• Title/Summary/Keyword: Stroke Rehabilitation

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Effect of Oral Motor Facilitation Technique on Oral Motor Function in Stroke Patients (구강운동촉진기술(Oral Motor Facilitation Technique)이 뇌졸중 환자의 구강운동기능에 미치는 효과)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.135-151
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    • 2023
  • Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

The relationship of cognitive function and physical recovery stage on quality of life in stroke patients (뇌졸중 환자의 인지기능과 신체회복단계가 삶의 질에 미치는 영향)

  • Yeoil Jeon;Sangwoo Kim;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.3
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    • pp.51-65
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    • 2024
  • Background: The patients common have side effects of cognitive and function dysfunction after a stroke. According to specific factors which influence quality of life(QoL), the QoL of stroke survivors are impacted resulting from diverse interactions. Therefore, This study aims to suggest that we determines the relationship between cognitive function and stage of physical recovery and the quality of life as well as the degree of recovery by cluster analysis of the relationship between the degree of physical recovery and the quality of life Design: Randomized Methods: The following tests were used in this study to evaluate cognitive function, recovery stages and quality of life respectively: Cognitive function was measured using Korea-Mini Mental State Examination(K-MMSE). For evaluation of recovery stages, Brunnstrom Rrecovery Stage(BRS), quality of life was measured using Stroke Specific -Quality Of Life(SS-QOL). The sample size of this study was calculated using G*Power Version 3.1.9.7 (Franz Faul, University kiel, Germany, 2020). Based on moderate effect size of 0.15, a significance level (α) of 0.05, and power of 0.90 in the two-sided test, the calculation revealed that 88 patients were required for questionnaires. Results: The results of this study showed significant positive correlation(p<0.05). As a result of cluster analysis, in the case of the physical recovery stage, the degree of physical recovery improves from cluster 1 to cluster 3 and in the case of the quality of life, the quality of life improves from cluster 1 to cluster 3. However, it was confirmed that the change in the quality of life of cluster 1 and cluster 2 was not significant. These results show that the degree of physical recovery has a greater impact on the quality of life in the late stages of physical recovery, while the degree of physical recovery does not have a significant effect on the quality of life in the early and mid-term of the physical recovery stage. Conclusion: This study confirms that cognitive function, recovery stages and quality of life have significant correlations, and the recovery status has impacted on quality of life.

The Effects of Rehabilitation Treatment on the Immune Cells and Cortisol Levels of Stroke Patients (뇌졸중 환자의 재활치료가 면역세포와 Cortisol에 미치는 영향)

  • Oh, Dong Sun
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.2
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    • pp.90-95
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    • 2015
  • The purpose of this study was to investigate the effects of exercise through an in-hospital rehabilitation program on the enhanced immunity of immune cells and on the reduction of serum Cortisol, an indicator of physiological stress responses, among stroke patients. The 25 subjects were put to the program for two years from March 2, 2013 to February 28, 2015. The experimental group included 13 stroke patients from S and C Hospital in Gwangju, and the control group was composed of 12 common people. The findings were as follows: there were no significant differences in T cells between the experimental group with $69.18{\pm}11.78%$ and the control group with $70.75{\pm}6.33%$; there were significant differences in B cells between the experimental group ($12.95{\pm}3.74%$) and the control group ($16.27{\pm}3.49%$). Furthermore, there were no statistically significant increases of NK cells between the experimental group ($21.98{\pm}8.98%$) and the control group ($15.72{\pm}5.07%$) with p<0.05, though the values for the experimental group did rise. While there was elevated Cortisol before exercise in the experimental group (p<0.05), which recorded $13.65{\pm}6.85%$ before and $9.90{\pm}4.66%$ after, there were no differences in the control group, which recorded $11.635{\pm}4.02%$ before and $12.64{\pm}2.30%$ after exercise. The present study also found continued exercise through an in-hospital rehabilitation exercise program increased differences in NK and T cells before and after exercise in the experimental group and thus had effects on enhanced immunity. Meanwhile, differences in Cortisol before and after exercise in the experimental group decreased, which indicates that the continued exercise was effective in reducing stress.

