• 제목/요약/키워드: Post - stroke patients

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뇌졸중 환자의 고관절 관절가동범위와 대퇴골두 전방가동성, 보행 능력간에 상관관계 (Correlation of Hip Joint Range of Motion and Femur Head Anterior Glide Mobility with Gait Ability in Stroke Patients)

  • 김영훈;김선엽;장현정
    • 대한물리의학회지
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    • 제9권1호
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    • pp.35-44
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    • 2014
  • PURPOSE: The aim of the study was to investigate the relationships among the hip joint passive range of motion (ROM) and femur head anterior glide (FHAG) mobility on the gait ability in patients with post-stroke hemiparesis. METHODS: The participants were 37 patients (30 male, 7 female) living in Daejeon. The ROM of the hip joint was measured by using goniometry and the FHAG mobility was measured by using the Prone Figure-4 test. The walking ability was assessed by using the 10m walk test (10MWT), and the 6-min walk test (6MWT). RESULTS: The FHAG was negatively correlated with hip extension (r=-.554, p<.05) and flexion (r=-.337) on the affected side as well as with hip extension (r=-.480), abduction (r=-.361), and adduction (r=-.426) on the non-affected side (p<.05). The gait ability was correlated with the hip joint external rotation on the non-affected side (p<.05), but showed no significant correlation with the hip ROM on the affected side (p>.05). CONCLUSION: This study provides evidence that in patients with post-stroke hemiparesis, the FHAG mobility might be correlated with hip extension. Based on these results, the FHAG mobility may be used to determine the hip extension in patients with post-stroke hemiparesis.

만성 뇌졸중 환자의 지역사회 보행: 다섯 보행 조건의 비교 (Community ambulation in patients with chronic post-stroke hemiparesis : Comparison of walking variables in five different community situations)

  • 황은옥;오덕원;김선엽
    • 대한물리치료과학회지
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    • 제16권1호
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    • pp.31-39
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    • 2009
  • Background: Community ambulation has been recently recognized as one of the most essential factors of activities of daily living in patients with post-stroke hemiparesis. This study aimed to compare walking velocity and step number in 5 community situations in patients with post-stroke hemiparesis. Methods: Ten chronic stroke patients volunteered for this study. The main variables analyzed were walking speed and step number, and these were measured in 5 different community situations: a physical therapy room, a parking lot, a bank, a crosswalk, and a hospital lobby. The measurements obtained for walking in the physical therapy room were measured using a 10m walk test and were used as baseline data for comparison with each option. The ambulation distance was set at 300m for the parking lot and the bank and 150m for the crosswalk and hospital lobby. For data analysis, walking speed and step number were standardized with the distance options of each ambulation. Results: Compared to the walking speed in the physical therapy room, those in the other situations, except for the parking lot, were significantly different (p<.05). Moreover, there were significant differences in the speeds between the bank and the parking lot and between the parking lot and the crosswalk (p<.05). Compared to the step number in the physical therapy room, those in all situations except for the crosswalk were significantly different (p<.05). Further, there was a significant difference in the step number between the bank and the crosswalk (p<.05). Conclusion: The walking ability of patients with hemiparesis in real environments within a community could be different from that in a physical therapy room. Therefore, the evaluation of walking should be performed in a variety of community situations.

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Comparison of the Symmetry of Buttock Pressure during Simulated Driving between Heathy Adults and Patients with Stroke

  • Shin, Hwa-Kyung;Lee, Du-Hwan
    • The Journal of Korean Physical Therapy
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    • 제29권4호
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    • pp.218-222
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    • 2017
  • Purpose: Driving is an important activity that is affected by various motor and cognitive deficits after stroke. On the other hand, there is no standard screening tool to evaluate the sitting asymmetry during driving, which is the stereotyped postural characteristic observed in patients with stroke. Therefore, this study compared the buttock pressure during simulated driving between healthy adults and patients with stroke. Methods: Ten post-stroke patients and ten healthy subjects participated in the experiment. The participants experienced simulated driving of 6.1 km during approximately 5 minutes for adaptation. The driving scenario consisted of 3.5 km urban traffic conditions, 10 km straight highway, and 7 km curved or hilly rural roads. Force sensitive application (FSA) was used to analyze the distribution of the buttock pressure on the driver's seat. The symmetry index (SI) was determined using the average buttock pressure of each side of the buttock. The closer SI is to zero, the higher the symmetry of buttock pressure. Results: These studies showed that the SI of healthy subjects was significantly closer to zero than that of the stroke patients. Conclusion: The buttock pressure of the stroke patients showed more asymmetry than that of the healthy subjects during simulated driving. Therefore, a therapeutic approach is needed for symmetrical sitting to improve the driving performance.

뇌졸중 환자의 디스트레스와 스티그마가 삶의 질에 미치는 영향 (Impact of Distress and Stigma on Quality of Life among Patients with Cerebrovascular Disease)

  • 이경희;전재희
    • 근관절건강학회지
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    • 제31권2호
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    • pp.95-106
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    • 2024
  • Purpose: This study investigated how distress and stigma affect the quality of life (QOL) in stroke patients. Methods: A descriptive research design was utilized with 150 stroke patients from three general and three long-term care facilities. Data were collected through an 86-item questionnaire from February 15 to April 10, 2023, using measures of distress, stigma, and QOL. Analysis was conducted using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and hierarchical regression analysis in SPSS/WIN 25.0. Results: The average QOL score was 156.37±38.27 out of 245 points. Factors affecting QOL of stroke patients were distress (β=-.56, p<.001), stigma(β=-.26, p<.001), biplegia (β=-.11, p=.045), and unemployment (β=-.10, p=.045), explaining 68% of the QOL variance. Conclusion: Programs aimed at reducing distress and stigma in stroke patients are essential for enhancing QOL. Effective strategies should address post-stroke physical and mental states, prevent complications, restore health, reduce anxiety, and leverage family and social support to mitigate stigma. Special attention is needed for stroke patients with hemiplegia and those who are unemployed.

