Journal of The Korean Society of Integrative Medicine
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v.8
no.2
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pp.169-185
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2020
Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.
Purpose: The purpose of this study is to examine effects of a self-help management program at public health centers on self-efficacy, self-esteem, knowledge of stroke and family supports in stroke patients. Methods: Based on a quasi-experimental design, 44 persons with stroke were assigned to the experimental group (n=21) or the control group (n=23). Data were analyzed through the descriptive statistics, t-test, $x^2$-test and Mann-Whitney test with the SPSS/WIN 18.0 program. Results: The experimental group showed significant improvement in its members' self-efficacy, self-esteem, knowledge of stroke and family supports. Conclusion: The self-help management program can be an effective nursing intervention to help stroke patients improve their self-efficacy, self-esteem, knowledge of stroke and family supports. That program is also meaningful in that it can contribute to more effective implementation of established programs for stroke patients in public health centers.
Kim, Jeong-Yeon;Cha, Jae-Kwan;Kim, Dae-Hyun;Nah, Hyun-Wook;Jeong, Jin-Heon
Journal of Neurocritical Care
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v.11
no.2
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pp.86-92
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2018
Background: A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods: This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm were selected. Results: During the observation period, 225 patients were treated under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P<0.01) shortened to 85 minutes without significant changes in transfer distance. The median onset to puncture time was also significantly (P=0.03) decreased from 365 minutes in 2013 to 270 minutes in 2017. Conclusion: Our results implicate that many hospitals in our stroke region might have recognized the importance of rapid transportation for AIS after 2015.
Purpose: Among the sources of anxiety and burden of family caregivers of stroke patients, this study investigated the role of self-efficacy and knowledge about care. Methods: Descriptive and correlational study design was used. One hundred and thirteen subjects were included. They were anticipated family caregivers of stroke patients. All patients were hospitalized at the intensive care unit (ICU) for the first time as a stroke patients. Data of family caregivers were collected during the time that patients were in the ICU with self-reported standardized questionnaire. Pearson's correlation coefficients and regression analysis were used to explore the role of self-efficacy and knowledge. Results: Self-efficacy was correlated with burden, but not with anxiety. Knowledge about care was correlated with anxiety and burden. Only knowledge about care was the significant predictor of anxiety and burden of anticipated family caregivers. Conclusion: The knowledge about care for stroke patients is important especially to the family caregivers who have to care stroke patients for the first time to reduce their anxiety and burden.
Purpose: This study compared the walking ability of chronic stroke patients following either treadmill training with knowledge of the result (KR group) or treadmill training with knowledge of the performance (KP group). Methods: Nineteen patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a KR group (10 patients) and a KP group (9 patients). They received 30 minutes of neuro-developmental therapy and treadmill training 30 minutes, five times a week for three weeks. The gait parameters were measured before and after training using the Optogait system. Results: After the training periods, the KR group showed significant improvement in gait speed, cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait assessment compared to the KP group (p<0.05). Conclusion: The results showed that treadmill training with KR was more effective in improving the gait speed and cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait ability than the treadmill training with KP. Therefore, to improve the walking ability of stroke patients, it is necessary to consider treadmill training with KR. If it can be combined with conventional neurological physiotherapy, it would be an effective rehabilitation for stroke patients.
Purpose: This study aimed to investigate the effect of neck exercises using proprioceptive neuromuscular facilitation (PNF) on dysphagia and neck pain in stroke patients. Methods: This study included 20 patients with stroke who performed the following neck exercises using PNF: flexion, lateral flexion, and rotation. The PNF technique was repeated under the guidance of verbal commands from a physical therapist. The exercise program consisted of 5 times, 30-minute sessions each week for four weeks. The Mann Assessment of Swallowing Ability (MASA) and the visual analogue scale (VAS) were used to evaluate the patients before and after the training. Swallowing ability was evaluated using MASA, and the patients' pain was evaluated using VAS. All data were analyzed using SPSS 21.0. Results: Significant differences were observed for the MASA and VAS in the subjects: MASA was significantly improved (p<0.00) and VAS was significantlyincreased (p<0.00). Conclusion: The neck is a very important part of the body in stroke patients. Neck exercises using PNF are effective for improving dysphagia and decreasing neck pain in patients with stroke. Thus, neck exercises using PNF are very effective for stroke patients, and this approach would be effective in clinical practice.
