• 한국전문물리치료학회지
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• 제21권2호
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• pp.37-47
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• 2014

Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

• ETRI Journal
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• 제45권6호
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• pp.1007-1021
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• 2023

Stroke is the leading cause of permanent disability in adults, and it can cause permanent brain damage. According to the World Health Organization, 795 000 Americans experience a new or recurrent stroke each year. Early detection of medical disorders, for example, strokes, can minimize the disabling effects. Thus, in this paper, we consider various risk factors that contribute to the occurrence of stoke and machine learning algorithms, for example, the decision tree, random forest, and naive Bayes algorithms, on patient characteristics survey data to achieve high prediction accuracy. We also consider the semisupervised self-training technique to predict the risk of stroke. We then consider the near-miss undersampling technique, which can select only instances in larger classes with the smaller class instances. Experimental results demonstrate that the proposed method obtains an accuracy of approximately 98.83% at low cost, which is significantly higher and more reliable compared with the compared techniques.

• Annals of Clinical Neurophysiology
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• 제9권1호
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• pp.1-4
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• 2007

Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. This review focuses on two common presentations of spontaneous vertigo: acute prolonged spontaneous vertigo and recurrent spontaneous vertigo. Common causes of acute prolonged spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. The history and detailed neurological/neurotological examinations usually provide the key information for distinguishing between peripheral and central causes of vertigo. Brain MRI is indicated in any patient with acute vertigo accompanied by abnormal neurological signs, profound imbalance, severe headache, and central patterns of nystagmus. Recurrent spontaneous vertigo occurs when there is a sudden, temporary, and largely reversible impairment of resting neural activity of one labyrinth or its central connections, with subsequent recovery to normal or near-normal function. Meniere's disease, migrainous vertigo, and vertebrobasilar insufficiency (VBI) are common causes. The duration of the vertigo attack is a key piece of information in recurrent spontaneous vertigo. Vertigo of vascular origin, such as VBI, typically lasts for several minutes, whereas recurrent vertigo due to peripheral inner-ear abnormalities lasts for hours. Screening neurotological evaluations, and blood tests for autoimmune and otosyphilis are useful in assessment of recurrent spontaneous vertigo that are likely to be peripheral in origin.

• Journal of Yeungnam Medical Science
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• 제20권1호
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• pp.1-12
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• 2003

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

• The Journal of Korean Physical Therapy
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• 제22권4호
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• pp.1-6
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• 2010

Purpose: This study was designed to evaluate the clinical utility of the Four square step test (FSST) for predicting falls in stroke patients, to compare the ability of the FSST test to discriminate between subgroups of fallers, and to determine if the test has any predictive value in identifying stroke patients who will fall. Methods: Stroke patients (N=37) who could walk at least 50 m with minimal assistance were recruited consecutively when attending a physical therapy session during their rehabilitation. Dynamic standing balance was measured using the FSST. The main outcome measures were FSST time and fall number. Numbers of falls were compared with FSST scores. Differences between the groups in FSST scores were examined using a t-test and 1-way analysis of variance. Post hoc analysis using the Tukey B procedure was used to identify specific group differences. Alpha was set at 0.05. Results: A total of 15 participants (40.5%) reported falls 6 had recurrent falls (2 falls) and 9 fell once. The mean FSST time differed significantly between groups with zero and multiple falls. A cutoff score of greater than 17 seconds on the FSST was associated with a sensitivity of 83% and a specificity of 84% for the identification of subjects with multiple risk factors for falls. Conclusion: The FSST is a feasible and valid clinical test of dynamic standing balance and can predict falls in post-stroke patients.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.25-34
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• 2007

Objectives : The present study was carried out to provide basic information necessary for the prevention and efficient treatment of stroke through a comparison between thr patients of the first attack and those of recurrence. Methods : The observation f3r the current study was made on 210 cases of stroke that were confirmed through brain CT-scan. The patients were hospitalized at one of two oriental medical hospitals in Seoul during 2006. Result : The main results were as follows. First, the male-to-female ratio of stroke patients were 1:1.26, with more primary stroke far females and more recurrent stroke for males. Second, in the age distribution, seventies was the top, and sixties, fifties, and forties were next in the order of frequency. A large city was the most frequent residential site and unemployment was the most frequent occupation to have stroke. The incidence of stroke became higher as patients had a taste for spicy and salty food. Third, the most common preceding disease was hypertension. In the relationship of diastolic blood pressure with recurrence, there was significance in the test of independence. Fourth, the most important precipitating conditions at the onset of stroke were rest and steeping. The most common precedent symptoms were verbal disturbance, numbness, and dizziness. In the stroke patients with hemiparesis, male and female patients usually showed It. hemiparesis. Fifth, as a result of brain CT-scan, cerebral hemorrhage was inclined to reduce but cerebral infarction was inclined to increase due to senility and change of lifestyle. Finally, total cholesterol findings disclosed that 22.4% were hypercholesteremia, 18.6 % were hyperlipemia in triglyceride findings, and 19.0% were glycosemia in glucose findings. Conclusions : The above results suggested avoidance of meat and salty fDod and positive control of hypertension and diabetes mellitus in order to prevent stroke.

• Journal of Acupuncture Research
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• 제20권2호
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• pp.29-41
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• 2003

Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. And among the 52 cases of Stroke cerebral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebellar or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of exercising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

• 대한한방내과학회지
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• 제24권2_4호
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• pp.967-974
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• 2003

Recurrent Aphthous Stomatitis(RAS) is inflammatory ulcerative condition of the oral mucosa. The lesions of RAS are self-limited and persist for 1 to 2 weeks, resolved with or without scarring and recurred after periods of remission. It is known that nicotine may protect oral mucosa from aphthous ulcers by keratinization of the oral mucosa. After quitting smoking, a stroke patient who suffered from RAS, used to relapse into RAS unless he didn't gargle with nicotine extract water. We diagnosed his case as heat in the stomach and treated with Chungwie-San(Qingwei-San). After medication with Chungwie-San, RAS was subsided and he stopped smoking during admission period.

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.258-264
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• 2010

Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

• Journal of Korean Neurosurgical Society
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• 제38권6호
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• pp.419-424
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• 2005

Objective : Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. Methods : We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. Results : The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases [66.7%]. The abnormality on the electrocardiographic feature [23.5%] and long-term history of hypertension [20.5%] were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group [P<0.05]. The mean number of risk factors was three in acute group. It is larger than that of hyperacute group [P<0.05]. Conclusion : If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.