal of Dong Guk Oriental Medicine
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    • v.5
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    • pp.79-95
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    • 1996
  • When we see normal gait, gait cycle is seperated as stance phase and swing phase. It needs 6 determinant of gait of pelvic rotation, pelvic tilt, knee joint of stance phase, ankle and foot motion, ankle and knee motion, and pelvic movement to be accomplished. In addition, a joint and muscle action is accomplished biomechanically at the same time with its gait cycle. In oriental medicine, the relationships between chang-fu physiology and meridian physiology are summaried as follows ; ${\bullet}$ chang-fu physiology : Spleen manages the extremities. Liver manages soft tissues. Liver stores blood. Kidney stores essences. Kidney manages bones. ${\bullet}$ meridian physiology : The Leg Greater Yang Meridian and meridian soft tissues The Leg Yang-Myeong Meridian and meridian soft tissues The Leg Lesser Yang Meridian and meridian soft tissues The Leg Greater Yin Meridian and meridian soft tissues The Leg Lesser Yin Meridian and meridian soft tissues The Leg Absolute Yin Meridian and meridian soft tissues Especially, we can find out relations between in a "blood supplied feet can walk well" that explains "blood regulations and by liver nourishing effects"that is the closest concept of muscle. Abnormal gaits are due to three causes as following; first, physical defect secoud, pain third, nervous system or instability of muscle. In oriental medicine, we can know relationship in "atrophy, numbness, stroke, convulsion, muscular dystrophy of knee, rheumatoid arthritis, five causes of infantile growing defects, five causes of softening, sprain". Especially, atrophy is the most important symptom. Gait evaluation should be emphasized where a point can walk 8 feet to 10 feet considering stride width, stride length, the body weight center, stride number, flexion, extension, rotation of a joint as a standard factor. The point is we should find out something strange in a patient's side, front and back view. After that we should find out its cause as an index that we can observe abnormal findings in a joint and muscle.

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The Effects of Self-Exercise Based on Health Care Application on Upper Extremity Function and Daily Living, Satisfaction in Patients with Stroke (헬스케어 애플리케이션 기반의 자가운동이 뇌졸중 환자의 상지기능, 일상생활, 만족도에 미치는 효과)

  • Moon, Jong-Hoon;Bak, In-Hye
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.3
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    • pp.515-524
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    • 2017
  • The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

A Systematic Review of the Dual-Task Training for Stroke With Hemiplegia (뇌졸중 환자에게 적용한 이중과제 훈련이 미치는 효과에 대한 체계적 고찰)

  • Lee, Yei-Jin;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.23-32
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    • 2016
  • Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.

The Effects of Visual Rhythmic Stimulation in Gait and Proprioception with Chronic Stroke Patients (시각리듬자극이 만성뇌졸중 환자의 보행과 고유수용감각에 미치는 영향)

  • Cho, Nam-Jeong;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3353-3357
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    • 2010
  • The purpose of this study is to investigate the effect of visual rhythmic stimulation in gait ability and proprioception in chronic stroke patients. Twenty-one persons after six months post stroke participated in pre and post test control. The subjects were randomly assigned to a rhythmic visual stimulation(RVS) 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 proprioception test and gait characteristics by gait analysis. In gait characteristics, the walking speed, cadence and the TUG time were significantly different from RVS group. The proprioception were significantly different RVS and control group. This study showed that the RVS training increased better functional activity by postural adjustment and gait learning of chronic stroke patients than that of control group. And so, the RVS training of hemiplegic patients was very important to successive rehabilitation. A continuous examination of RVS training could be practical use of physical therapy with exercise.

Effects of Task-Oriented programme on Balance and Upper Extremity in stroke (과제 지향적 프로그램이 뇌졸중환자의 균형과 상지기능에 미치는 효과: 단일사례연구)

  • Kim, Eun-Joo;Hong, So-Young;Kim, Kyeong-Mi
    • Therapeutic Science for Rehabilitation
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    • v.1 no.1
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    • pp.17-28
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    • 2012
  • Objective : The purpose of this study is to assess effects of task oriented programme on balance and upper extremity function in stroke patient. Methods : The subject is right hemiplegia with stroke and participated for 6 weeks. The design of study ABA designed of single subject research. The baseline phase consisted of 5 sessions. The intervention phase consisted of 15 sessions and performed task oriented training. The Maintenance phase consisted of 5 sessions. An assessment of upper extremity function was made using a Manual Function Test(MFT) and balance were assessed by the Time Up and Go test(TUG), Nintendo Wii Balance Board Test. Results : Dynamic balance improved from 51.53 to 42.62. At baseline, difference between left and right of the static balance was an average of 13.8, After treatment, the static balance difference was 6.29 and It was closer to zero than baseline, so static balance has been stable feature. Also, MFT point increased from 6 to 7.6. Conclusion : Task oriented programme can useful in balance and upper extremity function in stroke patient. Further studies need to generalize these findings.

The Effect of Symmetrical and Asymmetric Bilateral Training for Chronic Stroke Patients in Upper Extremity Recovery (만성 뇌졸중 환자의 대칭적, 비대칭적 양측성 상지훈련의 상지기능회복 효과)

  • Kim, Sun Ho;Han, Dae Sung
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.35-43
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    • 2017
  • Objective : To identify the effect of symmetrical and asymmetric bilateral training For stroke patients in upper extremity recovery. Methods : 15 patients with stroke, randomized to an in- phase group(n =7) and anti-phase group(n =8). Each groups received symmetrical and asymmetric bilateral training, 30-min sessions per a day for 5 weeks, total 20 session.Accelerometer was used to evaluate the amount used for both groups. Y-BAT was used to evaluate performance status and satisfaction, ARAT was used to evaluate hand function. Results : the amount used of symmetrical movement training showed significant changes in affected and unaffected side. asymmetric bilateral training. there is a significant difference in affected side before and after receiving asymmetric bilateral training. Also, There was a significant difference between the groups on the affected side. Both training, there was no significant difference in performance, satisfaction, and upper limb function between group but, there was significant differences within-groups, Conclusions : Symmetric training showed higher motor performance than asymmetric training, but, To obtain a clearer difference, it would be necessary to use a neuromuscular assessment tool such as fMRI. Also, need a clearer training protocol and the need for follow-up studies on more stroke patients is suggested.

The Effects of a Way-finding Exercise using a Map on the Cognitive Function and Performance of Activities of Daily Living in Patients with a Stroke (지도를 이용한 길 찾기 훈련이 성인 뇌졸중환자의 인지기능과 일상생활동작에 미치는 영향)

  • Jung, Sung-Wook;Kim, Heung-Yeol;Kim, Tack-Hoon
    • The Journal of the Korea Contents Association
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    • v.13 no.10
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    • pp.434-443
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    • 2013
  • The purpose of this study is to investigate the effectiveness of the way-finding exercise using a map in rehabilitation of cognitive function and activities of daily living in patients with a stroke. For the seven patients diagnosed with hemiplegia from a stroke, we executed the way-finding exercise using a map in the hospital, three times a week for two weeks. Loewenstein Occupational Therapy Cognitive Assessment(LOTCA) and Functional Independence Measure(FIM) were used to measure the cognitive function and performance of activities of daily living before and after intervention. For the visual perception area and the spatial relations of the spatial perception area of LOTCA, scores were significantly higher than before intervention(p<.05). For the walk/wheelchair of locomotion area and the problem solving of the social cognition area of FIM, scores were significantly higher than before intervention(p<.05). The results of this study show that a way-finding exercise for patients with a stroke is a useful therapeutic approach by enhancing cognitive function and performance of activities of daily living.