The Journal of the Society of Stroke on Korean Medicine
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v.8
no.1
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pp.48-57
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2007
Stroke is a disease which results in impairment of body functions and affects everyday life. The ability of cerebral neurons to become reorganized and restore function after damage is called plasticity. Motor impairment typically appears contralateral to the affected cerebral hemisphere in patients with cerebral lesions. The authors report a case of a patient with hemiplegia ipsilateral to affected cerebral hemisphere, along with its conjectured mechanism.
Purpose: The purpose of this study is to describe the effects of proprioceptive neuromuscular facilitation (PNF) on gait speed and genu recurvatum episodes in stroke patients. Methods: The patient is a 58-year-old woman with left hemiplegia who presented with genu recurvatum while walking. Each week the patient received two sessions of PNF that each lasted 45 minutes. During a six-week interval the patient underwent therapeutic exercises and occupational therapy five times a week between the two PNF treatments. During each treatment a preand post-test (a 4 m walk test) was conducted, the patient described their fear of falling down (10-point visual analogue scale), and the number of genu recurvatum episodes was recorded. Results: After the first PNF treatment, the fear of falling down was decreased from 8 points to 7 points, and the number of genu recurvatum episodes decreased from 11 to 6. After the second PNF treatment, the fear of falling down decreased from 6 points to 5 points, and the number of genu recurvatum episodes decreased from 5 to 1. The 4 m walking test time also decreased from 30 seconds to 24 seconds. Conclusion: The PNF treatment is beneficial for reducing the fear of falling down, reducing the number of genu recurvatum episodes, and improving the gait speed of stroke patients.
The purpose of this study is to evaluate the effects of the lower extremities patterns in proprioceptive neuromuscular facilitation to the gait and stair up of the hemiplegic stroke patient. the patient was taken lower extremities patterns in porprioceptive neuromuscular facilitation with 5 times per week for 8 weeks. The results were as followings ; 1. The walking times was decreased from 78 seconds to 39 seconds at 20m, 2. The stride length was increased from 48.3cm to 93.3cm. 3. The step length was increassed from 25.2cm to 47.2cm. 4. The stair up was increased from 3.2cm to 15.5cm.
Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.
The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.
Journal of Korean Academy of Fundamentals of Nursing
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v.8
no.1
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pp.81-94
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2001
The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.
Kim, Hyun-Jin;Yang, Ga-Ae;Kim, Su-Hyon;Kim, Tae-Youl
Journal of the Korean Academy of Clinical Electrophysiology
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v.7
no.1
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pp.11-15
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2009
Purpose : This study aims to comparison of ultrasonography on both sides of biceps brachii muscle of hemiplegic patient. Methods : The biceps brachii muscle of fifteen subjects (5 male, 10 female) with stroke were scanned with ultrasonography at the muscle belly at rest at elbow angles of 90 deg. The echogenicity (density, white area index; WAI, anatomic cross-sectional area; ACSA, volume) of ultrasonography was examined. Results : In the biceps brachii muscle, there were significant differences of density, WAI, ACSA, and volume between affected side and non-affected side. biceps brachii muscle, echogenicity (density, WAI) of the affected side was higher than non-affected side. biceps brachii muscle, echogenicity (ACSA, volume) of the non-affected side was higher than affected side. Conclusion : This study showed that change of skeletal muscle architecture properties occurred biceps brachii muscle of the affected side muscle of hemiplegic patient.
Journal of the Korean Academy of Clinical Electrophysiology
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v.5
no.1
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pp.1-10
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2007
This study aims to comparison of ultrasonography on both sides of the upper arm of hemiplegic patient. The biceps brachii and deltoid muscle of ten subjects(4 men, 6 women) with stroke were scanned with ultrasonography at the muscle belly at rest at elbow angles of 90 deg. The echogenicity(densit, white area index; WAI) and muscle thickness of ultrasonography was examined using real-time B-mode ultrasonography with 7.5 MHz linear-array prob. In the biceps brachii muscle, MHz there were significant differences of thickness, density, and WAI between affected side and non-affected side. In the deltoid muscle, there were significant differences of thickness, density, and WAI between affected side and non-affected side. Both of the muscles, thickness of the affected side was thin than non-affected side and echogenicity(density, WAI) of the affected side was higher than non-affected side. This study showed that change of skeletal muscle architecture properties occurred in the upper arm of the affected side muscle of hemiplegic patient.
Purpose: This study was performed to determine the difference or temporal-spatial gait asymmetry ratio according to static pelvic inclination level in hemiplegic patients. Methods: The subjects were 25 hemiplegic patients who was experienced stroke on MCA territory. Gait parameters and static pelvic inclination were recorded by $GAITRite^{(R)}$ system and radiologic PACS. The subjects were divided into three group according to static pelvic inclination. In the group I, the subjects have static pelvic inclination below $58^{\circ}$. The group II has $58^{\circ}{\sim}62^{\circ}$ or static pelvic inclination and the group m has over $62^{\circ}$ or static pelvic inclination. The data or three groups were analysed with ANOVA. Results: In comparison or single support time asymmetry ratio among 3 groups, the score or group II was significantly higher than the other groups(p<0.05). But the swing time asymmetry ratio was not significant(p>0.05). Conclusion: Asymmetry ratio of single support time was statistically significant by static pelvic inclination level. But asymmetry ratio or group II was the highest among three groups. It means that the patients or normal range of pelvic inclination was showed the most asymmetry or gait. And swing time asymmetry ratio was not significant among three groups. Even if the patient has normal ranged static pelvic inclination, it doesn't suggest that the patient has low gait asymmetry.
Purpose: The purpose of this study was to provide the basic data to decrease the stress of the family caregivers. Methods: The questionnaire was administrated to the family caregivers of 156 patients with stroke who consented to be interviewed. Among 156 caregivers, we analyzed 120 caregivers. We evaluated on the stress of the family caregivers. Results: First, the general characteristics of patient with CVA were high at 82.55% in male, 55.83% in infarction, 53.33% in the left hemiplegia, 47.50% in sixties, 80.83% in 1 recurrence rate, 27.50% in 1-2 years of disease period. Second, the general characteristics of family caregivers were high in above sixties, female in gender, existence in religion, married in marital status, high school in educational level, below 1 million-won in monthly income, spouse in relationship with patient, below 1 years in total caring period. Third, it showed that stress of family caregivers above 3.0 score has 8 items. Forth, the patient's characteristic that have the influence on the stress was significant in the period of disease(p<0.05). Finally, the characteristics of family caregivers that have the influence on the stress were the monthly income, caring period(p<0.05). Conclusion: These findings indicated that the stress of the family caregivers was correlated with the time in hospital, the income and nursing period.
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