• Title/Summary/Keyword: Stroke Rehabilitation

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A Biomechanical Modeling of Human Pharyngeal Muscular Dysfunction by Using FEM(Finite Element Method) (유한요소법을 이용한 인두의 기능이상에 대한 생체역학적 모델)

  • Kim Sung Jae;Bae Ha Suk;Choi Byeong Cheol;Kim Sung Min
    • Journal of Biomedical Engineering Research
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    • v.24 no.6 s.81
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    • pp.515-522
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    • 2003
  • Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

Study on Design of Advanced Smart Postural Change Device for Supine Posture Control (와상체위제어를 위한 스마트 고기능 자세변환기의 설계에 관한 연구)

  • Park, Seung Hwan;Jung, Jin Taek;Sim, Woo Jung;Kim, Yung Sear
    • 재활복지
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    • v.18 no.4
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    • pp.221-235
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    • 2014
  • Recently, the frequency of stroke disease is increased due to the rapid aging population, and is contributed to the major occurrence factors of the posteriori acquired disability. This study is about an postural change device for the control of supine posture which is an assisted equipment using in daily rehabilitation process for overcoming the disability by the aftereffects of the stoke disease. In this paper, the existing domestic and Japan postural appliances is examined and its comparison and categorization is performed according to its functions and purposes. Here, in order to control the supine posture state, the design method for advanced multi functional system is proposed, which is devised to have an unified mattress control operations of combining the bedsore prevention tube with the supine posture tilting tube. And also, in addition of an smart function, it is designed to enable to perform an RF functions such as the monitoring of the present device state, the alteration of the basic position and the control of alternative floating and supine posture. This system control hardware consists of three main parts : the sensor detection part, the motor driving /control part, and the system control part for bluetooth communication. In results, we confirmed that the system designed by this research is possible to make it practical as an advanced smart postural change device combined by IoT technology in the application field of the recent IT technology.

Effects of Communication Improvement on Caregivers Education and Training on Aphasia (보호자 교육과 경험학습 훈련이 실어증 환자의 의사소통 개선에 미치는 효과)

  • Park, Hee-June;Chang, Hyun-Jin
    • Therapeutic Science for Rehabilitation
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    • v.8 no.2
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    • pp.79-88
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    • 2019
  • Objective : Aphasia interferes with communication between the patient and conversation partner. Adequate communication is essential not only for the patient but also for caregiver education and training Method : This study examined the benefits of parental education and group training in terms of improving the communication of six aphasic patients and their caregivers(family members). Caregiver education provided caregivers with information on stroke and aphasia, and group training was conducted according to the experimental learning cycle. Result : As a result, communication increased in terms of sending and receiving messages or interactive communication. Furthermore, the questionnaire analysis showed that caregivers learned more about aphasia and had confidence in using facilitation strategies. Conclusion : Giving educational opportunities to patients and caregivers promotes caregiver's knowledge and positively interacts.

Studies on Motor Activity Log-28 and Actual Amount of Use Test, Actual Amount of Use Test Inter-rater Reliability in Healthy Individuals: Age Dependence and Handedness (연령과 손잡이에 따른 정상인들의 Motor Activity Log-28과 Actual Amount of Use Test 연구 및 Actual Amount of Use Test의 평가자간 신뢰도연구)

  • Kim, Kyeong-hyeon;Shin, Yu-mi;Lim, Mi-yu;Jung, Yu-chang;Oh, Ji-eun;Kim, Su-jin
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.24-33
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    • 2019
  • Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed ($n_1=20$), young left-handed ($n_2=21$), and older right-handed ($n_3=20$) groups. The AAUT was assessed by dividing 63 subjects into young right-handed ($n_1=25$), young left-handed ($n_2=18$), and older right-handed ($n_3=20$) groups. Student's t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.

