• Title/Summary/Keyword: Stroke dependent

검색결과 143건 처리시간 0.032초

뇌출혈으로 인한 편마비 환자의 재활치료 후 보행능력에 영향을 주는 요인 (Factors influencing the ambulatory status in Hemiplegia with Intracerebral Hemorrhage after rehabilitation)

  • 김찬규;김권영
    • 대한물리치료과학회지
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    • 제6권2호
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    • pp.1007-1017
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    • 1999
  • The purpose of this study was to evaluate the factors influencing the ambulatory status in hemiplegia with intracerebral hemorrhage after rehabilitation. Thirty patients with stroke who was admitted in the Chosun University Hospital, between from January 1st' 1998 and December 31st' 1998, were included in this study. The following variables as a potential predictors for ambulation were evaluated at treatment of the stroke onset; 1) general characteristics including age and sex, and 2) clinical characteristics including frequency and onset time of the stroke, affected side, duration of the treatment, time interval between onset and rehabilitation, manual muscle test of paretic limb, sitting and standing balance, proprioception, perception, cognitive function. We compared and analyzed the these variables to the two type of ambulatory status at the time of the discharge by Modified Barthel Index, independent, dependent. The data were analyzed by student t-test, Fisher-exact test, Mann Whitney-U test, $X^{2}$-test, correlation analysis(spearman's). The results were as follows; 1. Were no significantly inflenced independent ambulatory status among general characteristics. 2. Frequency of the stroke and proprioception (p<0.05), muscle strength of the lower limb, cognitive function and standing balance (p<0.01), perception and sitting balance (p<0.001) were significantly inflenced independent ambulatory status among clinical characteristics. 3. Independent Variable correlated with the ambulatory status were muscle strength of the lower limb, proprioception and sitting balance (p<0.05), standing balance, frequency of the stroke, perception and cognitive function (p<0.01). Therefore the muscle strength of the lower limb, proprioception, sitting balance, standing balance, frequency of the stroke, perception, cognitive function were the most significant influencing factors of ambulatory status after rehabilitation.

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Effects of Group Rehabilitation Gymnastics for Stroke Patients

  • Kim, Sun-Houng;Moon, Nam-Eun;Jeon, Mi-Yang;Jeong, Hyeon-Cheol
    • Physical Therapy Rehabilitation Science
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    • 제11권2호
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    • pp.207-214
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    • 2022
  • Objective: This study is an experimental study to investigate the effect of group rehabilitation gymnastics on stroke patients. Design: A randomized controlled trial. Methods: From August 1, 2017, to February 30, 2018, 49 subjects hospitalized after being diagnosed with a stroke at K Rehabilitation Hospital had at least 8 weeks (more than 3 times a week) in the group rehabilitation exercise experimental group (25 patients), and the control group (24 patients) did not attend. Data analysis was performed using paired t-test for dependent variables before and after the experiment using SPSS 25. Results: In the experimental group, daily activities were statistically significantly increased from 59.04±25.19 points before treatment to 66.96±24.35 points after treatment (t=2.24, p=0.035). Lung capacity also significantly increased from 280.00±86.99 points to 334.40±93.23 points (t=4.21, p<0.001), and hospital reuse intention also significantly increased from 8.04±1.57 points to 8.88±1.16 points (t=2.67, p=0.013). In the case of the control group, although the MBI, lung capacity, stress, hospital reuse intention, and hospital use satisfaction increased after the experiment compared to before the experiment, there was no significant difference. Conclusions: In conclusion, group rehabilitation gymnastics for stroke patients is effective for daily living movements, lung capacity, and hospital re-use intention. Therefore, if it is continuously applied to stroke patients, it can be used as an intervention to improve the quality of nursing by enhancing physical function.

