• Title, Summary, Keyword: Stroke patients

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The effects of virtual reality-based physical therapy in stroke patients

  • Kim, Charyong;Min, Won-Kyu
    • Physical Therapy Rehabilitation Science
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    • v.2 no.1
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    • pp.7-11
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    • 2013
  • Objective: Final goal of nerve advancement therapy is to provide maximum ability to function independently in life to patients. This paper appraises and describes basic concepts of the virtual reality (VR) based exercise program to improve functional movement for neurologically impaired patients. Design: Review article. Methods: Stroke patients from the physical therapy department while wearing comfortable clothing receive therapy and also VR based motion therapy administered by the therapist in charge. After evaluation of stroke patients, therapy includes an exercise program that is suitable for use with stroke patients; stroke patients wear head-mounted display while in front of the computer, where the camera is located; they follow the action on the screen and the computer perceives the operation of the stroke patients according to subject accomplishment. Results: According to obstacle condition of stroke patients using the method, which is various environments after setting, in stroke patients, there is a possibility of presenting suitable therapeutic environments. The display presentation of the method, which is identical, causes difficulty for all stroke patients. According to subject accomplishment; stroke patients result in execution of repetition training and deepening study, which leads to mobility. Conclusions: The VR based rehabilitation training programs is a difference of the existing video training program, is immediate feedback and compensation method. It will provide rehabilitation training services for the family of the patient whose condition could be improved with rehabilitative therapy where it is a continuous circumstance as a matter of the social welfare facility therapy.

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Patients' Lived Experience in Rehabilitating from Stroke (뇌졸중 환자의 재활 경험)

  • Lee, Young-Ae
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.20-30
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    • 2001
  • Stroke is known as a detrimental disease that leaves serious sequelae. The stroke patients suffer from limitations of physical and social activities. The patients try to adapt themselves to the limitations in order to achieve rehabilitation. This study was performed to clarify the lived experience of rehabilitation from the stroke patients. In collecting data for this study, in-depth personal interviews were made by a researcher from February to April in 2001 at rehabilitation clinics and physical therapy centers locate in Iksan city. The methodological approach was van Manen's hermeneutic phenomenological methodology in order to understand the meaning and nature of stroke patients' experiences in rehabilitating their physical limitations. Collected data were analyzed with phenomenological way of study that was develope by van Manen. The 8 patients who agreed to participate in this research were inter viewed by researcher under the private and comfortable environment. Personal interviews were done three or five times per each patients and each interview took 70 to 90 minutes. The statements were analyzed and finally revealed three essential themes : Theme 1 - Desperateness to achieve freedom again Theme 2 - Seizing hope of recovering Theme 3 - Seeking support from family members, relatives and friends Based on these themes, stroke patients' rehabilitation experience are described as following. The stroke patients have strong desire to achieve freedom again in order to escape from social isolation. The stroke patients want to go back to the state of their previous health state. The stroke patients strongly try to do anything for their recovering and also to have positive thinking. In the other hand, they feel pity for themselves through desperation, fear, sorrow, and self-pity. The stroke patients have dissatisfaction about neighbors' rumor and attitude toward themselves. The stroke patients have experiences to rely on neighbors' support seeking a warm word of consolation. This research showed us that van Manen's hermeneutic phenomenological methodology leads us to understand stroke patients' rehabilitation process more comprehensibly. Based on this research, it is suggested that further studies provide a foundation for the development of a rehabilitation theory for Korean stroke patients.

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Pathway of stroke patients seeking medical care (뇌졸중 환자의 의료이용 경로에 관한 연구)

  • Byun Young-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.149-163
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    • 2000
  • The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.

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Recent Epidemiological Trends of Stroke