Oral-Motor Facilitation Technique (OMFT): Part II-Conceptual Hierarchy and Key Point Technique (구강운동촉진기술: 2 부-개념적 위계 및 핵심 기법)

  • Min, Kyoung Chul;Seo, Sang Min;Woo, Hee-soon
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.53-61
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    • 2021
  • Introduction : OMFT is a therapeutic technique based on sensorimotor, motor control and motor learning, and its major goal is to improve oral motor function. The oral motor conceptual hierarchical development is divided into 5 steps: 1) sensorimotor, 2) movement integration, 3) structural movement, 4) functional oral motor, and 5) comprehensive oral motor. Discussion : The OMFT consists of 3 techniques, 10 categories, and 50 sub-item. 1) Warming up technique: 2 categories, 12 sub-item, warming up by sensory awareness and adaptation, therapy situation adaptation, neck movement; 2) Key point technique: 7 categories, 30 sub-item, oral motor facilitation and increasing chewing skill by direct stroke of oral structures such as the face, lips, cheeks, gum, jaws, and tongue; 3) Application technique: 1 category, 8 sub-item, facilitate food intake and swallowing. Conclusion : The goal of this article is to introduce 3 techniques, 50 sub-item of OMFT, as a comprehensive oral motor therapy method, for application to clients. This article provides information that will help oral motor specialists in treating clients with oral motor problems more effectively and professionally.

Factors Affecting Activity Restriction in the Elderly with Chronic Disease: Using data from the 8th period of the National Health and Nutrition Examination Survey (만성질환 노인의 활동 제한에 영향을 미치는 요인: 국민건강영양조사 제 8기 자료를 활용하여)

  • Hwang, Ho-Sung;Choi, Ji-Hyun;Kim, Su-Kyoung
    • Journal of the Korea Convergence Society
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    • v.12 no.11
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    • pp.359-369
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    • 2021
  • In this study, a complex sample logistic regression analysis was performed to identify the factors affecting the activity restriction of 2,701 normal elderly and chronically ill elderly aged 65 and over using raw data from the 8th period of the National Health and Nutrition Examination Survey. It was found that the elderly with chronic disease felt more restricted in their activities than the normal elderly. Activity limiting factors in stroke and hypertension patients are subjective health status, economic level, stress perception, and moderate-intensity work and leisure. The factors limiting activity in patients with heart disease were subjective health status and economic level, and factors limiting activity in patients with joint disease were subjective health status and high-intensity work and leisure. Activity limiting factors for lung disease patients are education level, high intensity work and leisure, and endocrine system activity limiting factors include subjective health status, stress perception, high intensity work and leisure, and activity limiting factors for cancer patients. is subjective health status, stress perception, moderate-intensity work and high-intensity leisure. Rehabilitation programs and policy support are needed for the continuous participation of the elderly with chronic diseases.

Analysis of Occupational Therapy Intervention Studies for Improvement of Neglect: Single Subject Study (편측무시 개선을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로)

  • Kim, Jin-Yeong;Youn, Sae-Woong;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.9-23
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    • 2023
  • Objective : Among the studies using neglect interventions in the field of occupational therapy, this study was conducted to confirm the contents and characteristics of literature applying single-subject studies, and to analyze the intervention effect and quality level. Methods : This study is a systematic review, and the single subject study published in academic journals for the last 10 years. Results : As a result of the thesis analysis, it was conducted on stroke, and the removal design with seven studies, and two studies were multiple baseline designs. As a result of analyzing the size of the intervention effect applied to neglect, 'highly effective' was found seven times, 'fairly effective' 18 times, 'questionable effective' five times, and 'unreliable effective' six times. As a result of the quality level, there were no studies with low level, with six high level and three medium level. Conclusion : As a result of the study, various methods were applied to neglect interventions. It is thought that this study will provide basic data for evidence-based interventions.

Development of a Occupation-Based Bilateral Upper Extremity Training Protocol in a Medical Setting for Stroke Patients (뇌졸중 환자를 대상으로 한 병원 환경에서의 작업 기반 양측성 상지 훈련 프로토콜 개발)

