• Journal of the Korean Society of Physical Medicine
• /
• v.12 no.2
• /
• pp.83-90
• /
• 2017

PURPOSE: Central post-stroke pain (CPSP), a chronic pain condition of stroke patients, can impair activities of daily living and worsen the quality of life (QOL), thereby negatively influencing the rehabilitation process. However, CPSP remains an underestimated complication of stroke. This study aimed to describe the prevalence and types of new-onset chronic pain and to identify the relation between pain and QOL in stroke patients. METHODS: All patients hospitalized because of a diagnosis of stroke were included. Questionnaire was used. Pain intensity was measured using Numerical rating scale (NRS), and pain characteristics were assessed using DN4. QOL was measured using SF-36. Descriptive statistics were used to analyze the characteristics and pain data, and chi-square test was used to compare QOL categorical data between the nociceptive and neurological pain groups. RESULTS: CPSP development was reported by 34% of the post-stroke pain patients. Perceived QOL was low in both groups, especially with respect to the physical functioning, bodily pain, physical-role functioning, emotional-role functioning, and mental health domains. However, no significant difference was observed in QOL between the nociceptive and neurological pain groups (p<.05). CONCLUSION: Our results indicated that CPSP is a common and disabling complication that is difficult to treat, often decreases QOL, and may negatively affect rehabilitation treatment.

• Physical Therapy Korea
• /
• v.29 no.2
• /
• pp.147-155
• /
• 2022

Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy. Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study. Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05). Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = -0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (n_p² = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks. Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

• Journal of Yeungnam Medical Science
• /
• v.38 no.4
• /
• pp.361-365
• /
• 2021

Stroke patients have reduced aerobic capacity. Therefore, intensive structured exercise programs are needed. We report the case of a patient with stroke and cardiac disease who underwent early inpatient cardiac rehabilitation (CR). A 38-year-old male patient with atrial fibrillation, heart failure, and cerebral infarction underwent a symptom-limited exercise tolerance test (ETT) without any problems on day 45 after admission. He completed a 2-week inpatient program and an 8-week home-based CR program. Follow-up ETT showed increased exercise capacity. The present case might be the first to report a safely performed CR program in a patient with stroke and cardiac comorbidity in Korea. Systematic guidance is needed for post-stroke patients to receive safe and effective CR for the secondary prevention of stroke and cardiovascular risk.

• PNF and Movement
• /
• v.18 no.2
• /
• pp.195-204
• /
• 2020

Purpose: The study investigated the effect of combined balance exercise using visual feedback and balance pads in rehabilitation of chronic stroke patients. Methods: The participants were 30 patients diagnosed with stroke who met the study selection criteria. Participants were randomly divided into 3 groups of 10: a balance pad exercise (BPE) group, a visual feedback exercise (VFE) group, and a combined balance exercise (CBE) group. All three groups engaged in 30 minutes of exercise, 3 times per week, for 6 weeks. Results: Pre-test and post-test results were analyzed using the functional reach test (FRT), the Berg balance scale (BBS), the timed up & go test (TUG), and the Korean version of the activities-specific balance confidence (K-ABC) scale. The study yielded the following results. Pre- and post-program FRT measures showed significant differences between the BPE and CBE groups (p < 0.05). BBS, TUG, and K-ABC scores showed clear differences in all three groups. Secondly, the CBE group and the BPE group a differed significantly on the BBS before and after the 6-week program (p < 0.05). Finally, the CBE group and the VFE group differed significantly on the BBS before and after the 6-week program (p < 0.05). Conclusion: The study results indicate that combined balance exercise improves balance more effectively than the balance pad and visual feedback exercises. This finding should help to improve rehabilitation in the future.

• Korean Journal of Adult Nursing
• /
• v.16 no.1
• /
• pp.37-48
• /
• 2004

Purpose: The purpose of this preliminary study was to develop and evaluate the effects of East-West Self-help program for Rehabilitation of post-stroke clients. Method: This program is developed through literature review, survey and seminar. The program is consisted of six sessions twice a week for 6 weeks. This program is composed of health education on stroke, exercise, oriental nursing interventions, and therapeutic recreation. The outcomes have been evaluated on the basis of perceived health status, self-efficacy, U/E function, ADLs and subjective response. Result: 1) After the 6 week program, the perceived health status had improved and the score of rehabilitation self-efficacy increased significantly. 2) After the 6 week program, the score of BADL increased significantly, but, the score of IADL was not statistically significant. 3) After the 6 week program, the amount of use and quality of movement of the affected U/E were increased significantly. 4) All of the participants showed satisfaction with this program. Conclusion: Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be continuously developed and implemented as a community based self-helf group program for post-stroke clients.

