• Title/Summary/Keyword: Return Stroke

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Delayed Intraventricular Nogo Receptor Antagonist Promotes Recovery from Stroke by Enhancing Axonal Plasticity

  • Kim, Tae-Won;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Tae-Sun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.130-135
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    • 2006
  • Objective : After ischemic stroke, partial recovery of function frequently occurs and may depend on the plasticity of axonal connections. Here, we examine whether blockade of the Nogo/NogoReceptor[NgR] pathway might enhance axonal sprouting and thereby recovery after focal brain infarction. Methods : Adult male Sprague Dawley rats weighing $250{\sim}350g$ were used. Left middle cerebral artery occlusion[MCAO] was induced with a intraluminal filament. An osmotic mini pump [Alzet 2ML4, Alza Scientific Products, Palo Alto, CA] for the infusion of NgR-Ecto[310]-Fc to block Nogo/NgR pathway was implanted 1 week after cerebral ischemia. Prior to induction of ischemia, all animals received training in the staircase and rotarod test. Two weeks after biotin dextran amine injection, animals were perfused transcardially with PBS, followed by 4% paraformadehyde/PBS solution. Brain and cervical spinal cord were dissected. Eight coronal sections spaced at 1mm intervals throughout the forebrain of each animal with cresyl violet acetate for determination of infarction size. Images of each section were digitized and the infarct area per section was measured with image analysis software. Results : Histological examination at 11 weeks post-MCAO demonstrates reproducible stroke lesions and no significant difference in the size of the stroke between the NgR[310]Ecto-Fc protein treated group and the control group. Behavioral recovery is significantly better and more rapid in the NgR-Ecto[310]-Fe treated group. Blockade of NgR enhances axonal sprouting from the uninjured cerebral cortex and improves the return of motor task performance. Conclusion : Pharmacological interruption of NgR allows a greater degree of axonal plasticity in response this is associated with improved functional recovery of complicated motor tasks.

The Effects of a Group Exercise Program with Competitive Games on Balance in Chronic Stroke Patients (경쟁적 게임을 적용한 집단 운동 프로그램이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Yong-Ho, Cho;Sun-Wook, Park
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.4
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    • pp.133-139
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    • 2022
  • PURPOSE: The purpose of this study was to investigate the effects of a group exercise program with competitive games on balance in chronic stroke patients. METHODS: The subjects were chronic stroke patients living at home after their discharge from the hospital. A total of 32 subjects were divided into two groups. The experimental group performed a group exercise program with competitive games, and the control group performed individual exercises. The exercise program duration was one hour, and it comprised 10 minutes of stretching, 40 minutes of the main exercise, and 10 minutes of stretching at the end. The experimental group was divided into two teams of 8 players each and played competitive games (transfer a gym ball to another person, relay 10 m walking and return, transfer an object to the next person using both arms while sitting). The control group performed an arm/trunk exercise for 15 minutes and gait training for 25 minutes. These exercises were conducted twice a week (4 weeks). The Berg Balance Scale (BBS) and timed up-and-go (TUG) tests were performed to confirm the change in balance. RESULTS: In the experimental group, BBS showed a significant increase (p < .05) and TUG showed a significant decrease (p < .05). In the control group, there was no statistically significant change in the BBS. However, the TUG showed a significant decrease (p < .05). The BBS and TUG both showed statistically significant differences (p < .05) in the between-group comparison of the change in pre-post intervention values. CONCLUSION: A group exercise program with competitive games to improve the balance ability for fall prevention in chronic stroke patients could be used as a good intervention method.