  • Park, Hyun-Seok;Kang, Myong-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.16-20
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    • 2008
  • Objective : Rapid increase in aged population and westernization of lifestyle have modified epidemiological status of stroke. The purpose of this study is to analyze changing trends of stroke epidemiology in South Korea. Methods : We reviewed retrospectively medical records of 1,124 cases diagnosed as stroke among 54,534 patients who visited the Emergency Medical Center at our hospital from January 1994 to December 1996 (Group A). Also, we evaluated 1,705 cases diagnosed as stroke among 55,381 patients who visited to the same hospital from January 2003 to December 2005 (Group B). The variable features of stroke, such as age, sex, seasonal variation and distribution of stroke subtypes were studied by comparing group A with B. Results : In group A, hemorrhagic stroke (67.9%) was more prevalent than ischemic stroke (32.1%). However, group B showed that the ratio of hemorrhagic stroke (40.3%) to ischemic stroke (59.6%) has been reversed. The highest incidence of stroke was noted in their sixties and seventies of age in group B, which was older than that of group A. In group A, male ischemic stroke (IS) patients outnumbered female patients (1.26:1). Moreover, this gender disproportion became higher in group B (1.53:1). In group A, the number of male intracerebral hermorrhage (ICH) patients were similar to that of female patients (0.97:1). However, male ICH patients outnumbered female patients in group B (1.23:1). As for subarachnoid hemorrhage (SAH), female patients outnumbered male patients more than two-fold in both groups. Both groups showed that the occurrence of ischemic stroke was highest in summer, but that of hemorrhagic stroke was the highest in winter. Conclusion : This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.

Research for Apraxia Prevalence Rate and Comparison of Clinical Characteristics in Stroke Patients (일부 뇌졸중 입원환자들의 사지 실행증 분포 및 특성)

  • Cho, In-Sul;Nam, Seok-Hyun;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.23 no.5
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    • pp.43-47
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    • 2011
  • Purpose: Apraxia is characterized by loss of the ability to execute learned, skilled, sequential purposeful movements which cannot be accounted for by elementary disturbances of strength, coordination, sensory, lack of comprehension, attention, and willingness etc. For an accurate diagnosis and treatment of patients with apraxia, an understanding of the prevalence rate and clinical characteristics of apraxia is necessary. The purpose of this study was to estimate the apraxia prevalence rate. Methods: The apraxia prevalence rate was investigated via an apraxia assessment tool in 137 stroke patients, and the clinical characteristics of general stroke patients and stroke patients with apraxia were compared. Results: 14 (1 left hemiplegia, 8 right hemiplegia, 5 quadri hemiplegia) of a total of 137 stroke patients were diagnosed with apraxia. The group of stroke patients with apraxia showed lower values of mmt, mbc and fac than those of general stroke patients. Conclusion: The apraxia prevalence rate of stroke patients was approximately 10%, while the clinical function of stroke patients with apraxia was generally inferior to that of general stroke patients.

Sex Differences in Patients with First-ever Stroke (in terms of stroke types, risk factors, warning signs and stroke complications) (뇌졸중 초발 환자의 남녀별 차이점에 대한 연구 (뇌졸중 유형, 위험인자, 전조증상, 합병증의 관점에서))

  • Jung, Jae-Han;Sun, Jong-Joo;Hong, Jin-Woo;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Na, Byung-Jo
    • The Journal of Korean Medicine
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    • v.28 no.3
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    • pp.207-215
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    • 2007
  • Objectives : The objective of this study was to assess whether there were sex differences in stroke types, risk factors, warning signs, and stroke complications among patients with first-ever stroke. Methods : Six-hundred seventy six patients with first-ever stroke were recruited at the Department Cardiovascular and Neurologic Diseases (Stroke center) of KyungHee University Oriental Hospital, DongGuk University International Hospital, and Kyungwon University In-cheon Oriental Medical Hospital from September 2005 to June 2007. Patients were hospitalized within 28 days after the onset of stroke. We investigated their stroke types, ischemic stroke subtypes by TOAST classification, risk factors, warning signs, stroke complications, general characteristics such as age, sex, etc. Results : Overall, 347 patients were male and 279 female. Compared with males, female patients were significantly older (mean age 67.3${\pm}$1.1 versus 62.4${\pm}$1.6 years) (P=0.000). We did not find significant sex differences in stroke types or ischemic stroke subtypes by TOAST classification. History of hypertension was significantly more frequent in female than male patients (P=0.000). Among stroke complications, urinary tract infection was significantly more frequent in female than male patients (P=0.003). Among warning signs, blepharospasm was significantly more frequent in female than male patients (P=0.006). Conclusions : Knowledge of sex differences of stroke patients can help us gain better insights on the characteristics of stroke patients. We need further and larger scale research to acquire more concrete conclusions on this theme.

