• 성인간호학회지
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• 제15권2호
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• pp.316-326
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• 2003

Purpose: The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. Method: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 10 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, ${\chi}^2-test$, and t-test. Result: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. Conclusion: It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it's simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

• 보건행정학회지
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• 제33권2호
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• 한국전문물리치료학회지
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• 제17권2호
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• pp.67-74
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• 2010

The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.

• PNF and Movement
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• 제7권4호
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• pp.37-43
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• 2009

Purpose : The purpose of this study was to evaluate the effect of core stability training at deep abdominal muscle for balance control of hemiplegic patient. Method : The subject of this study was a 47-year-old man with right hemiplegia. He was treated five times a week for three weeks with core stability training at deep abdominal muscles. Evaluation tool was used Functional reach test(FRT), timed up and go test(TUG) and one leg standing for stroke patients. Result : The FRT distance increase, TUG time decrease, one leg standing time increase core stability training at deep abdominal muscles for right hemiplegia improved was the ability for maintain balance. Posture and control of trunk stability are changing posture, and so which showed significant improve of total balance control. Conclusion : The result of this study showed that core stability training at deep abdominal muscles is an effective treatment for balance control. Therefore, it could be considered as a treatment method in the rehabilitation of stroke patient with poor postural control and imbalance, although further studies are needed.

• 대한중풍순환신경학회지
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• 제9권1호
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• pp.33-39
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• 2008

Ataxia and vertigo are frequent clinical findings in cerebellar infarction patients. In severe cases, they cannot achieve normal activity in daily life. A 65-year-old man was admitted with ataxia and vertigo diagnosed as acute cerebellar infarction. We prescribed for Chukdam-tang to treat the phlegm disease. After this treatment, ataxia and vertigo improved. We suggest Chukdam-tang is significantly effective on the treatment of cerebellar infarction.

• 사상체질의학회지
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• 제29권4호
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• pp.317-325
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• 2017

Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). Methods Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUI, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

• 대한한방내과학회지
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• 제21권5호
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• pp.805-811
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• 2000

Objectives : To determine the effects on blood flow of vertebrobasal vascular system in cerebral infarction, Methods : We altered 33 normal patients and 12 patients who were diagnosed cerebral infarction on Rt. middle cerebral artery(MCA) region and 8 patients who were diagnosed cerebral infarction on Lt, MCA region, and measured the mean velocity, systolic to diastolic rate(SD rate), asymmetrical index(A/I) by TCD. Results : The mean velocity of posterior cerebral artery(PCA), vertebral artery was increased in same direction as infarcted site and the mean velocity of basal artery was more increased than control, and the SD rate of PCA, vertebral artery, basal artery was larger than control. The A/l of PCA, vertebral artery was revealed that mean velocity of vertebrobasal vascular system is increase the same direction as infarcted area. Conclusion : TCD examination within 7 days(acute stage) after stroke can help to predict the infarcted direction.

• 대한한방내과학회지
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• 제40권5호
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• pp.999-1006
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• 2019

Objectives: The purpose of this study was to report the improvement of symptoms by Korean medicine in acute hemorrhagic infarction. Method: The patient was diagnosed with a cerebral infarction of the right temporal lobe accompanied by cerebral hemorrhage of the left basal ganglia. He did not receive intravenous thrombolytic treatment. Sunghyangjungi-san-gamibang was initially administered, and Gami-daebo-tang was administered during the recovery phase, together with Uhwangchungsim-won, Simjeok-hwan, and acupuncture. The prognostic observation was conducted using the manual muscle test (MMT), the Korean version of the modified Bathel index (K-MBI), and subjective assessment. Results: After Korean medicine treatment, the K-MBI score was improved from 52 to 93. The MMT score and subjective assessment also showed improvement. Conclusions: For patients who cannot be treated with intravenous thrombolytic treatment, Korean medicine treatment is effective during the early and recovery stages of stroke.

• 정신신체의학
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• 제20권2호
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• pp.98-104
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• 2012

연구목적 : 본 연구는 뇌졸중 급성기에 신경 및 정신 증상간의 연관성을 조사하고자 하였다. 방 법 : 뇌졸중 환자 412명을 대상으로, 신경증상 중 뇌졸중의 심각성는 미국국립보건원 뇌졸중척도(NIHSS), 일상생활 수행장애는 바델지수(BI) 및 수정 랑킨척도(mRS), 인지기능은 한국판 간이정신상태검사(K-MMSE), 그리고 근력은 표준화된 악력측정을 통해 평가하였다. 정신증상은 간이정신진단검사(SCL-90-R)를 통해 9가지의 증상영역(신체화, 강박증, 대인예민성, 우울, 불안, 적대성, 공포불안, 편집증, 정신증)과 한가지의 부가적 항목을 조사하였다. 신경 및 정신 증상간 연관성은 입원 당시와 퇴원직전(뇌졸중 치료시작 전과 후)에 각각 분석하였다. 결 과 : 입원 당시 NIHSS 점수는 공포불안 및 부가항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 그리고 부가항목과 연관성을 보였다. 퇴원 당시의 NIHSS 점수는 신체화, 우울, 공포불안, 부가 항목과 연관이 있었고, BI와 mRS 점수는 우울, 공포불안, 부가항목과 연관이 있었으며, MMSE 점수는 강박증, 우울, 공포불안, 부가 항목과 연관을 보였고, 악력은 신체화, 우울, 불안, 부가항목과 연관되었다. 결 론 : 뇌졸중의 급성기에는 신경 증상이 심할수록 우울, 공포불안, 수면 및 식욕 장애 등 정신 증상이 동반될 가능성이 높았다. 뇌졸중 후 신경증상이 심각한 환자에 대해 신경학적 치료와 함께 적극적인 정신과 치료가 필요하다.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.635-643
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• 2017

Objective : Acute basilar artery occlusion (BAO) is associated with severe neurological dysfunction and high mortality rates. The benefits of mechanical thrombectomy in BAO have not been explored in recent clinical trials. Therefore, we analyzed outcomes of stent retriever mechanical thrombectomy for BAO, and compared with anterior circulation occlusions (ACO). Methods : In total, 161 consecutive patients (24 BAO, 137 ACO) who underwent mechanical thrombectomy with the stent retriever between January 2013 and August 2016 enrolled in our study. All patients underwent clinical assessment with the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS). Radiological results were used to evaluate thrombolysis in cerebral infarction (TICI) scores and successful recanalization was defined by TICI 2b or 3. Results : Mean NIHSS scores at 24 hours and 30 days were significantly higher in the BAO group than the ACO group (p=0.021, p=0.001). mRS at 90 days was significantly higher in the BAO group (4.2) compared with the ACO group (3.0) (p=0.003). The BAO group (2.0) performed fewer stent retriever passages than the ACO group (2.7) (p=0.049). There were no significant differences between the two groups in terms of complications, but the BAO patients experienced a higher mortality (16.6%) rate than ACO patients (5.8%) (p=0.001). In subgroup analysis of BAO, patients with short procedure times achieved successful recanalization (p=0.001) and successfully recanalized patients exhibited more favorable mRS at 90 days (p=0.027). Conclusion : In our study, mechanical thrombectomy of BAO patients showed worse clinical outcome and higher mortality rate than ACO patients. However, mechanical thrombectomy with a stent retriever in BAO is an effective treatment, because successfully recanalized patients showed good clinical outcome in BAO patients.