두침과 상하지 침자극이 뇌와 뇌의 체성감각피질에 미치는 영향에 대한 fMRI Study (Effects of Head Acupuncture Versus Upper and Lower Limbs Acupuncture on Signal Activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex)

  • 박정미;곽자영;조승연;박성욱;정우상;문상관;고창남;조기호;김영석;배형섭;장건호;방재승
    • Journal of Acupuncture Research
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    • 제25권5호
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    • pp.151-165
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    • 2008
  • Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$). After stimulation of Head Acupuncture in Sishencong($HN_1$), $GB_{18}$, $GB_9$, $TH_{20}$ of Left versus Upper and Lower Limbs Acupuncture($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$ of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When $ST_{36}$ was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter-Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points($LI_1$, $LI_{10}4, $LV_3$, $ST_{36}$), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When $ST_{36}$ was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points' sensitivity and different sensory receptor to response acupuncture stimulation.

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속도-의존적 체중지지 트레드밀 보행이 뇌졸중 환자의 보행에 미치는 영향 (The Effect of Speed-dependent with Body Weight Supported Treadmill Training on the Ambulation of Stroke)

  • 김좌준;노민희;구봉오;안소윤
    • The Journal of Korean Physical Therapy
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    • 제17권3호
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    • pp.339-350
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    • 2005
  • This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.

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뇌졸중 환자의 일상 활동 수행에 영향을 미치는 인지요인 분석 -전산화 신경인지기능검사 중심으로- (Analysis of cognitive factors affecting stroke patient's activity of daily living performance -Using the computerized neurocognitive function test-)

  • 김지연
    • 한국산학기술학회논문지
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    • 제12권12호
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    • pp.5715-5721
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    • 2011
  • 본 연구에서는 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인을 분석하여, 일상생활동작 향상에 기여하는 인지요소를 파악하고 이를 치료에 적용하고자 함에 있다. 본 연구는 뇌졸중으로 진단을 받고 A병원 재활의학과에 입원하여 포괄적인 재활치료를 받고 있는 환자 21명을 대상으로 전산화 신경인지기능검사(SCNT), MBI를 평가하였다. 뇌졸중 환자의 일상생활동작에 영향을 주는 인지요인에 대한 효과성을 평가하기 위해 일상생활동작 값을 종속변수로 하고 10개의 인지요인을 모형에 포함하여 다중회귀분석을 실시하였다. 연구 결과 뇌졸중 환자의 일상생활동작 수행도에 영향을 미치는 인지요인으로는 주의력 배분과 운동조절, 선택적 주의력이 가장 영향을 주는 것으로 나타났다. 또한 뇌졸중 환자의 일상생활동작 수행도에 대하여 인지요인은 69.8%의 설명력을 나타내었다. 따라서 뇌졸중 환자의 재활치료 시 주의력 배분과 운동조절, 선택적 집중력을 우선적으로 고려하여 중점적인 훈련을 한다면 일상생활동작의 수행도 향상에 효율적일 것이다.

Discriminative validity of the timed up and go test for community ambulation in persons with chronic stroke

  • An, Seung Heon;Park, Dae-Sung;Lim, Ji Young
    • Physical Therapy Rehabilitation Science
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    • 제6권4호
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    • pp.176-181
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    • 2017
  • Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.

뇌졸중 환자의 경직측정을 위한 휴대형 장치의 유용성 (Clinical Effectiveness of New Portable System for Measuring Spasticity of the Stroke Patients)

  • 김거식;서정환;송철규
    • 전기학회논문지
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    • 제59권1호
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    • pp.217-219
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    • 2010
  • Spasticity is a motor disorder characterized by a velocity dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex. The aim of this study is to develop a portable system for quantifying the grade of spasticity which could calculate the biomechanical as well as neurophysiologic parameters, and for determining the relationship between the Tonic Stretch Reflex Threshold (TSRT) and Modified Ashworth Scale (MAS). Eleven patients with stroke participated in the study (6 males and 5 females, the average age of $64.5\pm16.0$ years). As a results, the mean and standard deviation values of the TSRT were $129.8\pm4.2$, $123.4\pm5.2$ and $119.1\pm2.6$ in the MAS 1, MAS 1+ and MAS 2 groups, respectively. Also, there was a negative correlation between the TSRT and MAS (rho=-0.72, p<0.05). This demonstrated that the TSRT could be made clinically available for the more objective and reliable evaluation of the spasticity, instead of using the conventional clinical scales and an isokinetic dynamometer.