Joint Angles Analysis of Intelligent upper limb and lower extremities Wheelchair Robot System (지능형 상 · 하지 재활 휠체어 로봇 시스템의 관절각도 분석)

  • Song, Byoung-Ho;Kim, Kwang Jin;Lee, Chang Sun;Lim, Chang Gyoon
    • Journal of Internet Computing and Services
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    • v.14 no.6
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    • pp.33-39
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    • 2013
  • When the eldery with limited mobility and disabled use a wheelchairs to move, it can cause decreased exercise ability like decline muscular strength in upper limb and lower extremities. The disabled people suffers with spinal cord injuries or post stroke hemiplegia are easily exposed to secondary problems due to limited mobility. In this paper, We designed intelligent wheelchair robot system for upper limb and lower extremities exercise/rehabilitation considering the characteristics of these severely disabled person. The system consists of an electric wheelchair, biometrics module for Identification characteristics of users, upper limb and lower extremities rehabilitation. In this paper, describes the design and configurations and of developed robot. Also, In order to verify the system function, conduct performance evaluation targeting non-disabled about risk context analysis with biomedical signal change and upper limb and lower extremities rehabilitation over wheelchair robot move. Consequently, it indicate sufficient tracking performance for rehabilitation as at about 86.7% average accuracy for risk context analysis and upper limb angle of 2.5 and lower extremities angle of 2.3 degrees maximum error range of joint angle.

Effects of task-oriented training for Gross Motor Function Measure, balance and gait function in persons with cerebral palsy

  • Han, Hyun-Kyung;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.9-14
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    • 2016
  • Objective: This study was to investigate the effects of Task-oriented training for Gross Motor Function Measure (GMFM), gait and balance function in cerebral palsy. Design: Randomized controlled trials. Methods: Twenty four subjects were recruited by means of a convenience sampling from Kangseo-Gu G rehabilitation center. Subjects were 24 inpatients and were randomly divided into a task-oriented training group and a conventional group. Twelve patients were experimental group who executed the task-oriented training (5 times/wk) for 4 weeks. The task-oriented program mainly focused on the capabilities of independent walking, with the angle of inclination set at 0 degrees and walking at a self-selected comfortable speed. In addition, balance training included the one-legged standing with weight-shifting and task-oriented training. Twelve patients were control group who executed only general conventional therapy (5 times/wk) for 4 weeks. All subjects were evaluated about the motor function, gait and balance function. Subjects have conducted the measured variables, GMFM, GAITRite, PDM Multifunction Force Measuring Plate after treatment. Results: There was statistically significant increase of Gross Motor Function Measure scores of the experimental group and control group after 4 weeks (p<.05). There was statistically significant increase of gait and balance function of the experimental group after 4 weeks of task-oriented training (p<.05). The experimental group showed a significantly improvement in GMFM, gait, and balance compared to the control group (p<0.05). Conclusions: This study proved that task-oriented training after stroke can improve Gross Motor Function Measure, gait and balance. Thus this study can suggest that task-oriented training for gross motor function, gait and balance be effective on the cerebral palsy.

A Review of Spatial Neglect: Types, Theories, Neuroanatomy, Assessments and Treatment (편측 공간무시에 관한 고찰: 유형 및 이론, 해부학적 영역, 평가와 치료)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.11-23
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    • 2017
  • Spatial neglect is a neurological disorder following stroke, a lesion that usually affects the right hemisphere, fail to process or attention on the contralateral side of body and space. Functional neuroimaging studies report that spatial neglect is associated with lesions of large middle cerebral artery, perisylvian network and attention network. Spatial neglect is associated with a poor outcome. For optimal diagnosis and intervention, Types and theories of spatial neglect should be considered, in addition to clinical assessment with the conventional test and functional test. The treatment for spatial neglect could be consist of top-down approaches and bottom-up approaches. Recent trends in rehabilitation intervention for spatial neglect have reported prism adaptation.

Work-Related Musculoskeletal Pain and Workload Evaluation of Physical Therapists: Focused on Neurological Injury Treatment of Adults (물리치료사의 작업관련 근골격계 통증과 부담작업 유해요인 평가: 성인 신경계 손상 치료를 중심으로)

  • Lee, Jung-Ho;Choi, Young-Chul;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.69-79
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    • 2012
  • Importance of the work-related musculoskeletal disorders (WMSDs) has been increasing in the hospital industry such as health care industry and financial industry. This study investigated in order to identify the factors like general, occupational and ergonomically characteristics of the subjects related to musculoskeletal disorders (MSDs) of physical therapists (PTs). Ergonomic tools of rapid upper limb assessment (RULA) were used for evaluation workload of the tasks. Prevalence of MSDs were 13 PTs (26.0%) for neck, 31 PTs (62.0%) for shoulder, 9 PTs (18.0%) for arm/elbow, 27 PTs (54.0%) for hand/wrist, 28 PTs (56.0%) for back, 14 PTs (28.0%) for leg/foot. The analysis of the rate of the pain intensity showed that 53.5% subjects experience moderate pain and 14.0% subjects experience severe pain. Factors which were general characteristics, for example, height, ergonomically characteristics such as 'Posture Score A' were related musculoskeletal subjective symptoms in logistic analysis (p<.05). Among physical therapists, action level of RULA were action level 2 (6.0%), action level 3 (52.0%), action level 4 (42.0%). Physical therapists were estimated one of the highest risk factor in this study. This study suggested that the need of preventive education and program for PTs (physical therapists). Comprehensive and systematic management plans should be established to include both ergonomic and sociopsychological aspects.

