• Title/Summary/Keyword: Stroke Rehabilitation

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Localization of Bilateral Hemisphere Lesion Using Combined Transcranial Magnetic Stimulation and Diffusion Tensor Imaging: Report of Two Cases (경두개 자기자극과 확산텐서 신경섬유로 검사를 통한 대뇌 병변의 국소화: 증례보고)

  • Lee, Hyung Nam;Oh, Young-Bin;Kim, Gi-Wook;Won, Yu Hui;Ko, Myoung-Hwan;Seo, Jeong-Hwan;Park, Sung-Hee
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.106-111
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    • 2018
  • Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.

Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow in Healthy Human - Evaluated by $^{99m}Tc-ECD$ Brain SPECT - (합곡-곡지 전침치료가 정상인의 뇌혈류에 미치는 영향 - Brain SPECT와 SPM을 이용하여 -)

  • Ryu Jong-Man;Kim Young-Suk;Park Sung-Uk;Jung Woo-Sang;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Kim Deok-Yoon;Moon Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.36-43
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    • 2006
  • Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

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Quality of Life of Patients in Acute Stage of Stroke (급성기 뇌졸중 환자의 삶의 질)

  • Kim, Se-Joo;Kim, Young-Shin;Choi, Nak-Kyung;Lee, Yoon-Young;Lee, Byung-Chul;Lee, Man-Hong
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.27-36
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    • 2002
  • Objectives : Stroke is a chronic condition that may carry significant negative impact on the quality of life in patients. Research, treatment and rehabilitation on stoke, however, have focused on physical aspects, neglecting its psychiatric aspects and quality of life. So, aim of this study is to compare quality of life in stroke patients and healthy controls by using WHO Quality of Life(QOL) Scale that evaluates the domains of physical health, psychological health, social relationship and environment. Additionally, relationship between clinical factors in patients with stroke and their quality of life were explored. Methods : 98 patients in acute stage of stroke and 24 healthy controls were recruited in this study and WHO QOL Scales were completed. Total scores and scores of domains of WHO QOL Scale in two groups were compared. Correlation analysis and multiple regression analysis were performed to examine the relationship between quality of life and the clinical characteristics in patients with stroke. Results : Total scores and scores of all domains of WHO QOL scale in patients with stroke were decreased compared to those in healthy controls. Clinical characteristics including the depression, anxiety, social support system showed significant correlation with quality of life in general and most of subscales of QOL. And male patients have higher level of quality of life than female patients. But, physical disabilities rated with Barthel's index did not show significant correlation with quality of life. Multiple regression revealed that the severity of depression, anxiety, gender, and level of social support system were factors directly affecting the quality of life in the patients with stroke. Conclusion : Quality of life in patients with stroke was poorer than that of healthy controls. The severity of depression, anxiety, gender, and the level of social support system were related to the quality of life in the patients with stroke.

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Effects of Backward Walking Training in the Gait ability and Foot Pressure of Hemiplegia Patients (편마비 환자의 후방보행훈련이 보행능력과 족저압에 미치는 영향)

  • Lee, Byung-Hoon;Jeong, Jin-Gyu;Kim, Chan-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.12
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    • pp.7259-7265
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    • 2014
  • This study examined the gait ability and foot pressure after backward walking training in hemiplegia patients after stroke to provide evidence for the application of backward walking to the rehabilitation of those patients. Twenty hemiplegia patients hospitalized at one rehabilitation hospital were enrolled in this study, which was conducted from 23 April to 18 May, 2012. The subjects were randomized into either the experimental group or control group. The control group received general physical therapy for 30 minutes and the experimental group received 20 minutes of physical therapy and 10 minutes of backwards walking training five times a week for four weeks. The gait ability and foot pressure of both feet were measured quantitatively and compared. The results showed the weight bearing (entire foot, anterior and posterior of foot) of the paralyzed foot during the stance phase showed a significant difference (p<.05). The difference in the foot pressure of right and left feet was more significant in the experimental group than that of the control group (p<.05). Therefore, this study confirmed that backward walking training in a rehabilitation program would be helpful for improving the gait ability of hemiplegia patients after stroke.