재가 뇌졸중환자의 일상생활활동, 자기효능감, 삶의 질, 자조관리프로그램요구도와의 관계에 관한 연구 (A Correlational Study on Activities of Daily Living, Self-efficacy, Stroke Specific Qualify of Life and Need for Self-help Management Programs for Patients with Hemiplegia at Home)

  • 김금순
    • 기본간호학회지
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    • 제8권1호
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    • pp.81-94
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    • 2001
  • The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.

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지역사회거주 성인의 뇌졸중 영향 요인 : 건강관련 삶의 질을 중심으로 (Factors Influencing Stroke in Community-dwelling Adults : Focusing on Health-related Quality of Life)

  • 문종훈
    • 대한지역사회작업치료학회지
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    • 제9권1호
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    • pp.35-45
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    • 2019
  • 목적 : 본 연구는 지역사회거주 성인에서 뇌졸중에 영향을 미치는 요인을 규명하고자 하였다. 연구방법 : 본 연구는 2016년 지역사회건강조사의 원시자료를 이용하였다. 이 조사에 참여한 대상자 228,452명 중 결측 값을 제거한 225,003명(98.5%)이 본 연구의 분석에 포함되었다. 사회인구학적 특성은 성별, 나이, 지역, 소득, 혼인상태로 설정하였고, 동반질환은 골다공증, 고혈압, 당뇨병, 이상고지혈증, 심근경색, 관절염이 선택되었다. 건강관련 삶의 질은 EuroQol-5 Dimension로 평가되었고 하위영역인 운동능력, 자기관리, 일상활동, 통증/불편, 불안/우울의 수준을 확인하였다. 종속변수는 뇌졸중 여부, 독립변수는 위에 서술한 16개 변수였다. 통계분석은 이분형 로지스틱 회귀분석을 이용하였다. 결과 : 인구사회학적 특성 변수에서는 남성일수록, 나이가 증가할수록, 소득수준이 낮을수록 뇌졸중을 높게 예측하였다. 동반질환 여부에서, 고혈압, 당뇨, 이상고지혈증, 심근경색이 있을수록 뇌졸중을 높게 예측하였다. 건강관련 삶의 질 하위영역에서 뇌졸중을 예측하는 영역은 자기관리, 일상활동, 운동능력, 불안/우울 순서로 나타났다. 결론 : 본 연구의 결과는 지역사회에 거주하는 뇌졸중 성인의 자조관리와 일상생활 능력 증진을 위한 맞춤형 건강증진 프로그램 개발이 필요함을 제안한다.

The conceptual design of the x y $\theta$ fine stage and its optimal design to obtain fast response in lithography system.

  • Kim, Dong-Min;Kim, Ki-Hyun;Lee, Sung-Q.;Gweon, Dae-Gab
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 2001년도 ICCAS
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    • pp.37.3-37
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    • 2001
  • The quality of a precision product, in genera, relies on the accuracy and precision of its manufacturing and inspection process. In many cases, the level of precision in the manufacturing and inspection system is also dependent on the positioning capability of tool with respect to the workpiece in the process. Recently the positioning accuracy level employed for some of precision product has reached the level of submicron and long range of motion is required. For example, for 1GDRM lithography, 20nm accuracy and 300nm stroke needs. This paper refers to the lithography stage especially fine stage. In this study, for long stroke and high accuracy, the dual servo system is proposed. For the coarse actuator, LDM(Linear DC Noter) is used and for fine or VCM is used ...

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