• Title/Summary/Keyword: STROKE PATIENTS

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Basic Experiment on Rehabilitation of Upper-Limb Motor Function Using Haptic-Device System (햅틱 장치를 이용한 상지 운동기능 장애인의 재활치료에 관한 기초 실험)

  • Lee, Ho-Kyoo;Kim, Young-Tark;Takahashi, Yoshiyuki;Miyoshi, Tasuku;Suzuki, Keisuke;Komeda, Takashi
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.5
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    • pp.459-467
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    • 2011
  • Rehabilitation exercises must maintain a patient's interest and permit a quantitative evaluation of the rehabilitation. We have developed a haptic-device system. When users move a grip, the haptic device provides a virtual force that either assists the movement of their arm or working against it. To investigate the functional effect of this system in a rehabilitation program, we used for five subjects with motor-function disorders and measured the grip position, velocity, force exerted on the grip, and EMG activities during a reaching task of one subject. The accuracy of the grip position, velocity and trajectories patterns were similar for all the subjects. The results suggested that the EMG activities were improved by applying the virtual force to the grip. These results can be used for the development of rehabilitation programs and evaluation methods.

The comparison between normal and cerebral infarction subject;using Transcranial Doppler (경두개 도플러(TCD)를 이용한 정상군과 뇌경색군의 상호비교연구)

  • Choi, Jae-Young;Lee, Dong-Won;Jeong, Sung-Hyun;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.157-167
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    • 1998
  • Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

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A Case Report on a Patient with Intracerebral Hemorrhage with Intraventricular Hemorrhage Suffering from Deep Stupor to Semi-coma Treated by Korean Traditional Medicine (뇌실내출혈을 동반한 뇌내출혈로 인한 중증 의식장애 환자의 한방 치험 1례 : 뇌내출혈의 한의학적치료)

  • An, Yu-min;Lee, Yoo-na;Baek, Kyung-min;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1225-1236
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    • 2019
  • Objective: This is a case report on the effect of Korean traditional medicine on deep stupor to semi-coma with intracerebral and intraventricular hemorrhage. Methods: The patient was treated by Korean traditional medicine such as acupuncture, moxibustion, and herbal medicine. The change of mental state was evaluated by the Glasgow Coma Scale (GCS). We used the Modified Medical Research Council Scale (MRC scale) and the Modified Barthel Index (MBI) to evaluate the effectiveness of the treatment. Results: After treatment, the physical function and ability to perform activities of daily living were improved. The Modified Barthel Index increased from 0 to 40 after treatment with Korean medicine. Conclusions: According to this study, Korean traditional medicine can be effective for the treatment of quadriparesis in patients with deep stupor to semi-coma in intracerebral and intraventricular hemorrhage.

Effects of Inspiratory Muscle Training on Diaphragm Thickness, Pulmonary Function, and Chest Expansion in Chronic Stroke Patients (흡기근 저항훈련이 만성 뇌졸중 환자의 횡격막 두께와 폐기능에 미치는 효과)

  • Jung, Ju-Hyeon;Kim, Nan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.1
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    • pp.59-69
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    • 2013
  • 연구목적: 본 연구는 만성 뇌졸중 환자를 대상으로 흡기근 저항훈련이 횡격막 두께와 폐기능 및 흉곽 확장에 미치는 효과를 알아보고자 수행하였다. 연구방법: 연구 대상자는 총 29명(남자 17명, 여자 12명)으로 흡기근 저항훈련군(15명)과 대조군(14명)으로 분류하였다. 모든 대상자는 6개월 이상된 만성 뇌졸중 환자로 일반적인 신경발달치료를 받고 있으며, 같은 기간 동안 흡기근 저항훈련군에 역치부하 흡기근육 단련기(threshold IMT device)를 제공하고 주 3회${\times}$1회 20분씩 6주간 시행하였다. 마비측과 비마비측 횡격막 두께측정을 위해 초음파의 7.5MHz linear probe를 사용하여 최대 흡기시(Tdi.con)와 휴식시(Tdi.rel)의 두께를 측정하고 수축률(TR)을 계산하였다. 또한 폐 활량계를 사용하여 노력성 폐활량을 측정하였으며, 줄자를 사용하여 흉곽 확장을 측정하였다. 연구결과: 6주간 중재 후 흡기근 저항훈련군에서 최대흡기시 횡격막 두께(Tdi.con)와 수축률(TR)은 유의한 증가를 보였다(p<.05). 1초간 노력성 호기량 ($FEV_1$)과 최대 호기 속도(PEF)도 유의한 증가를 보였으나(p<.05), 노력성 폐활량(FVC)과 1초간 노력성 호기량의 노력성 폐활량에 대한 비($FEV_1$/FVC), 흉곽 확장은 유의한 증가는 보이지 않았다(p>.05). 결론: 본 연구는 만성뇌졸중 환자를 대상으로 흡기근 저항훈련의 적용이 횡격막의 수축력과 폐기능 및 흉곽 확장력을 향상시켜 호흡근의 협응력을 증가시키고, 비활동성으로 인해 감소된 운동내성을 증가하게 함으로써 향후 재활에서 만성 뇌졸중 환자에게 2차적인 기능향상에 도움을 줄수 있을 것으로 보여진다.

