• Title/Summary/Keyword: Modified barthel index

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A Case Study of Chengsimyeonja-tang-gamibang Treatment of a Patient with a Pontine Hemorrhage, with Quadriparesis, Dysarthria, and Dysphagia (청심연자탕 가감방으로 호전된 교뇌 출혈 이후 발생한 양측 반신부전마비, 연하곤란, 언어장애 치험 1례)

  • Yang, Jee-yun;Jeong, Taek-su;Jeon, Gyeong-ryung;Ok, So-yoon;Sun, Jong-joo
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.217-225
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    • 2017
  • Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

Stereotactic Hematoma Removal of Spontaneous Intracerebral Hemorrhage through Parietal Approach

  • Kim, Jeong Hoon;Cho, Tack Geun;Moon, Jae Gon;Kim, Chang Hyun;Lee, Ho Kook
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.373-378
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    • 2015
  • Objective : To determine the advantages of parietal approach compared to Kocher's point approach for spontaneous, oval-shaped intracerebral hemorrhage (ICH) with expansion to the parietal region. Methods : We divided patients into two groups : group A had burr holes in the parietal bone and group B had burr holes at Kocher's point. The hematoma volume, Glasgow coma scale (GCS) score, and modified Barthel Index (mBI) score were calculated. At discharge, we evaluated the patients' Glasgow outcome scale (GOS) score, modified Rankin Scale (mRS) score, motor grade, and hospitalization duration. We evaluated the patients' mBI scores and motor grades at 6 months after surgery. Results : The hematoma volume in group A was significantly less than that in group B on postoperative days 1, 3, 5, 7, 14, and 21. Group A had significantly higher GCS scores than did group B on postoperative days 1 and 3. Group A had higher mBI scores postoperatively than did group B, but the scores were not significantly different. No differences were observed for the GOS score, mRS score, motor grade at discharge, or duration of hospitalization. The mBI score of group A at 6 months after surgery was significantly higher, and more patients in group A showed muscle strength improvement. Conclusion : In oval-shaped ICH with expansion to the parietal region, the parietal approach is considered to improve the clinical symptoms at the acute phase by removing the hematoma more effectively in the early stages. The parietal approach might help promote the long-term recovery of motor power.

Even in Patients with a Small Hemorrhagic Volume, Stereotactic-Guided Evacuation of Spontaneous Intracerebral Hemorrhage Improves Functional Outcome

  • Kim, Young-Zoon;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.109-115
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    • 2009
  • Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.

A Case Report of Treatment of a Patient with Neuromyelitis Optica and Suffering from Vision Disorder and Quadriplegia with Korean Traditional Medicine (시력장애와 사지마비를 호소하는 시신경척수염 환자의 한방 증례 보고 1례)

  • Woo, Seong-jin;Shin, Jae-wook;Jang, Woo-seok;Baek, Kyung-min
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.658-667
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    • 2017
  • Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.

A Study of the Effects of Follow-up Care for Stroke Survivors on Primary Caregivers' Quality of Life (뇌졸중 환자의 추후관리가 주간호제공자의 삶의 질에 미치는 영향)

  • Jeong, Hyun-Ju;Cho, Bok-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.169-181
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    • 2000
  • The purpose of this study was to identify the effect of follow-up care for stroke survivors on primary caregivers' quality of life. Quasi-experimental research was conducted in which an experimental group and a control group-each of 15 stroke survivors and their primary caregivers-were consecutively sampled. Data collected from July to September, 1999 by interview using a structured questionnaire with both the experimental and the control groups. After a month, the two groups were given the same questionnaire. The experimental group was also given a telephone follow-up every week for a month, as well as a home visit. The survey instruments used in this study were Saha and Cooper's "Modified Barthel Index" (11 items) for checking the stroke survivors' level of activities of daily living, and a modified form of Jeong's "Quality of life" (18 items) for primary caregivers' QOL level. The obtained data were analyzed by percentage, t-test, $X^2$-test, Kruscal-Wallis test, Spearman correlation coefficient by SAS/PC program. The results were as follows: 1. There was no significant difference in the stroke survivors' ADL level, though the level of the experimental group was higher than that of the control group. 2. There was a statistical difference in the before and after treatment of the primary caregivers' QOL level. In conclusion, the follow-up care program had a useful effect on the quality of life of primary caregivers.

