• Title/Summary/Keyword: Stroke Dependent

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Factors influencing the ambulatory status in Hemiplegia with Intracerebral Hemorrhage after rehabilitation (뇌출혈으로 인한 편마비 환자의 재활치료 후 보행능력에 영향을 주는 요인)

  • Kim, Chan-Kyu;Kim, Kweon-Young
    • Journal of Korean Physical Therapy Science
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    • v.6 no.2
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    • pp.1007-1017
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    • 1999
  • The purpose of this study was to evaluate the factors influencing the ambulatory status in hemiplegia with intracerebral hemorrhage after rehabilitation. Thirty patients with stroke who was admitted in the Chosun University Hospital, between from January 1st' 1998 and December 31st' 1998, were included in this study. The following variables as a potential predictors for ambulation were evaluated at treatment of the stroke onset; 1) general characteristics including age and sex, and 2) clinical characteristics including frequency and onset time of the stroke, affected side, duration of the treatment, time interval between onset and rehabilitation, manual muscle test of paretic limb, sitting and standing balance, proprioception, perception, cognitive function. We compared and analyzed the these variables to the two type of ambulatory status at the time of the discharge by Modified Barthel Index, independent, dependent. The data were analyzed by student t-test, Fisher-exact test, Mann Whitney-U test, $X^{2}$-test, correlation analysis(spearman's). The results were as follows; 1. Were no significantly inflenced independent ambulatory status among general characteristics. 2. Frequency of the stroke and proprioception (p<0.05), muscle strength of the lower limb, cognitive function and standing balance (p<0.01), perception and sitting balance (p<0.001) were significantly inflenced independent ambulatory status among clinical characteristics. 3. Independent Variable correlated with the ambulatory status were muscle strength of the lower limb, proprioception and sitting balance (p<0.05), standing balance, frequency of the stroke, perception and cognitive function (p<0.01). Therefore the muscle strength of the lower limb, proprioception, sitting balance, standing balance, frequency of the stroke, perception, cognitive function were the most significant influencing factors of ambulatory status after rehabilitation.

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Effects of Group Rehabilitation Gymnastics for Stroke Patients

  • Kim, Sun-Houng;Moon, Nam-Eun;Jeon, Mi-Yang;Jeong, Hyeon-Cheol
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.207-214
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    • 2022
  • Objective: This study is an experimental study to investigate the effect of group rehabilitation gymnastics on stroke patients. Design: A randomized controlled trial. Methods: From August 1, 2017, to February 30, 2018, 49 subjects hospitalized after being diagnosed with a stroke at K Rehabilitation Hospital had at least 8 weeks (more than 3 times a week) in the group rehabilitation exercise experimental group (25 patients), and the control group (24 patients) did not attend. Data analysis was performed using paired t-test for dependent variables before and after the experiment using SPSS 25. Results: In the experimental group, daily activities were statistically significantly increased from 59.04±25.19 points before treatment to 66.96±24.35 points after treatment (t=2.24, p=0.035). Lung capacity also significantly increased from 280.00±86.99 points to 334.40±93.23 points (t=4.21, p<0.001), and hospital reuse intention also significantly increased from 8.04±1.57 points to 8.88±1.16 points (t=2.67, p=0.013). In the case of the control group, although the MBI, lung capacity, stress, hospital reuse intention, and hospital use satisfaction increased after the experiment compared to before the experiment, there was no significant difference. Conclusions: In conclusion, group rehabilitation gymnastics for stroke patients is effective for daily living movements, lung capacity, and hospital re-use intention. Therefore, if it is continuously applied to stroke patients, it can be used as an intervention to improve the quality of nursing by enhancing physical function.

Effects of Head Acupuncture Versus Upper and Lower Limbs Acupuncture on Signal Activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex (두침과 상하지 침자극이 뇌와 뇌의 체성감각피질에 미치는 영향에 대한 fMRI Study)

  • Park, Jung-Mi;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Jang, Geon-Ho;Bang, Jae-Seung
    • Journal of Acupuncture Research
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    • v.25 no.5
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    • pp.151-165
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    • 2008
  • Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$). After stimulation of Head Acupuncture in Sishencong($HN_1$), $GB_{18}$, $GB_9$, $TH_{20}$ of Left versus Upper and Lower Limbs Acupuncture($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$ of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When $ST_{36}$ was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter-Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points($LI_1$, $LI_{10}4, $LV_3$, $ST_{36}$), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When $ST_{36}$ was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points' sensitivity and different sensory receptor to response acupuncture stimulation.

