• Title/Summary/Keyword: Stroke Rehabilitation

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Development of a Tele-Rehabilitation System for Outcome Evaluation of Physical Therapy

  • Park, Hyung-Soon;Lee, Jeong-Wan
    • Journal of Biomedical Engineering Research
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    • v.29 no.3
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    • pp.179-186
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    • 2008
  • This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

The Effect of Neck Strengthening Exercise Using Proprioceptive Neuromuscular Facilitation on Swallow ability of Patient with Dysphagia: A Single Case Study (고유수용성신경근촉진법을 이용한 목근육 강화운동이 삼킴 장애환자에게 미치는 영향: 단일사례연구)

  • Lee, Soon-Hyun;Won, Young-Sick
    • PNF and Movement
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    • v.13 no.3
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    • pp.163-168
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    • 2015
  • Purpose: The current study seeks to identify the effect of neck muscle strengthening exercise using proprioceptive neuromuscular facilitation (PNF) on the swallowing ability of patients diagnosed with dysphagia due to stroke. Methods: As a single case study, the current research conducted neck muscle strengthening exercise using PNF on the patient with dysphagia for 40 minutes, four times per week for a six-week period. At the same time, typical rehabilitation therapy for dysphagia was provided. This type of therapy included food-swallowing and the relation of the muscles surrounding the neck. The functional dysphagia scale and the penetration-aspiration scale were used to assess swallowing ability. Results: After the therapy, the functional dysphagia scale and the penetration-aspiration scale decreased by 18 points and 3 points, respectively, which proves the effectiveness of this type of therapy for dysphagia. Conclusion: The results of the current study indicate that neck muscle strengthening exercise using PNF reduces penetration-aspiration in patients with dysphagia, and that PNF can be clinically utilized to improve the swallowing ability of dysphagic patients.

The Effects of Self-Exercise Based on Health Care Application on Upper Extremity Function and Daily Living, Satisfaction in Patients with Stroke (헬스케어 애플리케이션 기반의 자가운동이 뇌졸중 환자의 상지기능, 일상생활, 만족도에 미치는 효과)

  • Moon, Jong-Hoon;Bak, In-Hye
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.3
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    • pp.515-524
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    • 2017
  • The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

Effects of the Dual-Task Training on Stroke Patients : A Systematic Review and Meta-analysis (이중과제 훈련이 뇌졸중 환자에게 미치는 영향 : 체계적 고찰 및 메타분석)

  • Won, Kyung-A;Lim, Seung-Ju;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.7-25
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    • 2020
  • Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

A Systematic Review of the Dual-Task Training for Stroke With Hemiplegia (뇌졸중 환자에게 적용한 이중과제 훈련이 미치는 효과에 대한 체계적 고찰)

  • Lee, Yei-Jin;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.23-32
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    • 2016
  • Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.

Clinical comparison studies on 20 cases of stroke patients with dysarthria by Sa-Am & General acupuncture (중풍후 언어장애 환자 20례에 대한 체침과 사암침 치료의 임상적 비교 고찰)

  • Song, Min-sic;Kim, Young-hwa;Jang, Suk-gun;Kim, Jeong-ho;Yim, Yun-kyoung;Kang, Jae-hui;Park, Young-soo;Lee, Byung-ryul;Lee, Hyen;Hong, Kwon-eui;Kim, Young-il;Song, In-sun
    • Journal of Acupuncture Research
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    • v.20 no.6
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    • pp.160-167
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    • 2003
  • Objective : The study was designed to evaluate the possibility of treatment of stroke patients with dysarthia by the sa-am acupuncture. Methods: From March 1st 2003 to June 30th 2003, the clinical comparison studies were carried out 20 cases of stroke patients with dysarthria treated by Sa-Am acupuncture(Group I) & general acupuncture(Group II), who had been treated in Dept. of acupuncture and Moxibustion, Dae-jeon Oriental Medical Hospital, Dae-jeon University. Results : The results obtained as follows; 1. The Articuration of Group I and Group II was improved significantly. Group I is more effective than Group II significantly(p<0.05). 2. The Vowel of Group I and Group II was improved but there was no signification(p>0.05). 3. The Alternation of Group I and Group II was improved significantly. Group I is more effective than Group II significantly(p<0.05). 4. The Speed of reading the sentence of Group I and Group II was improved but only Group I was improved significantly(p<0.05). Conclusions: This result suggest that sa-am acupuncture was effective treatment of stroke patients with dysarthria. So further research is needed continuously.

