• Title/Summary/Keyword: Stroke Dependent

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Effect of Balance Exercise using a Combination of Isotonics for Proprioceptive Neuromuscular Facilitation on Balance and Walking Ability in Patients with Hemiplegia Due to Stroke

  • Kim, Beomryong;Kang, Taewoo
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.470-478
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    • 2021
  • Objective: This study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) balance exercise on the ability to balance and walk in patients with hemiplegia caused by stroke. Design: A randomized controlled trial Methods: Following baseline measurements, patients (n=24) with hemiplegia caused by stroke were randomized into two groups: the PNF balance group (n=12) that received PNF balance exercise and the balance group (n=12) that received general balance exercise. Each group joined the intervention for 30 minutes, 5 times per week for 6 weeks. Both groups performed the Timed Up and Go test (TUG) and Berg Balance Scale (BBS) for balance, as well as the 10-meter walking test (10MWT) and 6-minute walk test (6MWT) for walking. The data were collected both before and after the intervention. The paired t-test was used to compare the post-intervention changes compared with pre-intervention data. An independent t-test was used to analyze the differences in the dependent variables between the two groups. Results: After the 6-week intervention, both groups showed significant improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) parameters (p<0.05). The patients in the PNF balance group showed greater improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) than those in the balance group (p<0.05). Conclusions: PNF balance exercise shows improvements in balance and walking parameters in patients with hemiplegia caused by stroke.

Lysophosphatidic Acid Receptor 1 Plays a Pathogenic Role in Permanent Brain Ischemic Stroke by Modulating Neuroinflammatory Responses

  • Supriya Tiwari;Nikita Basnet;Ji Woong Choi
    • Biomolecules & Therapeutics
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    • v.32 no.3
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    • pp.319-328
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    • 2024
  • Lysophosphatidic acid receptor 1 (LPA1) plays a critical role in brain injury following a transient brain ischemic stroke. However, its role in permanent brain ischemic stroke remains unknown. To address this, we investigated whether LPA1 could contribute to brain injury of mice challenged by permanent middle cerebral artery occlusion (pMCAO). A selective LPA1 antagonist (AM152) was used as a pharmacological tool for this investigation. When AM152 was given to pMCAO-challenged mice one hour after occlusion, pMCAO-induced brain damage such as brain infarction, functional neurological deficits, apoptosis, and blood-brain barrier disruption was significantly attenuated. Histological analyses demonstrated that AM152 administration attenuated microglial activation and proliferation in injured brain after pMCAO challenge. AM152 administration also attenuated abnormal neuroinflammatory responses by decreasing expression levels of pro-inflammatory cytokines while increasing expression levels of anti-inflammatory cytokines in the injured brain. As underlying effector pathways, NF-κB, MAPKs (ERK1/2, p38, and JNKs), and PI3K/Akt were found to be involved in LPA1-dependent pathogenesis. Collectively, these results demonstrate that LPA1 can contribute to brain injury by permanent ischemic stroke, along with relevant pathogenic events in an injured brain.

Feasibility of Virtual Reality for Enhancement of Upper Extremity Function Post Stroke (작업치료 임상에서 뇌졸중 환자의 상지기능 향상을 위한 가상현실 치료의 유용성에 관한 고찰)

  • Kwon, Jae-Sung;Yang, No-Yul
    • Therapeutic Science for Rehabilitation
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    • v.1 no.2
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    • pp.35-40
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    • 2012
  • The purpose of this review was to investigate feasibility of intensive virtual reality training to improve upper extremity function with brain plasticity of individuals with stroke through the literature. The recovery of the paretic upper extremity depends on regularity and intensity of training as use-dependent plasticity. In resent, virtual reality program has been widely used in the occupational therapy field of augmented stroke rehabilitation. There is a growing body of evidence that virtual reality training of the paretic extremity induces brain plasticity associated with motor improvement. In terms of therapeutic feasibility to improve paretic upper extremity, recent research has explored several important factors of virtual reality training for recovery of upper extremity motor function. These factors include high repetition intensity, high motivation like type of game, enhanced multisensory feedback regarding performance, and interactive task-oriented training. Therefore, occupational therapy combined with intensive and repetitive virtual reality training will enhance recovery of upper extremity motor function after stroke.

