Objective: This study aim is to identify whether 30minutes optokinetic stimulation(OKS) with smooth pursuit eye movement can alleviate chronic hemispatial neglect. Methods: We applied optokinetic stimulation with smooth pursuit eye movement to 2 chronic hemispatial neglect patients. experimental duration was total 4weeks - 1week baseline, 2weeks OKS intervention, 1week 2nd. baseline. The intervention was 10 OKS sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 3 times a week every other day. The OKS was provided on the screen when patient sat in front of the screen(13.5 inch). The OKS video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results: As a result of the OKS for 2weeks, the degree of neglect trends to decrease on both 2 cases compared to baseline A. The degree of the neglect of subject 1 tended to increase the at the baseline A. In contrast, the subject 2 showed that tendency that the degree of the neglect declined additionally at the baseline A. Conclusions: We identified that 30 minutes optokinetic stimulation with sooth pursuit eye movement is effective intervention method for chronic hemispatial neglect.
Objective : This study aim is to identify whether smooth pursuit eye movement(SPEM) using portable device can alleviate chronic hemispatial neglect. Methods : We applied smooth pursuit eye movement to one chronic hemispatial neglect patient. Experimental duration was total 4weeks - 1week baseline, 2weeks SPEM intervention, 1week 2nd. baseline. The intervention was 10 SPEM sessions (30min each, 1session daily, from Monday to Friday) over a period of 2weeks. The neglect test carried out 5 times a week. The SPEM was provided on the screen when patient sat in front of the screen(8.4 inch tablet pc, distance 40cm). The SPEM video that the 24 yellow squares moving coherently from the right to the left side. Patients were instructed to perform smooth pursuit eye movement without head and neck movement. Results : As a result of the SPEM for 2weeks, the degree of neglect tended to decrease compared to baseline A. The degree of the LBT tended to increase the at the baseline A'. In contrast, the SCT showed that tendency which the degree of the neglect maintained at the baseline A'. Conclusion : We identified that SPEM using portable device is effective intervention method for chronic hemispatial neglect.
In this study, a complex sample logistic regression analysis was performed to identify the factors affecting the activity restriction of 2,701 normal elderly and chronically ill elderly aged 65 and over using raw data from the 8th period of the National Health and Nutrition Examination Survey. It was found that the elderly with chronic disease felt more restricted in their activities than the normal elderly. Activity limiting factors in stroke and hypertension patients are subjective health status, economic level, stress perception, and moderate-intensity work and leisure. The factors limiting activity in patients with heart disease were subjective health status and economic level, and factors limiting activity in patients with joint disease were subjective health status and high-intensity work and leisure. Activity limiting factors for lung disease patients are education level, high intensity work and leisure, and endocrine system activity limiting factors include subjective health status, stress perception, high intensity work and leisure, and activity limiting factors for cancer patients. is subjective health status, stress perception, moderate-intensity work and high-intensity leisure. Rehabilitation programs and policy support are needed for the continuous participation of the elderly with chronic diseases.
Objective : The authors studied the risk factors of silent cerebral microbleeds (MBs) and old hematomas (OHs) and their association with concurrent magnetic resonance (MR) imaging findings in the patients of intracerebral hemorrhages (ICHs). Methods : From April 2002 to June 2007, we retrospectively studied 234 patients of primary hemorrhagic stroke. All patients were evaluated with computed tomography (CT) and 3.0-tesla MR imaging studies within the first week of admission. MBs and OHs were assessed by using $T2^{\ast}$-weighted gradient-echo (GRE) MR imaging. The patients were divided into 2 groups, depending on whether or not they had two GRE lesions of chronic hemorrhages. A correlation between MBs and OHs lesions were also statistically tested. Lacunes and white matter and periventricular hyperintensities (WMHs, PVHs) were checked by T1- and T2-weighted spin-echo and fluid attenuated inversion recovery sequences. Variables on the clinical and laboratory data and MR imaging abnormalities were compared between both groups with or without MBs and OHs. Results : MBs were observed in 186 (79.5%) patients and a total of 46 OHs were detected in 45 (19.2%) patients. MBs (39.6%), OHs (80.4%), and ICHs (69.7%) were most commonly located in the ganglionic/thalamic region. Both MBs and OHs groups were more frequently related to chronic hypertension and advanced WMHs and PVHs. The prevalence and number of MBs were more closely associated with OHs groups than non-OH patients. Conclusion : This study clearly demonstrated the presence of MBs and OHs and their correlation with hypertension and cerebral white matter microangiopathy in the ICHs patients. Topographic correlation between the three lesions (MBs, OHs, and ICHs) was also noted in the deep thalamo-basal location.
Eczema is a general term for skin diseases showing itching, vessiculopapular eruption, and erythema when acute, or lichenification and scale if chronic. It is classified as irritant dermatitis, atopic dermatitis, seborrheic dermatitis, neurodermatitis, nummular eczema, statis dermatitis, infective dermatitis, xerotic eczema, and pompholyx by afflicted regions and symptoms. Therapy for eczema is allopathic, and includes application of ice- pack to erythema, and application of emollients and steroids to the affected parts during subacute or chronic stages. Eczema is understood as ulceration(瘡), tinea(癬), wind syndrome(風證), and dryness syndrome(燥證) in terms of oriental medicine. Xerotic eczema is understood in dryness syndrome. Nourishing blood(養血) therapy is used. This is a case study on which xerotic eczema occurred on a patient's afflicted left palm and fingers after stroke. The patient's xerotic eczema was attributed to dryness syndrome. Therefore, Samul-tang(四物湯) and Saenghyeoryunbu-eum(生血潤膚飮) were used for nourishing blood. This therapy was effective on eczema and accompanying symptoms such as dizziness and numbness of the left hand.
