• Title/Summary/Keyword: Stroke recovery

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Spontaneous Vertigo (자발현훈)

  • Choi, Kwang-Dong;Kim, Ji Soo
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.1-4
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    • 2007
  • Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. This review focuses on two common presentations of spontaneous vertigo: acute prolonged spontaneous vertigo and recurrent spontaneous vertigo. Common causes of acute prolonged spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. The history and detailed neurological/neurotological examinations usually provide the key information for distinguishing between peripheral and central causes of vertigo. Brain MRI is indicated in any patient with acute vertigo accompanied by abnormal neurological signs, profound imbalance, severe headache, and central patterns of nystagmus. Recurrent spontaneous vertigo occurs when there is a sudden, temporary, and largely reversible impairment of resting neural activity of one labyrinth or its central connections, with subsequent recovery to normal or near-normal function. Meniere's disease, migrainous vertigo, and vertebrobasilar insufficiency (VBI) are common causes. The duration of the vertigo attack is a key piece of information in recurrent spontaneous vertigo. Vertigo of vascular origin, such as VBI, typically lasts for several minutes, whereas recurrent vertigo due to peripheral inner-ear abnormalities lasts for hours. Screening neurotological evaluations, and blood tests for autoimmune and otosyphilis are useful in assessment of recurrent spontaneous vertigo that are likely to be peripheral in origin.

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A Study on the Field Application and Prospect of Artificial Intelligence and Bio-Sensing Technology in Physical Therapy: Focusing on Customized Rehabilitation Treatment (물리치료 분야에서 인공지능 및 바이오센싱 기술의 현장적용 및 전망에 관한 연구: 맞춤형 재활치료를 중심으로)

  • Kyung-Tae Yoo
    • Journal of the Korean Society of Physical Medicine
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    • v.18 no.3
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    • pp.73-84
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    • 2023
  • PURPOSE: This study analyzed the impact of AI and biosensors on physical therapy, identifying the stage of customized technology development and future prospects. AI and biosensors improve the efficiency, establish customized treatment plans, and expand patient treatment opportunities. The study employed a literature review by searching databases and collecting research. METHODS: This study searched various databases related to the topic, collected existing research, papers, and reports, evaluated the literature, and summarize the results. RESULTS: Exercise therapy utilizing artificial intelligence can provide personalized and optimal exercise plans while monitoring rehabilitation progress. In addition, biosensors such as EMG sensors and accelerometers can monitor the individual progress in physical therapy, particularly in stroke patients, which can help improve physical therapy strategy and promote patient recovery. CONCLUSION: This study suggested that artificial intelligence can be applied in many areas of physical therapy, such as exercise therapy, customized treatment plans, rehabilitation and management, pain management, neuro rehabilitation, and auxiliary devices. Using AI technology, it is possible to analyze and improve exercise and posture, retrain the central nervous system, establish customized treatment plans for individual patients, predict and compare patient progress before and after treatment, and provide customized pain analysis and treatment methods. In addition, AI can provide neuro rehabilitation programs and customized auxiliary devices.

The Effect of Complex Exercise Program of Diabetic Rats with Ischemic Brain Injury Model (허혈성 뇌손상 모델 당뇨쥐의 복합운동프로그램의 효과)

  • Kim, Dong-Hyun;Bang, Hyun-Soo
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.1
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    • pp.41-48
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    • 2016
  • Objective : We tried to know the improvement and neurological effect of diabetes when the complex exercise training was applied on diabetes that delayed the recovery of the ischemic brain injury. Methods : We performed this study in a animal lab which located in Gyengsangbukdo. We used 10 diabetes rats with ischemic brain injury, which is induced by STZ. We applied the complex exercise training on the rats for 4 weeks. We executed the maze test to confirm the recovery of the brain function and checked the blood sugar to know the improvement. Results : As a result of applying the complex exercise on diabetes rats with ischemic brain injury, there was a significant reduce of error and escape time in 3 weeks and 1 weeks, respectively. There was no difference of the blood sugar in control but there was a significant improvement in experiment group after applying the exercise training in 4 weeks. Conclusion : The senile disease like stroke and diabetes was increased currently. It is important for rehabilitation to improve the quality of life during the remainder of their life. In the study, we've known the improvement of diabetes and the recovery of the brain function when the complex exercise training was applied the rats with both diabetes and the ischemic brain injury.

