• Title/Summary/Keyword: Stroke Rehabilitation

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Therapeutic Efficacy of Low Frequency Transcranial Magnetic Stimulation in Conjunction with Mirror Therapy for Sub-acute Stroke Patients

  • Cha, Hyun Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.1
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    • pp.52-56
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    • 2015
  • The purpose of the current study was to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in conjunction with mirror therapy on the balance function of patients with sub-acute stroke hemiparesis. This study was conducted with 36 subjects who were diagnosed with a hemiparesis due to stroke. Participants in the experimental (19 members) and control groups (17 members) received rTMS and sham rTMS during 10 minute sessions each, which were carried out five days per week for four weeks. This was followed by the mirror therapy over 30 minute sessions, which were carried out five days per week for four weeks. Motor recovery was assessed by balance index, dynamic limits of stability, Berg balance scale, and time up go test. The change values of the balance index ($-2.06{\pm}1.99$ versus $-0.41{\pm}1.11$), dynamic limits of stability ($3.68{\pm}2.71$ versus $1.17{\pm}2.38$), and time up go test ($-7.05{\pm}5.64$ score versus $-3.35{\pm}5.30$ score) were significantly higher in the experimental group than in the control group (p < 0.05). At post-test, balance index ($4.08{\pm}1.14$ versus $5.09{\pm}1.04$), dynamic limits of stability ($13.75{\pm}0.60$ versus $11.73{\pm}3.53$), and time up go test ($23.89{\pm}4.51$ versus $28.82{\pm}3.07$) were significantly higher in the experimental group than in the control group (p < 0.05). In the experimental group, significant differences were found in the pre- and post-test scores for the balance index, dynamic limits of stability, Berg balance scale, and time up go test (p < 0.01). In the control group, a significant difference was observed between the pre- and post-test only for the Berg balance scale and time up go test (p < 0.05). These findings demonstrate that the application of 1Hz rTMS in conjunction with mirror therapy can be helpful in improving the balance function of patients with sub-acute stroke hemiparesis, and this may be used as a practical adjunct to routine rehabilitation therapy.

Correlations and Comparison among Swallowing Function, Dietary Level, Cognitive Function, Daily Living according to Characteristic in Stroke Patients with Dysphagia (삼킴장애가 있는 뇌졸중 환자의 특성에 따른 삼킴기능, 식이수준, 인지기능, 일상생활의 비교 및 상관관계)

  • Moon, Jong Hoon;Kim, Kye Ho;Won, Young Sik
    • 재활복지
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    • v.20 no.4
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    • pp.265-281
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    • 2016
  • This study was to investigate the correlation among swallowing function, dietary level, cognitive function, daily living, and comparison for general characteristics in stroke patients with dysphagia. Subjects of this study participated to 56 stroke patients with dysphagia. Outcome measures is evaluated by Functional Dysphagia Scale(FDS), and Amerian Speech-Language-Hearing Association National Outcomes Measurements System(ASHA NOMS), and Korean Mini-Mental State Examination(K-MMSE), and Korean Modified Barthel Index(K-MBI). Collected all data analyezed to independent t test for four assessments, and general characteristics of study subjects analyzed by pearson correlation coefficient for four assessments. Results of study, swallowing function according to lesion location differed significantly(p<.05). Cognitive function according to onset duration differed significantly(p<.05). Age of subjects and dietary level, cognitive function showed a significant correlation(p<.05). Swallowing function and dietary level, cognitive function showed a significant correlation(p<.05). Cognitive function and dietary level, daily living showed a significant correlation(p<.05). Based on current results, we suggest that swallowing rehabilitation for stroke patients with dysphagia performed with consideration for cognitive function and characteristic of patients.

The Effects of Telerehabilitation Based Occupational Therapy on Executive Function, Activities of Daily Living, and Occupation Performance of People With Stroke (원격재활 기반 작업치료가 뇌졸중 환자의 실행기능, 일상생활수행, 작업수행에 미치는 영향)

