• Title/Summary/Keyword: Subacute stroke

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Clinical Application of Acute Ischemic Stroke in Perfusion Computed Tomography (초급성 허혈성 뇌졸중에서 관류 전산화단층촬영의 임상적 적용에 대한 연구)

  • Lee, Jong-Seok;Yoo, Beong-Gyu;Kweon, Dae-Cheol
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.149-160
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    • 2007
  • Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

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The Persisted Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation to Augment Task-Specific Induced Hand Recovery Following Subacute Stroke: Extended Study

  • Tretriluxana, Jarugool;Thanakamchokchai, Jenjira;Jalayondeja, Chutima;Pakaprot, Narawut;Tretriluxana, Suradej
    • Annals of Rehabilitation Medicine
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    • v.42 no.6
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    • pp.777-787
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    • 2018
  • Objective To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with task-specific training on paretic hand function following subacute stroke. Methods Sixteen participants were randomly selected and grouped into two: the experimental group (real LF-rTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour task-specific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training. Results Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks. Conclusion The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.

The Effect of PNF-Based Weight Support Exercise on Weight-Supporting Ability, Fear of Falling, and Stair-Walking Ability of Subacute Stroke Patients (PNF를 이용한 체중지지훈련이 아급성 뇌졸중 환자의 체중지지, 낙상에 대한 두려움 및 계단보행 기능에 미치는 영향 -증례보고-)

  • Kim, Chang-Beom
    • PNF and Movement
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    • v.15 no.1
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    • pp.105-113
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    • 2017
  • Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

Effects of Scapular Taping on Muscle Activity, Pain, Range of Motion and Proprioception in Subacute Stroke Patients (아급성 편마비환자의 어깨관절 Scapular Taping적용이 근 활성도와 통증, 관절가동범위 및 고유수용성감각에 미치는 영향)

  • Lee, Jae-Nam;Lim, Chae-Gil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5689-5697
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    • 2013
  • The purpose of this study was to determine the effects of scapular taping on muscle activities of the scapular rotators and anterior deltoid, ROM, shoulder pain, proprioception in subacute stroke patients. Twenty-eight patients were randomly assigned to an experimental and control groups of fourteen patients respectively. Muscle activity of upper and lower trapezius, serratus anterior, anterior deltoid was measured using surface electromyography. Visual analog scale was used for shoulder pain. Electro-Goniometry was used for shoulder elevation ROM. Assessment board was used for shoulder elevation proprioception. The muscle activity of the lower trapezius and serratus anterior increased significantly after scapular tape application (p<0.05). The AROM and PROM in the shoulder elevation significantly increased after scapular tape application (p<0.05). The VAS in the shoulder no significantly decreased after scapular tape application (p>0.05). The proprioception in the shoulder no significantly increased after scapular tape application (p>0.05). The results of this study suggest that scapular taping can be used an additional therapy for increasing muscle activity of lower trapezius and serratus anterior and ROM during shoulder elevation in subacute stroke patients.

Preliminary Study of Ambulation Training on Electromechanical Gait Trainer in Stroke Patients (전동식 보행 훈련기를 이용한 뇌졸중 환자 보행훈련의 사전연구)

  • Kim, Jae-Hyun;An, Seung-Huon;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.1-12
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    • 2006
  • Purpose : The purpose of this study was to investigate the effect of electromechanical gait trainer therapy in stroke patients. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overstraining therapist. To simulate normal gait, discrete stance and swing phase, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. Methods : This preliminary study investigated during 8 weeks therapy on the gait trainer could improve gait ability in 5 subacute and chronic hemiparetic stroke patients. Gait ability(time up & go [TUG], comfortable and maximal gait speed and functional ambulation category[FAC]), functional movement of lower extremity(Fugl-Meyer Assessment [FMA] and composite spasticity score [CSS]) and sensory of lower extremity(Fugl-Meyer Assessment sensory [FMA-s])were the measured. Results : TUG, comfortable and maximal gait speed and FMA were improved significantly. Although FAC, FMA-s and CSS were improved, there were not statistically significant. Conclusion : Therefore, the gait trainer enabled affected patients the repetitive practice of a gait-like movement, which is important for the restoration of walking ability.

