• Title/Summary/Keyword: post-stroke

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Predicting Factors of Post-Stroke Depression (뇌졸중 후 우울에 영향을 미치는 요인)

  • Kim, In Ja;Suh, Moon Ja;Kim, Kum Soon;Cho, Nam Ok;Choi, Hee Jung
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.147-162
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    • 2000
  • Predicting factors of post-stroke depression were investigated. The subjects were 254 stroke patients who had been discharged and visited regularly the outpatient clinic for follow up care. The influencing factors were classified into five categories : demographic, disease-related, current state, social support, and illness intrusiveness. Sex, age, job, and educational level were defined as the demographic factor. The disease-related factors included stroke type, illness duration, attack frequency, and NIH score. ADL, cognitive function, and social activity were considered as the current state factors. The social support was measured as the perceived amount of social support. Illness intrusiveness means the perceived illness induced life style disruptions. Demographic, disease-related, current state, and social support were hypothesized to directly and indirectly affect post-stroke depression through illness intrusiveness. The illness intrusiveness was hypothesized to directly affect post-stroke depression. The hierarchial multiple regression was used to identify significant factors. The result showed that this model explained 43.3% of variance of post-stroke depression. And the prevalence of post-stroke depression was 38.8%. Among the demographic factors, job was identified as a main contributor to indirectly increase the post-stroke depression. Among the disease-related factors, stroke type, attack frequency, and NIH score were found to indirectly affect the post-stroke depression. Among the current state factors, ADL and social activity indirectly affected the post-stroke depression through illness intrusiveness. Social support and illness intrusiveness were identified to directly affect the post-stroke depression. This study has proved the factors likely to be implicated in the development of post-stroke depression. Based upon these results, it is recommended that the nurses who take care of post-stroke patients consider the risk factors such as social support, illness intrusiveness et al. Also programs which decrease the illness intrusiveness and increase the social support to reduce post-stoke depression recommended to be developed.

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Correlation between Post Strolce Depression and Actirities of Daily Living (뇌졸중후 우울증과 일상생활 수행능력과의 상관관계)

  • Lee Jeong-A;Lee Jae-Hyuk;Yim Seung-Man;Park Sang-Dong
    • Journal of Oriental Neuropsychiatry
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    • v.11 no.2
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    • pp.149-154
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    • 2000
  • Objectives:This study was to investigate the post-stroke depression morbidity and to evaluate the post-stroke depression in relation to activities of daily living by using BDI(Beck's Depression Inventory)and MBI(Modified Barthel Index) in 45 patients with stroke. Methods:The subjects of this study were 45 stroke patients who were admittied to the Dong-Seo oriental hospital.The post-stroke depression was determined by using the BDI and the evaluation of activities daily living was measured by using the MBICollected data analysis were completed by using correlation analysis.Results:1. The post-stroke depression morbidity was 30%.2. The post-stroke depression have no significant correlation with activities of daily living skills.Conclusions:This study shows that the post-stroke depression have no significant correlation with impairment in activities of daily living.Advanced studies are required to investigate other factors that influence post-stroke depression and post-stroke depression follow-up studies.

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Post-stroke fatigue, depression, emotional incontinence, and anger-proneness (뇌졸중 후 후유증: 피로, 우울, 감정조절 장애, 분노 조절 장애를 중심으로)

