• Title/Summary/Keyword: post-stroke rehabilitation

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Impact of Patients' Level of Participation in Rehabilitation on Functional Outcome in Patients With Stroke (뇌졸중 환자의 재활참여가 기능회복에 미치는 영향)

  • Won, Jong-im
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.63-69
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    • 2020
  • Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients' high motivation and committed participation. Patients' motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients' participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients' level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients' participation at early intervention were important determinants of functional outcome. These findings suggest that patients' participation should be encouraged in order to achieve successful stroke recovery.

The effects of a task-oriented circuit training program of lower limb on walking ability after stroke (순환식 하지 훈련이 뇌졸중 환자의 보행능력에 미치는 영향)

  • Kong, Sun-Woong;Kim, Ji-Sun;Moon, Seong-Jang;Jin, Won-Hwa;Yun, Tae-Won;Han, Mi-Ran;Cho, Young-Hwan
    • PNF and Movement
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    • v.8 no.2
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    • pp.47-55
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    • 2010
  • Purpose : The purpose of present study was to determine effects of a task-oriented circuit training(TOCT) for lower limb on walking ability after stroke. Methods : Twenty one chronic stroke patients participated. Participants were randomly divided into either TOCT group or control group(11 experimental, 10 control). All of participants were in-patients at local rehabilitation centre and had been receiving a traditional rehabilitation program, five days a week. TOCT group have additionally undergone for four weeks, three days a week, the TOCT program but control group was not received any additional program except the traditional rehabilitation program. The 10 m walking test (10MWT), the 2 min walking test (2MWT), the step test (ST) and the figure-8 walking test (F8WT) to measure a walking ability were carried out twice before and after training. Results : After participation in the program, subjects of TOCT demonstrated a significant improvement in the scores of the 10MWT, 2MWT, the ST, the F8WT. The control group had no change on the any tests. After the training, the results to improve significantly in TOCT group compared to post-test of control group were the time of 10MWT and the time and the step of curved walking of F8WT. Conclusion : The present study suggests that the TOCT program may become a useful strategy for enhancing walking ability in the rehabilitation of stroke patients.

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The Effect of Chest Expansion and Pulmonary Function of Stroke Patients after Breathing Exercise (호흡운동이 뇌졸중 환자의 흉곽 확장과 폐 기능에 미치는 영향)

  • Lee, Jeon-Hyeong;Kwon, Yoo-Jung;Kim, Kyung
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.25-32
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    • 2009
  • Purpose: This study examined whether breathing exercises might increase the chest expansion and pulmonary function of stroke patients. Methods: Twenty four patients with stroke were assigned randomly into two groups: a combination of diaphragmatic resistive breathing and pursed-lip breathing exercise (CB) group (n=10) and control group (n=14). The CB group completed a 4-week program of diaphragmatic resistive breathing and pursed-lip breathing exercise. The subjects were assessed using the pre-test and post-test measurements of the chest expansion (length for resting, deep inspiration, deep expiration, deep expiration-inspiration) and pulmonary function (forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), vital capacity (VC), tidal volume (TV), expiratory reserve volume (ERV), inspiratory reserve volume (IRV)). Results: A comparison of the chest expansion between the pre and post tests revealed similar rest, deep inspiration, deep expiration, and deep expiration-inspiration lengths in the CB and control groups (p>0.05). A comparison of the pulmonary function between pre and post tests, revealed significant improvements in the FVC, FEV, PEF, VC, IRV, and ERV in the CB group (p<0.05). There was a significant difference in the FVC, FEV1, PEF, VC and IRV between the 2 groups (p<0.05). Conclusion: These findings suggest that breathing exercise should help improve the pulmonary function, such as the volume and capacity. This suggests that the pulmonary functions of stroke patients might be improved further by a continued respiratory exercise program.

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Challenges in neuro-machine interaction based active robotic rehabilitation of stroke patients

  • Song, Aiguo;Yang, Renhuan;Xu, Baoguo;Pan, Lizheng;Li, Huijun
    • Advances in robotics research
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    • v.1 no.2
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    • pp.155-169
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    • 2014
  • Study results in the last decades show that amount and quality of physical exercises, then the active participation, and now the cognitive involvement of patient in rehabilitation training are known of crux to enhance recovery outcome of motor dysfunction patients after stroke. Rehabilitation robots mainly have been developing along this direction to satisfy requirements of recovery therapy, or focusing on one or more of the above three points. Therefore, neuro-machine interaction based active rehabilitation robot has been proposed for assisting paralyzed limb performing designed tasks, which utilizes motor related EEG, UCSDI (Ultrasound Current Source Density Imaging), EMG for rehabilitation robot control and feeds back the multi-sensory interaction information such as visual, auditory, force, haptic sensation to the patient simultaneously. This neuro-controlled and perceptual rehabilitation robot will bring great benefits to post-stroke patients. In order to develop such kind of robot, some key technologies such as noninvasive precise detection of neural signal and realistic sensation feedback need to be solved. There are still some grand challenges in solving the fundamental questions to develop and optimize such kind of neuro-machine interaction based active rehabilitation robot.

