• Title/Summary/Keyword: Stroke Rehabilitation

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Analysis of Total Hospital Charges, Length of Stay, and Cost of Rehabilitation by Hospital and Stroke Type (의료기관별 뇌졸중 유형에 따른 진료비, 재원일수 이학요법료의 차이분석)

  • Kim, Sun-Mi;Kim, Da-Yang;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.91-105
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    • 2017
  • Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

Effects of the Group Task-related Program Training on Motor Function and Depression for Patient with Stroke (과제 지향적 그룹 운동 프로그램이 뇌졸중 환자의 운동 기능과 우울증에 미치는 효과)

  • Chung, Jae-Hoon;Ko, Myung-Sook;Lee, Jung-Ah
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.1
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    • pp.25-34
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    • 2010
  • Purpose : The purpose of this study is to assess the effect for gait, balance, and depression for stroke patients by group task-related program training based motor learning theory. Methods : The subjects of this study were administrated to the 11 stroke patients (9 male, 2 female) by 5 weeks, 3 times per week, 15 times. The group task-related program training were performed gait, balance, treadmill, muscle strengthening, and game program. Each program took 7~10 minutes and total time took 60 minutes including moving time. The difference of program training were compared using the paired t-test. Results : The results of this study revealed that Fugl-Meyer motor assessment, Chedoke-McMaster Stroke assessment of lower extremity and Berg balance scale were significantly correlated. However, impairment item of Chedoke-McMaster Stroke assessment, spatio-temporal gait parameters, Timed up and go test, and depression item of Minnesota Multiphasic Personality Inventory were not significantly correlated. Conclusion : These results support that group task-related program could be a useful treatment to improve the balance skills and motor function of lower extremity for the chronic stroke patients.

The Impacts of Cognitive Function, Disease Severity, and Disability on Ability to Perform Activities of Daily Living after Stroke (뇌졸중 환자의 인지기능, 질병의 심각도 및 장애 정도가 일상생활수행능력에 미치는 영향)

  • Oh, Eunyoung;Kim, Minsuk;So, Heeyoung;Jung, Misook
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.2
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    • pp.90-99
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    • 2013
  • Purpose: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. Methods: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. Results: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. Conclusion: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.

The Effects of Repetitive Transcranial Magnetic Stimulation on the Gait of Acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.2
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    • pp.129-132
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    • 2015
  • The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

The Immediate Effects of Posterior Pelvic Tilt with Taping on Pelvic Inclination, Gait Function and Balance in Chronic Stroke Patients

  • Wu, Yang-Ting;Choe, Yu-Won;Peng, Cheng;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.11-21
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    • 2017
  • PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p<.05). Post hoc test results differed significantly in the 10-meter walk test after intervention (p<.05). However, there were no significant differences in limits of stability test after intervention (p>.05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

Effectiveness of Gait Training Using an Electromechanical Gait Trainer Combined With Simultaneous Functional Electrical Stimulation in Chronic Stroke Patients (기능적 전기 자극을 적용한 전동식 보행 훈련이 편마비 환자의 보행에 미치는 영향)

  • An, Seung-Hun;Lee, Yun-Mi;Yang, Kyung-Hee
    • The Journal of Korean Physical Therapy
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    • v.20 no.1
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    • pp.41-47
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    • 2008
  • Purpose: This study aimed to assess the effectiveness of gait training with the use of an electromechanical gait trainer with functional electrical stimulation (FES) for patients that had undergone subacute stroke. Methods: The study subjects included nine subacute stroke patients of the Korea National Rehabilitation Center in Seoul, Korea. Outcome was measured using the timed Up and Go test, Fugl-Meyer-L/E assesment, with determination of the comfortable maximal gait speed, composite spasticity score, functional ambulatory category and Berg balance scale. All measured scores were recorded before, during, and after rehabilitation and at an eight-week follow-up. Results: Patients who received electromechanical-assisted gait training in combination with FES after subacute stroke were more likely to achieve independent walking, functional activities, balance and gait speed. Conclusion: The outcome of our gait-training program demonstrates that it may be practical to integrate FES into electromechanical gait training without any adverse effects. However, further randomized controlled studies are needed to evaluate if patient outcome after combined training is superior to outcome after the use of electromechanical gait trainer treatment alone or conventional gait training alone.

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Storing information of stroke rehabilitation patients using blockchain technology: a software study

  • Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.98-107
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    • 2022
  • Background: Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient's information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language. Methods: We created a mini blockchain to store the medical information of patients using the Java programming language. Results: After generating a unique pair of public/private keys for identity verification, a patient's identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks. Conclusion: We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.

Correlation among Motor Function and Gait Velocity, and Explanatory Variable of Gait Velocity in Chronic Stroke Survivors

  • Lee, Dong Geon;Lee, Gyu Chang
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.181-188
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    • 2022
  • Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

Recovery and Associated Factors of Cognitive Function in Patients with Hemorrhagic Stroke (출혈성 뇌졸중 환자의 인지기능 변화 및 연관 요인에 대한 추적조사)

  • Park, Minsu;Min, Ji Hong;Ko, Sung Hwa;Lee, Sang Won;Ko, Hyun-Yoon;Shin, Yong-Il
    • 재활복지
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    • v.21 no.2
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    • pp.247-259
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    • 2017
  • We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

Design of Upper-limb Rehabilitation Device with Power-assist Function for Stroke Survivals (뇌졸중 환자용 동력보조형 상지재활훈련기의 설계)

  • Bae, J.H.;Moon, I.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.5 no.1
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    • pp.79-85
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    • 2011
  • In this paper, we proposed a design of upper-limb rehabilitation device with power-assist function for stroke survivals. The designed upper-limb rehabilitation device has three degrees of freedom; it is possible to perform flexion and extension motions of wrist, index finger and the other fingers except the thumb independently. The power-assist for wrist motion is performed by a pneumatic double-acting cylinder, but the fingers are actuated by electrical linear actuators to assist motions. A prototype upper-limb rehabilitation device and its controller were implemented. The position controller showed 0.8 mm errors in the steady-state. Experimental results showed that the proposed upper-limb rehabilitation device with power-assist function is feasible.