Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.
The purpose of this study was to investigate the correlation of Intima-Media Thickness of common carotid artery(CCA-IMT) and The Second Derivative of Photoplethysmogram Waveforms(SDPTG). 38 subjects with acute ischemic stroke were recruited from the patients admitted to Dong-Eui Medical Center from the June 2013 to January 2014. We assessed 38 patient's SDPTG data and CCA-IMT data by B Mode ultrasonography. then 38 subjects were divided into two groups by the CCA-IMT difference; CCA-IMT 〈 0.8 mm group(n=11), CCA-IMT $$\geq_-$$ 0.8 mm group(n=27). We analyzed their characteristics, risk factor, blood test result, life style by CCA-IMT difference. As a result, Age, Hypertension were significantly higher in the CCA-IMT $$\geq_-$$ 0.8 mm group then in the CCA-IMT < 0.8 mm group. Regular exercise were significantly higher in the CCA-IMT < 0.8 mm group then in the CCA-IMT $$\geq_-$$ 0.8 mm group. The result of Multiple regression analysis on the factors affecting the CCA-IMT was hypertension, total cholesterol, age. and The result of Pearson's Correlation analysis on CCA-IMT and SDPTG is that e/a ratio, SDPTG AI were respectively and significantly correlated with CCA-IMT. According to the analysis, the Relationship between CCA-IMT and SDPTG in Ischemic Stroke Patients were founded. We suggest that further investigation with larger and better controlled trials of the Relationship between CCA-IMT and SDPTG could contribute to better understand the effects of risk factors on atherosclerosis.
Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.
PURPOSE: This study is to investigate the therapeutic effect of Tetrax on balance dysfunction caused by ataxia in cerebellar stroke. METHODS: A total of thirty subjects with cerebellar stroke were recruited. The participants was divided into two groups, the experimental (n=15) and the control group (n=15). Tetrax training and conventional physical therapy (CPT) were performed in experimental group, whereas the patients in the control group were treated with CPT twice a day. Each session of the Tetrax and CPT was carried out for 30 minutes, 5 times per week for 4 weeks. Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) was the primary outcome measure, and the secondary outcomes covered Berg balance scale (BBS), falling index (FI), Timed up and go (TUG), and modified Barthel index of Korean version (K-MBI). All outcome measures were evaluated before and after 4 weeks. RESULTS: K-SARA was decreased significantly after 4 weeks intervention in both the experimental (p<.05) and the control group (p<.05). Furthermore, the experimental group produced significantly better outcomes in K-SARA, BBS, FI, and TUG compared with the control group (p=.012, p=.027, p=.008, and p=.048). There were significant correlations between K-SARA and BBS, FI, TUG, and K-MBI (p<.001, p<.001, p=.004, and p<.001). CONCLUSION: The restoration of ataxia was related with the improvement of the balance, falling risk, mobility, and activity of daily living. Tetrax training was effectively aided recovery of ataxia after cerebellar stroke.
Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.
Purpose: To identify the relationship between medication use and falls among hospitalized stroke patients. Method: The medical records of 472 patients with strokes were reviewed using a questionnaire on falling developed by the authors. Frequencies, percentages, means, standard deviations, and t-test and ${\chi}^2$-test, multiple logistic regression analysis were done using the SAS program. Results: The rate for falls by the patients during their stay in the hospital was 14.0%. The length of stay was longer and the morbidity duration of stroke shorter in the fall group than in the non-fall group. The use of sedatives, laxatives, and antidepressants was a significant predictor of falls and was associated with increase likelihood of falling(1.82, 1.81, 1.75 times respectively). Conclusion: In hospitalized stroke patients, there was a significant association between the use of sedatives, laxatives, antidepressants and falls. The number and kinds of ingested drugs was also associated with falls. It is necessary to further analyze the causes of falls based on results of the present study.
The aim of this study is to investigate the serum cholesterol level of patients who visited Oriental Hospital of Daejeon University to predict stroke, in Korea. In the time of period June 15th 2009 to June 20th 2009, 45 patients visited Oriental Hospital of Daejeon University to check the risk of stroke. We checked their blood to find out the serum cholesterol level and investigated their past history according to Adult Treatment Panel III guidelines. Male has higher risk of coronary heart disease than the female. The average of the total serum cholesterol of the participants was lower than the average of Korean. The percentage of the participants who have less HDL-cholesterol than 40 mg/dL was 33.3% and this result is less than the average percentage of Korean. Only 8.9% of the participants were placed in group who need to use lipid-lowering drug to reduce the lipoprotein density. Checking the characters of the person is necessary to use lipid-lowering drugs. This study can be the baseline data of actual condition of serum cholesterol level.
