• Title/Summary/Keyword: Stroke and Non-stroke Patients

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Assessment of Body Fluid Alteration Using Bioelectrical Impedance in Stroke Patients with Hemiplegia Caused by Cerebral Hemorrhage and Cerebral Infarction

  • Shin, Yong Il;Kim, Gun Ho;Hwang, Young Jun;Baik, Seung Wan;Kim, Jae Hyung;Jeon, Gye Rok
    • Journal of Sensor Science and Technology
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    • v.26 no.3
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    • pp.160-167
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    • 2017
  • Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body composition in paretic and non-paretic regions. In this study, the body fluid alteration in the paretic and non-paretic regions of stroke patients with hemiplegia caused by cerebral hemorrhage and cerebral infarction was analyzed using bioelectrical impedance analysis (BIA). Alterations in body fluids were investigated to assess the physical status of the paretic and non-paretic regions of 20 stroke patients with hemiplegia caused by cerebral hemorrhage (7 patients) and cerebral infarction (13 patients). Extracellular water (ECW), intracellular water (ICW), ICW/ECW, total body water (TBW), ECW/TBW, and TBW/fat-free mass were utilized to evaluate the functional status of the paretic and non-paretic regions. Compared with the non-paretic region, the paretic region had high ECW and low ICW. Due to the loss of motor function and nutritional imbalance caused by the stroke, the amount of fat increased while the muscle quantity and quality significantly decreased in the paretic region. Thus, BIA can be a useful tool for quantitatively assessing paretic and non-paretic regions in stroke patients with hemiplegia.

Effects of Taping on Balance and Gait in Patients With Stroke: A Meta-analysis

  • Eun-Ji Kim;Joo-Hee Park;Yixin Wang;Hye-Seon Jeon
    • Physical Therapy Korea
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    • v.30 no.2
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    • pp.92-101
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    • 2023
  • Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.

Clinical characteristics of heat stroke in bath facilities, and analysis of predictive factors of multiple major complications (목욕시설에서 발생한 열사병의 임상양상 및 열사병의 다발성 주요 합병증에 관한 예측인자 분석)

  • Park, Seok-Jin;Hyun, Sung-Youl;Lim, Yong-Su;Cho, Jin-Seong;Min, Kyoung-Jeen;Yang, Hyuk-Jun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.500-508
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    • 2018
  • Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

Effect of Paretic and Non-paretic Side Spine Taping on Balance Ability in Patients with Stroke

  • Cho, Yonghun;Park, Shinjun;Kim, Soonhee
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1779-1784
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    • 2019
  • Background: A number of researchers have attempted to improve the balance of stroke patients, however there is still a question as to whether taping is effective in increasing balance. Objective: To determine the effect of paretic and non-paretic side taping on the balance ability in patients with stroke. Design: A single-blind randomized controlled trial Methods: This randomized single-blind controlled clinical trial with a repeated measures study included 45 subjects who were randomly assigned to paretic side taping groups (n=15), non-paretic side taping groups (n=15), and trunk exercise groups (n=15). Trunk exercise and paretic side taping groups had taping on the paralyzed erector spinae, while the non-paretic side taping group had taping on the non-paralyzed erector spinae. Trunk exercises were performed for 30 minutes to promote core muscles. The balance ability measured the center of pressure movement (paretic side, non-paretic side,forward, backward, limit of stability) in the sitting position. All measurements were evaluated using BioRescue. Results: All three groups showed significant increase in all variables after 4 weeks. The paretic and non-paretic side taping groups had a significant increase in all variables after 30 min of attachment. However, there was no significant difference among the three groups. Conclusions: Paralysis and non-paralysis taping improved the balance ability of patients with stroke in an immediate effect of 30 min. However, after 4 weeks of intervention, taping with trunk exercise did not differ from single trunk exercise. In future studies, various analyses need to be conducted through more diverse evaluations.