Validity of Ground Reaction Forces during Gait and Sit-to-Stand using the Nintendo Wii Balance Board in Healthy Subjects (Wii Balance Board를 이용한 Sit-to-Stand와 보행시 지면반발력의 타당도 분석)

  • Jeong, Yu-Jin;Park, Dae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.4
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    • pp.85-92
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    • 2016
  • PURPOSE: A good, valid, and feasible tool for evaluating sit to stand (STS) is needed to help clinicians quantify the STS ability of stroke patients and people with balance disorders. The purpose of this study was to evaluate the concurrent validity of the Nintendo Wii Balance Board (WBB) and a force plate during STS and gait. METHODS: Seventeen healthy adults performed five trials of STS and gait on the WBB placed on the force plate. The force plate and the WBB were compared in regard to center of pressure (COP) and ground reaction force (GRF) data that were collected simultaneously. The variables used for analysis were time (s), integral summation (%), COP path length (mm), COP x range, and COP y range, all of which were measured for both tasks. Counter (%), peak (%), and rebound (%) were analyzed for STS, and $1^{st}$ peak (%), min peak (%), and 2nd peak (%) were analyzed for gait. The concurrent validity was analyzed using an intraclass correlation coefficient (ICC) and a standard error of measurement (SEM) with a 95% confidence interval. RESULTS: The concurrent validity of the WBB for STS ranged from fair to good (ICC=.701~.994, SEM=.029~3.815). The concurrent validity for gait was good (ICC=.869 ~.989, SEM=.007~2.052) aside from path length and x and y ranges of COP (ICC=-.150~.371, SEM=3.635~4.142). CONCLUSION: The GRF of the WBB has a good validity for STS and gait analysis. The WBB is remarkably portable, easy to use, and convenient for clinically assessing STS and gait.

The Effect of Stretching and Pre-eccentric exercise on Delayed Onset Muscle Soreness (스트레칭과 사전원심성 운동이 지연성근육통에 미치는 영향)

  • Jeong, Jin-Gyu;Ryu, Seong-Sun;Kim, Yong-Nam;Kang, Jong-Ho;Kim, Su-Hyun;Hwang, Tae-Yeon
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.15-22
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    • 2010
  • Purpose : This study examines the effects of pre-eccentric exercise and stretch ing to bicepsbrachii to prevent delayed onset muscle soreness and recovery of muscular function depending on the training intensity with 28 normal adults in their twenties. Methods : The subjects were divided into a control group, a group without any previous eccentric exercise, and a stretching group. Pre-eccentric exercise group conducted exercise with the intensity of 25% of maximal voluntary contraction. Pre-eccentric exercise and stretching was applied before to induce delayed onset muscle soreness and after, 24 hour post, 48 hour post, and 72 hour post. Measurements were conducted to examine pain and muscular function changes before, immediately after, and after inducing delayed onset muscle soreness. After inducing delayed onset muscle soreness, measurements were taken at the 24th hour, 48th hour, and 72nd hour. Results : The pre-eccentric exercise group and stretching group showed a significant difference from the control group by isometric contract ion power and mechanical pain threshold as a result of measuring delayed onset muscle soreness. Conclusion : From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.

Development of Joint Angle Measurement System for the Feedback Control in FES Locomotion (FES보행중의 피드백제어를 위한 관절 각도계측 시스템 개발)

  • Moon, Ki-Wook;Kim, Chul-Seung;Kim, Ji-Won;Lee, Jea-Ho;Kwon, Yu-Ri;Kang, Dong-Won;Khang, Gon;Kim, Yo-Han;Eom, Gwang-Moon
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.58 no.1
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    • pp.203-209
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    • 2009
  • The purpose of this study is to develop a minimally constraint joint angle measurement system for the feedback control of FES (functional electrical stimulation) locomotion. Feedback control is desirable for the efficient FES locomotion, however, the simple on-off control schemes are mainly used in clinic because the currently available angle measurement systems are heavily constraint or cosmetically poor. We designed a new angle measurement system consisting of a magnet and magnetic sensors located below and above the ankle joint, respectively, in the rear side of ipsilateral leg. Two magnetic sensors are arranged so that the sensing axes are perpendicular each other. Multiple positions of sensors attachment on the shank part of the ankle joint model and also human ankle joint were selected and the accuracy of the measured angle at each position was investigated. The reference ankle joint angle was measured by potentiometer and motion capture system. The ankle joint angle was determined from the fitting curve of the reference angle and magnetic flux density relationship. The errors of the measured angle were calculated at each sensor position for the ankle range of motion (ROM) $-20{\sim}15$ degrees (dorsiflexion as positive) which covers the ankle ROM of both stroke patients and normal subjects during locomotion. The error was the smallest with the sensor at the position 1 which was the nearest position to the ankle joint. In case of human experiment, the RMS (root mean square) errors were $0.51{\pm}1.78(0.31{\sim}0.64)$ degrees and the maximum errors were $1.19{\pm}0.46(0.68{\sim}1.58)$ degrees. The proposed system is less constraint and cosmetically better than the existing angle measurement system because the wires are not needed.