The Effect of Internalized Shame and Self-Control on Interpersonal Relationships in Stroke Patients (내면화된 수치심과 자기통제력이 뇌졸중 환자의 대인관계에 미치는 영향)

  • Hwang, Jung-Ha;Lim, Jae-Ho
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.63-74
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    • 2020
  • Objective : The purpose of this study is to investigate the influence of internal shame and self-control on interpersonal relationships in stroke patients, and to provide evidence and information necessary for clinical trials by analyzing the relationship. Methods : For this study, 150 stroke patients receiving occupational therapy services at institutions where occupational therapists work in Jeollanam-do and Chungnam regions were targeted through email and mail from March 1, 2019 to April 30, 2019. The questionnaire was conducted using general characteristics, Relationship Change Scales(RCS), Self-Control Scales(SCS), and Internalized Shame Scale(ISS) questionnaire. Descriptive statistical analysis was performed for the general characteristics of the study subjects, and t-test and one-way batch variance analysis (ANOVA) were used to compare interpersonal relationships according to general characteristics. The relationship between internalized shame, self-control, and interpersonal competence was analyzed by Pearson's correlation coefficient, and multiple regression analysis was performed to determine the factors affecting interpersonal relationships of stroke patients. Results : As a result of comparing interpersonal competence according to general characteristics, significant differences were found in terms of age and education level. Interpersonal relationships and internalized shame, internalized shame and self-control showed a negative correlation, and self-control and interpersonal relationships had a positive correlation, but self-control was the sub-factors of interpersonal relationships such as openness, sensitivity, intimacy, It was not statistically significant with the communication item. In addition, the items of inadequacy (β =-0.32) and adventure seeking (β =-0.23), which are sub-areas of internalized shame, affect the negative direction, and physical activity (β =0.22), which is the sub-area of self-control and the self-centered (β =0.24) item was found to have an effect on the positive direction. Conclusion : Therefore, additional research is needed that can operate a rehabilitation treatment program that applies various psychological factors for the formation of interpersonal relationships among stroke patients.

Development of Finger-force Measuring System with Six-axis Force/moment Sensor for Measuring a Spherical-object Grasping Force (6 축 힘/모멘트센서를 이용한 구물체 잡기 손가락 힘측정장치 개발)

  • Kim, Hyeon-Min;Yoon, Joung-Won;Shin, Hee-Suk;Kim, Gab-Soon
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.11
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    • pp.37-45
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    • 2010
  • Stroke patients can't use their hands because of the paralysis of their fingers. Their fingers are recovered by rehabilitating training, and the rehabilitating extent can be judged by grasping a spherical object. At present, the used object in hospital is only a spherical object, and can't measure the force of fingers. Therefore, doctors judge the rehabilitating extent by touching and watching at their fingers. So, the spherical object measuring system which can measure the force of their fingers should be developed. In this paper, the finger-force measuring system with a six-axis force/moment sensor which can measure the spherical-object grasping force is developed. The six-axis force/moment sensor was designed and fabricated, and the force measuring device was designed and manufactured using DSP (digital signal processing). Also, the grasping force test of men was performed using the developed finger-force measuring system, it was confirmed that the average force of men was about 120N.

A Study on the Distribution of Plantar Pressure in Adult Hemiplegia during Gait with the Use of Cane

  • Cha, Yong-Jun;Kim, Kyoung
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.49-53
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    • 2010
  • Purpose: The purpose of this study was to investigate the plantar pressure distribution between the affected and unaffected side in adult hemiplegia during gait with the use of a quad-cane. Methods: Thirty-four stroke patients from 34 to 83 years of age were enrolled in this study, and in random order, all patients were asked to walk at their most comfortable speed three times along a walkway with the use of quad-cane over a period of three days. Plantar pressure distribution was measured with regard to foot contact pattern and center of pressure (CoP) trajectories during the stance phase, progressing from heel-strike to toe-off. The F-scan system was used to compare the foot pressure of the affected and unaffected sides. Results: A significant reduction in the total contact area, the width of fore foot (FF) and hind foot (HF), and anterior/posterior (AP) CoP trajectory of the affected side was found. However, contact pressure of the hind foot on the affected side during walking increased when compared to that on the unaffected side. Conclusion: We demonstrated that plantar pressure distribution on the affected side of adult hemiplegia patients was generally poorer than that on the unaffected side when these patients walked with cane assistance. However, the use of a quad-cane was shown to increase contact pressure of the hind foot on the affected side because weight can be borne on the affected side during heel-strike with use of the cane.