A Clinical Study of Combined Eastern and Western Treatment of Acute Stage Stroke (급성기 뇌졸중 환자의 한양방 협진치료에 대한 임상적 고찰)

  • Kim, Jong-Hwan;Sin, Woo-Jin;Jang, Ja-Won;Kim, Ji-Yun;Min, Sung-Soon;Hwang, Won-Duek
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.65-74
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    • 2004
  • Object : This is a study of acute stage stroke patients designed for comparison of combined Eastern and Western medical treatments and Oriental treatments alone. Methods : 51 patients were diagnosed by Brain-CT and Brain-MRI scan as having suffered stroke. They had entered Dong-eui hospital within seven days of attack, and remained over seven days, all between November 2002 and August 2003. Patients were divided into two groups: a group treated with both Eastern and Western medical treatments, and a group treated only with Oriental medical treatments (but examinations were done and medications were given in hypertension, Diabetes Mellitus and so on). Results : The Eastern-Western medical treatment group showed significant changes in NIHSS. A rate of improvement figure of 24.94% was obtained for the Eastern-Western medical treatment group, and for the Oriental medical group a figure of 7.84% was obtained. Conclusion : The East-West medical treatment group had significant rate of development that measure for NIHSS by treated comparatively dependent patients. And oriental medical treatment group had significant rate of development that measure for NIHSS by treated comparatively independent patients. The NIHSS measure for the Eastern-Western medical treatment group shows a significant rate of improvement for relatively dependent patients, and the NIHSS measure for the Oriental medical treatment group shows a significant rate of development for relatively independent patients.

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Effects of One-to-one Fall Prevention Education on Decrease in Falls of Adults with Stroke (뇌졸중 성인의 낙상 감소를 위한 1대 1 낙상 예방 교육의 효과)

  • Kim, Hee;Jung, Min-Ye
    • The Journal of the Korea Contents Association
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    • v.15 no.5
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    • pp.426-435
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    • 2015
  • The aim of this study was to investigate the effects of an one-to-one fall prevention education on the falls and fall factors of adults who have had a stroke. 17 adults who have had a stroke were recruited and a total of four sessions of weekly one-to-one fall prevention educational program was developed considering the stroke population's cognitive abilities. Each sessions were composed of different fall-related subjects of introduction of fall, fall prevention exercise, fall prevention assistive device, and fall prevention environment modification. Dependent variables were the number of fall and fall danger in the recent month, balance ability, fear of falls, fall efficacy and depression. After four sessions of one-to-one fall prevention education, participants showed significantly positive changes in all dependent variables except for the balance ability(p<.05). An one-to-one fall prevention education to adults with stroke could decrease the number of fall and fall danger, fear of falls, depressive symptoms and fall efficacy. In order for the stroke adults to remain safely in their community and hospital, an one-to-one fall preventive education considering their cognitive level is needed.

Effects of a Plastic Ankle Foot Orthosis on Balance and Gait of Adult with Poststroke Hemiplegia: A Systematic Review of Forcusing on Korea's Thesis (플라스틱 단하지보조기 중재가 뇌졸중 후 편마비 성인의 보행과 균형에 미치는 효과: 국내 학위 논문을 중심으로 고찰)

  • Cho, Byeongmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.4 no.4
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    • pp.33-39
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    • 2016
  • Purpose : The aim of this study was to investigate the effects of plastic ankle foot orthosis on adult post-stroke hemiplegic patients walking ability and balance. Method : The searched for the case controlled clinical trials about the effects of plastic ankle foot orthosis(pAFO) for walking ability and balance using quantitative gait analysis in adult post-stroke patients. Ten trials were selected from Riss4U databases published until June 2016 in Korea. The selected trials contained a control group with pre-test and post-test design, measured walking ability and balance as a dependent variable. Result : The selected ten trials involved a total of 180 patients. The walking speed, cadence, the portion of double limb supporting, stride length on affected side were improved by plastic ankle foot orthosis. Conclusion : The plastic ankle foot orthosis has some evidence to improve the walking ability and balance in post-stroke hemiplegic patients.