Effects of Painless Delivery on Hemodynamic Changes of Parturients with Epidural Analgesia (경막외진통을 이용한 무통분만이 임산부의 혈역학 변동에 미치는 영향)

  • Lee, Sang-Ha;Jang, Young-Ho;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.63-68
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    • 1996
  • Background; Epidural analgesia for controlling labor pain has recently gained world-wide popularity. However, many patients scheduled for continuous epidural analgesia voice concern over harmful effects to their fetus and other possible complications such as hemodynamic changes, back pain and neurologic sequelae etc. The aim of this study was to evaluate the hemodynamic changes with and without epidural block as a measure to determine the safety of epidural analgesia during labor and delivery. Methods: Twenty healthy subjects were divided equally into two groups(Group 1 without epidural block, and Group 2 with epidural block) and serial hemodynamic measurements were taken in all subjects with transcutaneous impedence cardiography. The epidural catheter was inserted at the level of $L_{3,4}$ in Group 2 and analgesia was maintained using 0.25% bupivacaine mixed with fentanyl. Results: Cardiac output increased slightly with cervical dilatation in both groups, but no significant differences were found between the two groups. Similarly, no significant differences were found in blood pressures between the two groups. Stroke volume and end-diastolic volume indices were slightly decreased in group 1 and slightly increased in group 2. However, there were no significant differences between the two groups. The ejection fraction was nearly constant and ranging 56~59%. Conclusion: We concluded epidural analgesia for labor and delivery is a safe technique for the parturients since results indicated no significant differences in hemodynamic changes, as compared to the control group.

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A Study on the Radiation Exposure Dose of Brain Perfusion CT Examination a Phantom (Phantom을 이용한 뇌 관류 CT검사에서 방사선 피폭선량에 관한 연구)

  • Jung, Hong-Rynag;Kim, Ki-Jeong;Mo, Eun-Hee
    • Journal of the Korea Convergence Society
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    • v.6 no.5
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    • pp.287-294
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    • 2015
  • The purpose of this study, was Let's examine the exposure dose at the time of cerebral blood flow CT scan of acute ischemic stroke patients. In particular, long-term high doses of radiation sensitive organs and we Measured using phantom and a glass dosimeter. Apply the existing protocol suggested by the manufacturer (fixed time delay technique) and the proposed new convergence protocol (bolus tracking technique), reporting to measure the dose, dose reduction was to prepare the way. Results up to 39.8% as compared to the existing protocols in a new suggested convergence protocol, a minimum of 5.8% was long-term dose is reduced. Test dose of $CDTI_{vol}$ and DLP values decreased 25%, respectively, were measured at less than recommended dose. Try checking the protocol set out in the existing based on the analysis result of the above, by applying the proposed new convergence protocol by reducing the dose would have to contribute to improved public health. It is believed to be research continues to find the optimum protocol in the other tests.

A Case Report of Hemiparesis and Hypesthesia in a Patient with an Intracerebral Hemorrhage at the Basal Ganglia Treated with Traditional Korean Medicine (기저핵 뇌출혈로 인한 반신부전마비, 감각장애에 대한 한방치험 1례)

  • Jeong, Taek-su;Jeon, Gyeong-ryung;Cho, Jun-ho;Park, Jin-seo;Sohn, Soo-ah;Kwon, Do-ick
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.1015-1022
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    • 2018
  • Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia. Methods: The patient was treated with herbal medicine (Gamicheongsim-tang, Hwangryunhaedok-tang-tablet), acupuncture, moxibustion, and rehabilitative therapy. The effects of these treatments were evaluated using the manual muscle test (MMT), sensory scale, Korean version of the modified Barthel index (K-MBI), and the National Institutes of Health Stroke Scale (NIHSS). Results: After treatment, the MMT grade improved from 3+/3+ to 4+/4+, and the sensory scale increased from 40%/40%/40% to 80%/80%/80%. In addition, the K-MBI score improved from 56 to 100, and the NIHSS score decreased from 7 to 1. Conclusion: The results suggest that traditional Korean medicine can be effective in the treatment of patients with ICH.