• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.479-489
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• 1998

This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

• The Journal of Korean society of community based occupational therapy
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• v.6 no.1
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• pp.41-48
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• 2016

Objective : We tried to know the improvement and neurological effect of diabetes when the complex exercise training was applied on diabetes that delayed the recovery of the ischemic brain injury. Methods : We performed this study in a animal lab which located in Gyengsangbukdo. We used 10 diabetes rats with ischemic brain injury, which is induced by STZ. We applied the complex exercise training on the rats for 4 weeks. We executed the maze test to confirm the recovery of the brain function and checked the blood sugar to know the improvement. Results : As a result of applying the complex exercise on diabetes rats with ischemic brain injury, there was a significant reduce of error and escape time in 3 weeks and 1 weeks, respectively. There was no difference of the blood sugar in control but there was a significant improvement in experiment group after applying the exercise training in 4 weeks. Conclusion : The senile disease like stroke and diabetes was increased currently. It is important for rehabilitation to improve the quality of life during the remainder of their life. In the study, we've known the improvement of diabetes and the recovery of the brain function when the complex exercise training was applied the rats with both diabetes and the ischemic brain injury.

• Proceedings of the KAIS Fall Conference
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• 2009.12a
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• pp.484-486
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• 2009

본 연구는 본 연구는 입원중인 뇌졸중 환자들이 겪는 경제적 스트레스 및 우울이 삶의 질에 미치는 영향을 알아보기 위해 대전에 소재하고 있는 대학병원, 종합병원, 재활센터 등에서 치료를 받고 있는 뇌졸중환자 209명으로 하였다. 자료수집방법은 각각 구조화된 설문지를 통해 1:1 면접조사를 실시하였다. 연구도구는 경제적-불편감척도(Gore, 1978)와 Arruda J.E가 개발한 시각상사척도와 GHO-60(Goldberg, 1972), MOS SF-36(Ware 등, 1992)을 김건엽(2002)이 표준화한 23문항 중 삶의 질을 측정하는 12문항을 수정, 변경하여 사용하였다. 수집된 자료는 SPSS(Statistical for the Social Science)12.0을 이용하여 분석하였고, 뇌졸중 환자의 일반적 특성, 물리치료 관련 특성, 질병 관련 특성, 경제적 스트레스, 독립변수로 빈도와 백분율, 평균과 표준편차를 구하고, 전체 연구 대상자의 기술 역학적 특성을 파악하기 위하여 기술통계와 일반적 특성, 물리치료, 질병관련 특성에 따른 환자의 경제적 스트레스, 우울, 삶의 질과의 차이를 알아보기위해 t-검정과 일원분산분석(analysis of variance, ANOVA)을 사용하였다. 발병 후 가계수입(p<0.05), 재정적 압박 수준(p<0.01), 삶의 질(p>0.05), 생활수준(p<0.05)이 통계적으로 유의한 것으로 나타났다. 감정상태가 낮고 생활수준과 재정적 압박 정도가 매우 심할 경우 더 유의하게 경제적 스트레스 점수가 높게 나왔다. 이는 뇌졸중환자가 겪는 경제적 스트레스 요인이 우울과 함께 중요한 영향을 미치며,인구분석학적 결과를 보더라도 가구의 소득수준이 큰 영향을 미치는 것으로 건강에 대한 재정적 부담, 가족으로부터 소외 일과에의 영향, 올가미를 쓴 느낌 이상의 결과로 볼 때 본 연구에서는 시각적 감정 상태, 재정적 압박상태, 우울, 생활수준, 질병 관련 특성, 삶의 질을 위주로 하여 경제적 스트레스 관련 요인을 살펴본 결과 후속연구에서는 보다 정확한 경제적 부담 수준을 측정하고 더불어 보다 객관적인 경제적 스트레스를 측정할 수 있는 도구를 이용하여 조사를 한다면 임상적으로 중요한 자료가 될 것이다. 또한 뇌졸중 환자의 경제적 스트레스를 감소하고 삶의 질 수준을 증진시킬 수 있는 치료적 중재의 개발이 절실히 요구된다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.371-380
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• 2016

