Purpose: The cerebellum is a region of brain structure that plays an important role in calibrating two different information of neural signal from descending motor commands and from ascending sensory inputs. Damage of the cerebellum shows a variety of classic motor symptoms such as postural and locomotor dysfunctions. Therefore, we tried to investigate motor function and skill in stroke patients with cerebellar lesions in sub-acute stage, and compare with these functions of patients with non-cerebellar lesions. Methods: Total twelve stroke patients with cerebellar lesion and 130 stroke patients with non-cerebellar lesions were retrospectively recruited in this study. For evaluation of motor strength, Motricity index (MI) for upper and lower limbs was tested. For measurement of motor skill function, the modified Brunnstrom classification (MBC), Manual function test (MFT), functional ambulatory category (FAC), and Barthel index were adopted. Results: In comparison of motor strength and motor skill function between two groups, statistical differences between the two groups were significantly observed only in upper MI and FAC. Although no significant differences were found in other variables, stroke patients with cerebellar lesion had higher scores in lower and total MI, MBC, and MFT, whereas they had lower scores in FAC and Barthel index. Conclusion: Our results showed that stroke patients with cerebellar lesion had greater impact on movement functions related to hand motor and walking ability in activities of daily life, compared with patients with non-cerebellar lesion, in spite of similar degree of motor function and skill between the two different lesioned-groups.
Purpose: The concept of a superior approach (SA) involves the use of a tissue-sparing posterior approach (PA), with exposure of the piriformis muscle and gluteus medius/minimus muscles. The objective of this study was to clarify the features of hip hemiarthroplasty (HA) using a SA in regard to early recovery and mid-term outcomes, with a comparison of the outcomes of SA-HAs and HAs using a PA (PA-HAs). Materials and Methods: A total of 120 HAs for treatment of primary femoral neck fracture with a healthy opposite hip joint were performed in our hospital from 2013 to 2018. Propensity score matching in regard to age, sex, body mass index, walking ability before injury, place of residence, time to surgery, and American Society of Anesthesiologists-Physical Status was performed for 79 patients with SA-HAs and 41 patients with PA-HAs. The final analysis included 34 patients who underwent SA-HAs and 34 patients who underwent PA-HAs. Results: The duration of surgery was 57.1 minutes and 72.1 minutes (P=0.001) for SA-HAs and PA-HAs, respectively. The scores for walking ability at postoperative one week were 4.9±1.4 and 4.2±1.0 (P=0.021) for SA-HAs and PA-HAs, respectively. The Barthel index (BI) at the start of rehabilitation was 26.2±18.7 and 17.4±16.3 (P=0.042) for SA-HAs and PA-HAs, respectively. The 4-year complication-free survival rates were 74.2% and 56.3% for SA-HAs and PA-HAs, respectively (P=0.310). Conclusion: SA-HA can be performed without torsion of the muscles and ligaments around the hip joint. Early recovery of walking ability and BI was a significant feature of SA-HAs.
The aim of this study was to examine the geriatric status, oral health, and oral health related quality of life of stroke patients hospitalized at a rehabilitatio ward and assess the relationships among these factors. A total of 78 stroke patients participated in this cross-sectional study. The following oral examinations were performed by a dentist and dental hygienist: Decayed, Missing, Filled Teeth, gingival, debris, calculus, and community periodontal index (CPI). The patients' sociodemographic and geriatric status were evaluated using the Barthel index and a mini-mental state examine (MMSE) according to their medical record and a questionnaire survey. Oral health related quality of life was assessed using the Oral Health Impact Profile (OHIP)-14 questionnaire. Except for three participants, most stroke patients had a gingival index of 2 or more, which means probing results in bleeding gums. Additionally, 53.8% of participants had a CPI code of 3 or 4, which indicates a probing depth of 4 mm or more. CPI index was significantly related to debris, calculus, and gingival index. The OHIP-14 score significantly related to the Barthel index and MMSE (p<0.05). The oral health of stroke patients in the rehabilitation ward was relatively poor and related to poor oral hygiene. Oral health related quality of life was related not to oral health but to geriatric status significantly.
Background: Hemispatial neglect is defined as the failure to attend, report, respond, or orient toward meaningful stimuli provided in the contralateral side of a brain lesion. Objects: This study was conducted to find out the effect of dynamic trunk equilibirum exercise for stroke patients with hemi-spatial neglect. Methods: This study included 21 stroke subjects, randomly assigned to either the experimental group or the control group. The exercise program consisted of 5 sessions of 20 minutes per week during 4 weeks. The line-bisection test, the Albert test, the balance function score, the Berg balance scale, the postural assessment scale for stroke and the modified Barthel index were measured before and after training. All data were analyzed using SPSS 12.0 for Windows. Between-group and within-group comparison was analyzed by using Independent t-test and Paired t-test respectively. Results: The results of study were as follows: There were significant differences between before and after intervention in both group (p<.05). There were significant differences in the line-bisection test, Albert test, balance function score, Berg balance scale, postural assessment scale for stroke and modified Barthel index between the experimental group and the control group (p<.05). Conclusion: Dynamic trunk equilibrium exercise had a positive effect on patients' neglect, balance ability and activities of daily living. Further studies are required to generalize the results of this study.
We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.
