• Title/Summary/Keyword: hemiplegic patients after stroke

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The Effect of Task-Oriented Training After Botulinum Toxin Injection on Upper Extremity Function and Activities of Daily Living For Patients with Stroke: Case Study (보툴리눔 독소 주사 후 과제 지향적 훈련이 뇌졸중 환자의 상지기능 및 일상생활활동에 미치는 효과: 사례연구)

  • Lee, Min-Jae
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.67-75
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    • 2016
  • Objective : This study was examined the effects of task-oriented training therapy after botulinum toxin injection, upper extremity function and activities of daily living for stroke patient. Methods : The subject was a 44 year old male who suffered from hemiplegic patient received a task-oriented training therapy after botulinum toxin injection on involved upper extremity for 30-min sessions 5 times every week during 8 weeks. The scores were obtained before the injection, at 4 weeks, and 8 weeks after the injection. The upper extremity function was assessed using a Manual Function Test and Box and Block Test, and also Modified Barthel Index was applied for evaluation of Activities of Daily Living performance ability. Results : The results of this study show that the subject's In-hand manipulation and dexterity function increase significantly. Also, In activities of daily living, personal hygiene area, feeding area, toilet area, dressing area scores are improved significantly. Conclusion : Through this study, task-oriented training after botulinum toxin injection can improve upper extremity function and Activities of Daily Living performance ability of patient with stroke.

A Study on Muscle Architectural and Tissue Compliance of Biceps Brachii in Stroke Patient Based on Elbow Joint Angle (뇌졸중 환자에서 주관절 각도 변화에 따른 상완이두근의 근구조 및 탄성 변화에 관한 연구)

  • Bae, Sea-Hyun;Jeong, Chan-Joo;Kim, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5867-5874
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    • 2012
  • The aim of this study was to find on muscle architectural and tissue compliance of biceps brachii in stroke patient based on elbow joint angle. The subjects of this study were twelve hemiplegic adults after stroke with passive range of motion in the elbow from $10^{\circ}$ to $90^{\circ}$ and Modified Ashworth Scale score 1 to 3 were recruited. Ultrasonography and Myotonometer was used to measure biceps brachii muscle pennation angle, fascicle length, and tissue compliance at the rest condition and pennation angle, fascicle length, and tissue compliance of the biceps brachii muscle were measured in the affected and unaffected sides of people after stroke at 9 different elbow angles ranging from $10^{\circ}$ to $90^{\circ}$ at the rest condition. The results of this study, comparisons found that the pennation angles of the affected biceps brachii muscle were significantly larger(p<.05) than the unaffected muscle in the most extended positions($<40^{\circ}$), whereas the affected fascicle lengths were significantly shorter(p<.05) than the unaffected muscle in most flexed positions($>20^{\circ}$), and the affected tissue compliance were significantly lower(p<.05) than the unaffected muscle in most extended positions($<50^{\circ}$) Therefore, pennation angles, fascicle lengths, and tissue compliance were found to be joint-angle-dependent in both the affected and unaffected sides at the rest condition. Suggest that, the results data can be used as a muscle architectural changes and clinical treatment research in stroke patients.

The Efficacy of Treadmill Training with Body Weight Support on Ambulation and Muscle Activity with Elderly Chronic Stroke (체중현수 트래드밀 훈련이 뇌졸중노인의 보행과 근활성에 미치는 영향)

  • Kim, Seong-Hak
    • Journal of Korean Physical Therapy Science
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    • v.11 no.2
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    • pp.27-37
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    • 2004
  • The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).

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Effects of Occupation-Based Bilateral Upper Extremity Training for Chronic Stroke: Pilot Study (뇌졸중 환자의 작업기반 양측성 상지훈련 효과: 예비연구)

  • Kim, Sun-Ho;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.6 no.2
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    • pp.47-58
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    • 2017
  • Objective : The purpose of this study is to observe effects of Occupation-Based bilateral UE training for chronic stroke. Methods : 4 patients with hemiplegic stroke were divided into two groups: experimental group and control group. From May to August 2016, we conducted a occupation - based bilateral UE training and a traditional bilateral UE training for 5 weeks, 3 times a week, and 60 minutes per session for each subject. EMG, accelerometer, ARAT, Y-BAT, SIS, and COPM were performed before and after the intervention. Results : The experimental group showed a large changes before and after intervention in ECR, DA and all items except for hand function and memory of SIS, compared with the control group. Also, the experimental group showed a large change before and after the intervention compared to the control group in the accelerometer measuring the amount used of bilateral hand and grasp, pinch, and gross movement items of ARAT and COPM, Y-BIT. Conclusions : Occupation-based bilateral upper extremity training was effective in the recovery of upper limb function and social participation through neurological changes. Future research will be required development studies to ensure a high content validity of the Occupation-based bilateral upper extremity training protocol.