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Effectiveness of Focal Muscle Vibration on Upper Extremity Spasticity and Function for Stroke Patients : A Systematic Review (뇌졸중 환자의 상지 경직 감소와 기능 향상을 위한 국소 진동자극의 효과에 대한 체계적 고찰)

  • Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.23-33
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    • 2018
  • Objective : This systematic review aimed to investigate the effect of focal muscle vibration in patients with post-stroke spastic hemiplegia. Methods : We searched literature published between April 2009 and October 2017 using PubMed and RISS databases. The main search terms were Vibration therapy, Focal vibration, Somatosensory, Upper limb, and Spasticity after stroke. Based on inclusion/exclusion criteria, 6 articles were selected. Results : Articles on focal muscle vibration intervention ranged from evaluation of application-only vibration to muscle vibration with task-oriented activity. Intervention effects on upper extremity spasticity and function and activities of daily living were assessed. There were significant effects on upper extremity spasticity, function, and cortical excitability. Conclusions : This study can provide information on focal muscle vibration for use by clinical therapists. However, further studies are needed to identify the optimal stimulation site and frequency/amplitude of application to maximize the effects of focal muscle vibration.

The Effects of Visual Rhythmic Stimulation in Gait and Proprioception with Chronic Stroke Patients (시각리듬자극이 만성뇌졸중 환자의 보행과 고유수용감각에 미치는 영향)

  • Cho, Nam-Jeong;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3353-3357
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    • 2010
  • The purpose of this study is to investigate the effect of visual rhythmic stimulation in gait ability and proprioception in chronic stroke patients. Twenty-one persons after six months post stroke participated in pre and post test control. The subjects were randomly assigned to a rhythmic visual stimulation(RVS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the proprioception test and gait characteristics by gait analysis. In gait characteristics, the walking speed, cadence and the TUG time were significantly different from RVS group. The proprioception were significantly different RVS and control group. This study showed that the RVS training increased better functional activity by postural adjustment and gait learning of chronic stroke patients than that of control group. And so, the RVS training of hemiplegic patients was very important to successive rehabilitation. A continuous examination of RVS training could be practical use of physical therapy with exercise.

Effect of the application of low-frequency rTMS on cognitive function in chronic stroke patients (저빈도 rTMS의 적용이 만성 뇌졸중환자의 인지기능에 미치는 영향)

  • Lee, Dong-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.12
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    • pp.7239-7247
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    • 2014
  • This study repeated low-frequency transcranial magnetic stimulation (rTMS) to evaluate the effects on cognitive function in chronic stroke patients. Among the chronic stroke patients, 30 patients selected by MMSE-K and BCRS-K were divided randomly into 3 groups. Group I (n=10) had only sound applied, group II (n=10) were applied 1 Hz rTMS on the damaged side and group III (n=10) were applied to 1 Hz rTMS on the opposite side for total 2 weeks, 20 minutes per a day, five times per a week. To examine the change in cognitive function, CREAD-K scores were measured before, 1 week, 2 weeks, and then 3 months after the intervention. The CREAD-K scores were measured before and 1 week, 2 weeks and 3 months after the interventions. The immediate recall memory showed a significant difference after 2 weeks and 3 months in groups II and III (p<.05), The recognition memory showed a significant difference after 2 weeks and 3 months in group III (p<.05). The delayed recall memory showed significant differences after 3 months in group III than in group I (p<.05). Therefore, the application of low-frequency rTMS has a positive influence on the cognitive rehabilitation of chronic stroke patients.