  • Kim, Sun-Ho;Kim, Jung Ran;Park, Hae Yean;Han, A-Reum;Kim, Jong-Bae;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.24-44
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    • 2020
  • Objective : To develop an occupation-based bilateral upper extremity training protocol that can be effectively applied in a medical setting Methods : The research process using the delphi technique was carried out in 3 stages. The first stage was an open questionnaire development stage, The first draft is prepared through literature review and open questions were developed through preliminary research based on the draft. The second stage was the delphi survey. Based on the responses of the experts obtained through the open Delphi survey, the adequacy of the training protocol was shown on a Likert 5 point scale. The items were edited and deleted, reconstructed by analyzing the mean and standard deviation, stability, convergence degree, consensus, and content validity ratio through the questionnaire. The third step was the completion of the protocol. After discussions between researchers, the finalized protocol contents were reorganized to complete the occupation-based bilateral upper extremity training protocol for medical setting. Results : The final protocol consisted of 9 items across 3 areas in the occupation-based intervention selection domain and 81 items across 4 areas in the bilateral upper extremity training domain, intervention period, and evaluation. Conclusions : This study suggests an evidence-based method that collects the opinions of occupational therapists in order to use occupation-based activities as interventions in a situation that currently sees occupational therapy primarily performed in hospitals. It is also meaningful that the bilateral upper extremity training can be applied effectively in clinical situations by concretely presenting.

A Study of Health Consciousness and Physical Therapy Cognition of Old Ages (고령자의 건강의식과 물리치료 인식에 관한 연구)

  • Park Hwan-Jin;Park Rae-Joon;Kim Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.175-184
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    • 2000
  • This study which applies to the 403 healthy people who don't have particular diseases recently(193 urban aged. 210 rural aged) among male and female aged over 60 years old living in Daegu(city) and Gyungbook(agricultural village) is fulfilled from November 1st to December 31st by interview using the questioned paper which researcher developed, and reached to these tallowing conclusions. 1. Every aged men independent of the place residence answered positively yes but aged women had weak assurance of their health. Especially $38.6\%$ of rural aged women said yes and $51.4\%$ of rural aged women said no. 2. In the sleep and well-regulated life, urban and rural aged generally marked on the sound sleep. Compared with male and female, men answered they had better sleep and regulated life than women. 3. The percentage of the urban and rural aged's judgement on their activity was high and the percentage of the rural aged was lower than the percentage of the urban aged. 4. While $62.6\%$ of urban aged answered they were active. $38.6\%$ of rural female aged answered yes, This shows that the rural female aged regard their health is not good. 5. Compared with same generation. urban aged ranked lower than urban aged in the confidence of physical strength. Especially rural need women answered $42.1\%$ of them were weaker than the same generation. This shows that rural aged women don't have confidence in general physical activities. 6. Taking exercises three times a week which can influence on health cue to sixties and seventies aged ranked $26.1\%$, rarely do is $18.8\%$ and never do is$28.8\%$. Urban and rural aged do not exercise on the purpose of health. 7. The reason of exercise was to advance the physical strength and quality of motion$(34.9\%)$ to get rid of stress$(13.4\%)$ and to prevention of adult illness$(27.8\%)$, prevention of fatness$(15.3\%)$. Aged have a correct understanding that exercise can promote health and protect from the diseases of adult people because the items about the diseases of adult people was marked high. 8. Among the subject of total investigation, 209 persons answered. It showed necessary to recognize that the exercise is still important essential part between adult illness and health care. 9. The $67.7\%$ of urban aged men answered yes in the question of undergoing a physical examination but the rate of not undergoing a physical examination was high in rural aged and urban aged women. According to this, there were the difference of consciousness about health between urban and rural aged. and men and women. 10. Among the people who haying undergone the physical examination, $80.3\%$ of the aged went back to the hospital again because of the result. 11. In the case of stroke, most aged answered the would be placed under medical care. but $53.9\%$ of rural aged women answered they would rely on Chinese medicine. According to this. aged preferred Chinese medicine in some particular diseases. 2. The $58.1\%$ of whole object of this study answered that stroke would be recovered.

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Shoulder Uptake in the Bone Scintigraphy in Patients with Hemiplegic Reflex Sympathetic Dystrophy Syndrome (반신마비성 반사성교감신경 이영양증후군 환자의 골스캔상 견관절 섭취)

  • Lee, Jong-Jin;Chung, June-Key;Lee, Dong-Soo;Hong, Joon-Beom;Han, Tai-Ryoon;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.288-293
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    • 2004
  • Purpose: increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was $63{\pm}10$ yrs. Ter normal volunteer (mean age: $60{\pm}5$, M:F=1:9) data was used as control group. TPBS was performed $59{\pm}32$ days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Conclusion: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.