• Title/Summary/Keyword: 급성기 뇌졸중

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Factors Influencing Post Stroke Depression in Acute Stroke Patients (급성기 뇌졸중 환자의 뇌졸중 후 우울에 영향을 미치는 요인)

  • Park, Soonjoo
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.385-394
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    • 2020
  • This study was carried out to investigate the post stroke depression (PSD) occurrence in acute stroke patients and to identify the factors that influence PSD. The study subjects were 104 adults in their 20s or older who were scheduled to be discharged due to inpatient treatment for ischemic stroke in two hospitals. Data were collected using Post Stroke Depression Scale for PSD, Multidimensional Scale of Perceived Social Support for social support, National Institutes of Health Stroke Scale for stroke severity, and Modified Rankin Scale for disability. The average length of stay after stroke onset of the study subjects was 5.9±2.1 days, and 79.8% were within 7 days. Stroke severity score was an average of 2.4±2.5 out of 42 points, and disability score was an average of 1.6±1.1 out of 6 points. Among the subjects, 32.7% had mild or more severe depression after stroke. The subjects with no religion, severe disability, high stroke severity, and less family support had a higher likelihood of experiencing PSD. These results show that depression can appear in the early stages of stroke onset. Therefore, it is necessary to develop nursing guidelines for depression intervention after acute stroke, including continuous early assessment of depression from the acute phase of stroke and religion or family support.

Relations of neurological and social cognitions in patients with acute phase and chronic phase before returning to the community (급성기와 지역사회 복귀 전 만성 뇌졸중 환자의 신경학적 인지기능과 사회인지 기능의 관계)

  • Park, Myoung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.549-556
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    • 2017
  • This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

Effects of Occupational Therapeutic Craft Activity on improvement cognitive function and hand function in acute patients with stroke (수공예 작업치료 프로그램 활동이 급성기 뇌졸중 환자의 손 기능에 미치는 효과)

  • Jang, Tae-Yong;Park, Bo-Ra;Yang, Yeong-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.355-365
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    • 2017
  • This study investigatedwhether occupational therapeutic craft activity improves cognitive function and hand function in patients with acute stroke, with the hope of providing clinically useful results for further studies. From March 2016 to November 2016, thirty acute patients with stroke at A general hospital and B rehabilitation hospital in Seoul and Gyeonggi-do, Korea were enrolled and randomly divided into two groups. One group was treated with occupational therapeutic craft activity,and the other general exercise. The subjects performed each activity for 30 minutestwice weekly, for four weeks. To test the effect of intervention, hand function was tested with the Box & Block Test and the Jebsen-Taylor Hand Function Test.Cognitive function measures were the NCSE and Trail-Making Test. Over the four weeks of treatment activities, in the occupational therapeutic craft activity group, hand function measures(p<.05) increased significantly,as did cognitive function measures(p<.05). This study shows that occupational therapeutic craft activity improves hand function and cognitive function effectively in patients with acute stroke. Occupational therapeutic craft activity programscan be based on this study to prepare intervention programs for further studies with acute stroke patients.

At the time of inspection CT cerebral blood flow in patients with acute ischemic stroke, a comparative study of Bolus Tracking Technique and Fixed Time Technique (급성기 허혈성 뇌졸중 환자의 뇌 관류 CT검사 시 고정시간기법과 조영제 추적기법의 비교 연구)

  • Kim, Ki-Jeong;Jeong, Hong-Ryang
    • Proceedings of the Korea Contents Association Conference
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    • 2013.05a
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    • pp.217-218
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    • 2013
  • 급성기 허혈성 뇌졸중 증상이 있는 뇌 관류 CT검사를 시행한 환자를 대상으로 장비사가 제시한 고정 시간 기법(fixed time technique)과 조영제 추적 기법(bolus tracking technique)을 비교하여 환자의 피폭선량을 분석하고자 하였으며 조영제 추적 기법의 유용성과 최적의 조영증강 구간을 구현하는 Time graph를 알아보기 위한 것이다.

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Nursing Quality Improvement for Acute Stroke Patients through the Use of NIHSS (NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략)

  • Park, Kyung-Hyun;Song, Young-Ae;Kong, Hye-Sung;Na, Hwa-Ju;Ryu, Soo-Kyung;Park, So-Young;Kim, Sang-Hee;Choi, Hye-Rim;Bae, Hee-Jun;Han, Moon-Gu;Yang, Mi-Hwa
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.73-81
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    • 2009
  • 문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로 활용하고 있지만 아직 간호현장에서는 보편적으로 사용하지 않고 있다. 이에 뇌졸중 환자 간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중 환자 간호의 질을 보다 향상시키기 위하여 본 활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를 향상시키기 위한 프로그램을 개발 적용한다. 둘째, 간호사가 급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중 악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬 수 있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과 치료를 위한 의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실. 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 "NIHSS 간호사 교육 프로그램"을 마련하였다. 둘째, NIHSS 측정을 통한 뇌졸중 악화 예측율 향상을 위하여 "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"을 개발하고 추적 관찰하였다. 개선효과: NIHSS 측정 신뢰도는 질 향상 활동 전 89%에서 92%로 향상되었다. 그리고 간호사의 뇌졸중 악화 양성 예측율은 58.7%에서 87.1%로 향상되었다(참고 : 간호사의 뇌졸중 악화 음성 예측율 100% 유지). 즉 "NIHSS 간호사 교육 프로그램 활용", "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"의 적용으로 뇌졸중의 조기 발견 및 치료가 가능하였고, 향후 환자 예후에 긍정적인 영향을 줄 수 있을 것이라 기대된다.

