• Title/Summary/Keyword: acute stroke

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Effects of Occupational Therapeutic Craft Activity on improvement cognitive function and hand function in acute patients with stroke (수공예 작업치료 프로그램 활동이 급성기 뇌졸중 환자의 손 기능에 미치는 효과)

  • Jang, Tae-Yong;Park, Bo-Ra;Yang, Yeong-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.355-365
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    • 2017
  • This study investigatedwhether occupational therapeutic craft activity improves cognitive function and hand function in patients with acute stroke, with the hope of providing clinically useful results for further studies. From March 2016 to November 2016, thirty acute patients with stroke at A general hospital and B rehabilitation hospital in Seoul and Gyeonggi-do, Korea were enrolled and randomly divided into two groups. One group was treated with occupational therapeutic craft activity,and the other general exercise. The subjects performed each activity for 30 minutestwice weekly, for four weeks. To test the effect of intervention, hand function was tested with the Box & Block Test and the Jebsen-Taylor Hand Function Test.Cognitive function measures were the NCSE and Trail-Making Test. Over the four weeks of treatment activities, in the occupational therapeutic craft activity group, hand function measures(p<.05) increased significantly,as did cognitive function measures(p<.05). This study shows that occupational therapeutic craft activity improves hand function and cognitive function effectively in patients with acute stroke. Occupational therapeutic craft activity programscan be based on this study to prepare intervention programs for further studies with acute stroke patients.

Dynamic Computed Tomography based on Spatio-temporal Analysis in Acute Stroke: Preliminary Study (급성 뇌졸중 환자의 시공간 분석 기법을 이용한 동적 전산화 단층 검사: 예비 연구)

  • Park, Ha-Young;Pyeon, Do-Yeong;Kim, Da-Hye;Jung, Young-jin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.543-547
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    • 2016
  • Acute stroke is a one of common disease that require fast diagnosis and treatment to save patients life. however, the acute stroke may cause lifelong disability due to brain damage with no prompt surgical procedure. In order to diagnose the Stroke, brain perfusion CT examination and possible rapid implementation of 3D angiography has been widely used. However, a low-dose technique should be applied for the examination since a lot of radiation exposure to the patient may cause secondary damage for the patients. Therefore, the degradation of the measured CT images may interferes with a clinical check in that blood vessel shapes on the CT image are significantly affected by gaussian noise. In this study, we employed the spatio-temporal technique to analyze dynamic (brain perfusion) CT data to improve an image quality for successful clinical diagnosis. As a results, proposed technique could remove gaussian noise successfully, demonstrated a possibility of new image segmentation technique for CT angiography. Qualitative evaluation was conducted by skilled radiological technologists, indicated significant quality improvement of dynamic CT images. the proposed technique will be useful tools as a clinical application for brain perfusion CT examination.

A Cross-Sectional Study on Lifestyle and Plasma Homocysteine Concentrations in Patients with Acute Cerebral Infarction (급성기 뇌경색 환자의 생활습관과 혈장 homocysteine 농도에 관한 단면적 연구)

  • Min, In-Kyu;Leem, Jung-Tae;Kim, Mi-Young;Choi, Won-Woo;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.56-62
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    • 2009
  • Objectives: We tried to clarify the relationship between lifestyle and plasma homocysteine concentration. We analyzed the data of patients with acute ischemic stroke from the Hanbang stroke registry supported by the Ministry of Science and Technology of Korea. Methods: 458 subjects were recruited from the patients admitted to the Internal Medical Department of Kyunghee University oriental medical center, Dongguk University Ilsan oriental medical center, Kyungwon University Songpa oriental medical center and Kyungwon University Incheon oriental medical center from April 2007 to August 2008. We divided the subjects into four groups by quartiles of plasma homocysteine concentrations and compared the first and last quartile groups. Results: 1. In univariate analysis, the high homocysteine concentration group showed higher rate of older age, male gender, smoking, drinking and lower values in vitamin B12, folic acid, creatinine than the control group with statistical significance. 2. In multivariate analysis, older age, male gender smoking and folic acid showed a close relationship with statistical significance (each OR=3.620, OR=4.218, OR=3.558, OR=0.789). Conclusions: According to the analysis, the relationship between high homocysteine concentration and smoking in patients with acute ischemic stroke were clarified. We hope to standardize and establish criteria on homocysteine in Korea by large epidemiological survey. These study results could be utilized in the future as a basis material.

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The effectiveness of oriental medical therapy compared to oriental-western medical therapy on acute bell's palsy (급성기 말초성 안면신경마비에 대한 한방치료와 한양방 병용치료의 효과비교)

  • Cho, Ki-Ho;Jung, Woo-Sang;Hong, Jin-Woo;Hwang, Jae-Woong;Na, Byung-Jo;Park, Seong-Uk;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.29 no.1
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    • pp.146-155
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    • 2008
  • Objectives : This study was to assess the effectiveness of oriental medical therapy (OM) on acute Bell's palsy, comparing its outcome with that of oriental-western medical therapy (OWM). Methods : Subjects were enrolled atKyung Hee Medical Center from March 2007 to December 2007. We prescribed Igigeopung-san and acupuncture therapy to both the OM and OWM groups, and prednisolone only to the OWM group. Effectiveness was assessed by the House-Brackmann facial nerve grading system (HBGS) and Yanagihara's unweighted grading system (YUGS) every week. Results : There were 31 patients in the OM group and 34 in the OWM group. About grading system scores and weekly score gaps, no significant differences were revealed between the two groups, but statistical significant difference was detected at recovery time. After 2 weeks of treatment, the OM group's HBGS score showed significant difference from baseline score, but the OWM group showed it after 1 week. After 3 weeks of medication, pain was reduced in 22% of OM group patients, but 50% in the OWM group (p=0.028). We made the same comparison study for patients treated within 4 days from onset, but there was no significant difference between the two groups. 3 cases of adverse effect of hyperglycemia were found in the OWM group, which could be due to hyperglycemic side-effect of prednisolone. Conclusion : This work could help us to understand the effectiveness of OM compared to OWM on acute Bell's palsy.