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A Case Report of Combined Korean Medicine Treatment for a Intracerebral Hemorrhage Patient with Hemiplegia and Gait Disturbance (좌측 편마비 및 보행장애를 주소로 한 뇌내출혈 환자에 대한 한방 복합 치료 증례보고 1례)

  • Yang, Ji-Hye;Chae, In-cheol;Choi, In-woo;Kim, Chan-young;Ryu, Ju-young;Yoo, Ho-ryong;Kim, Yoon-sik;Seol, In-chan
    • Journal of Haehwa Medicine
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    • v.29 no.2
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    • pp.1-11
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    • 2020
  • Objectives : The aim of this study was to report the effectiveness of Combined Korean Medicine treatment on a intracerebral hemorrhage patient with hemiplegia and gait disturbance. Methods : A 56-year-old, female patient with hemiplegia and gait disturbance was treated by Korean Medicine including acupuncture, moxibustion and herbal medicine. The effect of the treatment was evaluated by Manual Muscle Test(MMT), Modified Rankin Scale(MRS), Korean version of Modified Barthel Index(K-MBI). The gait of the patient was evaluated by 10m walk test, Timed Up&Go Test(TUG), Functional Ambulatory Category(FAC), GAITRite and Symmetry Criterion(SC). Results : After treatment, MMT, MRS, K-MBI, gait parameters and gait symmetry were improved. Conclusions : This study suggests that Combined Korean Medicine treatment might be effective for a intracerebral hemorrhage patient with hemiplegia and gait disturbance.

A Case Report on Hemiplegia in a Patient with an Intracerebral Hemorrhage of the Basal Ganglia of the Corona Radiata Treated with Traditional Korean and Western Medicine (기저핵-대뇌부챗살 뇌출혈로 인한 반신부전마비에 대한 한·양방 병행 치험 1례)

  • Jung, Da-hae;Kil, Bong-hun;Kim, Dong-won;Youn, Hye-soo;Lee, Eun-chang;Jo, Hye-mi;Han, Da-young;Son, Ah-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1131-1141
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    • 2021
  • Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

The Effects of mCIMT using PNF on the Upper Extremity Function and Activities of Daily Living in Patients with Subacute Stroke (고유수용성촉진법을 이용한 수정된 강제유도 운동치료가 아급성 뇌졸중 환자의 상지 기능과 일상생활수행능력에 미치는 영향)

  • Bang, Dae-Hyouk;Song, Myung-Soo;Cho, Hyuk-Shin
    • PNF and Movement
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    • v.16 no.3
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    • pp.451-460
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    • 2018
  • Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

A Case Report of Korean Medicine Treatment for Basal Ganglia Infarction with Hemiplegia and Gait Disturbance (편마비 및 보행장애를 호소하는 기저핵 뇌경색 환자에 대한 한의 치료 증례보고 1례)

  • Yang, Ji-hae;Shin, Joo-eun;Kang, Jie-yoon;Won, Seo-young;Yoo, Ho-ryong;Kim, Yoon-sik;Seol, In-chan
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.175-183
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    • 2022
  • Objective: The aim of this study is to report the improvement of a basal ganglia infarction patient with left hemiplegia and gait disturbance after treatment with Korean medicine. Methods: The patient was treated using acupuncture, moxibustion, and herbal medicine. To evaluate the effect on clinical symptoms, a manual muscle test, the Modified Functional Ambulation Classification, and the Korean version of the Modified Barthel Index were used. Results: After 118 days of treatment, scores for all three scales improved. Conclusion: Treatment with Korean medicine appears to be effective for improving the clinical symptoms of basal ganglia infarction with hemiplegia and gait disturbance, but further research is needed to verify this.

A Case Report of Intercranial Hemorrhage with Hemiplegia Improved by Jayumkeonbi-tang with Deer Antler and Other Korean Medicine Treatments (자음건비탕가녹용을 비롯한 한방치료로 호전된 편마비를 동반한 뇌출혈 환자 1례)

  • Jie-yoon Kang;Joo-eun Shin;Ji-soo Baek;Yoon-sik Kim;In-chan Seol;Ho-ryong Yoo
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.791-802
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    • 2023
  • Objective: This study reports on the effectiveness of Korean medicine treatment in a patient with intracerebral hemorrhages with symptoms of hemiplegia, personality change, and aphasia. Case presentation: The patient was treated using Korean medicine, including Jayumkeonbi-tang with deer antler as herbal medicine, acupuncture, moxibustion, and a limb activation exercise. To evaluate the effect on clinical symptoms, a manual muscle test, the Modified Functional Ambulation Classification, and the Korean version of the Modified Barthel Index were used. After 84 days of treatment, the MMT grade of the right upper and lower limbs improved from Gr. 2+/2- to Gr. 4/3~4 on average, and personality change and aphasia were gone. Conclusion: A complex treatment that includes Jaeumkunbi-tang, acupuncture, moxibustion, and limb activation exercises can be effective following an intracerebral hemorrhage resulting in hemiplegia and personality change. However, more research is needed.