Immediate Effect of Patterned Sensory Enhancement (PSE) on Upper Limb Function after Stroke (패턴화된 감각 증진(PSE)이 뇌졸중 환자의 상지 기능에 미치는 즉각적 영향)

  • Han, Soo Jeong;Kwon, Ae Ji;Park, Hye Young
    • Journal of Music and Human Behavior
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    • v.11 no.1
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    • pp.1-19
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    • 2014
  • The purpose of this study was to investigate the immediate effect of Patterned Sensory Enhancement (PSE) technique on the motor function of the affected upper limb in hemiplegic stroke patients by comparing the use of PSE and simple rhythmic cue. A total of 16 stroke patients were recruited from rehabilitative hospitals. The participants were assigned to the experimental group (n = 8) and control group (n = 8). While performing six different upper limb motions, musical stimuli applying the PSE technique was presented for the experimental group and simple rhythmic cue using the metronome was applied for the control group. The results showed that while the significantly increased range of motion (ROM) was found in the experimental group with the immediate use of PSE (p < .05), the control group did not show no significant change. This study implies that the use of musical elements in cueing for upper limb motion immediately leads to significant improvement in ROM by providing sufficient temporal, spatial, and dynamic information for expected motor performance.

Therapeutic Intervention to Reduce Spasticity (경련성 감소를 위한 치료적 중재 연구)

  • Lee, Jung-Ho
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.9 no.5
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    • pp.427-436
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    • 2019
  • This study investigated the effect of extracorporeal shock wave therapy on the knee angle, MAS, and TUG of the affected side in patients with hemiplegic strokes. This study selected 20 patients who received rehabilitation treatment at a hospital after having been diagnosed with stroke. The control group (n=10) received the general physiotherapy (proprioceptive neuromuscular facilitation), and the experimental group (n=10) applied the extracorporeal shock wave therapy (ESWT) to the injured limb after PNF treatment. This study used an integrated kinematics analyzer (4D-MT, Relive, Korea) to analyze walking, timed up and go test to evaluate the dynamic balance ability of patients, and MAS to evaluate the spasticity. In the study results, knee angle were significantly different in all groups(p<0.05) but there was no significant difference between the groups(p>0.05). In the study results, TUG were significantly different in all groups(p<0.05) but there was no significant difference between the groups(p>0.05). Based on the results of this study, I hope that more detailed research will proceed.

The Effect of Stretching and Pre-eccentric exercise on Delayed Onset Muscle Soreness (스트레칭과 사전원심성 운동이 지연성근육통에 미치는 영향)

  • Jeong, Jin-Gyu;Ryu, Seong-Sun;Kim, Yong-Nam;Kang, Jong-Ho;Kim, Su-Hyun;Hwang, Tae-Yeon
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.15-22
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    • 2010
  • Purpose : This study examines the effects of pre-eccentric exercise and stretch ing to bicepsbrachii to prevent delayed onset muscle soreness and recovery of muscular function depending on the training intensity with 28 normal adults in their twenties. Methods : The subjects were divided into a control group, a group without any previous eccentric exercise, and a stretching group. Pre-eccentric exercise group conducted exercise with the intensity of 25% of maximal voluntary contraction. Pre-eccentric exercise and stretching was applied before to induce delayed onset muscle soreness and after, 24 hour post, 48 hour post, and 72 hour post. Measurements were conducted to examine pain and muscular function changes before, immediately after, and after inducing delayed onset muscle soreness. After inducing delayed onset muscle soreness, measurements were taken at the 24th hour, 48th hour, and 72nd hour. Results : The pre-eccentric exercise group and stretching group showed a significant difference from the control group by isometric contract ion power and mechanical pain threshold as a result of measuring delayed onset muscle soreness. Conclusion : From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.

A Case Report on Right Hemiparesis after Left Thalamus Infarction Treated with Boyanghwanoh-tang-gagam and Complex Korean Medicine Treatment (보양환오탕가감방 및 복합한의치료로 호전된 시상 부위 뇌경색 후 우측 편마비 환자 치험 1례)

  • Eun-soo Park;Hyun-seo Park;Seong-hyun Jeon;Jin-won Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.823-829
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    • 2023
  • Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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Shoulder Uptake in the Bone Scintigraphy in Patients with Hemiplegic Reflex Sympathetic Dystrophy Syndrome (반신마비성 반사성교감신경 이영양증후군 환자의 골스캔상 견관절 섭취)

  • Lee, Jong-Jin;Chung, June-Key;Lee, Dong-Soo;Hong, Joon-Beom;Han, Tai-Ryoon;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.288-293
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    • 2004
  • Purpose: increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was $63{\pm}10$ yrs. Ter normal volunteer (mean age: $60{\pm}5$, M:F=1:9) data was used as control group. TPBS was performed $59{\pm}32$ days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Conclusion: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.