The Journal of Korean Physical Therapy

  • 제22권6호
  • /
  • Pages.53-58
  • /
  • 2010
  • /
  • 1229-0475(pISSN)
  • /
  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
권호 표지

A Comparative Study on Recovery of Motor Function in Stroke Patients with Corona Radiata Infarcts and Intracerebral Hemorrhage

  • Kim, Chung-Sun (Department of Physical Therapy, College of Rehabilitation Science, Daegu University) ;
  • Park, Sang-Young (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kwon, Jung-Won (Department of Rehabilitation Science, Graduate School, Daegu University)
  • 투고 : 2010.10.04
  • 심사 : 2010.12.08
  • 발행 : 2010.12.25
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

키워드

참고문헌

  1. Manimmanakorn N, Arrayawichanon P, Wattanapun P et al. Age-related rehabilitation outcome in stroke patients. J Med Assoc Thai. 2008;91(3):388-93.
  2. Gialanella B, Bertolinelli M, Santoro R. Rehabilitative outcome in supratentorial and infratentorial stroke: The role of motor deficits. Aging Clin Exp Res. 2008;20(4):310-5.
  3. Duncan PW, Goldstein LB, Matchar D et al. Measurement of motor recovery after stroke. Outcome assessment and sample size requirements. Stroke. 1992;23(8):1084-9. https://doi.org/10.1161/01.STR.23.8.1084
  4. Kautz SA, Patten C. Interlimb influences on paretic leg function in poststroke hemiparesis. J Neurophysiol. 2005;93(5): 2460-73. https://doi.org/10.1152/jn.00963.2004
  5. Jang SH, Byun WM, Han BS et al. Recovery of a partially damaged corticospinal tract in a patient with intracerebral hemorrhage: a diffusion tensor image study. Restor Neurol Neurosci. 2006;24(1):25-9.
  6. Jang SH, Ahn SH, Ha JS et al. Peri-infarct reorganization in a patient with corona radiata infarct: A combined study of functional MRI and diffusion tensor image tractography. Restor Neurol Neurosci. 2006;24(2):65-8.
  7. Kumral E, Bayulkem G. Spectrum of single and multiple corona radiata infarcts: Clinical/MRI correlations. J Stroke Cerebrovasc Dis. 2003;12(2):66-73. https://doi.org/10.1053/jscd.2003.11
  8. Woo D, Broderick JP. Spontaneous intracerebral hemorrhage: epidemiology and clinical presentation. Neurosurg Clin N Am. 2002;13(3):265-79. https://doi.org/10.1016/S1042-3680(02)00011-6
  9. Jang SH. A review of corticospinal tract location at corona radiata and posterior limb of the internal capsule in human brain. NeuroRehabilitation. 2009;24(3):279-83.
  10. Cho SH, Kim SH, Choi BY et al. Motor outcome according to diffusion tensor tractography findings in the early stage of intracerebral hemorrhage. Neurosci Lett. 2007;421(2):142-6. https://doi.org/10.1016/j.neulet.2007.04.052
  11. Cho SH, Kim DG, Kim DS et al. Motor outcome according to the integrity of the corticospinal tract determined by diffusion tensor tractography in the early stage of corona radiata infarct. Neurosci Lett. 2007;426(2):123-7. https://doi.org/10.1016/j.neulet.2007.08.049
  12. Yang DS, Kim DS, Kim YH et al. Demonstration of recovery of a severely damaged corticospinal tract: adiffusion tensor tractography and transcranial magnetic stimulation follow-up study. J Comput Assist Tomogr. 2008;32(3):418-20. https://doi.org/10.1097/RCT.0b013e31811eba4e
  13. Jang SH. The role of the corticospinal tract in motor recovery in patients with a stroke: a review. NeuroRehabilitation. 2009;24(3):285-90.
  14. Jang SH. A review of motor recovery mechanisms in patients with stroke. NeuroRehabilitation. 2007;22(4):253-9.
  15. Jang SH. A review of the ipsilateral motor pathway as a recovery mechanism in patients with stroke. NeuroRehabilitation. 2009;24(4):315-20.
  16. Park JW. Longitudinal motor function recovery in stroke patients with focal pons infarction: report of 4 cases. J Kor Soc Phys Ther. 2009;21(4):111-5.