Sweet Bee Venom 약침이 뇌졸중 후 편마비 환자의 견관절 동통에 미치는 영향 (The Effects of Sweet Bee Venom Pharmacopuncture on the Post-stroke Hemiplegic Shoulder Pain)

  • 박정아;이창환;권기순;이경아;장경전
    • Journal of Acupuncture Research
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    • 제28권4호
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    • pp.37-47
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    • 2011
  • Objective : The purpose of this study is to evaluate the effect of sweet bee venom pharmacopuncture on the post-stroke hemiplegic shoulder pain. Methods : 40 patients with post-stroke hemiplegic shoulder pain were randomly divided into 2 groups : study group(sweet bee venom pharmacopuncture treatment group, n=21) and Control group(normal saline treatment group, n=19). They were monitored for 4 weeks, followed up with visual analog scale(VAS), pain rating score(PRS), painless passive shoulder range of movement(PROM) and Fugl-Meyer Motor assessment(FMMA) at before treatment(T0), after 2 weeks(T2) and after 4 weeks(T4). Results : 1. Study group and control group showed pain decrease, but study group showed more significant effectiveness in VAS and PRS than control group. 2. Although there is no significant difference in PROM between study group and control group, both groups showed increase of PROM, and study group had some effectiveness on abduction and flexion as the treatment progresses. 3. There is no significant difference in FMMA between study group and control group. Conclusions : This study suggests that sweet bee venom pharmacopuncture has significant analgesic effect on the post-stroke hemiplegic shoulder pain. And it seems that sweet bee venom pharmacopuncture can be applicable to improve PROM in hemiplegia patients with stroke. Further studies based on larger population and long term follow-up are needed to confirm this suggestion.

손 재활 로봇의 적용이 만성 뇌졸중 환자의 손 기능 향상에 미치는 영향 (Effect of Robot-Assisted Hand Rehabilitation on Hand Function in Chronic Stroke Patients)

  • 박진혁
    • 로봇학회논문지
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    • 제8권4호
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    • pp.273-282
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    • 2013
  • The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(Amadeo(R)) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in Amadeo(R), and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of Amadeo(R), finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.

Task-Oriented Approach for Improving Motor Function of the Affected Arm in Chronic Hemiparetic Stroke Patients

  • Song, Chiang-Soon;Hwang, Su-Jin
    • 한국전문물리치료학회지
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    • 제19권1호
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    • pp.86-93
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    • 2012
  • The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.

뇌졸중후 경직에 대한 침치료 임상진료지침 (Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity)

  • 김제신;신승원;이의주;신병철;이명수;임성민;남동우;문상관
    • 대한한의학회지
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    • 제36권1호
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    • pp.1-8
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    • 2015
  • Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. 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 post-stroke spasticity, 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: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

중풍 후유증으로 인한 실어증 환자에 한방치료와 언어치료를 병행한 경험2례 (Two cases of Combination Therapy of Acupuncture, Herbal medication and Speech Therapy for Aphasic Stroke Patients)

  • 양태규;박정미
    • 대한한의학회지
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    • 제23권4호
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    • pp.196-202
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    • 2002
  • Aphasia is frequent in stroke patients and most patients with aphasia exhibit spontaneous progressive improvement in language abilities over time, but few recover completely. Neurological variables, especially initial severity of aphasia and time post-onset, appear to have influence on improvement. Effect of speech therapy and pharmacotherapy has been studied and some drugs, like amphetamine are proved to be benefit for recovery of aphasia following stroke. But there has been few evidence to facilitate recovery from aphasia by acupuncture or herbal medication therapy. So we report two cases of aphasic stroke patients who treated by combination therapy of acupuncture, herbal medication(Cheongsinhaeo-tang) and speech therapy over 6 months and improved in language abilities. Further clinical studies will be needed to explore the effects of acupuncture and herbal medication therapy for aphasia. Researchers should examine the long term effect of these treatment, and whether it is more effective than speech therapy and western pharmacotherapy or not..

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동작관찰훈련이 만성 뇌졸중 환자의 앉은 자세에서 균형과 몸통조절능력에 미치는 영향 (The Effect of Action on the Balance and the Trunk Control Ability in the Sit Position of Chronic Stroke Patients)

  • 황준현;이양진;주민철;김성렬
    • 대한통합의학회지
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    • 제7권3호
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    • pp.1-9
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    • 2019
  • Purpose : To find out how action observation training for chronic stroke patients affects their balance and body control abilities in the posture seated in the rehabilitation of stroke. Methods : This study was conducted on 30 subjects who were diagnosed with stroke. The group conducted motion observation training through video clips, while the control group only conducted physical training, and the general physical therapy was performed equally by both counties. The static balance was measured using Biorescue and the dynamic balance was measured using Modified Functional Reach Test (MFRT), Postural Assessment Scale for Stroke, and Trunk Impairment Scale. Results : Static balance showed statistically significant difference in foot pressure (p<.05) as a result of comparison between pre and post exercise training. Dynamic balance was statistically significant (p>.05) as a result of comparing pre and post differences using modified functional reach test. The trunk control ability was statistically significant (p>.001). Comparison between the results of before and after motion observation training showed a statistically significant difference. Conclusion: This study confirmed that exercise training in sitting position was effective for static, dynamic balance ability and trunk control ability of hemiplegic patients due to stroke. These results suggest that the use of motion monitoring in stroke patients may have a positive impact on the diversity and function of rehabilitation.