• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.130-137
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• 2022

Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

• 대한한방내과학회지
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• 제34권4호
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• pp.428-437
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• 2013

Objectives : The aim of this study was to examine if there is a significant correlation between the changes of Fire- and Heat- related symptoms and motor function recovery in acute cerebral infarction patients. Methods : We studied inpatients within a month after the onset of cerebral infarction who were admitted at Kyunghee University Medical Center from May 2011 to January 2013. We executed correlation analysis between Fire-heat pattern score and motricity index score at visit 1 and visit 2, and checked if there was a significant correlation between the changes of Fire-heat pattern score and changes of motricity index score. Also, we compared the changes of both scores in patients taking Fire-heat and non Fire-heat pattern prescriptions. Results : There was a significant correlation between the Fire-heat pattern score and Motricity index score at visit 1 and visit 2, and changes of Fire-heat pattern score showed significant correlation with changes of motricity index score. Patients taking Fire-heat pattern prescriptions showed significant change in Fire-heat pattern score after herb-medication treatment while patients taking non-Fire-heat prescriptions showed insignificant change in Fire-heat pattern score. Conclusions : This study provides evidence that taking a Fire-heat pattern prescription could be considered as a first line herb-medication treatment in acute cerebral infarction patients.

• International Journal of Arrhythmia
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• 제17권1호
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• pp.41-45
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• 2016

Atrial fibrillation (AF) can occur in acute coronary syndrome (ACS), which is a serious medical condition and may require the use of antiplatelet agents in addition to anticoagulants for stroke prevention. Recently, novel or non-vitamin K antagonist oral anticoagulants (NOACs) have been increasingly used for stroke prevention in patients with AF instead of traditional OACs. The duration of treatment or treatment with a stepwise approach (e.g. triple, double, or monotherapy) is determined depending on the clinical setting and the balance between the risks of ischemic stroke and bleeding. However, some concerns and controversies in the use of NOACs in patients with AF and ACS need to be addressed. Here, the current management for NOAC therapy in patients with ACS and AF will be reviewed based on recently published guidelines.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.31-36
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• 2009

Purpose: Pusher syndrome in stroke patients is the tendency to push strongly toward the paretic side with the non-affected limbs. The purpose of this study was to estimated inter-rater and intra-rater reliability of the Scale for Contraversive Pushing (SCP). Methods: Fourteen patients in the acute phase after stroke onset were diagnosed with pusher syndrome. Two physical therapists randomly assessed the same patients on different occasions on the same day. Almost all patients were assessed on more than one day. The inter-rater and intra-rater reliability of the SCP was estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of the SCP ranged from 0.87 to 0.97; the inter-rater reliability of the SCP ranged from 0.71 to 0.99 in sitting and standing positions. These results show good reliability for the calculated variables. Conclusion: The results provide support for the use of the SCP in assessing pusher syndrome based on its reliability in stroke patients. It may use the standardized clinical assessments in clinical implication.

• 한국산학기술학회논문지
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• 제13권2호
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• pp.718-724
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• 2012

본 연구는 뇌졸중 환자에 적용한 시각 통제 균형훈련이 환자의 균형에 어떠한 영향을 미치는지를 알아보고자 하였다. 연구대상으로는 26명의 뇌졸중 환자들로 하여 환측 1/2시각통제군(9), 건측 1/2시각통제군(9), 비시각통제군(8)으로 나누어 연구에 참여하였다. 세 그룹 모두 흔들림 균형 판(posturo-med)위 시각통제 후 거울 1m앞에서 자기를 주시하며 균형 훈련을 8주간 주 4회 20분간 실시하였으며, 각 집단의 중재 전, 4주, 8주 후 균형 능력을 측정하여 균형유지시간, 근 활성도를 측정 하였다. 훈련 전후 뇌졸중 환자에게 적용된 시각통제 균형 훈련은 균형시간의 증가와 안쪽 넓은 근의 근 활성도가 유의하게 향상되는 것을 확인할 수 있었다(p<0.05). 본연구의 결과 뇌졸중 환자에게 적용된 시각통제 균형 훈련은 뇌졸중 환자의 균형 훈련을 위한 효과적인 운동방법이 될 수 있을 것이라 생각한다.

• 융합정보논문지
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• 제11권9호
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• pp.182-190
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• 2021

뇌졸중 환자는 신체활동 저하로 삶의 질이 저하 된다. 뇌졸중 환자에게 신체활동 증진과 삶의 질 회복에 재활견과 걷기가 사용될 수 있다. 본 연구는 재활견과 걷기가 뇌졸중 환자의 삶의 질과 신체활동에 미치는 영향을 조사하였다. 본 연구를 위해 24명의 뇌졸중 환자가 모집되었다. 24명의 뇌졸중 환자를 모집하여 두 그룹으로 1:1 무작위 배정하였다. 결과측정에는 삶의 질 평가, 6분 보행, 악력평가를 수행하였다. 연구군은 주 1회, 8주 동안 재활견과 함께 걷기를 하였다. 연구 결과 연구군은 중재 후 뇌졸중 삶의 질, 6분 보행, 마비측 악력에 유의한 증가가 있었다. 더하여 연구군은 대조군보다 삶의 질, 6분 보행, 마비측 악력에 유의한 개선을 보였다. 재활견과 걷기는 뇌졸중 후 삶의 질과 신체활동을 개선할 수 있는 하나의 좋은 중재 방법이 될 수 있다.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.61-68
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• 2022

