• Title/Summary/Keyword: post-stroke rehabilitation

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Effects of Eccentric Exercise of Hip Abductors on Gait Balance (고관절 외전근의 원심성 운동이 보행시 균형에 미치는 효과)

  • Choi, Won-Ho;Kim, Myung-Jong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.9 no.2
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    • pp.59-67
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    • 2003
  • The purpose of this study was to identify the effects of eccentric exercise of affected hip abductor muscles on Gait balance in patient with hemiplegia. 30 patients with hemiplegia were recruited among in and out patients of Gil Hospital(age x=50.5, SD=10.1, range 37-80. post stroke days x=383.2, SD=309.3, range 57-1165). These patients were divided into eccentric and control groups by random sampling. TUG were used for this study. Paired t- test was used to identify the effects of eccentric exercise of hip. The results were stastically significantly differences in the effect of exercise between experimental and control groups by TUG(p<0.05). The results indicate that the eccentric exercise of affected hip abductor muscles is effects on gait balance in patient with hemiplegia.

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A Case Study of Chengsimyeonja-tang-gamibang Treatment of a Patient with a Pontine Hemorrhage, with Quadriparesis, Dysarthria, and Dysphagia (청심연자탕 가감방으로 호전된 교뇌 출혈 이후 발생한 양측 반신부전마비, 연하곤란, 언어장애 치험 1례)

  • Yang, Jee-yun;Jeong, Taek-su;Jeon, Gyeong-ryung;Ok, So-yoon;Sun, Jong-joo
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.217-225
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    • 2017
  • Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

A Study on the Relationship between Body Function and Prelusive Movement to Falls to Promote Wellness in Chronic Stroke Patients (만성뇌졸중 환자의 웰니스 증진을 위한 신체기능과 낙성전조동작의 관련성 연구)

  • Park, Chang-Sik;Kim, Jin-Young
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.7
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    • pp.181-192
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    • 2021
  • This study was conducted to investigate the effects of a participatory rehabilitation program on sit-rise and rise-to-walk test performances, and perception and motor skills in adults with medically vulnerable individuals and, adults with developmental disabilities in particular. Seventeen adults with developmental disabilities participated in a participatory rehabilitation program using resistance bands and exercise balls, for 60 minutes once weekly over 13 weeks. Their performances were measured before and immediately after the intervention, and 12 weeks after. The findings were as follows. In the sit-rise test, the number of times rising from sitting posture increased after the intervention versus before, but the difference was not statistically significant. In the rise-to-walk test, the performance showed statistically significant difference over time, and the post-hoc test showed a significant effect after the intervention versus before. There was no significant difference in perception and motor skills. In sum, the participatory rehabilitation program positively influenced dynamic balancing related to functional activities but had no significant effect on perception and motor skills, which is related to motor control and motor learning. It is suggested that to increase the participation in community activities, reduce fall risk, and improve dynamic balancing abilities in adults with developmental disabilities, participatory rehabilitation programs should be utilized to promote the physical wellbeing.

Relationship between Ipsilateral Motor Deficits on the Less-Affected Side and Motor Function Stage on the Affected Side

  • Son, Sung Min;Nam, Seok Hyun;Kang, Kyung Woo;Kim, Dae Hyun
    • The Journal of Korean Physical Therapy
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    • v.30 no.6
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    • pp.234-238
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    • 2018
  • Purpose: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. Methods: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. Results: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. Conclusion: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

A Study of a Pattern of the Stress Perceived by Stroke Patients through the Rehabilitative Process (뇌졸중 환자의 재활과정에 따른 스트레스 변화 양상)

  • Lee, Jung-Min
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.82-98
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    • 1997
  • The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

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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.

Effect of Treadmill Gradient Training on Lower Limb Muscle Activity in Chronic Stroke Patient (만성 뇌졸중 환자의 하지 근육의 활성도에 트레드밀 경사도 훈련이 미치는 영향)

  • Kim, Shin-Gyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.220-226
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    • 2012
  • The purpose of this study was to identify the effect of treadmill gradient training on lower limb muscle activity in chronic stroke patients. The subject were 32 stroke patients.. Subjects were randomly divided into three group which were control group($0^{\circ}$treadmill training(n=10)) and experimental group($5^{\circ}$treadmill training (n=10) and $10^{\circ}$treadmill training(n=12)). Three groups received treadmill gradient training for 30 minutes while 3 times per week for 6 weeks in addition to conventional physical therapy. Muscle strength was measured by EMG on rectus femoris, biceps femoris, tibialis anterior and gastrocnenius for muscle activities. In comparison of activity of rectus femoris and gastrocnemius between pre and post value, the activity of rectus femoris was significant in the experimental and control group(p<.05) and the activity of biceps femoris was significant in the $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group(p<.05). The activity of tibialis anterior was significant in the $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group(p<.05). In comparison of the difference of activity of rectus femoris among 3 groups, there was a significant difference between the $5^{\circ}$treadmill gait training group and control group(p<.05). and difference of activity of tibialis anterior was significant difference between the $10^{\circ}$treadmill gait training group and control group(p<.05). These findings suggest that $5^{\circ}$treadmill gait training group and $10^{\circ}$treadmill gait training group can be used to improve lower limb muscle activity in chronic stroke patient. In conclusion, these treadmill gradient training helped improving function of gait ability in chronic stroke patient.

Comparison of Peripheral Blood Flow in Post-Stroke Hemiparetic Patients and Normal Person with Doppler Ultrasonography (도플러 초음파 기기를 이용한 편측 부전마비성 뇌졸중 환자와 정상인의 말초 혈류 비교 연구)

  • Han, Deok-Jin;Bang, Chang-Ho;Kim, Sergey;Bae, Young-Min;Shin, Sae-Ron;Yang, Chung-Yong;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1491-1496
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    • 2009
  • Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.

Effect of GB 34-GB 39 Electro-acupuncture on Regional Cerebral Blood Flow in Stroke Patients and Normal Volunteers Evaluated by $^{99m}Tc-ECD$ SPECT (양릉천-현종 전침치료가 뇌경색환자 및 정상인의 뇌혈류에 미치는 영향 - SPECT와 SPM을 이용한 연구 -)

  • Han, Jin-An;Jeong, Dong-Won;Bae, Hyung-Sup;Park, Sung-Uk;Jung, Woo-Sang;Park, Jung-Mee;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.3 s.67
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    • pp.187-200
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    • 2006
  • Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

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Effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in chronic stroke patients (만성 편마비 환자에 대한 교감신경 활동 강화가 근 긴장도와 중추신경흥분성 변화에 미치는 영향)

  • Kang, Byeong-Kil;Nam, Ki-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.11
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    • pp.5019-5026
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    • 2011
  • The purpose of this study was to investigate the effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in the chronic stroke patients. This study was conducted from October 12th 2009 to December 4th 2009. 30 patients with chronic hemiplegia for at least 6 months were participated. Before and during the mental arithmetic, static handgrip and post-handgrip ischemia tasks, the central nervous system action potentials and global synkinesis level were compared. The central nerve action potentials were measured with H/Mmax ratio and V/Mmax ratio. To obtain global synkinesis level, surface electromyography data were digitized, processed to root mean square. In our study, The global synkinesis level during knee flexion and extension was decreased in the mental arithmetic and in the post-handgrip ischemia task(p<.05) but not in the grip task. Also, V/Mmax ratio was decreased all in the three task(p<.05). In conclusion, we know that the central nervous system excitability and the muscle tone in chronic hemiplegic patients were decreased by the increased sympathetic outflow.