• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.11-17
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• 2016

PURPOSE: The aim of the present study was to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) can improve balance ability in acute stage stroke patients. METHODS: The study was conducted on 30 subjects diagnosed with hemiparesis caused by stroke. The experimental group consisted of 15 patients that underwent rTMS for 15 mins and the control group consisted of 15 patients that underwent sham rTMS (for 15 minutes). A 70-mm figure 8 coil and a Magstim Rapid stimulator was used in both groups. Patients in the experimental group received 10 Hz rTMS applied to the hotspot in the lesioned hemisphere in 10-second trains with 50-second intervals between trains, for 15 minutes (total 2,000 pulses). Both groups received conventional physical therapy for 30 minutes a day, 5 days a week, for 4 weeks. Static balance ability analysis was performed using the Gaitview system to measure pressure rate, postural sway, and total pressure, and dynamic balance ability analysis was performed to measure pressure variables using a balance system. RESULTS: A significant difference was observed in post-training gains for pressure rate, total pressure in static balance, and overall stability index in dynamic balance between the experimental group and the control group (p<.05). CONCLUSION: The results of this study indicate that high frequency rTMS may be beneficial for improving static and dynamic balance recovery in acute stroke patients.

• Journal of Korean Physical Therapy Science
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• v.25 no.1
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• pp.31-43
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• 2018

Purpose: The purpose of this study is to investigate and to verification of changes that the effect of treadmill and body weight support treadmill training on balance and gait ability for sub-acute stroke patients during 4 week. Method: 16 subjects who was diagnosed stroke were divided into 2 groups(8-treadmill training group, 8-body weight support treadmill group) by randomized control trial. Both training programs were consisted with 40 minuted, 5 times a week for 4 weeks and after training programs. Analysis: We analysed effects and changes on balance and gait ability. Analyses were performed using PASW ver. 18.0 and results were reported as mean ${\pm}$ standard deviation (S.D.). To investigate within group comparisons and to verification on effects of exercise, we did paired t test and repeated measured ANOVA test. Significance was set at p<.05. Result: Both training programs showed positive changes in Limit of Stability but significant results which is area of hemiside, area of intact side, area of posterior, total area were reported in body weight support treadmill training group. Changes of Berg Balance Scale was significantly increase and it had significant correlation between groups. Changes of 6 Minutes Walking Test was significant increase in both groups but there was no significant changes on Foot print and Romberg test. Conclusion: After considering all factors, both training programs showed effect on improvement of balance and gait ability in sub-acute stroke patients, but body weight support treadmill training group had better improvement in dynamic balance than treadmill training group. For the increase of balance and gait ability in sub-acute stroke patients, we need to continues study on difference of treadmill and body weight support treadmill and then we will give stroke patients a better satisfaction if we develop and provide a rehabilitation program for improvement of balance and gait ability.

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.531-540
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• 2020

Objectives: This study aimed to investigate the effects of a 4-weeks intervention using a monitor-based virtual reality game intervention(VRI) on the cognitive function and activities of daily living of individuals with acute stroke. Methods: For this study, 19 individuals with acute stroke were recruited. To compare the effectiveness of the VRI and the computer based cognitive intervention(CBCI), Each of the two groups were provided different interventions a 30 minutes a day, 5 times per week for 4 weeks, and to measure the effects of the intervention, the TMT A&B, DST, RKMT and K-MBI were performed before and after interventions. Results: Both the VRI and the CBCI were found to have significantly improved the cognitive function and activities of daily living, and the difference in change compared between groups showed that the effectiveness of the VRI was significantly higher. Conclusion: Based on the findings of this study, the monitor-based VRI is anticipated to prove useful as an effective intervention for the cognitive function and activities of daily living of stroke patients. Furthermore, the utility of monitor-based VRI is likely to be high in clinical occupational therapy.

• Health Policy and Management
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• v.33 no.4
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• pp.440-449
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• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

• Clinical and Experimental Pediatrics
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• v.56 no.9
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• pp.411-415
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• 2013

Infectious diseases precede a significant proportion of acute ischemic strokes in children. Here, we report a case of acute ischemic stroke in a 3-year-old girl with a Mycoplasma pneumonia-associated respiratory tract infection. She developed an acquired prothrombotic state of protein S deficiency and had increased fibrinogen and fibrinogen degradation product levels and increased titer of antinuclear antibodies. However, these conditions were completely alleviated at the 1-month follow-up examination. Infection with M. pneumoniae may cause a transient prothrombotic state that can potentially cause a thrombus.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.98-98
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• 2003

We will present various MR findings of hyperacute ischemic stroke with our own experiences in the management of the patients according to the findings. 대상 및 방법： A total of 441 patients were underwent 'acute stroke MR' imaging protocol between Mar. 2001 and Jun. 2003. The protocol included initial T2-weighted image (WI), diffusion WI (DWI, b=2000), time-of-flight (TOF) MR angiography (MRA), and pefusion WI(PWI), and follow-up T2WI, DWI, TOF MRA, and neck vessel contrast-enhanced MRA obtained three to five days after the insult. Among them, we retrospectively reviewed the MR findings and clinical courses of 193 patients with anterior circulation territorial infarction. Those ICA and MCA lesions were divided into six and five groups respectively according to the level and mechanism of the occlusion. PWI findings can be another factor in the management planning.

• International Journal of Contents
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• v.7 no.4
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• pp.98-102
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• 2011

In this study, we investigated the effects of neuromuscular electrical stimulation (NMES) on the treatment of 20 acute stroke patients with dysphagia. For both the treated and control groups, the basic facial stimulation training was conducted for 30 minutes, five times a week, for four weeks. NMES was performed on the treated group only, for 30 minutes each time. Both groups were evaluated according to the functional dysphagia scale (FDS) using a videofluoroscopic swallowing study (VFSS). After the treatment was performed for four weeks, the FDS results of the treated group showed a significance difference in oral transit time in the oral phase and in the triggering of pharyngeal swallow fluid, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow fluid, and pharyngeal transit time in the pharyngeal phase. In addition, the treated group showed a significant difference in laryngeal elevation and epiglottic closure, nasal penetration, and pharyngeal transit time in the pharyngeal phase after the treatment compared to the control group. The results of this study showed that neuromuscular electrical stimulation may be an effective method of treating dysphagia in acute phase stroke patients.

• Physical Therapy Korea
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• v.17 no.3
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• pp.11-19
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• 2010

The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

• Investigative Magnetic Resonance Imaging
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• v.22 no.2
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• pp.131-134
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• 2018

Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.75-79
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• 2005

Vestibular evoked myogenic potentials (VEMP) have been known to useful in documenting abnormality in patients with various vestibular disorders but the studies of VEMP in stroke patients are rare. We recorded VEMP in 17 consecutive patients with acute ischemic stroke in the brainstem lesions. All patients underwent magnetic resonance imaging and we compare VEMP results with the lesion documented by brain imaging. VEMP were defined to be abnormal when they were very asymmetrical (one is 2 times of more as large as the other), or absent in one side. VEMP abnormalities were found in 71%(12/17) of acute infarction patients with brainstem lesions. Most abnormalities found in the ipsilateral side of the lesion(9/12) but abnormalities in contralateral side of lesion were found in 25%(3/12) of patients.VEMP would be considered a useful complementary neurophysiological tool for the evaluation of brainstem dysfunction in acute stroke patients.