Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of an Integrated Management Program on Physical Function, Cognitive Function, and Depression in Patients with Subacute stroke

통합관리 프로그램이 아급성 뇌졸중 환자의 운동기능, 인지기능, 우울에 미치는 효과

  • Received : 2021.01.13
  • Accepted : 2021.02.08
  • Published : 2021.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke. Methods : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks. Results : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group. Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.

Keywords

References

  1. Rodgers H, Mackintosh J, Price C, Wood R, McNamee P, Fearon T, et al. Does an early increased-intensity interdisciplinary upper limb therapy programme following acute stroke improve outcome?. Clinical Rehabilitation. 2003;17(6):579-89. https://doi.org/10.1191/0269215503cr652oa
  2. Dickstein R, Shef S, Marcovitz E, Villa Y. Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients. Archives of Physical Medicine and Rehabilitation. 2004;5(2):261-7. http://doi.org/10.1016/j.apmr.2003.05.011
  3. Oh EY, Jung MS. Effects of a cognitive training program on cognitive function and activities of daily living in patients with acute ischemic stroke. Journal of Korean Academic Nursing. 2017;47(1):1-13. https://doi.org/10.4040/jkan.2017.47.1.1
  4. Kim IJ, Suh MJ, Kim KS, Cho NO, Choi HJ. Predicting factors of post-stroke depression. Korean Journal of Adult Nursing. 2000;12(1):147-62.
  5. Garcia-Rudolph A, Sánchez-Pinsach D, Salleras EO, Tormos JM. Subacute stroke physical rehabilitation evidence in activities of daily living outcomes: a systematic review of meta-analyses of randomized controlled trials. Medicine (Baltimore). 2019;98(8):e14501. https//doi.org/10.1097/MD.0000000000014501
  6. Wade DT, Wood VA, Hewer RL. Recovery after stroke: the first 3 months. Journal of Neurology, Neurosurgery, Psychiatry. 1985;48(1):7-13. http://doi.org/10.1136/jnnp.48.1.7
  7. Duncan PW, Goldstein LB, Matchar D, Divine GW, Feussner J. Measurement of motor recovery after stroke: outcome assessment and sample size requirements. Stroke. 1998;23(8):1084-9. https://doi.org/10.1161/01.str.23.8.1084
  8. Kim YH. Usefulness of functional MRI for the study of brain function. Experimental Neurobiology. 2001; 1(1):65-76.
  9. Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJB, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870-947. http://doi.org/10.1161/STR.0b013e318284056a
  10. Perlmutter S, Lin F, Makhsous M. Quantitative analysis of static sitting posture in chronic stroke. Gait Posture. 2010;32(1):53-6. http://doi.org/10.1016/j.gaitpost.2010.03.005
  11. Shin YL, Lim HY. The effect of training using virtual reality system on balance and gate for stroke patients. Journal of Coaching Development. 2007;9(1):126-35.
  12. Kang TW, Kim TY. Effects of task-oriented postural control training on the postural control, balance and ADL in patients with sub-acute stroke. Journal of Special Education & Rehabilitation Science. 2016;55(2):135-48. https://doi.org/10.15870/jsers.2016.06.55.2.135
  13. Ji SG, Nam GW, Kim MK. The effects of motor dual task training on balance and gait of subacute stroke patients. Journal of Special Education & Rehabilitation Science. 2012;51(3):331-45.
  14. Jeong SH. Effects of music·movement program for stroke survivors [dissertation]. Seoul: Seoul National University; 2003.
  15. Han SS, Her JJ, Kim YJ. Effects of muscle strengthening exercises using thera band on lower limb function of hemiplegic stroke patients. Journal of Korean Academy of Nursing. 2007;37(6):844-54. https://doi.org/10.4040/jkan.2007.37.6.844
  16. Nam JH, Park HS. The effect of elastic band exercise therapy on gait ability of the hemiplegia patients. The Journal of Korean Association of Security and Safety. 2013;9(1):171-88.
  17. Duncan P, Studenski S, Richards L, Gollub S, Lai SM, Reker D, et al. Randomized clinical trial of therapeutic exercise in subacute stroke. Stroke. 2003;34 (9):2173-80. http://doi.org/10.1161/01.STR.0000083699.95351.F2
  18. Lee HS, Kim YH. The effects of group rehabilitation exercise and physical education program on local community stroke patient's walking function, balance index and muscle strength in the knee joint. Journal of Korean Society of Integrative Medicine. 2018;6(4):15-27. https:/doi.org/10.15268/ksim.2018.6.4.015
  19. E Silva EMGS, Ribeiro TS, da Silva TCC, Costa MFP, Cavalcanti FADC, Lindquist ARR. Effects of constraint-induced movement therapy for lower limbs on measurements of functional mobility and postural balance in subjects with stroke: a randomized controlled trial. Topics in Stroke Rehabilitation. 2017;24(8):555-61. https://doi.org/10.1080/10749357.2017.1366011