  • ChoiKwon, Smi
    • Perspectives in Nursing Science
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    • v.2 no.1
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    • pp.76-91
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    • 2005
  • Stroke patients often develop post stroke sequelae when they survive. Post stroke fatigue and emotional disturbances including depression are common along with motor dysfunction. However, medical personnel have paid relatively little attention to emotional changes and the presence of fatigue following strokes. Post-stroke fatigue was common, occurring in 57% of the patients in our series. The post-stroke fatigue appears to be related to the pre-stroke fatigue, physical disability and post stroke depression (PSD) although the relation to the lesion location remains elusive. The prevalence of post-stroke emotional disturbance has been reported to range from 12% to 64%. The wide variation in the frequency of post stroke depression may be related to methodological heterogeneity in items such as the criteria for depression, the timing of assessment, and the study population. Emotional incontinence, which is characterized by inappropriate or excessive laughing or crying is also common. The incidence of and factor related to this post-stroke emotional incontinence (PSEI) also remains unclear. We reported that out-patients with single, unilateral stroke, 18% had PSD and 34% had PSEI. Although both PSD and PSEI were related to motor dysfunction and location (anterior vs. posterior cortex) of the lesion, the latter was a stronger determinant for PSD. PSEI was more closely associated with subcortical strokes than was PSD. Another manifestation of post stroke patients is the occurrence of post stroke anger proneness (PSAP). They may become easily irritated, impulsive, less generous, and prone to be angry or aggressive at others. We also have reported the PSAP which seems to be closely associated with the presence of PSEI. The lesion distribution appears to be also similar. Both PSEI and PSAP respond well to serotonin reuptake inhibitors suggesting that these symptomsmay be possibly related to the alteration of serotonin after brain injury. Likewise, PSAP also produces a great deal of frustration and embarrassment among patients and caregivers. In summary, emotional disturbances such as depression, emotional incontinence, anger-proneness and fatigue are fairly common but under-recognized sequelae of stroke. These emotional disturbances decrease the quality of life of the patients and caregivers, and may adversely affect the overall prognosis. Therefore, these problems must be appropriately recognized and alleviated. Finding strategies to relieve the symptoms is imperative by understanding the causative factors in individual patient.

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A Study on Relationship between the Post-stroke Depression and Acceptance (뇌졸중 환자의 우울과 수용간의 관계)

  • Seo, Joo-Hee;Kim, Ja-Yeong;Sung, Woo-Yong;Lim, Ho-Jea;Kim, Jin-Won;Kim, Su-Yeon;Jang, Ha-Jeong
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.2
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    • pp.167-177
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    • 2006
  • Objective : We aimed to study the relationship between the post-stroke depression and acceptance of the stroke. Method : For this study, 80 stroke patients were surveyed by using questionnaires for CES-D, acceptance for stroke, and social support. Result & Conclusion : 1. Acceptance for stroke varied inversely as the post-stroke depression. 2. The acceptance for the stroke appeased the negative influence caused by the stress of the stroke, and the post-stroke depression was biggest predictable variant. And location of the stroke were the predictable variants of the post-stroke depression. 3. When the gender, location of the stroke, motor power, age, period of stroke, and social support were controlled, the group with depression and the one without depression had a significant difference in the acceptance of the stroke.

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Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

  • Chankyu Kim;Hyun-Joong Kim
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.471-477
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    • 2022
  • Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

A Case Report of Post-stroke Depression Patient Using Bunsimgi-eum(Fenxingiyin) (분심기음으로 호전된 뇌경색 후 우울증환자 치험 1례)

  • Ryu, Ho-Sun;Ahn, Hyo-Jin;Park, Se-Jin
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.86-94
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    • 2012
  • Object : The purpose of this case report is to show an efficacy of Bunsimgi-eum(Fenxingiyin) for patient with Post-stroke Depression. Methods : This Patient was 64 year-old man who was diagnosed with Stroke by Brain MRI. And after the stroke, the patient showed some Post-stroke depression(PSD) behaviors, like mutism, waxy flexibility and have no willness of rehabilitation. He was treated by Herbal medicines, acupunctore and moxibustion therapy. 40 days after hospitalization, Bunsimgi-eum was prescribed to the patient. Results : After Bunsimgi-eum Herbal treatment, the symtoms of Post-stroke depression have improved remarkably. The grade of Rt. side hemiparesis and time of rehabilitation treat were also increased. Conclusions : This study suggests that Bunsimgi-eum could have a positive efficacy for Post-stroke depression. As a result, it makes the patient to take more rehabilitation treatment.