Short-term Prognosis according to Time of Treatment of Patients with Acute Cerebral Infarction : Measurement by NIHSS (급성기 뇌경색환자의 치료시기에 따른 단기 예후 평가 : NIHSS를 이용한 후향적 연구)

  • Park, Seung Chan;Cho, Seung Mo;Kim, Do Gyoung;Lim, Chi Yeon;Lee, Jae Wook;Hong, Jin Woo;Lee, In;Lee, In Sun;Kim, Young Kyun;Kwon, Jung Nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.6
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    • pp.929-933
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    • 2012
  • This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis (일측 뇌경색 환자에서 반대측 뇌의 보상성 뇌관류 증가에 대한 SPM 분석)

  • Hong, Sun-Pyo;Yoon, Joon-Kee;Choi, Bong-Hoi;Joo, In-Soo;Yoon, Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.347-353
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    • 2008
  • Purpose: Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Materials and Methods: Fifty seven $^{99m}TC-Ethylene$ Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=$56{\pm}17\;years$) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age=$36{\pm}10\;years$) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. Results: All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Conclusion: Using $^{99m}Tc-ECD$ SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

Effect of reperfusion with leukocyte-depleted blood on the expression of myocardial vascular cell adhesion molecule-1 (VCAM-1) and myocardial function in isolated working heart perfusion model (단순 작업성 심관류 모델에서의 신생돈 심장의 보존 후 백혈구-제거 혈액을 이용한 재관류가 심근 VCAM-1 발현 및 심기능에 미치는 영향)

  • 이정렬;석철준;서정욱;한재진
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.213-220
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    • 2000
  • Background: Adhesion of leukocytes to myocardium or vascular endothelium has been known as an importation initial step in the ischemia-reperfusion injury which may affect the cardiac function. Therefore, leukocyte-depleted reperfusion may inhibit ischemia-reperfusion induced functional and ultrastructural deterioration. In this study, we quantified the time-dependent expression of the vascular cell adhesion molecule-1(VCMA-1) on piglet myocardium and demonstrated its relation to functional recovery using isolated piglet heart perfusion model. Material and Method: Neonatal(1 to 3 day old) piglet heart was harvested with 4$^{\circ}C$ University of Wisconsin solution (UWS) and presrved in the same solution for 12 hours. Ex vivo model of an isolated working neonatal piglet heart perfusion consisting of membrane oxygenator and roller-pump was used (Fig. 1). Hearts were grouped into leukocyte-non-depleted (group A, n=8) and leukocyte-depleted group(group B, n=8). In group B, hearts were reperfused with leukocyte-depleted blood using a leukocyte filter (Sepacell R, Asahi Medical, Japan). Segments of right atrium were taken before and after 1, 2, 3, and 4 hours of reperfusion for the evaluation of expression of VCAM-1. The intensity of immunohistochyemical satining of the VCAM-1 on the myocardium were graded semiquantitatively (0 to 4). For the evaluation of myocardial stroke work indices were calculated as well at the same time-points. Result: Mean expressins of VCAM-1 on the myocardium at 0, 1, 2, 3, adn 4 hours of reperfusion were 0.63, 1.44, 1.64, 2.65, and 3.34 in group A, while 0.56, 1.40, 1.50, 1.88 and 2.14 in group B (Fig. 3). Mean stroke work indices at 0.5, 1, 2, 3, and 4 hours after reperfusion were 1.35$\times$104, 1.32$\times$104, 1.14$\times$104, 0.81$\times$104, 0.68$\times$104 erg/gm in group A, while 1.40$\times$104, 1.43$\times$104, 1.43$\times$104, 1.28$\times$104, and 1.12$\times$104 erg/em in group B(Fig. 4). Conclusion : In this study, we demonstrated that leukocyte-depletion attenuated the expression of VCAM-1 during reperfusion and the time-dependent functional deterioration of the myocardium was well correlated with the degree of VCAM-1 expression.

