• Journal of International Academy of Physical Therapy Research
• /
• v.10 no.1
• /
• pp.1734-1738
• /
• 2019

Background: Stroke patients usually have arm weakness, which affects trunks and arms. Objective: To investigate the effects of paretic side and non-paretic side arm training on trunk control and upper limb functions. Design: Randomized Controlled Trial (single blind). Methods: Twenty patients with stroke in hospital were enrolled in the study. Twenty subjects were randomly assigned to paretic side arm training group (PATG, n = 10) or non-paretic side arm training group (NATG, n = 10). Trunk impairment scale (TIS) was used for trunk control, and box and block test (BBT) was used for upper limb function. Training was conducted for 4 weeks. Results: PATG showed significant difference in TIS (static balance, dynamic balance, coordination, total score) and BBT. NATG showed significant differences in static balance, and dynamic balance and total score except for coordination and BBT. PATG also showed a more significant difference in BBT and coordination and total score than NATG. Conclusions: The arm training performed on the paretic side are more effective than those performed on the non-paretic side in improving both upper limb function and trunk control in stroke patients.

• Physical Therapy Korea
• /
• v.20 no.4
• /
• pp.47-54
• /
• 2013

The purpose of this study was to investigate the effects of active and passive postural perturbation on ankle dorsiflexor responses in stroke patients. The subjects consisted of 13 stroke patients. Using wireless electromyography, the patients' ankle dorsiflexor muscle responses were measured under the following conditions: active dorsiflexion (AD), active perturbation (AP), and passive perturbation (PP). Tibialis anterior muscle activity increased most significantly during PP of the affected side ($118.64{\pm}56.28$). The most significant increase for the non-affected side was in AD ($72.64{\pm}24.56$). Tibialis anterior muscle activity was compared under each condition. The affected side showed significant differences between PP and AD and between PP and AP (p<.05). The non-affected side showed not significant differences between each condition. The ratios of tibialis anterior muscle activity under AP to that under AD were 1.00 on the affected side and .75 on the non-affected side and the difference was not significant (p>.05). The ratios of tibialis anterior muscle activity under PP to that under AD were 3.30 on the affected side and 1.14 on the non-affected side and the difference was significant (p<.05). Passive perturbation improved tibialis anterior muscle activity on the affected side, and training based on this approach may have the potential to improve the ankle dorsiflexion of people with stroke.

• The Journal of Korean Medicine
• /
• v.40 no.3
• /
• pp.1-20
• /
• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• Korean Journal of Radiology
• /
• v.21 no.5
• /
• pp.582-587
• /
• 2020

Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.21 no.6
• /
• pp.1655-1659
• /
• 2007

The purpose of this study was to investigate that which symptoms are adequate indicator of the deficiency of Eum pattern in the stroke patients. In the time period Dec. 2006 to Aug. 2007, 479 patients with a first-ever stroke admitted in the department of Internal Medicine of 12 Oriental Medical Hospitals were included. Patients were hospitalized within 1 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Eum-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Deficiency of Eum group included 65 case, Non Eum group 414 case out of 479 patients. dryness of mouth, short and rapid purse, white face and reddish zygoma, mirror-like tongue were higher among Eum group. Eum and Non Eum patients do not significantly differ in reddened tongue, dryness in tongue, night sweat, palpitation, afternoon tidal heat, palmar heat, sores of the mouth or tongue. This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.

• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.3
• /
• pp.73-80
• /
• 2016

PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

• The Journal of Korean Medicine
• /
• v.22 no.2
• /
• pp.94-101
• /
• 2001

Background and Purpose : Relationship between 17-KS.17-OHCS in 24hrs urine and Deficiency Syndrome of the Kidneys had been examined, but the study about 17-KS.17-OHCS in stroke patients was rare6'. In this study, we aimed to investigate the usefulness of 24hrs urine 17-KS.17-OHCS in stroke patients as an index for the Differentiation of Deficiency Syndrome of the Kidneys. Subjects : 66 stroke patients(male : female =2 9 : 37) were selected, they were admitted in the hospital of oriental medicine, Kyunghee university(from November 1 st, 1998 to May 30th, 2000). Their age was over 65 years. The patients who had renal malfunction, hyperthyroidism, hypothyroidism were excluded and who took chlorpromazine, spironolactone, digoxin, reserpine, hormonal agent were also excluded. Methods : After we selected the patients, we investigated the Differentiation of Syndrome by use of Diagnostic Paper and examined the level of 17-KS.17-OHCS in 24hrs urine. We compared Deficiency Syndrome with non-Deficiency Syndrome of the Kidneys using of 17-KS.17-OHCS in 24hrs urine. Results : 1. Stroke did not affect 17-KS.17-OHCS excretion in 24hrs urine. 2. In 24hrs urine, 17-KS of male stroke patients and 17-OHCS of female stroke patients were lower in patients diagnosed as a Deficiency Syndrome than non-Deficiency Syndrome of the Kidneys(p<0.05). 3. Among Deficiency Syndrome of Yin, Yang, Yang and Yin of the Kidneys group, there was no differentiation of 17-KS.17-OHCS in 24hrs urine(p>0.05).

• The Journal of Korean Physical Therapy
• /
• v.24 no.2
• /
• pp.151-156
• /
• 2012

Purpose: The purpose of this study was to investigate the adverse effects of sensorimotor function at the shoulder joint according to long-term cane usage in stroke patients without apraxic behavior, in terms of the presence of shoulder joint pain, accuracy of tracking task, proprioceptive joint position sense, and nine-hole pegboard. Methods: Nineteen stroke patients with long-term cane usage (cane usage group) and nineteen stroke patients without cane usage (non-cane usage group) were recruited. All subjects were tested in pain presence, a tracking task for visuomotor function, joint reposition, and nine-hole pegboard in the shoulder joint regarding the non-affected side. Results: In the accuracy index for tracking task and the nine-hole pegboard test, significant differences were observed between the cane usage group and the non-cane usage group. However, although a higher emergence of shoulder pain and a lower accuracy for joint reposition sense were detected in the cane usage group in comparison to the non-cane usage group, there were no significant differences between the two groups. Conclusion: Our findings suggest that long-term cane usage could induce to decrease in delicate movement and coordination in the non-affected upper arm in stroke patients. In addition, they could experience high frequency of shoulder pain and poor joint reposition sense. Therefore, careful evaluation and observation will be required concerning stroke patients with long-term cane usage.

• Research in Community and Public Health Nursing
• /
• v.22 no.2
• /
• pp.192-203
• /
• 2011

Purpose: This study was conducted to develop and assess the feasibility of an upper extremity exercise program based on Patterned Sensory Enhancement (PSE) for home-bound stroke patients by measuring the level of upper extremity function, depression, and interpersonal relationship. Methods: The experiments were performed on stroke patients at three different rehabilitation centers in Incheon City. Twenty patients participated in the experimental group or in the control group. The program was executed three times a week for 6 weeks. Data were collected from August to October, 2006. Manual Function Test was used to quantify and evaluate upper extremity function. The depression level and the effectiveness of interpersonal relationship were quantified and measured using CES-D and Relationship Change Scale, respectively. Results: The effectiveness of upper extremity function of stroke patients who participated in the PSE upper extremity exercise program was higher than that of non-participating patients. The depression level decreased and interpersonal relationship improved in the stroke patients who participated in this program compared to those who did not. Conclusion: These findings prove that the PSE upper extremity exercise program for home-bound stroke patients was an effective strategy for enhancing upper extremity function, decreasing the depression level, and improving interpersonal relationships.

• The Journal of Internal Korean Medicine
• /
• v.26 no.2
• /
• pp.353-359
• /
• 2005

Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.