• Journal of the Korean Society for Precision Engineering
• /
• v.30 no.4
• /
• pp.450-458
• /
• 2013

The aim of this study was to develop and verify gait training system for post-stroke hemiplegia patients with step length asymmetry. Most post-stroke hemiplegic patients show gait asymmetry and weight shifting training has been suggested as a useful method for improving the walking ability. However, verbal cue by physical therapist may be not effective. Therefore, our weight shift training system was designed to give a feedback to patients through precise plantar pressure and center of pressure (COP) measurement. This weight shifting biofeedback training system is composed of F-Scan plantar pressure measurement system and software development kit (SDK) for Windows operating system. Two post-stroke patients with step length asymmetry were enrolled in this study. After training for six weeks, the weight shift score and step length ratio of two all patients were improved and approached to them of non-disabled. This system developed in this study may improve the step length asymmetry, and therefore this system is also expected to improve a walking ability in hemiplegic patients.

• The Korean Journal of Rehabilitation Nursing
• /
• v.2 no.2
• /
• pp.206-214
• /
• 1999

The effect s of social support on post-stroke depression were investigated. Social support was classified into three categories : primary caregiver's, significant other's, and professional support. And primary caregiver's and significant other's support were divided into their relation, living state (which means they living together or not), frequency which they met at, and perceived satisfaction about the support, respectively. Professional support was divided into number of professionals who take care of, frequency they met at, and perceived satisfaction. The subjects were 254 stroke patients who had been discharged and were taken follow-up care at the out patient department. The depression was measured using CES-D. Out of the primary caregiver's support, only relation and perceived satisfaction were identified to affect the post-stroke depression. The patients who primarily their spouse takes care of were less depressed than those who their adult children take care of. None of the significant other's support affects the post-stroke depression. Only perceived satisfaction of the professional support was found to affect the post-stroke depression. So it was found that the quality, not the amount, of care was important to post-stroke depression. These results also support the claim that the facilities and teaching programs for primary caregivers are necessary.

• Journal of Magnetics
• /
• v.20 no.2
• /
• pp.133-137
• /
• 2015

This study was conducted to determine the effects of repetitive transcranial magnetic stimulation (rTMS) integrated mirror therapy on the gait of post-stroke patients. Thirty patients who were six months post-stroke were assigned to either the experimental group (n = 15) or the control group (n = 15). Stroke patients in the experimental group underwent rTMS and mirror therapy for the lower limbs, while those in the control group underwent rTMS and sham therapy. Participants in both groups received therapy five days per week for four weeks. A significant difference in post-training gains for the single support phase, step length, stride length and velocity was observed between the experimental group and the control group (p < 0.05). The experimental group showed a significant increment in the single support phase, step length, stride length, swing phase, velocity, cadence, double support phase and step width as compared to pre-intervention (p < 0.05). The control group showed a significant increment in step length, velocity, cadence and step width compared to preintervention (p < 0.05). Further investigation of the availability and feasibility of rTMS integrated mirror therapy for post-stroke patients as a therapeutic approach for gait rehabilitation is warranted.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.2
• /
• pp.47-54
• /
• 2015

PURPOSE: The purpose of this study is to examine the relationship between the physical activities of individuals post-stroke and their HRQL, as well as to determine whether their functional abilities contribute to their amounts of physical activity. METHODS: The study's subjects included 90 individuals post-stroke. Their amounts of physical activity were measured using the International Physical Activity Questionnaire (IPAQ), and their HRQL was measured using the Medical Outcomes Study 36-Item Short-form Health Survey (SF-36). In addition, the functional abilities of the subjects were measured. For the measures of physical activities and the HRQL, Pearson's correlation coefficients were used to identify the strengths of the associations between the measures. A hierarchical linear regression model was used to determine whether physical activities had independent impacts on the HRQL. RESULTS: This study found that the physical activities performed by the subjects affected the SF-36 physical component score (PCS) (12%). However, the physical activities and the SF-36 mental component score (MCS) showed no statistically significant relationship, whereas functional abilities and physical activities had a statistically significant relationship (r = .57~.86, p<.001). CONCLUSION: The present study identified a correlation between physical activity and the PCS. Therefore, individuals post-stroke should be encouraged to carry out more physical activities, including more frequent walking activities.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.1
• /
• pp.6-12
• /
• 2018

Objective: The purpose of this study was to investigate the effects of an additional weight aquatic exercise program on the balance and lower extremity strength on aquatic environment in persons with stroke. Design: Randomized controlled trial. Methods: All subjects were randomly divided into three groups where thirteen subjects were in the additional weight aquatic exercise group, twelve subjects in the aquatic exercise group, and fifteen subjects in the control group. Subjects received a graded aquatic exercise program for 30 minutes, with 3 sessions per week for 6 weeks, and subjects in all groups received conventional physical therapy. All subjects were assessed with the Medical Research Council (MRC), the Berg Balance scale (BBS), Timed Up and Go test (TUG), and 10-meter walk test (10MWT) pre and post intervention. Results: The MRC, BBS, TUG, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved in all areas post-treatment (p<0.05). In addition, it has been confirmed that the additional weight aquatic exercise group had significantly improved in MRC, BBS, and TUG scores compared with the aquatic exercise and control group (p<0.05). Conclusions: The findings of this study suggested that the additional weight aquatic exercise program improves lower extremity and balance in persons with stroke.