The Effects of Backward Walking Training With Inclined Treadmill on the Gait in Chronic Stroke Patients (경사트레드밀에서 후방보행 훈련이 뇌졸중 환자의 보행에 미치는 영향)

  • Oh, Yong-seop;Woo, Young-keun
    • Physical Therapy Korea
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    • v.23 no.3
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    • pp.1-10
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    • 2016
  • Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

The Effect of Chest Physical Therapy on Improvement of Pulmonary Function in the Patients with Stroke (호흡기계 물리치료가 뇌졸중환자의 폐기능 증진에 미치는 영향)

  • Kim Jae-Hyun;Hong Wan-Sung;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.133-144
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    • 2000
  • The purpose of this study was to determine whether respiratory physical therapy might increase the pulmonary function of the patients with stroke or not. Twenty patients with stroke were randomly assigned to experimental and control group. During four weeks, both groups participated in the conventional physical therapy and only the experimental group added in a program of respiratory physical therapy. Respiratory physical therapy consisted of chest mobilization, resistive ventilatory muscle training used the method of PNF technique and relaxed diaphragm breathing. Baseline and post-test measurements were made of vital capacity. inspiratory capacity, expiratory reserve volume, farced vital capacity, forced expiratory volume at one second, $FE1/FVC(\%)$ and maximal voluntary ventilation. Ater four weeks, the experimental group showed the significant improvement in VC(p<.05). FVC(p<.05), FFV1(p<.05) md MVV(p<.05). However, the controll group showed no significant differnece. As compared th the relationship of dependent variables between the experimental group and control group. experimental group showed the significant difference in VC(p<.01), FEV1(p<.05) and MVV(p<.05). These findings suggest that respiratory physical therapy can be used to improve pulmonary function in stroke patients. Also, respiratory physical therapy should be performed for at least four weeks and be followed by the continuous respiratory exercise programs.

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Considering on the Ground Reflection Effect on the Electromagnetic Fields due to Lightning Channel

  • Izadi, Mahdi;Ab Kadir, Mohd Zainal Abidin;Hajikhani, Maryam
    • Journal of Electrical Engineering and Technology
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    • v.8 no.4
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    • pp.824-831
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    • 2013
  • Lightning electromagnetic fields are important issues for the evaluation of lightning induced overvoltage on power lines and for setting the appropriate protection level for power networks. Such electromagnetic fields are strongly dependent on lightning return stroke currents at different heights along the lightning channel. On the other hand, the ground reflection factor due to the difference between the return stroke channel impedance and the equivalent ground impedance at channel base can have an effect on the shape of the return stroke currents by entering additional reflected currents into the channel. In this paper, the effect of the ground reflection factor on the return stroke currents at different heights along a channel and the electromagnetic fields associated with the lightning channel at close distances are considered. Moreover, the behavior of the electromagnetic fields versus the reflection factor changes and the radial distance changes are considered and the results are discussed accordingly. The results illustrate that the reflection factor has a direct relationship with the values of the electromagnetic fields while this is usually ignored in earlier studies.

Cardiac Response to Head-Out Water Immersion in Man

  • Choi, Jang-Kyu;Park, Won-Kun
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.3
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    • pp.253-261
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    • 2000
  • Head-out water immersion induces marked increase in the cardiac stroke volume. The present study was undertaken to characterize the stroke volume change by analyzing the aortic blood flow and left ventricular systolic time intervals. Ten men rested on a siting position in the air and in the water at $34.5^{circ}C$ for 30 min each. Their stroke volume, heart rate, ventricular systolic time intervals, and aortic blood flow indices were assessed by impedance cardiography. During immersion, the stroke volume increased 56%, with a slight (4%) decrease in heart rate, thus cardiac output increased ${\sim}50%.$ The slight increase in R-R interval was due to an equivalent increase in the systolic and diastolic time intervals. The ventricular ejection time was 20% increased, and this was mainly due to a decrease in pre-ejection period (28%). The mean arterial pressure increased 5 mmHg, indicating that the cardiac afterload was slightly elevated by immersion. The left ventricular end-diastolic volume index increased 24%, indicating that the cardiac preload was markedly elevated during immersion. The mean velocity and the indices of peak velocity and peak acceleration of aortic blood flow were all increased by ${\sim}30%,$ indicating that the left ventricular contractile force was enhanced by immersion. These results suggest that the increase in stroke volume during immersion is characterized by an increase in ventricular ejection time and aortic blood flow velocity, which may be primarily attributed to the increased cardiac preload and the muscle length-dependent increase in myocardial contractile force.

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