Design and Implementation of a Wearable Hand Rehabilitation Robot for spasticity patient (경직환자를 위한 착용형 손 재활로봇 설계 및 구현)

  • Kim, Dae-Hee;Yoon, Sung-jo;Park, Yong-sik;Jeon, Kwang-woo;Park, Sung-Ho;Jeon, Jung-Su;Seo, Kap-Ho
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2014.07a
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    • pp.21-24
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    • 2014
  • 본 연구는 뇌손상(뇌졸중, 외상성 뇌손상, 뇌성마비 등)으로 인하여 손의 능동적 움직임이 결여되어 발생하는 관절의 구축, 근육의 단축, 근육의 탄력성 저하 등의 문제점을 분석하여 인체 역학적 모델에 따른 과학적 설계를 기반으로 환자의 손 기능 회복을 위하여 로봇 기술과 스마트폰의 융합을 통한 재활 로봇 보조 치료기를 설계하고 구현하였다. 제안된 시스템은 일반적인 근 경직을 치료하는 방법을 응용하여 IT 기술과 로봇기술을 융합하여 치료사들의 부담을 덜어 주고, 환자들에게 오랫동안 정확한 운동을 반복적으로 할 수 있도록 하는데 목적이 있다. 하나의 구동기로 2자유도의 움직임을 조절 할 수 있는 링크 매커니즘과 링크의 길이를 조절하여 신전(extension)과 과신전(Hyperextension)의 범위 조절이 가능하도록 로봇 플랫폼을 설계하였다. 또한 환자의 재활정도 및 상태에 적합한 운동속도, 운동반복횟수 등을 손쉽게 조작할 수 있는 등의 개인 맞춤형 재활훈련이 가능한 사용자 인터페이스를 설계 및 구현하였다.

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A Literature Study of Gait (보행(步行)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Kim, Bum-Chol;Keum, Dong-Ho;Lee, Myeong-Jong
    • The Journal of Dong Guk Oriental Medicine
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    • v.5
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    • pp.79-95
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    • 1996
  • When we see normal gait, gait cycle is seperated as stance phase and swing phase. It needs 6 determinant of gait of pelvic rotation, pelvic tilt, knee joint of stance phase, ankle and foot motion, ankle and knee motion, and pelvic movement to be accomplished. In addition, a joint and muscle action is accomplished biomechanically at the same time with its gait cycle. In oriental medicine, the relationships between chang-fu physiology and meridian physiology are summaried as follows ; ${\bullet}$ chang-fu physiology : Spleen manages the extremities. Liver manages soft tissues. Liver stores blood. Kidney stores essences. Kidney manages bones. ${\bullet}$ meridian physiology : The Leg Greater Yang Meridian and meridian soft tissues The Leg Yang-Myeong Meridian and meridian soft tissues The Leg Lesser Yang Meridian and meridian soft tissues The Leg Greater Yin Meridian and meridian soft tissues The Leg Lesser Yin Meridian and meridian soft tissues The Leg Absolute Yin Meridian and meridian soft tissues Especially, we can find out relations between in a "blood supplied feet can walk well" that explains "blood regulations and by liver nourishing effects"that is the closest concept of muscle. Abnormal gaits are due to three causes as following; first, physical defect secoud, pain third, nervous system or instability of muscle. In oriental medicine, we can know relationship in "atrophy, numbness, stroke, convulsion, muscular dystrophy of knee, rheumatoid arthritis, five causes of infantile growing defects, five causes of softening, sprain". Especially, atrophy is the most important symptom. Gait evaluation should be emphasized where a point can walk 8 feet to 10 feet considering stride width, stride length, the body weight center, stride number, flexion, extension, rotation of a joint as a standard factor. The point is we should find out something strange in a patient's side, front and back view. After that we should find out its cause as an index that we can observe abnormal findings in a joint and muscle.

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Effect of Symmetrical Reciprocal Pattern of Scapula and Pelvis in PNF Concept on the Gait Speed and Balance of thePatients with Hemiplegia (PNF Concept중 Scapula and Pelvis의 Symmetrical Reciprocal Pattern이 Hemiplegia환자의 보행속도와 균형감각에 미치는 효과)

  • Maeng, Gwan-Cheol;Baek, Sun-Young
    • PNF and Movement
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    • v.13 no.2
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    • pp.73-80
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    • 2015
  • Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.