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Silent Microbleeds and Old Hematomas in Spontaneous Cerebral Hemorrhages

  • Lim, Jae-Bum;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.38-44
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    • 2009
  • Objective : The authors studied the risk factors of silent cerebral microbleeds (MBs) and old hematomas (OHs) and their association with concurrent magnetic resonance (MR) imaging findings in the patients of intracerebral hemorrhages (ICHs). Methods : From April 2002 to June 2007, we retrospectively studied 234 patients of primary hemorrhagic stroke. All patients were evaluated with computed tomography (CT) and 3.0-tesla MR imaging studies within the first week of admission. MBs and OHs were assessed by using $T2^{\ast}$-weighted gradient-echo (GRE) MR imaging. The patients were divided into 2 groups, depending on whether or not they had two GRE lesions of chronic hemorrhages. A correlation between MBs and OHs lesions were also statistically tested. Lacunes and white matter and periventricular hyperintensities (WMHs, PVHs) were checked by T1- and T2-weighted spin-echo and fluid attenuated inversion recovery sequences. Variables on the clinical and laboratory data and MR imaging abnormalities were compared between both groups with or without MBs and OHs. Results : MBs were observed in 186 (79.5%) patients and a total of 46 OHs were detected in 45 (19.2%) patients. MBs (39.6%), OHs (80.4%), and ICHs (69.7%) were most commonly located in the ganglionic/thalamic region. Both MBs and OHs groups were more frequently related to chronic hypertension and advanced WMHs and PVHs. The prevalence and number of MBs were more closely associated with OHs groups than non-OH patients. Conclusion : This study clearly demonstrated the presence of MBs and OHs and their correlation with hypertension and cerebral white matter microangiopathy in the ICHs patients. Topographic correlation between the three lesions (MBs, OHs, and ICHs) was also noted in the deep thalamo-basal location.

Implementation of Motion Analysis System based on Inertial Measurement Units for Rehabilitation Purposes (재활훈련을 위한 관성센서 기반 동작 분석 시스템 구현)

  • Kang, S.I.;Cho, J.S.;Lim, D.H.;Lee, J.S.;Kim, I.Y.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.2
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    • pp.47-54
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    • 2013
  • In this paper, we present an inertial sensor-based motion capturing system to measure and analyze whole body movements. This system implements a wireless AHRS(attitude heading reference system) we developed using a combination of rate gyroscope, accelerometer and magnetometer sensor signals. Several AHRS modules mounted on segments of the patient's body provide the quaternions representing the patient segments's orientation in space. We performed 3D motion capture using the quaternion data calculated. And a method is also proposed for calculating three-dimensional inter-segment joint angle which is an important bio-mechanical measure for a variety of applications related to rehabilitation. To evaluate the performance of our AHRS module, the Vicon motion capture system, which offers millimeter resolution of 3D spatial displacements and orientations, is used as a reference. The evaluation resulted in a RMSE of 2.56 degree. The results suggest that our system will provide an in-depth insight into the effectiveness, appropriate level of care, and feedback of the rehabilitation process by performing real-time limbs or gait analysis during the post-stroke recovery process.

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Application of Cardiac Electromechanical FE Model for Predicting Pumping Efficacy of LVAD According to Heart Failure Severity (심부전 정도에 따른 좌심실보조장치의 박동효율예측을 위한 심장의 전기역학적 유한요소 모델의 응용)

  • Jung, Dae Hyun;Lim, Ki Moo
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.8
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    • pp.715-720
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    • 2014
  • In order to maximize the effect of left ventricular assist device (LVAD) on ventricular unloading, the therapy should be begun at appropriate level of heart failure severity. We predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used 3 dimensional finite element model of ventricle coupled with 6 Wind-kessel compartmental model of vascular system. Using the computational model, we predicted cardiac responses such as contractile ATP consumption of ventricle, left ventricular pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous LVAD. Contractile ATP consumption, which indicates the ventricular energetic loading condition decreased maximally at the $5^{th}$ level heart-failure under LVAD therapy. We conclude that optimal timing for LVAD treatment is $5^{th}$ level heart-failure when considering LVAD treatment as "bridge to recovery".

Effects of Plastic AFO and Shoes on Static Standing Balance in Hemiplegic Patients (플라스틱 단하지 보조기와 신발 착용이 편마비 환자의 정적 선자세 균형에 미치는 영향)

  • Kim, Joong-Hwi;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.13 no.2
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    • pp.381-397
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    • 2001
  • In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.

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