Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(${\chi}^2=18.629$, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.
Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.
Objective : Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. Methods : We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. Results : The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases [66.7%]. The abnormality on the electrocardiographic feature [23.5%] and long-term history of hypertension [20.5%] were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group [P<0.05]. The mean number of risk factors was three in acute group. It is larger than that of hyperacute group [P<0.05]. Conclusion : If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.
Objectives : This study was designed to investigate significant differences between the first attack and reattack groups to form fundamental data for decreasing recurrence and secondary prevention of stroke. Methods : I studied 204 patients admitted within 7 days of onset, after the diagnosis of stroke, in the Oriental Medical Hospital of Dongeui University from February to July in 2001.compared the reattack group with the first attack group for risk factors, clinical symptoms and progress, average mark and degree of improvement in Activity Index. Results : 1. Meaningful risk factors associated with the reattack group were male sex, a past history of hypertension and transient ischemic attack, and a family history of stroke. 2. The reattack group had conscious or cognitive disorder in early stage of onset, dysphagia, constipation, urinary incontinence, visual field defect in acute stage, high blood pressure and tachycardia in abnormalvital sign in acute stage, neuropsychosis, shoulder pain and rigidity, and pneumonia in complications more than the first attack group. 3. In Activity Index, the average mark of reattack group was lower than that of the first stroke group and improvement of the reattack group was delayed compared with the first attack group. Conclusions : The reattack group had more severe symptoms and clinical progress than the first attack group.
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 177 patients who were admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University with a diagnosis of stroke from Jan. I, 1999 to Dec. 31, 1999. Results : Ischemic stroke (74.0%) was more common than hemorrhagic stroke (19.8%). The proportion of males was 53.7%, of females was 46.3%, and the most prevalent age group is those in their sixties. Cerebral infarction was most frequently noticed in MCA territory, hemorrhage in putamen. Hypertension was the most common preceding disease, followed by diabetes mellitus. The rate of recurrence was high in cerebral infarction. The onset mode of cerebral infarction was sleeping and rising and of cerebral hemorrhage was acting. Most patients visited the hospital within 24 hours. The most common symptoms at admission were motor weakness and speech disorder. The most common complication was urinary tract infection. Admission period was 29.5 days. Physical treatment from onset in cerebral infarction and in cerebral hemorrhage was 17.4 and 22.0 days, respectively. Conclusions : Our study of CVA patients was similar to previous studies from 1994 to 1998. In most cases, western and oriental treatment and medicine were given synthetically. Prescription of sasang constitutional medicine had wide application.
Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.
Objective: The purpose of this research is to investigate Chinese clinical studies of the treatment of hiccup after stroke with herbal medicine. Methods: We used the China National Knowledge Infrastructure (CNKI) database to search for clinical studies about using herbal medicine to treat hiccup after stroke. Results: Nineteen clinical articles Until August 31, 2017 were analyzed. The most commonly used herbal prescription was Xuanfudaizhe-tang (旋覆代?湯). According to analysis, the most commonly used medical herbs were Haematitum (代?石), Inulae Flos (旋覆花), and Pinelliae Tuber (半夏). Clinical symptoms, total incidence rate of adverse reaction, recurrence rate, symptom improvement time, patient satisfaction comparison, and dietary status improvement were used to evaluate the treatments. The effective rate of the treatment group was 86.0-97.8%, significantly higher than control group in all papers. Side effects occurred much less frequently in the treatment group than in the western medicine control group. Conclusion: The treatment of hiccup after stroke with herbal medicine was shown to be highly effective in 19 studies. Additional well-designed clinical trials are needed; this study can be used as a basis for further research regarding the treatment of hiccup after stroke.
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 169 patients who were admitted to Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2003 to Dec. 31, 2003. Results : Ischemic stroke(include TIA, 85.2%) was more common than hemorrhagic stroke(14.8%). The incidence in male was 46.7%, in female was 53.3% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA territory and lacunar-inf., hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus. The rate of recurrence was 30.18%. Cerebral infarction and cerebral hemorrhage was much occurred in acting. The most patients visited the hospital after 5 days. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract infection. Physical treatment from onset, in cerebral infarction was 9.14 days and in cerebral hemorrhage was 18.33 days. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2002. In most cases, western and oriental treatment and medicine were given synthetically.
Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 75 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2005 to Dec. 31, 2005. Results : Ischemic stroke(include TIA, 93.3%) was more common than hemorrhagic stroke(6.7%). The incidence in male was 36.0%, in female was 64.0% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA-infarction and hemorrhage in putamen & thalamus. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 21.3%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract inflamation. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2004. In most cases, western and oriental treatment and medicine were given synthetically.
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