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Clinical and Electrophysiological Characteristics of Post-stroke Tremor (뇌졸중후 진전의 임상적, 전기생리학적 특성)

  • Seo, Man-Wook;Kim, Young Hyun
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.128-135
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    • 2001
  • Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

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Effect of Stroke Health Education on Knowledge of Stroke for Rural Elders (일 지역 농촌 노인의 뇌졸중 교육이 뇌졸중 지식정도에 미치는 효과)

  • Kim, Eun-Mi;Hong, Ji-Yeon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.4 no.2
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    • pp.103-109
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    • 2009
  • Purpose: This study was conducted to test the effect of a 5 weeks health education program on stroke for rural elderly people. Methods: A total of 55 rural elders in Kok Sung County were participated in the health education on stroke program. Descriptive statistics, and paired t-test were used for statistical analysis with SPSS 12.0. Results: The results are summarized as follows : Mean age was 67.3 years and 88.2% of participants were female. The mean pre-test scores for knowledge of stroke were 0.35 and post-test, 0.85 (p< .001). Percentage of accurate response rates of warning signs of stroke were sudden dizziness pre-test 45.5% post-test 80.0%, sudden trouble speaking or understanding, pre-test 27.3% post-test 41.8%, sudden trouble walking, loss of balance or coordination, pre-test 32.7% post-test 70.9%, sudden numbness or weakness of the arm or leg, especially on one side of the body, pre-test 47.3% post-test 72.7%, sudden confusion, pre-test 27.3% post-test 81.8%, sudden numbness or weakness of the face especially on one side of the body, pre-test 40.0% post-test 76.4%, sudden severe headache with no known cause, pre-test 40.0% post-test 70.9%, Sudden trouble seeing in one or both eyes, pre-test 38.1% post-test 66.0%, nausea or vomiting pre-test 16.4% post-test 43.6%. The increases after the health education on stroke were statistically significant. Conclusions: Health education on stroke for rural elderly people are needed and should focus on community health care programs, especially for those who are older, had a low level of education, and low socio-economical status.

Case of Central Post-Stroke pain Patients Treated with Chukyu pharmacopuncture (척유(脊愈) 약침을 이용한 뇌졸중 후 통증 치험 1례)

  • Cha, Ji-Yoon;Heo, Jong-Won;Jo, Hyun-Kyung
    • Journal of Haehwa Medicine
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    • v.24 no.2
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    • pp.59-64
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    • 2016
  • Objectives : This study report case of central post-stroke pain patient mainly treated by Chukyu pharmacopuncture. Methods : patient with central post-stroke pain were treated by Chukyu pharmacopuncture at the oriental medicine hospital of Daejeon University. Chukyu pharmacopuncture was treated once a day. Then, we observed the patients' appearances of pain. Results & Conclusions : After treatment, pain were reduced. In conclusion, Chukyu pharmacopuncture are effective to treat central post-stroke pain, and future studies will be required to ascertain this method on central post-stroke pain.

The Oriental and Western Medical Study of Communication Disorder with Post-Stroke (중풍언어장애에 대한 동서의학적 고찰)

  • Hong, Soun-Sung;Hong, Seo-Young;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.181-189
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    • 2007
  • Objectives : The purpose of this study is to search for more effective methods of diagnosis and treatment of Communication Disorder with Post-Stroke. Methods : Literature review on Communication Disorder with Post-Stroke in view of oriental and western medicine. Conclusions : Communication Disorder with Post-Stroke is relative with aphasia in western medicine, Sul-um(舌瘖) oriental medicine Aphasia, apraxia of speech, and dysarthria come after strock Each of them has its own mechanism. Yomchon(CV23), Amun(GV15), Chuldol(CV22), Tongni(HT5), Pungnyung(ST40), Pungbu(GV16), Chigu(TE6), Yongchon(KI1), Hapkok(L14), Peakoe(GV20), Kokchi(LI11), Puryu(KI7), Shinsu(BL23), Kumjin-okaek, and Chohea(KI6) was used on Communication Disorder with Post-Stroke treatment.

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