• 제목/요약/키워드: Stroke and Non-stroke Patients

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Muscle Coactivation Analysis during Upper-Limb Rehabilitation using Haptic Robotics in Stroke Survivors (뇌졸중 환자의 햅틱 로봇 기반 상지 재활 시 근육 동시활성도 분석)

  • Keonyoung Oh
    • Journal of Biomedical Engineering Research
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    • 제45권2호
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    • pp.66-74
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    • 2024
  • This study analyzed the occurrence of abnormal muscle coactivations based on the assistance of upper limb weight during reaching task in stroke patients. Nine chronic stroke survivors with hemiplegia performed reaching tasks using a programmable haptic robot. Electromyography (EMG) coactivation levels in the upper limb muscles were analyzed using a linear model describing the activation levels of two muscles when the patient's upper limb weight was assisted at 0%, 25%, and 50%. As the upper limb weight assistance of the haptic robot decreased, the magnitude of the EMG signal in both the deltoid and biceps muscles increased simultaneously on both the paretic and non-paretic sides. However, no difference was found between the paretic and non-paretic sides when comparing the slope of the linear model describing the activation relationship between the deltoid and biceps. The aforementioned results suggest that in some stroke survivors, the deltoids, triceps, and biceps on the paretic side may not be abnormally coupled when supporting the upper limbs against gravity. Furthermore, these results suggest that the combination of haptic robots and EMG analysis might be utilized for evaluating abnormal coactivations in stroke patients.

The Relationship among Blood-stasis, CAVI and Cardiovascular Risk in Stroke Patients (뇌졸중환자의 어혈병태모형과 CAVI, 심혈관질환 위험도간의 상호관계에 관한 임상적 연구)

  • Kim, Seok-Min;Sun, Jong-Joo;Choi, Chang-Min;Jung, Jae-Han;Hwang, Jae-Woong;Min, In-Kyu;Kim, Chang-Hyun;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Young-Suk
    • The Journal of Internal Korean Medicine
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    • 제28권3호
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    • pp.421-433
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    • 2007
  • Objectives : This study was performed to evaluate the relationships among blood-stasis. cardio-ankle vascular index(CAVI) and cardiovascular risk. Methods : We obtained general characteristics. blood-stasis score and CAVI from 150 stroke patients. Blood-stasis score was evaluated by blood-stasis criteria. Cardiovascular risk (the following. Stuart's risk score) was evaluated by Stuart's risk scoring scale. We divided subjects into a blood-stasis group and a non blood-stasis group by blood-stasis scores. high CAVI and normal CAVI groupsby CAVI. We compared the general characteristics. CAVI (excluded from comparison between high CAVI group and normal CAVI group), Stuart's risk score and blood-stasis score (excluded from comparison between blood-stasis group and non blood-stasis group) between each pair of groups. Pearson correlation analysis was applied to examine the relationship between blood stasis score and CAVI, blood stasis score and Stuart's risk score. CAVI and Stuart's risk score. Results : The blood-stasis group had significantly higher CAVI and Stuart's risk scores than the non blood stasis group. The high CAVI group had significantly higher blood-stasis score and Stuart's risk score than the normalCAVI group. In correlation analysis. there were significant positive relationship between blood stasis score and Stuart's risk score, CAVI and Stuart's risk score. and blood stasis score and CAVI. Conclusions : This study suggeststhat there is a significant relationship among blood stasis,CAVI and cardiovascular risk.