  • Park, Seong-Sun;Kim, Su-kyung;Yoo, Doo-Han;Kim, Hee
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.115-127
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    • 2021
  • Objective : The purpose of this study was to investigate the effect of telerehabilitation on executive function, activities of daily living, instrumental activities of daily living, and occupational performance in stroke patients. Methods : The participants of this study were 30 outpatients with stroke residing in community. Both groups underwent the intervention 3 times a week for a total of 18 sessions. For the experimental group telerehabilitation was administered at home to only fifteen participants in the experimental group schedule, and it was supervised by the caregiver. Fifteen people in the control group underwent only the traditional occupational therapy. Executive function and instrumental activities of daily living were evaluated using the Korean version of the Executive Function Performance Test (EFPT-K). The basic daily activities of living were assessed using the Modified Barthel Index (MBI). The Canadian Occupational Performance Measure (COPM) was used to evaluate the client-centered occupational performance. Results : After the intervention, the experimental and control groups showed improvements in executive function, instrumental activities of daily living and occupational performance. Occupational performance improved more significantly in the experimental group than in the control group. Conclusion : Telerehabilitation and occupational therapy positively affect executive function, instrumental activities of daily living and occupational performance of patients with stroke. We suggest that telerehabilitation combined with occupational therapy is more effective in improving the occupational performance of stroke patients.

The Effect of Transcranial Direct Current Stimulation over the Primary Somatosensory Cortex in Patients with Chronic Stroke on Somatosensory and Upper Limb Function for Improving Life Care (만성 뇌졸중 환자를 대상으로 한 일차 체성 감각 피질을 자극한 경두개 직류 전류 자극이 라이프 케어 증진을 위한 체성감각과 상지기능에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.269-277
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    • 2020
  • The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

Effects of a Digital Pegboard Training Program With Visual and Auditory Feedback on Hand Function and Visual Perception in Patients With Stroke (시각, 청각 피드백을 이용한 디지털 페그보드 훈련 작업치료 프로그램이 뇌졸중 환자의 손 기능 및 시·지각에 미치는 영향)

  • Hong, Jang-Woo;Yoo, Chan-Uk;Gang, Mi-Yeong;Chang, Ki-Yeon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.85-97
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    • 2022
  • Purpose : This study aimed to investigate the effects of a digital pegboard training program with visual and auditory feedback on hand function and visual perception in stroke patients. Methods : Twenty two participants were randomly assigned to an experimental or control group. The experimental group received training using a digital pegboard training program with visual and auditory feedback (n=11), while traditional occupational therapy was administered to the control group (n=11). Hand function was assessed before and after the intervention using the Nine-Hole Peg Test and manual function test (MFT), while visual perception was assessed using the Motor-Free Visual Perception Test-3rd edition (MVPT-3). Results : Following the intervention, both the experimental and control groups showed significant improvements in performance in the Nine-Hole Peg Test and MVPT-3 (p<.05). The improvement on both tests was significantly greater in the experimental group than in the control group (p<.05). Conclusion : The results suggest that digital pegboard training with visual and auditory feedback may improve hand function and visual perception in stroke patients. Therefore, this intervention can be effective in occupational therapy to aid the recovery of stroke patients.

Evaluation of Upper Limb Movement and Function in Stroke Patients Using Electromyography : A Review (근전도를 활용한 뇌졸중 환자의 상지 운동 및 기능 평가에 관한 고찰)

  • Lee, Jiyeon;Lee, Gyeong A;Jung, Jae Hyu;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.11 no.3
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    • pp.37-50
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    • 2022
  • Objective : This study aimed to investigate the use of electromyography (EMG) to evaluate upper limb movement or function in stroke patients. Methods : We reviewed papers published in journals between January 2018 and December 2021 using PubMed, EMBASE, Scopus, RISS, and KISS. The main keywords of databases were ('stroke' OR 'hemiplegia') AND ('EMG' OR 'electromyography' OR 'electromyogram' OR 'muscle activity') AND ('Upper limb' OR 'Hand'). Results : Fifteen studies were selected, most of which evaluated muscle activity. Interventions performing tasks related to activities of daily living (ADLs), using assistive technology, and interventions that provide repetitive training were most frequently applied. Conclusions : When evaluating upper limb functions using electromyography, it is meaningful to present an evaluation that can be used according to the purpose of the study and to provide a basis for setting up interventions that can utilize electromyography during evaluation.