Clinical Application of Ma Huang in the Obesity Treatment (비만처방에서 마황의 임상활용에 대한 고찰;용량, 효과, 부작용 등의 측면에서)

  • Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.1
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    • pp.1-7
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    • 2007
  • Background : Use of Ma Huang is controversial. Multiple reports of adverse effects led the U.S. Federal Drug Administration (FDA) to announce about prohibiting dietary supplements containing ephedrine alkaloids/Ma Huang. Objective : The objective of the study was to review the evidence from literature and rigorous clinical trials on the dosage, effectiveness, and adverse effects. Methods : Literature searches were conducted in U.S. FDA database after 2003 and digital Uibujeonok(醫部全錄). Hand searches of medical journal and bibliographies of identified articles were conducted. Results : Ma Huang has been used in Korean Oriental Medicine to treatment asthma and other ailments. Recently, Ephedrine/Ma Huang are used for weight loss or to enhance athletic performance in Europe and America, Korea. Ephedrine/Ma Huang are associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. In addition to that, a risk of serious adverse events, including heart attack, stroke, epilepsy and psychiatric problem are also have been reported. Therefore, max dose of total alkaloids of ephedrine is studied in need of a specialist's part. Conclusion : In most reports, Ma Huang effectively promoted short-term weight loss and enhancement of athletic performance, But, safety with long-term use requires further investigation.

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The effect of neuromuscular electrical stimulation on the spasticity of elbow flexor in stroke patients (신경근 전기자극이 뇌졸중 환자의 주관절 굴곡근 경직에 미치는 영향)

  • Jeong Byoung-Ok;Kwon Young-shil;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.89-96
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    • 1999
  • The purpose of this study was to examine the effects of neuromuscular electrical stimulation(NMES) on the spasticity of elbow flexor. Ten spastic hemiplegia who have been at EUL-JI medical college hospital in Taejon with age range of 35 to 70 years$(56.8\pm9.5)$, were participated in this study. The subjects (5male, 5female) took neuromuscular electrical stimulation therapy on the triceps of the affected elbow. To compare the effect of the treatment, the grade of spasticity of affected elbow flexor was measured at pre-treatment and the end of each weeks using modified Ashworth scale. Then, the range of extension of the affected elbow was measured at pre-treatmen and the end of each weeks using full circle goniometer. The data were analyzed with ANOVA to determine significant differences with the passage of time. The results were as follows: 1. ANOVA test showed significant differences in reducing spasticity of NMES group with the passage of time (p<.01). 2. ANOVA test showed significant differences in increasing range of motion with the passage of time of NMES group(p<.01). The neuromuscular electrical stimulation is a effective method to reduce the spasticity of elbow flexor.

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A Study on the Correlation of shoulder Pain and Hand Edema in Hemiplegia with Shoulder-Hand Syndrome (견관절 수부증후군을 가진 편마비 환자의 견관절 동통과 수부부종의 상관관계 연구)

  • Kim Byung-Jo;Ahn So-Youn;Kim Soo-Min;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.39-47
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    • 2000
  • The purpose of this study was to evaluate the relationship between shoulder pain and hand edema in stroke patient with shoulder hand syndrome. In this study, 26 hemiplegic patients with the clinical symptom and sign of shoulder hand syndrome were evaluated. Hand volume was measured by hand volumeter, and hand edema was calculated by volume difference of both hands. Shoulder pain was evaluated using VAS (visual analog scale). and spasticity of shoulder was graded by modified Ashworth scale. The relationship among three factors such as shoulder pain. hand edema and shoulder spasticity was evaluated using correlation analysis. Results through correlation analysis among three factors are as follows : 1. Correlation between shoulder pain and hand edema was not significant$(\gamma=-.028)$. 2. Correlation between shoulder spasticity and hand edema was not significant $(\gamma=-.027)$. 3. Correlation between shoulder spasticity and shoulder pain was not significant $(\gamma=-.093)$. As the result of correlation analysis. this study shows that there was no statistically significant difference between shoulder pain and hand edema.

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