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Weekly Variation in Ischemic Stroke Incidence According to the Age and Sex (성별과 연령에 따른 허혈성 뇌졸중 발생의 요일 변화)

  • Kim, So-Yeon;Lee, Sang-Kwan
    • The Journal of Internal Korean Medicine
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    • 제31권2호
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    • pp.308-313
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    • 2010
  • Objectives : The weekly variation of ischemic stroke incidence according to the age and sex. Methods : 977 consecutively admitted patients (521 males and 456 females) in a single stroke center from 2006 to 2008. All cases were confirmed with standardized criteria. We used the independent t-test and $x^2$ test in statistical methods. Results : The results demonstrated significant weekly variations of ischemic stroke incidence showing higher incidence on Saturday, Monday and Tuesday and lower incidence on the other days. Difference of ischemic stroke incidence was also shown between transit days, which included the transit days from the weekend to the week and vice versa, and non-transit days. Those aged older than 60 years and females showed more significant differences of weekly variation on transit days than on non-transit days. Conclusions : Ischemic stroke incidence has significant weekly variation, and transit days have higher incidence than non-transit days. Further study is required to identify the general weekly variation by multi-center trial.

Effect of gait training with additional weight on balance and gait in stroke patients

  • Shin, Seung Ho;Lee, Mi Young
    • Physical Therapy Rehabilitation Science
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    • 제3권1호
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    • pp.55-62
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    • 2014
  • Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.

The Analysis on Diaphragm Thickness and Lung Function of Stroke Patients by Walking Ability (뇌졸중 환자의 보행능력에 따른 횡격막 두께와 폐기능 분석)

  • Jung, Ju-Hyeon;Kim, Nan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • 제6권4호
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    • pp.437-445
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    • 2011
  • Purpose : The purpose of this study was to analysis on diaphragm thickness and lung function of stroke patients by walking ability. Methods : We recruited thirty-five adults after stroke(20 male, 15 female) for our study. The subjects were divided into two groups; independent walking group(11 male, 9 female) and non-independent walking group(9 male, 6 female). Assessment of diaphragm thickness was performed using ultrasound in B-mode with a 7.5 MHz linea probe. During the experiment, the subject was seated in the chair. All subjects performed maximal expiratory flow maneuvers using a spirometer in order to determine the forced expiratory volume in 1 second ($FEV_1$), forced vital capacity(FVC), peak expiratory flow(PEF) and $FEV_1$/FVC. Chest expansion was measured with a tape-measure placed circumferentially around the chest wall at the xiphoid process. The collected data analyzed by independent t-test. Results : The diaphragm thickness were significant differences between the independent walking and nonindependent walking group. Values of forced vital capacity, forced expiratory volume at one second, peak expiratory flow in pulmonary function tests were significant differences between the independent walking and non-independent walking group. However, chest expansion were not significant differences in both of the group. Conclusion : This study showed that walking ability of stroke patients have influenced on diaphragm thickness and pulmonary function.

The effects of EMG-triggered functional electrical stimulation on upper extremity function in stroke patients

  • Kim, Young
    • Physical Therapy Rehabilitation Science
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    • 제2권1호
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    • pp.1-6
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    • 2013
  • Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.

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The Comparison of Kinematic Data of the Body Orientation in Sitting Position to Adapt Dynamically Changing Angle of the Base of Support in Stroke Patients and Healthy Adults (뇌졸중 환자와 정상 성인의 앉은 자세에서 지지면의 동적 각도 변화에 적응하는 신체 정위의 운동형상학적 비교)

  • Song, In-Su;Choi, Jong-Duk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제13권8호
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    • pp.3513-3520
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    • 2012
  • This study aimed to investigate the difference of the body orientation ability in sitting position to adapt to dynamically changing angle of the base of support in stroke patients and Healthy adults. The angle between vertical and head and trunk in 12 stroke patients (6 male and 6 female) and 12 healthy adults (6 male and 6 female) were measured by video motion analysis system. The head and trunk angle between stroke patients and healthy adults in sitting position were significantly different when increase the angle of dominant side(p<.05). The head and trunk angle between stroke patients and healthy adults in sitting position were significantly different when increase the angle of non-dominant side(p<.05). The head and trunk angle between stroke patients and healthy adults in sitting position were significantly different when decrease the angle of non-dominant side(p<.05). The head angle between stroke patients and healthy adults in sitting position was significantly different(p<.05), but the trunk angle was not significantly different when decrease the angle of dominant side(p>.05), Stroke patients compared to healthy adults had more deficits in their body orientation ability in sitting position to adapt to dynamically changing angle of the base of support. This finding may help to understand postural control deficits more clearly in stroke patients in sitting position.

