• Title, Summary, Keyword: Chronic stroke

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Comparison of Pulmonary and Gait Function in Subacute or Chronic Stroke Patients and Healthy Subjects (아급성과 만성 뇌졸중 환자 및 정상인의 심폐와 보행 기능 비교)

  • Kim, Chang-Beom;Choi, Jong-Duk
    • The Journal of Korean Physical Therapy
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    • v.23 no.5
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    • pp.23-28
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    • 2011
  • Purpose: The aim of this study was to evaluate functional gait and pulmonary function of patients with subacute or chronic stroke for aperiod after the onset of stroke. Healthy people of similar ages served as a control group. The study focused on the clinical importance of intervention with cardiopulmonary rehabilitation treatment in patients with stroke. Methods: The standard time period used to differentiate the subacute and the chronic stroke groups was six months. Each group, including the control, was allocated 11 subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume at one second ($FEV_1$) were measured with a spirometer for each subject. Walk tests (10 m and 6 min) and functional gait tests were then conducted. Results: Significant differences were noted for VC, FVC, and $FEV_1$ between the subacute stroke group and the normal group and between the chronic stroke group and the normal group (p<0.05), but no significant difference was evident between the subacute stroke group and the chronic stroke group (p>0.05). No significant difference was seen between the subacute stroke group and the chronic stroke group in the 6min walk test (p>0.05), whereas a significant difference was observed between the subacute stroke group and the chronic stroke group in the 10 m walk test (p<0.05). Conclusion: The general rehabilitation treatment is effective with respect to functional aspects, but it has limited effect in improving pulmonary function and muscular endurance. Therefore, additional intervention of cardiopulmonary rehabilitation is necessary in the rehabilitation treatment process of patients with stroke.

Examining the Quality of Life Related to Fall Experience in Chronic Stroke Patients

  • Lee, Ju-Hwan;Park, Shin-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.3
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    • pp.73-80
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    • 2016
  • PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

Effects of a Group Exercise Program for the Upper Extremities on Sensory and Motor Function and Activities of Daily Living in Chronic Stroke Patients: A Case Series

  • Ko, Myung-Sook;Jeon, Yong-Jin
    • Physical Therapy Korea
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    • v.22 no.2
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    • pp.59-69
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    • 2015
  • The purpose of this study was to identify the effects of an upper extremities group exercise program based on motor learning in chronic stroke patients and to assess improvements in upper sensory motor function and activities of daily living (ADL). Five chronic stroke patients participated for the duration of 25 weeks. On the assessment of motor and process skills, there was a statistically significant improvement in motor area functioning in 4 of the subjects. In process area functioning, there was a statistically significant change in 3 of the subjects. Therefore, further studies are needed to assess sensorimotor area and ADL changes in chronic stroke patients to reduce medical cost and assess for positive psychological changes.

Relationship of Cognitive Functions and Physical Activities in Persons with Chronic Stroke

  • Woo, Young-Keun;Hwang, Su-Jin
    • PNF and Movement
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    • v.10 no.4
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    • pp.1-7
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    • 2012
  • Purpose : The purpose of this study was to evaluate the relationship between physical performance, such as gait and postural control, and cognition on as assessed by clinical tools in individuals with chronic hemiparetic stroke. Methods : Twenty-six patients who had hemiparetic stroke participated in this study, and were evaluated four common clinical measurements, including the Berg balance scale (BBS), 10 meter walk test (10MWT), 6 minute walking test (6MWT), and Montreal cognitive assessment (MoCA). Multiple regression analysis was used BBS score, 10MWT, and 6MWT as the dependent variables; MoCA score, post-stroke duration, age, and affected side as independent variables. Results : In the regression equation of the BBS score, the correlation coefficient (r) was 0.875, the coefficient of determination (R2) was 0.786, and the MoCA score was the most important variable for determining the BBS score. In the regression equation for the 10MWT, ther was 0.888, the R2 was 0.999, and the MoCA score was the most important variable for determining 10MWT. Finally, the r was 0.777, the R2 was 0.998, and the MoCA score was the most important variable for determining 6MWT in the regression equation of the 6MWT. Conclusion : The results show that cognitive abilities affect gait proficiencies in individuals with chronic hemiparetic stroke. Therefore, these results suggest that cognitive tests are necessary for examining and evaluating the abilities of postural control and gait performance for chronic stroke patients in research and clinical environments.

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Effects of Action Observational Physical Training Based on Mirror Neuron System on Upper Extremity function and Activities of Daily Living of Chronic Stroke Patients (거울신경세포시스템에 근간한 동작관찰-신체훈련이 만성 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 영향)

  • Ko, Hyo-Eun
    • PNF and Movement
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    • v.13 no.4
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    • pp.175-180
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    • 2015
  • Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.

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Applications of Diffusion Tensor MRI to Predict Motor Recovery of Stroke Patients in the Chronic Stages

  • Tae, Ki-Sik;Song, Sung-Jae;Kim, Young-Ho
    • Journal of Biomedical Engineering Research
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    • v.29 no.2
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    • pp.114-121
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    • 2008
  • Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation. In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that tractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.

