• Title/Summary/Keyword: Rehabilitation after stroke

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The Effect of Transcranial Direct Current Stimulation over the Primary Somatosensory Cortex in Patients with Chronic Stroke on Somatosensory and Upper Limb Function for Improving Life Care (만성 뇌졸중 환자를 대상으로 한 일차 체성 감각 피질을 자극한 경두개 직류 전류 자극이 라이프 케어 증진을 위한 체성감각과 상지기능에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.269-277
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    • 2020
  • The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

Effects of a Digital Pegboard Training Program With Visual and Auditory Feedback on Hand Function and Visual Perception in Patients With Stroke (시각, 청각 피드백을 이용한 디지털 페그보드 훈련 작업치료 프로그램이 뇌졸중 환자의 손 기능 및 시·지각에 미치는 영향)

  • Hong, Jang-Woo;Yoo, Chan-Uk;Gang, Mi-Yeong;Chang, Ki-Yeon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.85-97
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    • 2022
  • Purpose : This study aimed to investigate the effects of a digital pegboard training program with visual and auditory feedback on hand function and visual perception in stroke patients. Methods : Twenty two participants were randomly assigned to an experimental or control group. The experimental group received training using a digital pegboard training program with visual and auditory feedback (n=11), while traditional occupational therapy was administered to the control group (n=11). Hand function was assessed before and after the intervention using the Nine-Hole Peg Test and manual function test (MFT), while visual perception was assessed using the Motor-Free Visual Perception Test-3rd edition (MVPT-3). Results : Following the intervention, both the experimental and control groups showed significant improvements in performance in the Nine-Hole Peg Test and MVPT-3 (p<.05). The improvement on both tests was significantly greater in the experimental group than in the control group (p<.05). Conclusion : The results suggest that digital pegboard training with visual and auditory feedback may improve hand function and visual perception in stroke patients. Therefore, this intervention can be effective in occupational therapy to aid the recovery of stroke patients.

Effect of Virtual Reality Training Focus on ADL on Upper Extremity Function and Activities of Daily Living in Stroke Patients (일상생활에 중점을 둔 가상현실 훈련이 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 효과)

  • Park, In-Hye
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.321-329
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    • 2019
  • This study aimed to investigate the effect of virtual reality training focus on ADL on upper extremity function and activities of daily living in stroke patients. 20 patients with chronic stroke were included in this study. The participants were divided into the experimental (n=10) or control (n=10) groups. Both groups received conventional rehabilitation therapy for 30 min a day, 5 times per week for 4 weeks. The experimental group also performed virtual reality training focus on ADL for 30 min a day, and the control group performed general virtual reality training for 30 min a day. The Fugl-Meyer Assessment (FMA) and Functional Independence Measure (FIM) scores were evaluated before and after the intervention, and both groups showed significant improvement (p<.05). Compared to the control group, the experimental group showed significant improvement in the FMA wrist score and the FIM total, self-care, and sphincter control scores (p<.05). These findings suggest that virtual reality training focus on ADL may have a positive effect on wrist function and overall ADLs compared to that using general virtual reality training in stroke patients.

Analysis of Corticospinal Tract Injury by Using the Diffusion Tensor Imaging of 3.0 T Magnetic Resonance in Patients with Hypertensive Intracerebral Hemorrhage

  • Cho, Hee-Cheol;Son, Eun-Ik;Lee, So-Young;Park, Gi-Young;Sohn, Chul-Ho;Yim, Man-Bin
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.331-337
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    • 2005
  • Objective : The purpose of this study is to identify correlations between diffusion tensor imaging[DTI] and motor improvement by quantifying and visualizing the corticospinal tract on DTI to predict motor impairment in patients with hypertensive intracerebral hemorrhage[ICH]. Methods : Fifteen normal subjects and 7 patients with hypertensive ICH were examined and the latter were treated surgically. DTI was performed with a 3.0 T MRI. The region of interest[ROI] from the posterior limbs of both internal capsules was measured on a fractional anisotropy[FA] map, and the ratios of ROIs were calculated. Tractography, 3-dimensional DTI was then constructed. Motor impairment was assessed on admission and 2weeks after stroke by the Motricity Index[MI]. The FA ratio, tractography and score on MI were analyzed for correlations. Results : The FA ratio from the initial DTI did not show a linear correlation with motor impairment. However, after 2weeks, patients with high FA ratios showed high degrees of motor recovery, regardless of the initial severity, and patients with low FA ratios showed low recovery rates. Otherwise, a relationship between the amount of hematoma and the degree of motor recovery could not be determined. On tractography, injury of the corticospinal tract could be visualized and estimated 3-dimensionally. Conclusion : FA ratio analysis and tractography constructed from DTI may be useful in understanding corticospinal tract injury and in predicting the recovery from motor impairment in patients.