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Effect of Suprahyoid Muscle Resistance Exercise Using Kinesio Taping on Suprahyoid Muscle Thickness in Patients with Dysphagia after Subacute Stroke

  • Lee, Myunglyeol;Kim, Jinuk;Oh, Donghwan;Lee, Kuija
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.3
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    • pp.2135-2139
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    • 2020
  • Background: Recently, a new method of dysphagia rehabilitation using Kinesio taping (KT) has been attempted and demonstrated an immediate increase in the activation of the suprahyoid muscle during swallowing in healthy adults. Objectives: To investigate the effect of dysphagia rehabilitation using KT on the thickness change of the suprahyoid muscle in patients with dysphagia after stroke. Design: Two-group pre-post design. Methods: In this study, 20 patients with dysphagia after stroke were enrolled and assigned to the experimental and control groups. The experimental group applied KT to the front of the neck and repeatedly swallowed against the tension of the tape. On the other hand, the control group performed repeated swallowing without applying KT. Patients in both groups had swallowed 50 times a day/5 times a week for 4 weeks. For evaluation, the volume of the geniohyoid, mylohyoid, and digastric muscle was measured before and after the intervention using portable ultrasound equipment. Results: As a result of comparing the two groups after the intervention, the experimental group showed more volume increase in mylohyoid (P<.05) and digastric muscle (P<.05) than the control group. Conclusion: This study proved that suprahyoid muscle resistance exercise using KT is effective in increasing the volume of the suprahyoid muscle.

The Effect of Physical and Occupational Therapy on Activities of Daily Living in Stroke Inpatients at Least 3 Months After Stroke (발병 후 3개월이 경과한 뇌졸중 환자의 일상생활동작에 물리치료와 작업치료가 미치는 영향)

  • Kim, Won-Ho;Hwang, Myoung-Ok;Park, Eun-Young
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.74-81
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    • 2007
  • The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI${\leq}$74 and MBI${\geq}$75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI${\leq}$74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI${\geq}$75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.

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The Relationship Between Postural Control and Functional Performance Ability in Subacute Stroke Patients (아급성기 뇌졸중 환자의 체간 조절과 기능적 수행능력과의 관계)

  • An, Seung-heon;Cho, Gyu-Haeng
    • PNF and Movement
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    • v.10 no.3
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    • pp.7-18
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    • 2012
  • Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

Factors Influencing Caregiver Burden During Rehabilitation of Stroke Patients (뇌졸중 환자 재활 시 간병인 부담에 영향을 미치는 요인)

  • Yu-Mi, Kim;Seung-Min, Baek;Yong-Il, Na;Yong-Soon, Yoon
    • Journal of Industrial Convergence
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    • v.20 no.11
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    • pp.27-34
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    • 2022
  • In this study, we aimed to determine which medical conditions of the stroke patients admitted for rehabilitation more than four weeks after onset affect caregiver burden. Participants diagnosed with stroke and their respective primary caregivers were enrolled and assessed after an 8-week follow-up period. The areas of evaluation for stroke patients included neurologic state, cognition, performance in daily life movements, gait, and balance, and caregivers were evaluated in the area of burden. The evaluation was conducted at the start of the rehabilitation course and eight weeks later. Patient caregivers were found to be under mild to moderate burden while providing care throughout the hospitalization period. The patient's neurologic state and cognition were correlated with caregiver burden. In the all patient and the subacute stroke patient group, multiple regression analysis confirmed that the neurologic state and balance stability were factors that influenced caregiver burden. Hence, we suggest that improvement in the patient's balance stability be emphasized during the course of rehabilitation to mitigate caregiver burden.