Journal of the Korean Society of Physical Medicine
/
v.11
no.1
/
pp.133-140
/
2016
PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.
Introduction: Geriatric depression is one of the significant mental health issues for older people. This descriptive study aimed to investigate the correlation between selected factors and depression among older people, living in homes for the aged in the western part of Thailand. Methods: 107 older people, living in two homes for the aged of the western part of Thailand were recruited to the study, using cluster sampling. Three questionnaires, including the Barthel Index Activity of Daily living (BADL), the Thai Geriatric Depression Scale (TGDS), and personal characteristics, perceived health status, chronic diseases, family relationship, and recent grief and loss experience were used. The quality of all questionnaires, especially the reliability of BADL, TGDS, and selected factors (e.g., health factors) were 0.95, 0.93, and 0.72 respectively. After finishing data collection, percentages, medians, and Spearman's rank correlation and Mann-Whitney U were used to analyze the data. Results and discussion: The results revealed that nearly half (41.1%) of older people suffered from depression. Furthermore, income, perceived health status, and Barthel ADL index were significantly negatively associated with depression at p<0.01; whereas, the number of chronic diseases was significantly positively associated with depression at p<0.05. Conclusion: results on the correlation may guide the practice in the future. For example, the officers or health care providers in homes for the aged should encourage older people to be independent, improve their perceived health status, increase health promoting behaviors to prevent or delay chronic illnesses, or increase older people incomes by promoting the appropriate occupation.
Objective : The aim of this study was to investigate the effect of tong's acupuncture on recovery of motor disorders in stroke patients. Methods : Twenty two patients with poststroke-hemiplegia were randomized into two groups. Ten patients(test group) treated by 2 methods-tong's acupuncture and body acupuncture. The other twelve patients(control group) treated only by body acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale(NlHSS) and Modified Barthel Index(MBI). The therapy was performed one a day for 2 weeks. Results: In terms of score of NIHSS. the test group showed statistically meaningful decrease after 2 week treatment. but the control group showed statistically meaningful decrease after I week(p<0.05). And in terms of score of MBI. the test group showed statistically meaningful increase after 2 week treatment. but the control group showed statistically meaningful increase after I week(p<0.05). There was no statistically meaningful difference after 1 and 2 week treatment between the groups. Conclusions: These results support that test group has almost same effectness compared with control group in improvement of the activity of daily living of poststroke-hemiplegic patients.
An, Yu-min;Lee, Yoo-na;Baek, Kyung-min;Jang, Woo-seok
The Journal of Internal Korean Medicine
/
v.40
no.6
/
pp.1225-1236
/
2019
Objective: This is a case report on the effect of Korean traditional medicine on deep stupor to semi-coma with intracerebral and intraventricular hemorrhage. Methods: The patient was treated by Korean traditional medicine such as acupuncture, moxibustion, and herbal medicine. The change of mental state was evaluated by the Glasgow Coma Scale (GCS). We used the Modified Medical Research Council Scale (MRC scale) and the Modified Barthel Index (MBI) to evaluate the effectiveness of the treatment. Results: After treatment, the physical function and ability to perform activities of daily living were improved. The Modified Barthel Index increased from 0 to 40 after treatment with Korean medicine. Conclusions: According to this study, Korean traditional medicine can be effective for the treatment of quadriparesis in patients with deep stupor to semi-coma in intracerebral and intraventricular hemorrhage.
The purpose of this study was to identify the factors affecting family functioning of stroke patients. A descriptive survey research was conducted in which 65 stroke patients and their primary caregivers were conveniently sampled. Data were collected from July to September, 1998 through interviewing using a structured questionnare. The measuring instruments used were Barthel Index by Mahoney and Barthel(15 items), Quality of Relationship Scale by Archbold and Stewart(15 Items), Role Stress of Caregiver Scale by Yang(14 items), Situational Definition Scale by Lee(9 items), Family Hardiness Index by McCubbin, McCubbin. and Thompson(20 items), and Family Adaptability Cohesion Evaluation Scale(FACES-III) by Olson, Portner, and Lavee(20 items). The obtained data were analyzed using percentage, t-test, ANOVA, Duncan test, and Pearson coefficients correlation by SAS/PC program. The results were as follows; 1. Role Stress of Caregiver was not severe and Quality of Relationship was moderate. The level of Situational Definition of primary caregivers was not high but Family Hardiness and Family Functioning were rather high. 2. The following relationships between research variables and demographic characteristics of the primary caregivers of stroke patients were significantly different; occupation of caregiver between Quality of Relationship, occupation of caregiver between Situational Definition, family type between Role Stress, caregiving duration between Family Hardiness, caregiving duration between Family Functioning, and hospitalization days between Family Functioning. 3. The correlations between research variables were as follows; There was positively correlated between patient's ADL and Quality of Relationship. The relationship of the patient's ADL between Role Stress was negatively correlated. Quality of Relationship between Situational Definition, Family Hardiness, and Family Functioning were significantly correlated. The correlation of Situational Definition between Family Hardiness, and Situational Definition between Family Functioning were very high. As a result of these findings, Quality of Relationship, Role Stress, Situational Definition. and Family Hardiness were useful variables for identifying Family Functioning of stroke patients. It is important for the rehabilitation nurse to be knowledgeable about family functioning of stroke patients to promote rehabilitation process.
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