• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.175-182
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• 2015

Purpose: The purposes of this study were to develop the Korean version of the trunk impairment scale (K-TIS) and to examine reliability and responsiveness of the K-TIS in patients with stroke. Methods Subjects of the study were 51 stroke patients (mean age: 57.78 years) recruited from two stroke clinics. For the interrater and test-retest reliability, two raters measured the K-TIS two times using video clips with an interval of 2 weeks. For the responsiveness, intensive physical therapy training was provided to all participants 2 times a day for one month or three months depending on the onset of the stroke and the admission rules of the two clinics. Inter-rater reliability and test-retest reliability of the K-TIS three subscales (static sitting balance, dynamic sitting balance, and coordination) scores and total scores were examined using intra-correlation coefficient ($ICC_{3,1}$) and Pearson's correlation coefficient (r). To examine responsiveness, the minimally important difference (MID) was calculated with effect size. Results: Inter-rater reliability of the K-TIS subscales and total scores were all high (ICC3,1=0.920-0.983 and r=0.924-0.984). For the test-retest reliability, $ICC_{3,1}$=0.805-0.901 and r=0.806-0.903, and the MID for acute and post-acute as well as chronic stroke patients remained in the mean change range. Conclusion: It is suggested that the K-TIS might be used for clinical and research purposes as a standardized tool for stroke patients. In addition, it can also be useful in establishment of treatment goal(s) and planning treatment program(s) for patients with stroke.

• 보건의료산업학회지
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• 제12권2호
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• 대한중풍순환신경학회지
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• 제11권1호
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• pp.46-54
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• 2010

Objective : The purpose of this study was to investigate the characteristics of the acute stroke patient who take Yanggyeoksanhwa-tang, and arrange the indication of Yanggyeoksanhwa-tang. Method : We studied hospitalized patients within 4 weeks after their accident who were hospitalized at Kyunghee University Oriental Medical Center, Kyunghee University East-West Neo Medical Center, Kyungwon University Oriental Medical Center, Semyung University Oriental Medical Center from February 2010 to July 2010. We classified and found out the characteristics of acute stroke patient according to herb medicine. Result : The patient who take Yanggyeoksanhwa-tang show meaningful difference for TG, HDL-cholesterole, total lipid, AST, homocysteine, chest burning sensation, and oriental medical diagnosis. Conclusion : The result of this study show that Yanggyeoksanhwa-tang can be applied to acute stroke patient who feels chest burning sensation, and whose oriental medical diagnosis is fever type. Additory evaluations would be needed to better understand the difference between Yanggyeoksanhwa-tang group and other herb medicine group on acute stroke patients.

• 대한한의학회지
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• 제23권4호
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• pp.73-90
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• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.322-326
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• 2011

Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

• 대한한방내과학회지
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• 제29권4호
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• pp.1011-1024
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• 2008

Objectives : The aim of this study was to assess the distribution of general characteristics and risk factors according to onset time in acute stroke patients. Methods : We studied hospitalized patients within 4 wks after the onset of stroke who were admitted to the Department of Internal Medicine at Kyunghee University Oriental Medical Hospital, Kyunghee University East-West Neo Medical Hospital, Kyungwon University Songpa Oriental Medical Hospital, Kyungwon University Incheon Oriental Medical Hospital, and Dongguk University Ilsan Oriental Medical Hospital from April 2007 to August 2008. The 24-hour day was divided into quartiles (6:00 to 12:00, 12:00 to 18:00, 18:00 to 24:00 and 24:00 to 6:00). We analyzed the general characteristics and risk factors according to onset time in acute stroke patients. Results : 468 subjects were included into the final analysis. 1. The most common time period for ischemic stroke onset was between 6:00 and 12:00. It demonstrated a 50% excess risk between 6:00 and 12:00. 2. On the demographic variables of the patients, the rate of hypertension was significantly higher from 18: 00 to 24: 00 than 24:00 to 6:00. 3. There was no significant difference of stroke type, Sasang constitution, or lifestyle between times. 4. According to the blood test, high density lipoprotein cholesterol was significantly higher at 24:00 to 6:00 and lower at 12:00 to 18:00 than other time-groups. 5. The patients diagnosed with metabolic syndrome were significantly more at 12:00 to 18:00 and fewer at 24:00 to 6:00. 6. Hypertension and coffee drinking showed close relationship with patients whose stroke occurred while awake in multivariate analysis. Conclusions : The above results showed that the overall tendency of acute stage cerebral infarction patients varied according to their onset time. These results can be utilized in the future as a basis material.

• 한국응급구조학회지
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• 제24권2호
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• pp.27-38
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• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• 대한응급의학회지
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• 제29권5호
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.57-66
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• 2019

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

• 대한물리치료과학회지
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• 제25권1호
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• pp.31-43
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• 2018

Purpose: The purpose of this study is to investigate and to verification of changes that the effect of treadmill and body weight support treadmill training on balance and gait ability for sub-acute stroke patients during 4 week. Method: 16 subjects who was diagnosed stroke were divided into 2 groups(8-treadmill training group, 8-body weight support treadmill group) by randomized control trial. Both training programs were consisted with 40 minuted, 5 times a week for 4 weeks and after training programs. Analysis: We analysed effects and changes on balance and gait ability. Analyses were performed using PASW ver. 18.0 and results were reported as mean ${\pm}$ standard deviation (S.D.). To investigate within group comparisons and to verification on effects of exercise, we did paired t test and repeated measured ANOVA test. Significance was set at p<.05. Result: Both training programs showed positive changes in Limit of Stability but significant results which is area of hemiside, area of intact side, area of posterior, total area were reported in body weight support treadmill training group. Changes of Berg Balance Scale was significantly increase and it had significant correlation between groups. Changes of 6 Minutes Walking Test was significant increase in both groups but there was no significant changes on Foot print and Romberg test. Conclusion: After considering all factors, both training programs showed effect on improvement of balance and gait ability in sub-acute stroke patients, but body weight support treadmill training group had better improvement in dynamic balance than treadmill training group. For the increase of balance and gait ability in sub-acute stroke patients, we need to continues study on difference of treadmill and body weight support treadmill and then we will give stroke patients a better satisfaction if we develop and provide a rehabilitation program for improvement of balance and gait ability.