A Systematic Review of Treatment for Chronic Pain after Stroke (중풍환자의 통증 치료에 관한 체계적 고찰 연구)

  • Kim, Tae-in;Chung, Ji-won;Choi, Jae-wan;Kim, Eun-jung;Lee, Ji-won;Kim, Yun-seo;Chun, Gyung-jin;Bae, Sun-kyu;Kim, Ji-yu;Chae, Woo-ri;Jung, Jae-won;Song, Gyu-seok;Lee, He-sol;Park, Jeong-su;Lee, Ju-ah;Kim, Young-ji;Kong, Kyung-hwan;Go, Ho-yeon
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.929-939
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    • 2016
  • Objectives: Strokes have diverse symptoms and signs. One of ten stroke patients has chronic pain after a stroke. Pain after a stroke interrupts rehabilitation and worsens quality of life, but there is no efficient treatment for this pain. This study surveyed and reports on the clinical studies of treatment for chronic pain after a stroke. Methods: We searched journals for reports on clinical studies of treatment for chronic pain after a stroke through the databases OASIS (http://oasis.kiom.re.kr), NDSL (ndsl.kr), Kmbase (http://kmbase.medric.or.kr/), and PubMed (http://www. pubmed.com). The search words were "stroke & pain", "jungpung中風 & pain", "pungbi風痺", "cerebral hemorrhage & pain", and "cerebral infarction & pain". Results: Twenty-nine studies of treatment for chronic pain after a stroke were found. Of these, 15 were randomized controlled trials, 10 were nonrandomized controlled trials, and 4 were "before and after" studies. Treatments were diverse, including acupuncture, electroacupuncture, herbal acupuncture, herbal medicine, and more. The treatment periods were longer than 3 weeks on average. Conclusions: These results show that good quality randomized controlled trials of treatment for chronic pain after a stroke are small in number. We need larger and more diverse studies of treatment for chronic pain after a stroke.

Effects of elastic band orthosis (aider) on balance and gait in chronic stroke patients

  • Daher, Noha;Lee, Seungjun;Yang, You Jin
    • Physical Therapy Rehabilitation Science
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    • v.2 no.2
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    • pp.81-86
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    • 2013
  • Objective: The objective of this study was to investigate the feasibility and effects of balance training using a newly developed elastic band orthosis (aider) for improvement of mobility and balance in chronic stroke patients. Design: Cross-sectional study. Methods: Ten patients with chronic hemiplegia participated in this study. There were six males and four females; two patients had right hemiplegia and eight had left hemiplegia. This study investigated the effect of the elastic band orthosis on balance and gait ability compared with bare foot condition. Gait parameters were measured using the opto-gait system for analysis of the spatial and temporal parameters of walking in stroke patients. In addition, balance ability in stroke patients was evaluated using the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Results: This study investigated the effect of the elastic band orthosis on balance compared with bare foot condition. The TUG and BBS showed significant improvement with use of the elastic band orthosis (p<0.05). Use of the Elastic band orthosis resulted in significantly improved velocity, cadence, less-affected step length, less-affected stride length, and less-affected single limb support in stroke patients (p<0.05). Conclusions: We demonstrated a significant improvement in dynamic balance and gait ability in chronic stroke patients using the elastic band orthosis. This orthosis may aid in prevention of spastic foot drop, leading to improvement of walking ability.

Effects of Balance Training through Visual Control on Balance Ability, Postural Control, and Balance Confidence in Chronic Stroke Patients (시각 통제를 이용한 균형훈련이 만성 뇌졸중 환자의 균형능력과 자세조절, 균형자신감에 미치는 영향)

  • Jeong, Seong-Hwa;Koo, Hyun-Mo
    • PNF and Movement
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    • v.18 no.1
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    • pp.133-141
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    • 2020
  • Purpose: The purpose of this study was to conduct balance training through vision control to improve the balance, postural control, and balance confidence and to decrease the visual and sensory dependence of stroke patients. Methods: Twenty-eight chronic stroke patients volunteered to participate in the study. They were randomly assigned to the eyes-closed and the eyes-open training groups. Three times a week for four weeks each group performed an unstable-support session and a balance training session for thirty minutes per set. Their balance, postural control, and balance confidence were assessed using BIO Rescue (BR), the postural assessment scale for stroke (PASS), and the Korean activity-specific balance confidence scale (K-ABC), respectively. All data were analyzed using SPSS version 22.0. Statistical methods before and after working around the average value of each dataset were independent T-test. The significance level for statistical analyses was set at 0.05. Results: Comparison between the groups showed statistically significant effects on all variables before and after the intervention (p < 0.05). Conclusion: This study reflected that balance-training programs involving vision control improve the balance, postural control, and balance confidence of chronic stroke patients. Thus, stroke patients should undergo training programs that increase the use of their other senses with vision control in clinical practice.

Virtual Reality Community Gait Training Using a 360° Image Improves Gait Ability in Chronic Stroke Patients

  • Kim, Myung-Joon
    • The Journal of Korean Physical Therapy
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    • v.32 no.3
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    • pp.185-190
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    • 2020
  • Purpose: Gait and cognitive impairment in stroke patients exacerbate fall risk and mobility difficulties during multi-task walking. Virtual reality can provide interesting and challenging training in a community setting. This study evaluated the effect of community-based virtual reality gait training (VRGT) using a 360-degree image on the gait ability of chronic stroke patients. Methods: Forty-five chronic stroke patients who were admitted to a rehabilitation hospital participated in this study. Patients meeting the selection criteria were randomly divided into a VRGT group (n=23) and a control group (n=22). Both these groups received general rehabilitation. The VRGT group was evaluated using a 360-degree image that was recorded for 50 minutes a day, 5 days per week for a total of 6 weeks after their training. The control group received general treadmill training for the same amount of time as that of the VRGT group. The improvement in the spatiotemporal parameters of gait was evaluated using a gait analyzer system before and after training. Results: The spatiotemporal gait parameters showed significant improvements in both groups compare with the baseline measurements (p<0.05), and the VRGT group showed more improvement than the control group (p<0.05). Conclusion: Community-based VRGT has been shown to improve the walking ability of chronic stroke patients and is expected to be used in rehabilitation of stroke patients in the future.