The Comparative Study of Effectiveness of Cotreatment with $Samgieum-gagam$, Acupuncture and Sweet Bee Venom Acupuncture on Post-stroke Shoulder Pain (삼기음가감방과 봉약침, 체침의 병행치료가 뇌졸중 후 견관절 통증에 미치는 효과 비교연구)

  • Cho, Song-Hyun;Cho, Hong-Seok;Lee, Kyung-Yun;Yun, Suk-Hoon;Jung, Woo-Suk;Kim, Sang-Ho
    • Journal of Acupuncture Research
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    • v.29 no.2
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    • pp.15-27
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    • 2012
  • Objectives : The purpose of this study is to evaluate the effect of cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture on post-stroke shoulder pain. Methods : The subjects in this study were 43 patients with post-stroke hemiplegic shoulder pain. These patients were randomly divided into four groups : the group treated with acupuncture, the group cotreated with acupuncture and sweet bee venom acupuncture, the group cotreated with acupuncture and $Samgieum-gagam$, the group cotreated with acupuncture, sweet bee venom acupuncture and Samgieumgagam, They were treated for 4 weeks, and the effectiveness was assessed by visual analogue scale(VAS), Fugl-Meyer motor assessment(FMMA), painless passive ROM of shoulder external rotation(PROM), Modified Ashworth sacle(MAS) and Satisfaction. Results : All groups showed significant change in VAS, FMMA and PROM. The group cotreated with acupuncture, sweet bee venom acupuncture and $Samgieum-gagam$ showed more effectiveness in VAS and FMMA than the group treated with acupuncture. There was no significant difference in MAS among groups. Conclusions : This study suggests that cotreatment with $Samgieum-gagam$, acupuncture and sweet bee venom acupuncture is more effective than acupuncture treatment only on post-stroke shoulder pain. Further study based on many other combination methods, larger population, and long term follow-up is needed to confirm this suggestion.

The Effects of Repetitive Transcranial Magnetic Stimulation on the Gait of Acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.2
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    • pp.129-132
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    • 2015
  • The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

The Immediate Effects of Posterior Pelvic Tilt with Taping on Pelvic Inclination, Gait Function and Balance in Chronic Stroke Patients

  • Wu, Yang-Ting;Choe, Yu-Won;Peng, Cheng;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.3
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    • pp.11-21
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    • 2017
  • PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p<.05). Post hoc test results differed significantly in the 10-meter walk test after intervention (p<.05). However, there were no significant differences in limits of stability test after intervention (p>.05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

The Effects of Individualized Education on Stroke Patients' Post-discharge Anxiety and Self-care Compliance (개별화된 교육이 허혈성 뇌졸중 환자의 불안과 자가간호수행에 미치는 효과)

  • Park, Hyoung-Sook;Lee, Mee-Hun;Ha, Jae-Hyun
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.1
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    • pp.1-8
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    • 2013
  • Purpose: This study aimed to identify the effect of individualized education on stroke patients' post-discharge anxiety and self-care compliance. Methods: It was a pretest-posttest design with non-equivalent groups. A total of 32 hospitalized stroke patients in experimental group were given individualized education three times at one day before, the day of and one week after discharge. Data were analyzed using descriptive statistics, t-test and $x^2$-test. Results: The scores of anxiety at posttest were $45.66{\pm}9.58$ in control group and $35.44{\pm}8.21$ in the experimental group. Self-compliance scores were $44.00{\pm}7.99$ in control and $61.06{\pm}7.69$ in the experimental group. These indicate that anxiety score is significantly lower (t=-4.58, p<.001), and self-compliance score is significantly higher (t=8.70, p<.001) in experimental group. Conclusion: If stroke patients receive a relevant individualized education, it could help reduce their anxiety. Also it would be useful to maintain and improve their self-care compliance after discharge.

Targetting Balance and Gait Rehabilitation with Multichannel Transcranial Direct Current Stimulation in a Sub-Acute Stroke Survivor-A Case Report

  • Gakhar, Kazal;Arumugam, Narkeesh;Midha, Divya
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.8-15
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    • 2022
  • Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

Effects of Sympathetic Conversation on Electroencephalogram, Stress, Anxiety-Depression, and Muscle Tone in Chronic Stroke Patients

  • Choe, Yu-Won;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.99-111
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    • 2018
  • PURPOSE: This study was conducted to identify the effects of sympathetic conversation on stress, anxiety and depression, and muscle tone in chronic stroke patients. METHODS: Patients were randomly assigned to either an experimental group (EG, n=7) or control group (CG, n=7). Both groups participated in a pretest before intervention. Subjects were asked to undergo: 1) electroencephalogram, 2) Stress Response Inventory, 3) Hospital Anxiety and Depression Scale, 4) muscle tone and stiffness testing. After the pretest, EG received sympathetic conversation and CG received a simple explanation about stroke recovery and rehabilitation. Following the intervention, both groups were immediately administered a post test. RESULTS: In EG, the electroencephalogram relative alpha power was significantly increased (p<.05), while the electroencephalogram relative gamma power was significantly decreased (p<.05). The Stress Response Inventory and Hospital Anxiety and Depression Scale scores decreased significantly in both groups (p<.05). In addition, muscle tone and stiffness decreased significantly in the EG (p<.05) CONCLUSION: The results of the present study indicate that sympathetic conversation had a positive effect on stress, anxiety and depression, and muscle tone in patients with chronic stroke. Therefore, sympathetic conversation could be used to improve not only psychological problems in chronic stroke patients including stress and anxiety, but also physical conditions including muscle tone.