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The Effect of Speed-dependent with Body Weight Supported Treadmill Training on the Ambulation of Stroke (속도-의존적 체중지지 트레드밀 보행이 뇌졸중 환자의 보행에 미치는 영향)

  • Kim, Jwa-Jun;Rho, Min-He;Goo, Bong-Oh;Ahn, So-Youn
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.339-350
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    • 2005
  • This study is the quasi-experimental study on the gait training rehabilitation. The purpose of this study is to prepare the baseline data for most suitable of gait while we were scrutinizing how the walking characters, functional walking ability, gait quality of stroke patients were affected by the gait on BWSTT (Body Weight Supported Treadmill Training) through the change of treadmill velocity and body weight support. To accomplish this purpose, this study used thirty subjects, more than 3 months post stroke, for rehabilitation who were divided between two gait training groups they received the neurophysiological physical therapy. For 6 weeks, 5 times a week for 15 minutes per session, the BWSTT group participated in 30 sessions structured speed-dependent treadmill training with 30% body weight supported, and the ratio of body weight support was gradually decreased as the patients advanced the capability of more self-support. The OGT(Over Ground Training) group received the same quantity of equal sessions like BWSTT. Firstly, we measured the absolute improvement of walking velocity (m/s), capacity(min/m) and cadence(steps/min) among walking characters. Secondly, we measured the functional walking ability such as Functional Ambulatory Category(FAC, score out of 5), Modified Motor Assesment Scale(MMAS, score out of 6) and Gait Quality Chart(score out of 41). Data analysis was performed with using SPSS 10.0 win program. The descriptive analysis was used to obtain average and standard deviation. The independent t-test and the paired t-test were used to compare both the groups about pre and post training test. Treatment effects were established by pre and post assessment. Subjects tolerated the training well without side-effects. Therefore, the results of this study were as follows; 1. There was a more significant difference from the improvement of walking velocity(0.09m/s), endurance(4.53min/m), cadence(4.20steps/min), FAC(0.26score), MMAS(0.33 score) and hip joint and pelvic of gait quality(0.39 score) ever before in the BWSTT group(p<.05). 2. There was a more significant increase from the walking velocity(0.01m/s) in the OGT group(p<.05). 3. There was a more statistical significant increase from comparing the average of walking velocity in both groups ever before(0.42m/s in BWSTT group and 0.31m/s in OGT group)(p<.05). There was a statistical significant difference from the average of cadence in both groups(61.87step/min in BWSTT group and 3.60steps/min in OGT group)(p<.05). As we can see from above, the findings suggest that BWSTT may be more effective than the OGT for improving some gait parameters such as gait velocity and cadency. This conclusion also suggest that BWSTT is more effective for the improvement of gait of stroke patients.

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Analysis of cognitive factors affecting stroke patient's activity of daily living performance -Using the computerized neurocognitive function test- (뇌졸중 환자의 일상 활동 수행에 영향을 미치는 인지요인 분석 -전산화 신경인지기능검사 중심으로-)

  • Kim, Ji-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5715-5721
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    • 2011
  • This research analyzed the cognitive factors affecting stroke patient's activity of daily living performance and suggests the approaches which can contribute to the effective activity of daily living performance in the rehabilitation treatment of stroke patients. In this study, Seoul Computerized NeuroCognitive Function Test (SCNT) and MBI have been performed for 21 patients under extensive rehabilitation treatments, hospitalized in the rehabilitation clinic of A hospital after being diagnosed as a stroke caused by cerebrovascular disorders. To assess the effectiveness of the cognitive factors which affect the stroke patient's activity of daily living performance, activity of daily living performance values were set as dependent variables and 10 cognitive factors were included in the model to carry out analysis of the multiple regression analysis. The results show that stroke patient's activity of daily living performance have statistically significant correlations with divided attention, motor control and selectivir attention. In addition, cognitive factors explained 69.8% of the stroke patient's activity of daily living performance. Consequently, if divided attention and motor control are considered as a focal point of training in the rehabilitation treatment of stroke patients, we can effectively promote the improvement of the activity of daily living performanceroutine activities.