Effects of Hypovolemic Hypotension on Cardiopulmonary Functions and Acid-Base Balance (출혈성 쇼크가 심폐기능 및 산.염기평형에 미치는 영향)

  • Sou, Won-Young;Lee, Sung-Haing
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.131-142
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    • 1973
  • Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

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Effect of Two Hours Head-down Bedrest on Orthostatic Tolerance

  • Park, Won-Kyun;Lyo, Woon-Jae;Bae, Jae-Hoon;Song, Dae-Kyu;Chae, E-Up
    • The Korean Journal of Physiology
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    • v.30 no.2
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    • pp.237-247
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    • 1996
  • This study was carried out to determine the effect of $-6^{\circ}$ head-down bedrest on the cardiovascular and hormonal responses to orthostasis and to evaluate the mechanism of orthostatic intolerance. Ten healthy young men were changed the body position from $-6^{\circ}$ head-down or supine bedrest for 2 hr to $70^{\circ}$ head-up tilt for 20 min. During the bedrest, there were no differences in hemodynamic and hormonal changes between the head-down and the supine positions. However, the tendency of decreased end-diastolic volume and increased cardiac contractility during the later period of 2 hr showed that the cardiovascular adaptation could be accelerated within a relatively short period in the head-down bedrest. During the head-up tilt, presyncopal signs were developed in five subjects of the supine bedrest, and one of the same subjects of the head-down bedrest. In the tolerant subjects, the increase in cardiac contractility and plasma epinephrine level during the bend-up tilt was greater following the head-down bedrest than that following the supine bedrest to compensate for reduced venous return. The intolerant subjects showed the greater decrease in end-diastolic and stroke volume, and the greater increase in heart rate during the head-up tilt than the tolerant subjects. Cardiac contractility and plasma epinephrine level were remarkably increased. However, arterial pressure was not maintained at the level for the appropriate compensation of the reduced venous return. It seems that the tolerance to orthostasis is more effective after the short-term head-down bedrest than after the supine bedrest, and the secretion of epinephrine induces the higher cardiac performance as a compensatory mechanism fur the reduced venous return during the orthostasis following the head-down bedrest than the supine bedrest.

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Waveform Parameters of the Electric and Magnetic Fields Radiated Form Lightning Return Strokes (낙뢰에 의해 방사된 전계와 자계 파형의 파라미터)

  • Lee, Bok-Hee;Baek, Young-Hwan;Lee, Woo-Chul
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.20 no.5
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    • pp.57-63
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    • 2006
  • This paper deals with the physical properties and statistical analysis of waveform parameters of electric and magnetic folds radiated from lightning return strokes. The lightning electric and magnetic fields were detected by an plate-type electric field sensor and a loop-type magnetic field sensor respectively, and they were recorded by a data acquisition system having a resolution of 12bits, a sampling rate of 10[MS/s] and recording length of 10[ms]. As a result, a little difference between the parameters of electric and magnetic fields for positive and negative polarities was observed. The rise times of electric and magnetic fields were within the range of less than $13[{\mu}s]$ and the average values for positive and negative polarities were $4.1[{\mu}s]\;and\;4.2[{\mu}s]$, respectively. The average values of the zero-to zero crossing times were $65.2[{\mu}s]\;and\;67.0[{\mu}s]$, and the average depths of the dip to opposite polarity were 38.0[%] and 40.3[%], for positive and negative polarities, respectively.

Receiver operating characteristic curve analysis of the timed up and go test as a predictive tool for fall risk in persons with stroke: a retrospective study

  • Lim, Seung-yeop;Lee, Byung-jun;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • v.7 no.2
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    • pp.54-60
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    • 2018
  • Objective: Persons with chronic stroke fall more often than healthy elderly individuals. The Timed Up and Go test (TUG) is used as a fall prediction tool, but only provides a result for the total measurement time. This study aimed to determine the optimal cut-off values for each of the 6 components of the TUG. Design: Retrospective study. Methods: Thirty persons with chronic stroke participated in the study. TUG evaluation was performed using a wearable miniaturized inertial sensor. Sensitivity, specificity, and predictive values were calculated using the Receiver Operating Characteristic (ROC) curve analysis for the measured values in each section. Optimal values for fall risk classification were determined. Logistic regression analysis was used to investigate the risk of future falls based on TUG. Results: The cut-off values of the 6 sections of the TUG were determined, as follows: sit-to-stand >2.00 seconds (p<0.05), forward gait >4.68 seconds (p<0.05), mid-turn >3.82 seconds (p<0.05), return gait >4.81 seconds (p<0.05), end-turn >2.95 seconds (p<0.05), and stand-to-sit >2.13 seconds (p<0.05). The risk of falling increased by 2.278 times when the mid-turn value was >3.82 seconds (p<0.05). Conclusions: The risk of falls increased by 2.28 times when the value of the mid-turn interval exceeded 3.82 seconds. Therefore, when interpreting TUG results, the predictive accuracy for falls will be higher when the measurement time for each section is analyzed, together with the total time for TUG.