  17. Choi JH, Kwon YH. Medial reorganization of primary motor cortex in patient with traumatic brain injury: a fMRI case study. J Kor Soc Phys Ther. 2005;17(3):421-8.
  18. Jang SH, Kim SH, Cho SH et al. Demonstration of motor recovery process in a patient with intracerebral hemorrhage. NeuroRehabilitation. 2007;22(2):141-5.
  19. Kwon YH, Lee CH, Ahn SH et al. Motor recovery via the peri-infarct area in patients with corona radiata infarct. NeuroRehabilitation. 2007;22(2):105-8.
  20. Jang SH, Kwon YH. Motor recovery in stroke patients. Yeungnam Univ J of Med. 2005;22(22):119-30.
  21. Kwakkel G, Kollen B, Twisk J. Impact of time on improvement of outcome after stroke. Stroke. 2006;37(9):2348-53. https://doi.org/10.1161/01.STR.0000238594.91938.1e
  22. Appelros P, Stegmayr B, Terent A. A review on sex differences in stroke treatment and outcome. Acta Neurol Scand. 2010;121(6):359-69.
  23. Bilic I, Dzamonja G, Lusic I et al. Risk factors and outcome differences between ischemic and hemorrhagic stroke. Acta Clin Croat. 2009;48(4):399-403.
  24. Wei JW, Heeley EL, Wang JG et al. Comparison of recovery patterns and prognostic indicators for ischemic and hemorrhagic stroke in china: The chinaquest (quality evaluation of stroke care and treatment) registry study. Stroke. 2010;41(9):1877-83. https://doi.org/10.1161/STROKEAHA.110.586909
  25. Demeurisse G, Demol O, Robaye E. Motor evaluation in vascular hemiplegia. Eur Neurol. 1980;19(6):382-9. https://doi.org/10.1159/000115178
  26. Brunnstrom S. Motor testing procedures in hemiplegia: Based on sequential recovery stages. Phys Ther. 1966;46(4):357-75.
  27. Cunha IT, Lim PA, Henson H et al. Performance-based gait tests for acute stroke patients. Am J Phys Med Rehabil. 2002;81(11):848-56. https://doi.org/10.1097/00002060-200211000-00008
  28. Han BS, Hong JH, Hong C et al. Location of the corticospinal tract at the corona radiata in human brain. Brain Res. 2010; 1326:75-80. https://doi.org/10.1016/j.brainres.2010.02.050
  29. Kim CS, Kwon JW. Motor function recovery in stroke patients with corona radiata infarct: 4 case studies. J Kor Soc Phys Ther. 2010;22(3):31-5.
  30. Sterr A, Shen S, Szameitat AJ et al. The role of corticospinal tract damage in chronic motor recovery and neurorehabilitation: a pilot study. Neurorehabil Neural Repair. 2010;24(5):413-9. https://doi.org/10.1177/1545968309348310
  31. Aminoff MJ, Boller F, Swaab DF. Clinical neurology and stroke. Foreword. Handb Clin Neurol. 2009;93:vii.
  32. Bejot Y, Rouaud O, Jacquin A et al. Stroke in the very old: Incidence, risk factors, clinical features, outcomes and access to resources--a 22-year population-based study. Cerebrovasc Dis. 2010;29(2):111-21. https://doi.org/10.1159/000262306
  33. Khoo CW, Lip GY. Clinical outcomes of acute stroke patients with atrial fibrillation. Expert Rev Cardiovasc Ther. 2009; 7(4):371-4. https://doi.org/10.1586/erc.09.11
  34. Lu ZN, Yu SZ. Somatosensory evoked potentials in patients with cerebral hemorrhage and infarct. Correlation with CT, clinical data and their. Chin Med J (Engl). 1993;106(1):35-9.
  35. Chae J, Zorowitz RD, Johnston MV. Functional outcome of hemorrhagic and nonhemorrhagic stroke patients after in-patient rehabilitation. Am J Phys Med Rehabil. 1996;75(3): 177-82. https://doi.org/10.1097/00002060-199605000-00004
  36. Wong KS. Risk factors for early death in acute ischemic stroke and intracerebral hemorrhage: a prospective hospital-based study in Asia. Asian acute stroke advisory panel. Stroke. 1999;30(11):2326-30. https://doi.org/10.1161/01.STR.30.11.2326
  37. Ireland SE, Arthur HM, Gunn EA et al. Stroke prevention care delivery: predictors of risk factor management outcomes. Int J Nurs Stud. 2010[Epub ahead of print].