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The Relationship between Stroke Risk Factors, Stroke Subtypes and Diagnostic Pattern in Korean Medicine of Acute Stroke - Multi Center Trials (급성기 중풍 환자들의 위험요인 및 중풍유형과 변증분형의 관련성 연구)

  • Shin, Ae-Sook;Lee, In-Whan;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.9 no.1
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    • pp.19-24
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    • 2008
  • Objectives : This study was conducted as part of the national project to standardize stroke diagnosis in Korean medicine. In this study, we assessed what categories of stroke diagnosis these three most common risk factors of cerebro-vascular attack(CVA), hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) fall into. Also we looked into stroke subtypes and its diagnosis in Korean medicine. Methods : 806 patients with acute stroke from 5 universities(Kyung-Hee University oriental medical center, Kyung-Hee University East-West Neo Medical Center, Kyungwon university Incheon oriental medical center, Kyungwon university Songpa oriental medical center and DongGuk university Ilsan oriental medical center) across the country were involved from April, 2007 til August, 2008. We had data of 482 patients to be analyzed and diagnosed by a Korean medicine training doctor and a professor. Results : All three major stroke risk factors were diagnosed as being dampness-phlegm pattern, but no significant difference was observed except in hyperlipidemia patients. Stroke subtypes such as hemorrhage and infarction showed no significant difference in this study. Conclusions : This study provides evidence that hyperlipidemia can be diagnosed as dampness-phlegm by Korean medicine. Further studies with various subtypes of stroke patients are required to prove solid evidence with other stroke risk factors.

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Impact of an Early Hospital Arrival on Treatment Outcomes in Acute Ischemic Stroke Patients (급성 뇌경색 환자의 증상 발현 후 응급실 도착까지의 시간이 치료 결과에 미치는 영향)

  • Kwon, Young-Dae;Yoon, Sung-Sang;Chang, Hye-Jung
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.130-136
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    • 2007
  • Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

Factors Related to Prehospital Delay Time in Patients with Stroke (뇌졸중 환자의 병원 내원전 지연시간 관련 요인)

  • Lee Jong-Kyung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.154-162
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    • 2003
  • Purpose: The purpose of this study was to investigate factors which can delay hospital arrival for patients with acute stroke. Method: The participants for this study were 102 patients who were admitted to the Department of Neurology in a hospital in Chungnam province. Data were collected from Oct, 2002 to June, 2003. The data were analyzed with frequencies, percentages, and $x^2$ test using the SPSS PC program. Result: The results of this study were as follows: 1. Only 33.8 % of participants arrived at the hospital within 3 hours. 2. Educational level, economic status, people living in same residence, and place of residence were factors which significantly affected prehospital delay time. Also there were significant differences in prehospital delay time according to family history of stroke, day of the week when symptoms began, perception of seriousness of symptoms, type of hospital first used, and transportation. Conclusion: Therefore, to reduce prehospital delay time, educational programs which focus on the above factors need to be developed. Also, a public campaign for utilizing emergency service to reduce transportation time for acute stroke patients need to be facilitated.

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Effect of Oropharyngeal Sensory Stimulation Using Capsaicin in Acute Stroke Patients with Dysphagia (연하장애를 가진 급성기 뇌졸중환자의 캡사이신을 이용한 구인두 감각 자극의 효과)

  • Bae, Hansol;Lee, Eunnam
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.73-86
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    • 2021
  • Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

Multi-dimensional Factors related to the Functional state of Acute Ischemic Stroke Patients - For Patients Visiting a Hospital in Gangwon-do (급성 허혈성 뇌졸중 환자의 퇴원시 기능 상태와 관련된 다차원적 요인 분석 - 강원도 소재 일개 병원의 환자를 대상으로)

  • Song, Hyun-Ju;Park, Ju-Hyun;Dong, Jae-Yong;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.12 no.2
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    • pp.125-134
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    • 2018
  • Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

The Relationship between Pattern Identification and Stroke Risk Factors of Acute Ischemic stroke Patients (급성기 허혈성 뇌경색 환자들의 변증 분형과 위험 요인들간의 관련성 연구)

  • Lee, Ji-Hyun;Doo, Kyeong-Hee;Lu, Hsu-Yuan;Shim, So-Ra;Park, Joo-Young;Cho, Seung-Yeon;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Seong-uk
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.43-51
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    • 2012
  • Object : The purpose of this study was to evaluate the relationship between pattern identification (PI) and stroke risk factors, such as hypertension, diabetes mellitus, dyslipidemia, stroke history, obesity, abdominal obesity and metabolic syndrome. Methods : 46 patients with acute ischemic stroke were recruited from May 2012 to November, 2012. We analyzed the data of 32 patients, and pattern identification was identified by resident and specialist of Korean medicine. We analized patient's PI and risk factor by Fisher's exact test. Results : We found that Dampness-phlegm group was more related with patient's metabolic syndrome than non Dampness-Phlegm group. And Yin deficiency group had less relationship with patient's metabolic syndrome, obesity, abdominal obesity and dyslipidemia than non Yin deficiency group. Conclusions : According to the analysis, these results provide evidence for relationship between the Dampness-phlegm group, Yin deficiency and metabolic syndrome.

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