Discriminative validity of the timed up and go test for community ambulation in persons with chronic stroke

  • An, Seung Heon;Park, Dae-Sung;Lim, Ji Young
    • Physical Therapy Rehabilitation Science
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    • v.6 no.4
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    • pp.176-181
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    • 2017
  • Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.

Clinical Effectiveness of New Portable System for Measuring Spasticity of the Stroke Patients (뇌졸중 환자의 경직측정을 위한 휴대형 장치의 유용성)

  • Kim, Keo-Sik;Seo, Jeong-Hwan;Song, Chul-Gyu
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.59 no.1
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    • pp.217-219
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    • 2010
  • Spasticity is a motor disorder characterized by a velocity dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex. The aim of this study is to develop a portable system for quantifying the grade of spasticity which could calculate the biomechanical as well as neurophysiologic parameters, and for determining the relationship between the Tonic Stretch Reflex Threshold (TSRT) and Modified Ashworth Scale (MAS). Eleven patients with stroke participated in the study (6 males and 5 females, the average age of $64.5\pm16.0$ years). As a results, the mean and standard deviation values of the TSRT were $129.8\pm4.2$, $123.4\pm5.2$ and $119.1\pm2.6$ in the MAS 1, MAS 1+ and MAS 2 groups, respectively. Also, there was a negative correlation between the TSRT and MAS (rho=-0.72, p<0.05). This demonstrated that the TSRT could be made clinically available for the more objective and reliable evaluation of the spasticity, instead of using the conventional clinical scales and an isokinetic dynamometer.

A Correlational Study on Activities of Daily Living, Self-efficacy, Stroke Specific Qualify of Life and Need for Self-help Management Programs for Patients with Hemiplegia at Home (재가 뇌졸중환자의 일상생활활동, 자기효능감, 삶의 질, 자조관리프로그램요구도와의 관계에 관한 연구)

  • Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.1
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    • pp.81-94
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    • 2001
  • The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.

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Factors Influencing Stroke in Community-dwelling Adults : Focusing on Health-related Quality of Life (지역사회거주 성인의 뇌졸중 영향 요인 : 건강관련 삶의 질을 중심으로)

  • Moon, Jong-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.1
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    • pp.35-45
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    • 2019
  • Objective : The purpose of this study was to investigate the factors influencing stroke in community-dwelling adults. Methods : This study used raw data from the community health survey in 2016. Among the 228,452 subjects who participated in the survey, 225,003 (98.5%) of them were included in the analysis of this study. The sociodemographic characteristics were selected as gender, age, region, income, marital status, and comorbidity was selected as osteoporosis, hypertension, diabetes, dyslipidemia, myocardial infarction and arthritis. Health-related quality of life was assessed by EuroQol-5 Dimension(EQ-5D) and the subcategory of EQ-5D (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) were included in the analysis. Dependent variables were stroke, and the independent variables were the 16 variables described above. Statistical analysis was performed using binomial logistic regression analysis. Results : In sociodemographic variables, stroke was predicted by men, aging, and lower income levels. In comorbidity variables, stroke was predicted by hypertension, diabetes mellitus, hyperlipidemia, and myocardial infarction. In sub-domains of health-related quality of life, stroke was predicted by self-care, usual activities, mobility, anxiety/depression, and pain/discomfort. Conclusion : These finding suggest that it is needed development of a customized health promotion program for the improvement of self-care and activities of daily living in community-dwelling stroke survivors.

The conceptual design of the x y $\theta$ fine stage and its optimal design to obtain fast response in lithography system.

  • Kim, Dong-Min;Kim, Ki-Hyun;Lee, Sung-Q.;Gweon, Dae-Gab
    • 제어로봇시스템학회:학술대회논문집
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    • 2001.10a
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    • pp.37.3-37
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    • 2001
  • The quality of a precision product, in genera, relies on the accuracy and precision of its manufacturing and inspection process. In many cases, the level of precision in the manufacturing and inspection system is also dependent on the positioning capability of tool with respect to the workpiece in the process. Recently the positioning accuracy level employed for some of precision product has reached the level of submicron and long range of motion is required. For example, for 1GDRM lithography, 20nm accuracy and 300nm stroke needs. This paper refers to the lithography stage especially fine stage. In this study, for long stroke and high accuracy, the dual servo system is proposed. For the coarse actuator, LDM(Linear DC Noter) is used and for fine or VCM is used ...

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