PURPOSE : This study attempts to find the effects of water perturbation exercise performed on stroke patients in their physiological cost index and gait ability tests. METHOD : The subjects were 30 stroke patients, water perturbation exercise group was performed 3 day per week, for 40 minutes a day, for a period of eight weeks. The physiological cost index and gait of all subjects were assessed by using the polar, 6 Minute Walk Test (6MWT), and 10 meter Walk Test(10mWT) at pre training and post training. Paired t-test was used to analyze change before and after intervention in group. Pearson's correlation was used to analyze correlation of all variables. RESULT : Water perturbation exercise group showed increased physiological cost index. Water perturbation exercise increased gait ability, showing a significant difference. Showing the correlation between the relatively high amount between physiological cost index and 6 minutes walking test. CONCLUSION : From the result of the study, we found that water perturbation exercise was effective in improving physiological cost index and gait ability. The patient is considered to be used by itself to involve the treatment and the risk of falling from the lowered state into the treatment method for the intensive treatment of stroke patients to be useful in improving the cardiovascular system and ability to walk. Through underwater training for stroke patients in the future on the basis of this study it is considered to require additional clinical studies on the impact on daily living and quality of life of stroke patients.
Purpose: This study was to develop a screening model for identifying a high risk group of dementia and to develop and evaluate the web-based prevention program. Method: It was conducted in 5 phases. 1) Data were collected from dementia patients and non-dementia patients in a community. 2) A screening model of the high risk population was constructed. 3) The validity test was performed and the model was confirmed. 4) Four weeks-prevention program was developed. 5) The program was administered, and evaluated the effects. Result: The model consisted of age, illiteracy, history of stroke and hypercholesterolemia. The program was designed with 12 sessions, group health education using web-based individual instruction program, and 12 sessions of low-intensity physical exercise program. After the completion, their self-efficacy, and health behaviors in experimental group were significantly improved over those in the control group. The perceived barrier in the treatment group is significantly decreased. Conclusion: The screening model developed is very simple and can be utilized in diverse community settings. And the web based prevention program will encourage individual learning and timely feedback, therefore it can facilitate their active participation and promote health management behaviors at home.
The Clinical Study on the Body Weight Loss of Taeumin Inpatients in Stroke by Sasang Constitutional Medicinal Treatment. Purpose: It has been frequently noted that overweight and obesity have a stronger relationship to hypertension and diabetes mellitus than to the risk of stroke. The purpose of this study is to find out whether Sasang Constitutional Medicinal treatment in the stroke patients of Tae-um-in has an effect on local or general weight loss. Methods: Case-control study was applied. The experiment group is the 24 Taeumin stroke inpatients who were in hospital in Kyung-Hee Oriental Hospital from July 1, 2000 to October 1 and received Sasang Constitutional Medicinal treatment. The control group is the 13 Taeumin stroke inpatients who were in the hospital during the same period but didn't receive Sasang Constitutional Medicinal treatment. In the two groups, body weight, BMI, the skin fold(cm) of triceps, suprailiac, abdominal portion, and thigh and the circumference(cm) of wrist, biceps, triceps, and W/H ratio were compared and studied for three weeks. Results: 1. In the experiment group, there were 8 women and 15 men, 23 in total and in the control group, there were 5 women and 9 men, 14 in total. 2. From two weeks later, there was a significant decrease in the experiment group in weight loss, the ratio of loss, and BMI(p<0.05). 3. Concerned with the change in the skin fold of suprailiac portion, there was a significant decrease in each group(p<0.05). 4. Concerned with the change in the skin fold of Chunchu-Hyel portion(天樞穴), thigh and in the circumference of hip, W/H ratio, there was a significant decrease in the experiment group(p<0.05). 5. Concerned with the change in the value of Lipid Profile, GOT, and GPT, only Glucose(GLU) showed a significant decrease(p<0.05) in the experiment group(p<0.05). As Conclusion, Sasang Constitutional Medicinal treatment in the stroke patients of Tae-um-in has an effect on local or general weight loss.
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