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

  • Chankyu Kim;Hyun-Joong Kim
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.471-477
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    • 2022
  • Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

An Exploratory Study Comparing Blood Metal Concentrations between Stroke and Nonstroke Patients in Koreans

  • Park Yeong-Chul;Park Hae-Mo;Ko Seong-Gyu;Lee Sun-Dong;Park Hong-Duok
    • Journal of Environmental Health Sciences
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    • v.32 no.3
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    • pp.199-206
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    • 2006
  • Various heavy metals have been known for causing ischemic stroke. In order to describe the causative relationship between the blood levels of various heavy metals and stroke patients, 116 patients with stroke and 111 patients without stroke were selected from one Oriental medical hospital in Wonju, Korea. Total of 9 kinds of metals such as As, Cd, Co, Cu, Hg, Mn, Ni, Pb, and Zn were analyzed in blood from patients with and without stroke. There were no significant differences in the means of metal concentrations between the stroke and nonstroke patients except for the mean of Co concentration. In the case of Co, the means for stroke and non-stroke patients were 0.44 ug/l and 0.40 ug/l showing a significant difference at the level of p-value=0.05. The odds ratios for each metal ranged from 0.96 to 2.86. Most odds ratios were not significant but the odds ratio for Co, $2.86{\pm}1.49$ was significant, indicating that Co increases the risk of stroke by 2.86 times. In order to identify the specific risk level of stroke increased by a multiple interaction of metals, regression coefficients and odds ratio for a pair or multiple pair of metals were reanalyzed. However, all of regression coefficients and odds ratios were not significant. In conclusion, Co showed the significant level in blood from patients with stroke. In addition, the odds ratio of stroke was significantly different from other metals. Thus, it is considered that Co among various metals analyzed in this study is the important metal for increasing the risk of stroke.

Pulmonary Function Index Comparisons Depending on Various Postures of Stroke Patients

  • Lee, Kyung-Soo;Lee, Myung-Mo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.43-51
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    • 2019
  • PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25-75% (FEF 25-75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.

Comparison of Tension According to the Type of Sling Cord during the Bridging Exercise with Sling in Stroke Patients (뇌졸중 환자의 교각 운동 시 슬링 줄의 종류에 따른 장력 비교)

  • Jang, Gwonuk;Chang, Jongsung
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.2
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    • pp.189-194
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    • 2019
  • Objectives The purpose of this study was to examine comparison of tension according to the type of sling cord during the bridging exercise with sling in stroke patients. Methods Twenty six stroke patients were recruited for this study. Subjects were randomly performed sling bridging exercise with three types of sling cords such as nonelastic cord with affected side-nonelastic cord with non affected side (NC-NC), nonelastic cord with affected side-elastic cord with non affected side (NC-EC), and elastic cord with affected side-nonelastic cord with non affected side (EC-NC). They were measured tension with a tensiometer of sling cord during the bridging exercise with sling. Results The tension of sling cord was significantly different in affected side, non affected side, and tension ratio of affected side/non affected side. There were significant differences tension in NC-EC from NC-NC and EC-NC and the NC-EC method was increased tension of affected side and decreased tension of non affected side. Conclusions These results showed that the NC-EC method was improved the symmetry of affected side and non affected side. Sling exercise with appropriate type of sling cord should be increased activities of affected side and improved recovery in stroke patients.

Comparison of Motor Function and Skill between Stroke Patients with Cerebellar and Non-cerebellar Lesion in Sub-acute Stage

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.423-427
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    • 2012
  • Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.

A Questionaire Analysis for the Vertigo as the prodrome of Stroke (뇌졸중(腦卒中) 전조증상(前兆症狀)으로서의 현훈(眩暈)에 대한 설문조사분석(設問調査分析))

  • Ko, Sung-Gyu;Yong, Hyung-Soon
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.135-145
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    • 2000
  • Objective : This study has been made to analysis of clinical type of vertigo prodromic Cerebral Vascular Disease in stroke patients who admitted to sangji oriental hospital department of circulatoty internal medicine in the period from July. 1999 to October 1999. Methods : A Questionaire was done after explanationin details to patients and agreement of patients. The inquire was done as follows. Sex and age, risk factor of stroke, type of stroke, existence of vertigo last three years before stroke attack, the beginning age of vertigo and period of prevalence, frequency, continuance time of vertigo, predilection season and time, factor of causing vertigo, accompanying symptoms of vertigo, severity of vertigo. Result and Conclusion : The existence of Rotation sense(Rotation group and non-Rotation group) and the type of Stroke is no difference significantly but the Rotation vertigo group and non-Rotation vertigo group is difference significantly in distribution. The sixties in age of vertigo attack, previous vertigo before 3 year Stroke attack, irregular in predilection season of vertigo, have a high frequency significantly in distribution and previous period of vertigo has no significantly difference in distribution. One or two per a month in frequency of vertigo, below 5 minute in continuance time of vertigo, irregular in predilection time of vertigo, stand up and sit down in causing vertigo position have a high frequency significantly in distribution.

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