Background: This study aimed to investigate the effects of noninvasive electrical stimulation combined with trunk stabilization exercise on balance and fall risk in patients with stroke. Methods: Twenty-two patients with stroke were enrolled in the study and randomly divided into experimental and control groups, each with 11 patients. noninvasive electrical stimulation combined with trunk stabilization training was applied to the experimental group, and sham noninvasive electrical stimulation combined with trunk stabilization training, to the control group. Both groups were treated for 6 weeks, five times a week for 30 min each time; the balance and fall risk of patients with stroke were measured before and after treatment, and the changes in the two groups were compared and analyzed. Results: The experimental group's left and right weight-bearing indices (affect and non-affect sides) and the front and rear weight-bearing indices, were significantly improved (p<.05, p<.001). when the changes in balance ability between groups were compared before and after treatment. The total fall efficacy score in the experimental group was substantially lower than that in the control group when the changes in fall efficacy score were compared between groups following treatment (p<.001). Conclusion: The improvement in balance and fall risk in patients with stroke can be attributed to using noninvasive electrical stimulation in combination with trunk stabilization training. This clinically helpful treatment method for patients with stroke warrants further promotion and implementation in the clinic.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.23-30
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• 2010

Objectives : The second derivative of photoplethysmogram waveform(SDPTG) is a simple, convenient and non-invasive technique for pulse wave analysis. This study was designed to investigate the differences in the SDPTG between the affected side and the unaffected side in hemiparetic patients after stroke, and the effects of acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : To evaluate the differences between the affected side and the unaffected side in hemiparetic patients after stroke, their SDPTG were recorded by using a Cardio Peri SA6000. To evaluate the effects of acupuncture at Palsa(BaXie) in 20 hemiparetic patients after stroke and 20 healthy subjects, their SDPTG were recorded 2 times(pre-acupuncture and post-acupuncture). The SDPTG consists of an a, b, c and d wave in systole and an e wave in diastole. Sano aging index was defined as (b-c-d)/a. Results : 1. The affected side in hemiparetic patients after stroke had higher average b/a ratio(p<0.05)and Sano aging index(p<0.05) than the unaffected side 2. In a comparison of pre-acupuncture and post-acupuncture at the Palsa(BaXie), b/a ratio(p<0.05) and Sano aging index(p<0.05) was decreased significantly in both hemiparetic patients and healthy subjects. Conclusions : These findings suggest that acupuncture at Palsa(BaXie) may be effective method of reverting some of the deleterious effects on vascular function produced by stroke.

• 대한정형도수물리치료학회지
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• 제28권1호
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• pp.71-80
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• 2022

Background: This study investigated the effect of robot-assisted arm training on muscle activity of arm and weight bearing in stroke patients. Methods: The study subjects were selected 20 stroke patients who met the selection criteria. 10 people in the robot-assisted arm training group and 10 people in the task-oriented arm training group were randomly assigned. The experimental group performed robot-assisted arm training, and the control group performed task-oriented arm training for 6 weeks, 5 days a week, 30 minutes a day. The measurement tools included surface electromyography and smart insole system. Data were analyzed using independent sample t-test and the paired sample t-test. Results: Comparing the muscle activity of arm within the group, the experimental group and the control group showed significant differences in muscle activity in the biceps brachii, triceps brachii, anterior deltoid, upper trapezius, middle trapezius, and lower trapezius. Comparing the muscle activity of arms between the groups, the experimental group showed significant difference in all muscle activity of arm compared to the control group. Comparing the weight bearing within the groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings and there were significant differences in anterior and posterior weight bearing. The control group showed significant difference only in the non-affected side weight bearing. Comparing the weight bearings between groups, the experimental group showed significant difference in the affected side and non-affected side weight bearings compared to the control group. Conclusion: This study confirmed that robot-assisted arm training applied to stroke patients for 6 weeks significantly improved muscle activity of arm and weight bearing. Based on these results, it is considered that robot-assisted arm training can be a useful treatment in clinical practice to improve the kinematic variables in chronic stroke patients.

• Korean Journal of Acupuncture
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• 제35권4호
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• pp.187-202
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• 2018

Objectives : Non-invasive transcranial electrical stimulation is one of therapeutic interventions to change in neural excitability of the cortex. Transcranial electro-acupuncture (TEA) can modulate brain functions through changes in cortical excitability as a model of non-invasive transcranial electrical stimulation. Some composites of fermented Scutellaria baicalenis (FSB) can activate intercellular signaling pathways for activation of brain-derived neurotrophic factor that is critical for formation of neural plasticity in stroke patients. This study was aimed at evaluation of combinatory treatment of TEA and FSB on behavior recovery and cortical neural excitability in rodent focal stroke model. Methods : Focal ischemic stroke was induced by photothrombotic injury to the motor cortex of adult rats. Application of TEA with 20 Hz and $200{\mu}A$ in combination with daily oral treatment of FBS was given to stroke animals for 3 weeks. Motor recovery was evaluated by rotating bean test and ladder working test. Electrical activity of cortical pyramidal neurons of stroke model was evaluated by using multi-channel extracellular recording technique and thallium autometallography. Results : Compared with control stroke group who did not receive any treatment, Combination of TEA and FSB treatment resulted in more rapid recovery of forelimb movement following focal stroke. This combination treatment also elicited increase in spontaneous firing rate of putative pyramidal neurons. Furthermore expression of metabolic marker for neural excitability was upregulated in peri-infract area under thallium autometallography. Conclusions : These results suggest that combination treatment of TEA and FSB can be a possible remedy for motor recovery in focal stroke.