Purpose: The purpose of this study was to verify the effect of applying clam exercise on improving trunk control and balance ability in stroke patients. Based on this, we tried to provide clinical information. Methods: In this study, 18 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a clam exercise group (9 patients) and a control group (9 patients). After 30 minutes of neuro-development therapy, they performed clam exercise or bridge exercise for 3 weeks, 5 times a week for 30 minutes. A trunk impairment scale (TIS) and a postural assessment scale for stroke patients-trunk control (PASS-TC) were performed to evaluate the subjects' ability to control trunk before and after intervention. Balance ability was measured by Balancia before and after intervention. Results: After the training periods, area 95% COP and weight distribution of the affected side were significantly different from the clam exercise group compared to the control group (p<0.05). Conclusion: Based on the results of this study, in can be seen that the clam exercise is effective in improving the balance ability compared to the bridge exercise. Maintaining the standing posture requires muscle strength of the hip abduction and extension, which is the result of the clam exercise selectively strengthening these muscles. Therefore, if you want to provide intervention to improve the balance of stroke patients, it is recommended to perform a clam exercise.
Purpose: This study was to examine the effects of a footbath program on heart rate variability, blood pressure, body temperature and fatigue of stroke patients with stroke-induced hemiparesis. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 40 stroke patients, twenty for the footbath program and twenty for the control group, who were hospitalized in a long-term rehabilitation hospital in G city of Korea, from February to April 2014. The twenty participants in the experimental group received the intervention of footbaths and an educational program focused on the prevention of stroke complications; Collected data were analyzed by the IBM SPSS WIN 20.0 program using a t-test, ${\chi}^2$ test, Mann-Whitney U test and repeated measures ANOVA. Results: Significant differences were found in heart rate variability, systolic blood pressure, hand and foot temperatures and fatigue between the two groups. But no significant differences were found in diastolic blood pressure, core temperatures, forehead temperatures, and hand temperatures between the two groups. Conclusion: The footbath program was an effective intervention for skin temperature change and fatigue reduction for stroke patients. Therefore, it is recommended that the footbath program can be utilized as an effective nursing intervention for stroke patients in long-term rehabilitation care hospitals.
Objectives : To gain better insights on the characteristics of stroke patients admitted to oriental medical hospitals, we analyzed the data of 363 consecutive patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Methods : Subjects' enrollment was in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We assessed the subjects' general characteristics, risk factors, and etiology of stroke. Each patient's TOAST classification type was confirmed by two independent specialists. Those were small vessel occlusion (SVO), large artery atherosclerosis (LAA), cardioembolism (CE), stroke with other determined etiology (SOE), and stroke with undetermined etiology (SUE).Results 'The distribution of the subjects' general characteristics and risk factors for stroke were similar with result storm previous reports. However, in the TOAST classification, SVO was the major type occupying 78.5% in the total subjects, which is the highest share compared with other research with similar methods. These results imply that patients with more severe symptoms rarely visit oriental medical hospitals. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of stroke patients at oriental medical hospitals, and contribute to expansion of the Korean Hanbang Stroke Data Bank.
Purpose: The purpose of this study was to identify factors contributing to health-related quality of life in patients under rehabilitation after stroke. Methods: A descriptive correlational study design was used. Ninety-two stroke patients under rehabilitation from a university hospital were included. Data were collected on March and April, 2013 using structured questionnaires. Hierarchial multiple regression analysis was used to identify factors influencing health-related quality of life. Results: There were significant differences in health-related quality of life according to type of impairment. The health-related quality of life had significant correlations with age, functional dependency, and stress. Factors influencing health-related quality of life for stroke patients under rehabilitation were stress, functional dependency, type of impairment, and age, which explained about 34.5% of total variance. Conclusion: To promote health-related quality of life for stroke patients under rehabilitation, stress and functional dependency should be managed in this population, especially for older adults. Also these results can be utilized in the development of program for helping rehabilitation of stroke patients. The effect of depression and anxiety on health-related quality of life should also be addressed in future research.
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