The Service of Community-Based Rehabilitation in Stroke Patient: A Case Study (뇌졸중 환자의 지역사회중심재활서비스: 사례연구)

  • Kim, Ji-hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.1 no.2
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    • pp.31-43
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    • 2011
  • Objective : The purpose of this case study was to proposed a introduction and result of the disabled with stroke in community using services of Community-Based Rehabilitation. Methods : The subject was a 63-years old female patient with stroke who first visit to Public health center in July. She was evaluated on activity daily living action level by using the Modified Barthel Index(MBI) and depression level by using Beck Depression Inventory(BDI). The intervention that was suggested by WHO were Community-Based Rehabilitation(CBR) and general occupational therapy. We were applied from April, 27th 2011, to November 30th, 2011 by occupational therapist. Results : The patient's total MBI score increased from 35 to 55, it means that activity daily living performance capacity was improved. And BDI score decreased from 26 to 14, it means that depressed symptoms were in great decline. She could stand until 5-10 minutes at first, but later stand over 30minutes now. It means her muscle strength and endurance level was increased. The patient's mood condition also was stabilized and then she often showed her smiling face during the therapy. And her protector feels the client's change too. Conclusion : We could know that function level and quality of life of the patient with stroke who return to the community was improved through service of community-based rehabilitation.

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Design of Link-type Thumb Rehabilitation Robot for Finger Patients (손가락환자를 위한 링크형 엄지손가락 재활로봇 설계)

  • Kim, Hyeon Min;Kim, Gab Soon
    • Journal of the Korean Society for Precision Engineering
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    • v.30 no.7
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    • pp.709-716
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    • 2013
  • Rehabilitation of finger patients requires that the patients exercise their hands and fingers for proper functioning to return. A thumb rehabilitation robot, equipped with a two-axis force sensor, can prevent injury to the thumb by monitoring the applied pulling force. In this paper, we describe a link-type thumb rehabilitation robot designed for patients' thumb rehabilitation exercise. Tests of the manufactured link-type thumb rehabilitation robot were performed on normal male patients. Our results show that the robot can be used for flexibility and muscle-strength rehabilitation exercises for a patient's thumb.

Development of a New-Concept Lightning Warning System (신개념 뇌경보 시스템 개발)

  • Choi, Su-Yeon;Park, Chan-Yong;Kil, Gyung-Suk;Ahn, Chang-Hwan;Lee, Young-Kun
    • Proceedings of the Korean Institute of IIIuminating and Electrical Installation Engineers Conference
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    • 2008.10a
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    • pp.297-300
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    • 2008
  • This paper described a New-Concept lightning warning system (LWS) which can measure electric field intensity on the ground level by an electric field mill (EFM) and calculate the lighting location by radiated electro-magnetic waveform. The EFM measures electric field up to 20[kV/m] with the sensitivity of 0.15[V/kV/m] and frequency bandwidth of the loop antenna was ranges from 5.2[kHz] to 1.71[MHz]. The LWS provides data on the movements of thunderclouds and the possibility of lightning return stroke.

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Characteristics of the stepped leaders in cloud-to-ground lightning discharges (낙뢰에 있어서 계단상 리더의 특성)

  • Lee, B.H.;Jeang, K.H.;Lee, T.M.;Sung, J.W.;Ahn, C.H.
    • Proceedings of the KIEE Conference
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    • 2000.07c
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    • pp.1996-1998
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    • 2000
  • In this paper, the electric and magnetic field waveforms produced by cloud-to-groud lightning discharges were measured and statistically analyzed. The measuring system used to measure the electric and magnetic fields is consisted of the hemisphere electric field sensor, the loop magnetic field sensor and the data acquisition system. The stepped leader is appeared before the return stroke. Some parameters of the electric and magnetic fields produced by the stooped leaders in cloud-to-ground lightning discharges were investigated.

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