Thromboxane A2 Synthetase Inhibitor Plus Low Dose Aspirin : Can It Be a Salvage Treatment in Acute Stroke Beyond Thrombolytic Time Window

  • An, Gyu-Hwan;Sim, Sook-Young;Jwa, Cheol-Su;Kim, Gang-Hyeon;Lee, Jong-Yun;Kang, Jae-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제50권1호
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    • pp.1-5
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    • 2011
  • Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

Effect of Trans cranial Directed Current Stimulus on Temporal and Spatial Walking Capacity for Hemiparalysis Patients (경 두개 직류자극이 뇌졸중 환자의 시간적, 공간적 보행능력에 미치는 영향)

  • Lee, Yeon Seop;Jun, Hun Ju
    • Journal of Korean Physical Therapy Science
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    • 제29권3호
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    • pp.75-84
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    • 2022
  • Background: This study was to investigate the effect of non-invasive transcranial direct current stimulation due to hemiplegic patients due to stroke on temporal and spatial gait ability. Design: Randomized sham controlled trial. Methods: For the study method, 42 patients with hemiplegia due to stroke were randomly assigned to 14 patients each, and the general walking group, tDCS walking group, and tDCS (sham) walking group were subjected to 5 times a week, 30 minutes a day, and 6 weeks. In the temporal gait variables of hemiplegic patients due to stroke, the effect of the gait time, gait cycle, single support, double support, swing phase, stance phase, gait speed, cadence were measured. In spatial variables, one step length and one step length were measured. Results: As a result of the study, the EG group significantly increased in the step time, gait velocity, and cadence of the paralysis side in the comparison of temporal walking variables between groups according to the application of tDCS of walking ability in hemiplegic patients due to stroke patients(p<.05). In the change in spatial walking variables between groups according to the application of tDCS, the step length and stride length of the EG group showed a significant increase. Both the comparison of temporal and spatial symmetry walking variables between groups according to tDCS application was not significant(p>.05) Conclusion: As a result, tDCS has an effective effect on the improvement of the gait ability of stroke patients. In particular, it is an effective method of physical therapy that can improve the cadence and speed of gait, which can be combined with the existing gait training to effectively increase the gait of hemiplegia due to stroke patients.

Carpal Tunnel Syndrome in Stroke Patients According to the Degree of Spasticity in Median Nerve Cross-Sectional Area and Nerve Conduction Velocity and Comparison of Upper Extremity Function (수근관증후군 뇌졸중 환자에서 경직정도에 따른 정중신경 단면적과 신경전도속도 및 상지기능의 비교)

  • Kim, Tae-Gon;Jung, Dae-In;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • 제13권11호
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    • pp.288-296
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    • 2013
  • The purpose of this study were carpal tunnel syndrome in stroke patients according to the degree of spasticity in the median nerve cross-sectional area, nerve conduction velocity, and to evaluate differences in upper extremity function. The subjects of this study was in adult patients with stroke 42 patients from 21 patients CTS group and 21 patients Non-CTS group were selected. Measurement of median nerve-cross sectional area, nerve conduction velocity, GST, FMAS, CTS-FSS was measured. The study results were each group between the unaffected side and the affected side CTS and Non-CTS group in each grade between groups unaffected side(p<.001), and affected side(p<.001) median nerve-cross sectional area, median motor and sensory nerve onset latency, there was a statistically significant difference. CTS and Non-CTS group between groups in each grade GST(p<.05), FMAS(p<.05), CTS-FSS(p<.001), there was a statistically significant difference. In this study, the carpal tunnel pathokinesiology ever presented by the contents of upper extremity functional training in stroke patients is one of the information that you need to consider when presented.