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A Preliminary Study of the Effects of Monitor-Based Virtual Reality Games on the Cognition & Activities of Daily Living for Acute Stroke : A Double-blind Randomized Controled Trial (모니터기반 가상현실게임을 이용한 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대한 사전연구: 이중 맹검 무작위 대조 시험 연구)

  • Choi, Bong-Geun;Kwon, Jae-Sung
    • The Journal of the Korea Contents Association
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    • v.20 no.9
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    • pp.531-540
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    • 2020
  • Objectives: This study aimed to investigate the effects of a 4-weeks intervention using a monitor-based virtual reality game intervention(VRI) on the cognitive function and activities of daily living of individuals with acute stroke. Methods: For this study, 19 individuals with acute stroke were recruited. To compare the effectiveness of the VRI and the computer based cognitive intervention(CBCI), Each of the two groups were provided different interventions a 30 minutes a day, 5 times per week for 4 weeks, and to measure the effects of the intervention, the TMT A&B, DST, RKMT and K-MBI were performed before and after interventions. Results: Both the VRI and the CBCI were found to have significantly improved the cognitive function and activities of daily living, and the difference in change compared between groups showed that the effectiveness of the VRI was significantly higher. Conclusion: Based on the findings of this study, the monitor-based VRI is anticipated to prove useful as an effective intervention for the cognitive function and activities of daily living of stroke patients. Furthermore, the utility of monitor-based VRI is likely to be high in clinical occupational therapy.

Motor Evoked Potential Study with Magnetic Stimulation in Ischemic Stroke Patients (허혈성 뇌졸중 환자에서 Magnetic Stimulation에 의한 운동유발전위 반응)

  • Kim, Seong-Min;Suh, Sang-Dug;Lee, Jun;Hah, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.248-261
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    • 1994
  • This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 ischemic stroke patients. The central motor conduction time (CMCT) was represented by the difference of latency to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.

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Effects of Swallowing Training with Biofeedback on Swallowing Function and Satisfaction in Acute Stroke Patients with Dysphagia (생체되먹임을 통한 삼킴훈련이 삼킴장애가 있는 급성기 뇌졸중 환자의 삼킴기능과 만족감에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Gyu-Yong;Won, Young-Sik
    • The Journal of the Korea Contents Association
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    • v.17 no.4
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    • pp.63-71
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    • 2017
  • The purpose of current investigation was identified to the effects of swallowing training with surface electromyography biofeedback on swallowing function and dietary level, satisfaction in acute stroke patients with dysphagia. Sixteen acute stroke patients with dysphagia was participated in our study. All stroke paitents were allocated in randomly to experiemental group(n=8) and control group(n=8). Both group received traditional dysphagia therapy during 30min/day, five per week, for four weeks. experimental group was perfomed swallowing training with surface electromyography biofeedback, additionally 30 min/day, and control group received only swallowing training, additionally 30 min/day. Assessments evaluated Functional Dysphagia Scale(FDS) and Penetration-Aspiration Scale(PAS) for measure of swallowing function, and Functional Oral Intake Scale(FOIS) assessed for measure of dietary level. satisfaction assessed by using Visual Analog Satisfaction Scale(VASS). In results, after intervention both group improved significant on swallowing function, and dietary level, compared to before intervention(p<0.05). After intervention, satisfaction of both group was not significant difference(p>0.05). In comparison of change score between two group, experimental group improved significantly than control group in dietary level(p<0.05). Swallowing training with surface electromyography biofeedback may be a effective dysphagia therapy to improve on dietary level in acute stroke patients with dysphagia.

The Effect of Therapeutic Exercise on Cardiac Stress in Patients With Stroke (치료적 운동이 뇌졸중 환자의 심혈관 부담에 미치는 영향)

  • Kim, Won-Ho;Lee, Young-Jung;Kang, Kwon-Young
    • Physical Therapy Korea
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    • v.10 no.4
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    • pp.69-76
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    • 2003
  • 본 연구는 급성기가 지난 뇌졸중 환자를 위한 치료적 운동 프로그램이 심박동수에 미치는 영향과 부가적으로 뇌졸중 환자의 기능적 상태에 따라 치료적 운동 형태를 알아보기 위해서 시행되었다. 대상자는 뇌졸중이 발생한지 3개월이 지난 23명의 환자이었다. 심박동수의 변화는 대상자가 각자의 치료적 운동을 수행하는 동안 Polar Vantage XL Heart Rate Monitor를 사용하여 측정하였다. 그 결과, 치료적 운동 동안 환자의 기능 수준 및 발병 기간에 따른 심박동수와 치료 형태의 차이는 없었다. 또한 전체 치료 시간 중 목표심박동수에 도달하는 시간은 2.47%에 불과하였다. 이는 치료적 운동이 뇌졸중 환자에게 과도한 심혈관 부담을 주지 않을 뿐만 아니라 유산소 훈련의 효과는 거의 존재하지 않음을 의미한다. 따라서 환자의 상태에 적절하고 유산소 훈련 효과를 고려한 치료적 운동 프로그램의 구성이 필요하다.

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