BACKGROUND: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chronically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few studies explicitly investigated the role of informal caregivers in the management of other chronic conditions such as stroke or depression or physical consequences of long-term caregiving. While most studies were focused on negative aspects of caregiving, a few studies found it rewarding. Often the burden, stress, and socio-economic effects on the family caregiving for an elderly person were not sufficiently appreciated. CONCLUSIONS: Positive outcomes for both the caregiver and the care recipient are more likely to occur when effective levels of collaboration exist between health professionals and caregivers. As a first step, a better understanding of the caregiving experience such as caregiver characteristics, care recipient characteristics, and social stigma is important for nurses to minimize the burden of care so that appropriate interventions can be developed. In addition, further studies are needed to examine the role and needs of informal caregivers in the care of increasing number of frail and/or chronic ill elderly treated in the community.
The purpose of this study was to determine the effect of treadmill training on gait, balance, and trunk control in a patient with hemiparesis. A female subject who had suffered a left hemiparesis 12 months previously was selected for this study. A single subject ABA design was used. Eight data-collection sessions were conducted during each of three phases (baseline-intervention-withdrawal). During baseline and withdrawal phases, the treatment based on Bobath approach was performed for the subject, and during the intervention phase, treadmill walking training was added. Assessment tools were made using the 10 m walk test, Rivermead Visual Gait Assessment(RVGA), Berg Balance Scale(BBS), and a seated Lateral Reach Test(LRT). During the intervention phase, the time measured in 10 m walk test and the scores of RVGA and BBS were significantly improved, and the number of steps in 10 m walk test and LRT showed a small improvement. During withdrawal phase, the time measured in 10 m walk test and the scores of RVGA and BBS were shown the carry-over effect. This findings indicate that treadmill training has significant effect to gait function and balance in a patient with chronic hemiparesis.
Cho, Jaeyoung;Choi, Sun Mi;Park, Young Sik;Lee, Chang-Hoon;Lee, Sang-Min;Lee, Jinwoo
Tuberculosis and Respiratory Diseases
/
v.82
no.4
/
pp.335-340
/
2019
Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.
The Journal of Korean society of community based occupational therapy
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v.5
no.1
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pp.11-21
/
2015
Objective : This study is aimed to examine the degree of independence in stroke patients residing in a community based on their self-efficacy and Instrumental Activities of Daily Living and also correlation between community-residing stroke patients and their guardians by figuring out the life quality of their guardians. Methods : For total two weeks between May 12th and 23rd, 2014, this researcher collected data by using a survey (K-IADL, a scale to measure self-efficacy, WHOQOL-BREF) targeting 138 stroke patients who received over 24 points in MMSE-K among the outpatients of three hospitals located in Busan Metropolitan City and two hospitals located in Geoje-si, Gyeongsangnam-do, and total 125 sheets were finally used for analysis. Results : Among the 125 patients, 70 were males, and 55 were females, and their average age was 58.72 (16 to 82). The subjects' general self-efficacy (p<0.01) and detailed self-efficacy (p<0.01) indicated significant correlation with their guardian's life quality, and there was no significant correlation found between their Instrumental Activities of Daily Living and their guardian's life quality. Conclusion : Their general self-efficacy and detailed self-efficacy indicated correlation with their guardian's life quality, and among their general characteristics, the factor of their financial situation indicated correlation with their guardian's life quality. In conclusion, when stroke patients' self-efficacy is higher, their guardian's life quality increases, too, and if their financial situation is more favorable, their guardian's life quality gets higher. However, stroke patients' Instrumental Activities of Daily Living did not indicate correlation with their guardian's life quality. When looking at the chronic trend of outpatients, therapeutical plan must be established about the self-efficient recovery for the development of those who are not satisfied.
The purpose of this study was to evaluate the effect of the tongue's maximum resistance training program on the accuracy of the tongue training program using the Iowa Oral Performance Instrument (IOPI) and to compare the effects of tongue muscle strength and spoken language function on objective function. The experiment was diagnosed with stroke hemiplegia divided into tongue pressure strength and accuracy training therapy group and the oromotor exercise therapy group Anterior Tongue Pressure(ATP), Posterior Tongue Pressure (PTP), and Posterior Tongue Pressure (PTP) were measured before and after the intervention to evaluate changes in tongue strength and verbal ability. Maximum Phonation Time (MPT). The results of this study are as follows. There was no significant difference in tongue strength and verbal function between training group and oral facial exercise group. There was no significant difference between tongue strength training and oral facial exercise group. Therefore, it was shown that the tongue pressure strength and accuracy training therapy group was not effective to improve tongue muscle strength and spoken language ability than the oromotor exercise therapy group.
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