• 대한예방한의학회지
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• 제15권3호
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• pp.67-81
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• 2011

Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

• 한방재활의학과학회지
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• 제19권2호
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• pp.187-202
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• 2009

Objectives : The purpose of this study is to investigate the efficacy of adjusting leg length inequality(LLI) by chuna manual treatment for post-stroke hemiplegia. Methods : 39 patients with stroke-originated hemiplegia who had leg length inequality were included in this study. Chuna manual treatment at pelvic girdle was applied to 20 patients and they had been treated by general oriental rehabilitation therapy(test group). The other 19 patients had been treated by general oriental rehabilitation therapy only(control group). Outcomes were assessed by Modified Barthel Index(MBI), Berg Balance Scale(BBS), lower extremity Fugl-Meyer Assessment(FMA) at the point of beginning and end of the study. Results : 1. In terms of activity of daily living(ADL), test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group(onset had been past under 6 months), test group didn't showed statistically meaningful differences compared to control group. In chronic group(onset had been past over 6 months), test group didn't showed statistically meaningful differences compared to control group. 2. In terms of lower extremity function and balance, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.01). 3. In terms of lower extremity function of hemiplegic side, test group showed statistically meaningful differences compared to control group(p<0.05). In subacute group, test group didn't showed statistically meaningful differences compared to control group. In chronic group, test group showed statistically meaningful differences compared to control group(p<0.05). Coclusions : Adjusting LLI by chuna manual treatment is efficacious for rehabilitation of stroke-originated hemiplegia, in terms of ADL, balance and lower extremity function, and is especially efficacious for chronic patients.

• 재활간호학회지
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• 제3권2호
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• pp.196-211
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• 2000

The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

• 한국전문물리치료학회지
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• 제5권1호
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• pp.17-29
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• 1998

The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.89 and $r_s$=0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.82 and $r_s$=0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

• 한국전문물리치료학회지
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• 제17권3호
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• pp.77-86
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• 2010

The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

• 디지털융복합연구
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• 제13권7호
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• pp.445-452
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• 2015

본 연구는 뇌졸중환자를 대상으로 동작관찰 디지털콘텐츠 활용교육과 동작관찰 없이 과제 지향적 작업치료를 실시하여, 뇌졸중 환자의 상지기능과 일상생활수행력에 미치는 영향에 대해 알아보았다. 뇌졸중 환자 30명을 대상으로 무작위로 실험군(동작관찰)과 대조군(과제 지향적 작업치료)으로 각각 15명씩 나누어 1주일에 5회 총 30분씩 5주간 실시하였다. 치료 중재 전과 후의 마비측 상지기능을 알아보기 위해, Jebsen-Taylor Hand Function Test (JTHFT)과 Box and Block Test (BBT)를 실시하였고, 일상생활수행을 비교하기 위해 Korean-Version of Modified Barthel Index (KMBI)를 실시하였다. 실시 결과 두 그룹 모두에서 상지기능 및 일상생활수행은 증가하였고, 그룹간의 차이는 보이지 않았다. 그러므로 동작관찰 디지털콘텐츠 활용교육과 과제 지향적 작업치료는 뇌졸중환자의 상지기능 및 일상생활수행에 긍정적인 영향을 미친다는 것을 알 수 있었다.

• 인간행동과 음악연구
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• 제11권1호
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• pp.1-19
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• 2014

본 연구는 패턴화된 감각 증진(Patterned Sensory Enhancement, PSE) 기법이 뇌졸중 환자의 상지 기능에 미치는 즉각적인 효과를 알아보기 위해 PSE와 단순 리듬 자극 간의 차이를 비교분석 하였다. 연구 대상은 서울시와 수원시 소재의 재활병원에서 입원 치료 중인 뇌졸중 편마비 환자 16명이며 실험군과 대조군으로 각각 8명씩 배치하였다. 본 연구의 종속변인은 뇌졸중 환자의 환측 상지 기능으로 6가지 동작의 관절가동범위(ROM, range of motion)와 장악력이며 실험군에게는 PSE를, 대조군에게는 메트로놈으로 제공되는 단순 리듬 자극을 제공하였다. 실험은 음악 자극이 없을 때와 있을 때의 같은 상지 기능을 측정하는 순서로 진행되었으며 측정한 값의 경향을 정확하게 파악하기 위해 동일한 실험을 총 2회 실시하여 평균값을 도출하였다. 연구 진행 결과, PSE를 제공받은 실험군은 음악을 들으며 동작을 수행할 때 상지 관절가동범위가 유의미하게 향상되는 즉각적인 효과를 보였으나(p < .05), 대조군은 즉각적인 효과를 보이지 않았다. 이는 단순 리듬 자극보다 PSE가 상지 운동 향상에 더 적절하게 적용될 수 있다는 것과 음악의 청각적 패턴이 운동 범위의 확장 즉, 운동 향상에 영향을 줄 수 있다는 것을 보여주었다. 본 연구는 PSE가 상지 운동 기능에 미치는 즉각적인 영향을 단순 리듬 자극과 비교분석하였다는 점에서 의의가 있으며 음악 요소의 특징이 유도하고자 하는 신체 운동의 목표와 밀접한 연관성을 가질 때 효과적으로 영향을 미칠 수 있음을 시사한다.

• 대한물리치료과학회지
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• 제11권2호
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• pp.27-37
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• 2004

The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).

• 한국산학기술학회논문지
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• 제12권11호
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• pp.5019-5026
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• 2011

본 연구는 만성 편마비 환자의 교감신경 활동 강화가 근 긴장도 및 중추신경 흥분성 변화에 미치는 영향을 알아보기 위해 시행하였다. 연구기간은 2009년 10월 12일부터 12월 4일까지 실시하였으며, 연구대상자는 발병 후 6개월 이상 된 만성 편마비 환자 30명을 대상으로 하였다. 실험은 교감신경 활동을 강화하는 세 가지 과제(암산, 정적인 상태에서 쥐기운동, 쥐기운동 후 허혈)를 실시하였으며 측정은 과제를 수행하기 전과 중의 global synkinesis 수준과 중추신경원 활동전위을 각각 측정하였다. 중추신경원 활동전위는 H/Mmax비, V/Mmax비를 측정하였고, global synkinesis 수준은 근전도 활동전위의 실효치 값을 측정하여 분석하였다. 본 연구에서, global synkinesis 수준은 정적인 상태에서 쥐기 과제를 제외한 나머지 과제(암산, 쥐기 후 허혈)에서 슬관절 굴곡, 신전 시 감소했다(p<.05). 또한 V/Mmax비에서는 세 가지 과제 모두에서 감소하였다(p<.05). 결론적으로, 교감신경 활동 강화는 만성 편마비 환자의 중추신경 흥분성과 근 긴장도를 감소시킴을 알 수 있었다.

• 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.