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Tactile and Proprioceptive Discriminative Sensory Dysfunction After Unilateral Stroke (뇌졸중 환자의 촉각 및 위치 식별감각 이상에 관한 연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.138-147
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    • 1996
  • Although sensory deficits caused by stroke have been occasionally reported, dysfunctions of discriminative sensation have seldom been studied in patients with strokes. With the use of specifically designed methods, discriminative sensations including texture discrimination and position sense were tested in 67 patients with acute unilateral stroke. Thirty-two age and sex-matched healthy subjects were used as controls. Impaired discriminative sensation was common in patients with unilateral stroke (detected in 57 out of the 67 patients) regardless of the lesion location except for patients with lateral medullary stroke. Proprioceptive discriminative sensation remained intact in all except for three out of 25 patients who were initially diagnosed as having pure motor stroke on the bases of conventional sensory tests. However, tactile discriminative sensation remained intact in only 17 out of 25 patients. Discriminative sensory disturbances are common in patients with unilateral stroke even in those with intact sensory function on routine examination. The subtle disturbances of this sensation may explain, at least in part, the clumsiness of the patients that is not readily explained by conventional neurological tests.

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Factors Delaying Hospital Arrival Time after Stroke (뇌졸중 환자들의 지연도착시간에 관한 요인들)

  • Song Yung Sun;Lee Su Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.1075-1078
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    • 2002
  • Objective: The management for the stroke should ,given as soon as possible to be effect. But Patients with stroke symptoms commonly delay many hours before seeking medical attention. We evaluated the factors which are related to the time of hospital arrival after acute stroke. Method: Data were obtained from 317 patients admitted to our hospital within 72 hours of stroke onset. We assessed demographic variables, stoke subtype. referral routes. history of previous stroke, level of consciousness, distance from the place where stroke occurred to hospital, and the time interval between onset of stroke and arrival at the hospital. Results: Mean patient age was 65.99±9.57 years. The mean time interval between onset of stroke and hospital arrival was 17.26±18.69 hours and 128 (40.38%) patients arrived within 6 hours. The patients whoes stoke subtype was infarction, who arrived our hospital by way of other hospital, who had no suffered from previous stroke and who showed no impairement of consciousness was arrived at the hospital late(p<0.05). Conclusion: The majority of patients arrive at the hospital after prolonged delays for multiple reasons, and patients with milder symptoms, for whom treatment might be more effective, were less likely to arrive in time for therapy. Our study suggest that effective education about stroke to the patients and public would be highly necessary.

Changes of spatio-temporal gait parameters according to experience falls in post-stroke patients

  • Cho, Ki Hun;Lee, Wan Hee
    • Physical Therapy Rehabilitation Science
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    • v.1 no.1
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    • pp.22-27
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    • 2012
  • Objective: Falls are defined as contact of the body with the floor after losing balance during activities of daily living. Falls commonly occur among the elderly, and stroke patients in particular are at a high risk of falling. The purpose of this study was to investigate the changes of temporal and spatial gait parameters and gait symmetry according to experience falls in post-stroke patients. Design: Cross-sectional study. Methods: Fifty three patients with stroke were recruited on a voluntary basis from the rehabilitation unit, who currently undergoing physical therapy. All participants were asked to answer questions regarding the frequency of falls in the past 1 year. Fifty-three patients with stroke were allocated 2 groups according to experienced falls: stroke with falls (n=26) during past 1 year and stroke without falls (n=27). The spatial and temporal gait parameters and gait symmetry ratio were measured using GAITRite system. Results: The spatial gait parameters and the temporal gait parameters were significantly different between the stroke with falls group and the stroke without falls group (p<0.05). Furthermore, step length was the only significantly different among symmetry ratio (p<0.05). Conclusions: Experience of falls can lead to impairment of gait ability in stroke patients. This result is expected to be used as a basic data for rehabilitation program development to prevent a fall of post-stroke patients.

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AN EXPLORATORY STUDY COMPARING BLOOD METAL CONCENTRATIONS BETWEEN STROKE AND NON-STROKE PATIENTS IN KOREANS

  • Lee, Sun-Dong;Ko, Seong-Gyu;Kim, Rok-Ho;Hu, Howard;Amarasiriwardena, Chitra J.;Park, Hae-Mo
    • Proceedings of the Korean Environmental Health Society Conference
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    • pp.87-94
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    • 2005
  • Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

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