  20. Kim MH, Park JM, Lee NJ. The effect of the computer-based cognitive rehabilitation program (CoTras) on the cognitive function and daily living activities of elderly stroke patients. Journal of Korean Society of Integrative Medicine. 2020;8(2):121-30. https://doi.org/10.15268/ksim.2020.8.2.121
  21. An TG, Kim KU. The effects of computerized cognitive rehabilitation program on depression and cognitive function in stroke patients. Journal of Korea Academic-Industrial Cooperation Society. 2017; 18(5):211-8. https://doi.org/10.5762/KAIS.2017.18.5.211
  22. Cho YN, Kim DH, Kwon HC. The effects of computerized cognitive rehabilitation on cognitive function in elderly post-stroke patients. Journal of Special Education & Rehabilitation Science. 2012;51(4): 261-78.
  23. Jang YJ, Jun SS. Effect of cognitive rehabilitation program on cognitive function, depression, and activities of daily living among patients with strokes. Korean Journal of Adult Nursing. 2012;42(3):305-16. https://doi.org/10.7475/kjan.2012.24.3.305
  24. Song SI, Lee JM. The effects of game program on depression and self-efficacy, rehabilitation motivation for stroke patients. Journal of Special Education & Rehabilitation Science. 2014;53(3):133-53.
  25. Lee MJ, Lee SM. Effect of board game program on depression and quality of the life for elderly with stroke. Journal of Special Education & Rehabilitation Science. 2015;54(3):235-49.
  26. Woo GM, Lee MH. An effect of beach ball play for depression, powerlessness, self-esteem, activity of daily living in stroke patients. The Korean Journal of Rehabilitation Nursing. 1998;1(1):15-25.
  27. Plummer-D'amato P, Altmann LJP, Saracino D, Fox E, Behrman AL, Marsiske M. Interactions between cognitive tasks and gait after stroke: a dual task study. Gait Posture. 2008;27(4):683-8. https://doi.org/10.1016/j.gaitpost.2007.09.001
  28. Carr JH, Shepherd RB. Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. 1st ed. PA: Elsevier; 2003.
  29. Kouwenhoven SE, Kirkevold M, Engedal K, Kim HS. Living a life in shades of grey: experiencing depressive symptoms in the acute phase after stroke. Journal of Advanced Nursing. 2012;68(8):1726-37. https:/doi.org/10.1111/j.1365-2648.2011.05855.x
  30. Berg K, Wood-Dauphinee S, Williams JI. The balance scale reliability assessment with elderly residents and patients with an subacute stroke. Scandinavian Journal of Rehabilitation Medicine. 1995;27(1): 27-36.
  31. Kiernan RJ, Mueller J, Langston JW, Van Dyke C. The neurobehavioral cognitive status examination: a brief but differentiated approach to cognitive assessment. Annals of Medicine. 1987;107(4):481-5. https://doi.org/10.7326/0003-4819-107-4-481
  32. Kim CY, Lee KW, Park IH. A study for clinical application of neurobehavioral cognitive status examination (NCSE): for the subjects over age of 60. Journal of Korean Neuropsychiatric Association. 1994;33(6):1329-42.
  33. Beck AT, Steer RA, Brown GK. Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation; 1996.
  34. Sung HM, Kim JB, Park YN, Bai DS, Lee SH, Ahn HN. A study on the reliability and validity of Korean version of the Beck Depression Inventory-II (BDI-II). Journal of Korean Society of Biological Therapies in Psychiatry. 2008;14:201-12.
  35. Thielman GT, Dean CM, Gentile AM. Rehabilitation of reaching after stroke: task-related training verse progressive resistive exercise. Archives of Physical Medicine and Rehabilitation. 2004;85(10): 1613-8. https://doi.org/10.1016/j.apmr.2004.01.028
  36. Lee HS, Choi HS, Kwon OY. A literature review on balance control factors. KAUTPT. 1996;3(3): 82-91.
  37. Park SH. The effect of elastic band training on blood lipids and body composition, physical fitness of stroke patients [master's thesis]. Seoul: Han Yang University; 2005. p. 24-26.
  38. Song CH, Choi KW, In TS. Effects of progressive task-oriented resistive training on lower extremity strength, balance and gait in stroke. Journal of Special Education & Rehabilitation Science. 2010;49(2): 157-79.
  39. Jun HJ, Lee JS, Kim KJ, Jegal H, Nam KW. Effect of auditory biofeedback training and kicking training on weight-bearing ratio in patients with hemiplegia. Journal of Korean Society of Physical Medicine. 2014;9(4):363-73. https://doi.org/10.13066/kspm.2014.9.4.363
  40. Park SJ, Lee JM, Ruy SH. The effects of game and art therapy on cognitive function for elderly with stroke. Journal of Special Education & Rehabilitation Science. 2015;54(1):377-91. https://doi.org/10.15870/jsers.2015.03.54.1.377
  41. Kauhanen ML, Korpelaninen JT, Hilltunen P, Brusin E, Mononen R, Maatta P, et al. Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke. 1999;30(9):1875-80. https://doi.org/10.1161/01.STR.30.9.1875