Effects of Melatonin on Improvement of Neurological Function in Focal Cerebral Ischemic Rats

  • Lee, Seung-Hoon;Shin, Jin-Hee;Lee, Min-Kyung;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • v.35 no.2
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    • pp.167-174
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    • 2011
  • Acute ischemic stroke results from sudden decrease or loss of blood supply to an area of the brain, resulting in a coinciding loss of neurological function. The antioxidant action of melatonin is an important mechanism among its known effects to protective activity during ischemic/reperfusion injury. The focus of this research, therapeutic efficacy of melatonin on recovery of neurological function following long term treatment in ischemic brain injured rats. Male Sprague-Dawley rats (n=40; 8 weeks old) were divided into the control group, and MCAo groups (Vehicle, MT7 : MCAo+ melatonin injection at 7:00, MT19 : MCAo+melatonin injection at 19:00, and MT7,19 : MCAo+melatonin injection at 7:00 and 19:00). Rat body weight and neurological function were measured every week for 8 weeks. After 8 weeks, the rats were anesthetized with a mixture of zoletil (40 mg/kg) and xylazine (10 mg/kg) and sacrificed for further analysis. Tissues were then collected for RNA isolation from brain tissue. Also, brain tissues were analyzed by histological procedures. We elucidated that melatonin was not toxic in vital organs. MT7,19 was the most rapidly got back to mild symptom on test of neurological parameter. Also, exogenous melatonin induces both the down-regulation of detrimental genes, such as NOSs and the up-regulation of beneficial gene, including BDNF during long term administration after focal cerebral ischemia. Melatonin treatment reduced the loss of primary motor cortex. Therefore, we suggest that melatonin could be act as prophylactic as well as therapeutic agent for neurorehabilitative intervention.

Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg's Syndrome: A Case Study (발렌버그 증후군(Wallenberg's Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.69-83
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    • 2022
  • Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

A Study on Evaluation of the Appropriateness of Hospitalization for Patients with Stroke (뇌졸중 환자의 재원 적절성 평가에 관한 연구)

  • Choi, Eun-Mi;Yoo, In-Sook
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.233-240
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    • 2012
  • This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

The Effects of Occupational Therapy Intervention Using Fully Immersive Virtual Reality Device on Upper Extremity Function of Patients With Chronic Stoke: Case Study (완전 몰입형 가상현실 기기를 이용한 작업치료 중재가 만성 뇌졸중 환자의 상지기능에 미치는 영향: 사례연구)

  • Han, Soul;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.7 no.2
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    • pp.17-27
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    • 2018
  • Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.

Clinical Study on the Effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain (뇌졸중 후 중추성 통증 환자에 대한 봉독약침요법약침 치료 효과에 대한 임상적 연구)

  • Jeoung, Kyoung-suk;Kim, Su-hyun;Park, Seon-kyeong;Lim, Ho-jae;Yoon, Hyoung-seon;Ahn, Ho-jin
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.69-75
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    • 2005
  • Objective : This study is designed to find out the effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain. Methods : Bee venom solution was injected on Seven Points of CVA-GB2l(肩井), LI15(肩隅), Ll11(曲池), GB31(風市), ST36(足三里), GB39(絶骨), ect- every other day for 3 weeks, in twenty patients who were admitted in Dong-Seo Oriental Medical Hospital, as diagnosed by their typical pain characteristics of central pain from stroke. Result : After 3 weeks treatment, visual analogue scale of pain severity showed significant decrease.

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Effects of Ankle Joint Mobilization With Movement on Lower Extremity Muscle Strength and Spatiotemporal Gait Parameters in Chronic Hemiplegic Patients (만성 편마비 환자의 발목에 적용한 능동운동을 동반한 관절가동술이 하지근력과 보행의 시공간적 변수에 미치는 영향)

  • An, Chang-Man;Won, Jong-Im
    • Physical Therapy Korea
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    • v.19 no.3
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    • pp.20-30
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    • 2012
  • The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.