The purpose of this study was to investigate the caregiving stress and depression of spouses who support adults with physical disabilities, calculate the activity of daily living (ADL) of the disabled and determine the correlation of each area and the influence of their ADL on the caregiving stress and depression of spouses. This study was performed on 86 spouses of the disabled who were receiving rehabilitation treatment in two hospitals located in S and K cities from July to August 2016. According to the results, the total caregiving stress scores were $71.43{\pm}17.78$ and the economic and psychological stresses among low items were higher than the other items. The total depression score was $50.34{\pm}26.41$, which was slightly higher than the average of normal adults. The caregiving stress and depression were high for aged women, for cases of high caregiving expense and time, for young disabled and for stroke disease. Factors that affected the caregiving stress were the age of the disabled and the duration of their disability; their ADL had no influence on the caregiving stress. The result showed that the depression affected their age, disabled type and grade, and ADL. Actual policy support capable of giving economic, physical, and psychological assistance should be prepared to reduce caregiving stress and depression.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.11
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• pp.421-431
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• 2016

The purpose of this study was to identify the influence of depression, social isolation, and meaning in life on the swallowing related quality of life in patients with dysphagia. In this study, 87 the dysphagia patients diagnosed with stroke, degenerative disease, and neurological disorder in a general or rehabilitation hospital in Seoul, Gyeonggi, and Incheon were assessed. The data were collected between February and April, 2015 using CES-D, RULS, PIL, SWAL-QOL. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression with SPSS 22.0. Of the participants, 20.7% reported having had depression, 92.0% middle-high social isolation and 64.4% existential vacuum. The mean scores were SWAL- QOL 158.89(35.97). Stepwise multiple regression revealed that tube feeding to have the greatest effect on SWAL-QOL(${\beta}=-0.57$, p<.001), followed in order by age (${\beta}=0.26$, p=.001), lower MIL (${\beta}=0.19$ p=.014), and education (${\beta}=0.17$, p=.032). The most influential factor to SWAL-QOL was tube feeding. These variables accounted for 50.7% of SWAL-QOL in dysphagia patients (F=28.84 p=.031). Therefore, it is essential to develop the intervention that can improve the meaning in life in patients with dysphagia. In addition there is a need to study the psychological factors and quality of life of tube feeding.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.81-92
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• 2016

Objective: This study aim is to identify whether 30minutes optokinetic stimulation(OKS) with smooth pursuit eye movement can alleviate chronic hemispatial neglect. Methods: We applied optokinetic stimulation with smooth pursuit eye movement to 2 chronic hemispatial neglect patients. experimental duration was total 4weeks - 1week baseline, 2weeks OKS intervention, 1week 2nd. baseline. The intervention was 10 OKS sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 3 times a week every other day. The OKS was provided on the screen when patient sat in front of the screen(13.5 inch). The OKS video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results: As a result of the OKS for 2weeks, the degree of neglect trends to decrease on both 2 cases compared to baseline A. The degree of the neglect of subject 1 tended to increase the at the baseline A. In contrast, the subject 2 showed that tendency that the degree of the neglect declined additionally at the baseline A. Conclusions: We identified that 30 minutes optokinetic stimulation with sooth pursuit eye movement is effective intervention method for chronic hemispatial neglect.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.929-933
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• 2012

This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

• Physical Therapy Korea
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• v.17 no.2
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• pp.1-9
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• 2010

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was $0^{\circ}$, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was $90^{\circ}$, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.59-79
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• 2004

The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• Therapeutic Science for Rehabilitation
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• v.6 no.1
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• pp.71-83
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• 2017

Objective : This study aim is to identify whether smooth pursuit eye movement(SPEM) using portable device can alleviate chronic hemispatial neglect. Methods : We applied smooth pursuit eye movement to one chronic hemispatial neglect patient. Experimental duration was total 4weeks - 1week baseline, 2weeks SPEM intervention, 1week 2nd. baseline. The intervention was 10 SPEM sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 5 times a week. The SPEM was provided on the screen when patient sat in front of the screen(8.4 inch tablet pc, distance 40cm). The SPEM video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results : As a result of the SPEM for 2weeks, the degree of neglect tended to decrease compared to baseline A. The degree of the LBT tended to increase the at the baseline A'. In contrast, the SCT showed that tendency which the degree of the neglect maintained at the baseline A'. Conclusion : We identified that SPEM using portable device is effective intervention method for chronic hemispatial neglect.