The Effect of Amount of Use on the Affected and Unaffected Side Using an Accelerometer in Stroke Patients on the Upper Limb Function Assessment for Improving Life Care (가속도계를 활용한 뇌졸중 환자의 환측과 건측의 사용량이 라이프 케어 증진을 위한 상지 기능 평가에 미치는 영향)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.511-518
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    • 2020
  • The purpose of this study was to provide useful data for clinical occupational therapy by examining the correlation between the use of affected and unaffected sides measured using an accelerometer and upper limb function in chronic stroke patients. In this study, accelerometer, Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and Yonsei-Bilateral Activity Test(Y-BAT) was measured on 40 stroke patients who were hospitalized in Won-ju city Y hospital between May 2, 2019 and July 18, 2020. As a result of the study, there was a significant negative correlation between amount of use on the unaffected side and FMA and MAL's Amount of Use(AOU), Quality of Movement(QOM), the quality and satisfaction of performing both hands through Y-BAT. The amount of use on the affected side showed a significant positive correlation with FMA and MAL's AOU, QOM, satisfaction of performing both hands. This study is meaningful in that it suggested the possibility that the actual amount of use on the affected and unaffected side measured using an accelerometer could be used as an evaluation item for upper limb function in stroke patients.

The Effects of Self-Sit-to-Stand Training Using Multi-Sensory Feedback Device on Balance Ability and Sit-to-Stand Ability in Hemiplegic Stroke Patients (다중감각 되먹임 장치를 이용한 자가 일어서기 훈련이 편마비 환자의 균형능력과 일어서기 동작 수행능력에 미치는 영향)

  • Min, Jun-Ki;Choi, Won-Jae;Jung, Jihye;Lee, Seung-Won
    • PNF and Movement
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    • v.20 no.2
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    • pp.157-166
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    • 2022
  • Purpose: The aim of this research was to investigate the effects of self-sit-to-stand training on balance ability and sit-to-stand ability in hemiplegic stroke patients using a multisensory feedback device. Methods: A total of 19 stroke patients participated in this study, and they were divided into two groups: 10 underwent self-sit-to-stand training using a multisensory feedback device, and 9 underwent sit-to-stand training with a physical therapist. In both groups, sit-to-stand training was performed for 30 min, 3 times a week, for 6 weeks. The subjects also underwent physical therapy twice a day for 30 min, 10 times a week, for a total of 60 sessions. Balance ability was evaluated using the AFA-50 and Berg Balance Scale. Sit-to-stand ability was evaluated using the five times sit-to-stand test. Results: Sway length, pressure, and total pressure all significantly increased in both groups, and there was no difference between the two groups. The Berg Balance Scale results showed that balance ability significantly increased in both groups, and there was no difference between the two groups. The five times sit-to-stand test results showed that sit-to-stand ability significantly increased in both groups, and there was no difference between the two groups. It was found that the self-sit-to-stand training using a multisensory feedback device had a positive effect on balance control and sit-to-stand ability. When the two groups were compared, no difference in balance ability or sit-to-stand ability was observed. Conclusion: The findings of this study indicate that self-sit-to-stand training using a multisensory feedback device is as effective as sit-to-stand training with a physical therapist. Hence, self-sit-to-stand training using a multisensory feedback device could be an effective home-based exercise protocol for hemiplegic stroke patients to improve their balance and sit-to-stand abilities.

Effect of Virtual Reality Training Focus on ADL on Upper Extremity Function and Activities of Daily Living in Stroke Patients (일상생활에 중점을 둔 가상현실 훈련이 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 효과)

  • Park, In-Hye
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.321-329
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    • 2019
  • This study aimed to investigate the effect of virtual reality training focus on ADL on upper extremity function and activities of daily living in stroke patients. 20 patients with chronic stroke were included in this study. The participants were divided into the experimental (n=10) or control (n=10) groups. Both groups received conventional rehabilitation therapy for 30 min a day, 5 times per week for 4 weeks. The experimental group also performed virtual reality training focus on ADL for 30 min a day, and the control group performed general virtual reality training for 30 min a day. The Fugl-Meyer Assessment (FMA) and Functional Independence Measure (FIM) scores were evaluated before and after the intervention, and both groups showed significant improvement (p<.05). Compared to the control group, the experimental group showed significant improvement in the FMA wrist score and the FIM total, self-care, and sphincter control scores (p<.05). These findings suggest that virtual reality training focus on ADL may have a positive effect on wrist function and overall ADLs compared to that using general virtual reality training in stroke patients.

A study on environmental status, FIM and Illness intrusiveness of home stayed stroke patients (재가 노졸중 환자의 환경상태, 기능적 독립, 질병으로 인한 장애영향에 관한 연구)

  • Kim, Keum Soon;Roh, Kook Hee
    • 한국노년학
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    • v.25 no.2
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    • pp.143-154
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    • 2005
  • This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.