• 대한약침학회지
• /
• 제4권2호
• /
• pp.95-103
• /
• 2001

Background : Central poststroke pain(CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulty in the social activities and daily life. In this study, we evaluate the clinical effectiveness of east-west medical management for CPSP through VAS(visual analogue scale), infrared themography, MBI(Moderfied Barthel Index) and Rankin scale. Methods : We treated thirty patients with oriental medical treatment method and western & oriental medical treatment method. Each group has fifteen patients of the CPSP. We evaluated their pain(characterizes tingling and burning sensation, aching, hyperalgesia, and allodynia) through VAS(visual analog scale) pain score, the skin temperature of pain site by infrared thermography and assessed their mobility & rehabilitation ability through MBI(Moderfied Barthel Index), Rankin scale before and after pain treatment. Results : The skin temperature of pain site was lower than non-pain site. The difference of skin temperature improved from $0.65{\pm}0.45^{\circ}C$ to $0.39{\pm}0.25^{\circ}C$ after oriental medical treatment and $0.68{\pm}0.54^{\circ}C$ to $0.27{\pm}0.24^{\circ}C$ after western & oriental medical treatment VAS scores improved from $7.9{\pm}1.4$ to $4.7{\pm}1.6$ after oriental medical treatment and $8.1{\pm}1.3$ to $4.6{\pm}1.2$ after western & oriental medical treatment. MBI scores improved from $61.40{\pm}13.58$ to $85.00{\pm}13.85$ after oriental medical treatment and $52.26{\pm}13.52$ to $77.13{\pm}12.04$ after western & oriental medical treatment. And Rankin scale scores improved from $3.33{\pm}0.72$ to $2.46{\pm}0.74$ after oriental medical treatment and $3.60{\pm}0.82$ to $2.66{\pm}0.81$ after western & oriental medical treatment Conclusion : The difference of skin temperature and Rankin scale scores more significantly improved after western & oriental medical treatment than oriental medical treatment. According to the results, we thought east-west medical management is very useful treatment for CPSP and rehabilitation of the patients with stroke.

• 대한본초학회지
• /
• 제24권1호
• /
• pp.179-189
• /
• 2009

Objectives : Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it's mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods : Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-$\alpha$, IL-6, IL-1$\beta$), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results : CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1$\beta$, IL-6 and TNF-$\alpha$. In serum, CR 500 decreased the amount of IL-1$\beta$, 12h, 24h and 48h respectively (p < 0.05), also decreased that of IL-6 and TNF-$\alpha$, 12h respectively (p < 0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions : This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.

• 대한지역사회작업치료학회지
• /
• 제4권1호
• /
• pp.75-84
• /
• 2014

목적 : 이 연구에서는 단일 뇌졸중환자를 대상으로 체간안정화 훈련 프로그램 적용하여 자세조절과 일상생활 동작에 미치는 영향을 알아보고 분석함으로써 뇌졸중환자의 효과적인 임상적 중재 방안을 제시하고자 한다. 연구방법 : 경북 경주시에 소재한 C병원에 입원중인 75세 여성 뇌졸중 환자 1명을 대상으로 하였다. 연구 설계는 단일사례연구(single subject design)로써 ABA반전설계를 사용하였고, 연구기간은 2014년 4월 21일부터 5월 23일까지 총 5주 동안 진행되었다. 실험 과정은 기초선(A) 3회, 중재 기간(B) 9회 유지(A') 3회로 총 15회 진행하였고 중재기간 동안 체간안정화 프로그램을 적용하였다. 연구 참여자의 자세조절과 일상생활동작의 평가를 위해 Postural Assessment Scale for Stroke(PASS)와 Modified Barthel Index(MBI)를 사용하였다. 수집된 자료는 마이크로 소프트 오피스 Excel 2013 을 사용하여 그래프로 나타내는 시각적 분석(visual analysis)을 사용하였다. 결과 : 자세조절 검사에서 평균 점수는 기초선 구간 11.7점, 중재 구간 14.8점, 유지 구간 15.3점으로 향상되었고, 일상생활동작 평가에서 기초선 기간 66점으로 보통의 의존을 보였지만 중재 후와 유지 구간에서는 80점으로 향상되어 가벼운 의존을 나타냈다. 결론 : 체간안정화 훈련 프로그램이 뇌졸중 환자의 신체의 자세조절이나 정렬에 효과를 나타내고 나아가 일상생활활동의 수행에도 유익한 향상을 보이는 것으로 확인되었다.

• 대한물리치료과학회지
• /
• 제15권1호
• /
• pp.39-45
• /
• 2008

This study was undertaken to identify the influence which affect on gait speed and energy consumption regarding putting on arm sling during gait of the 40 hemiplegic patients selected from University Hospital and rehabilitation center in seoul during two months. The analysis of data was performed using the paired samples ttest to compare the differences of gait velocity, heart rate, oxygen consumption and oxygen cost in gait of preand post－ arm sling. The results of this study were as follows; 1. When comparing the result before putting on arm sling in the gait of hemiplegic patient, gait velocity after putting on arm sling was statistically significantly increased(p<.05). 2. When comparing the result before putting on arm sling in the gait of hemiplegic patient, heart rate after putting on arm sling was statistically significantly decreased(p<.05). 3. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption per weight after putting on arm sling was statistically significantly decreased(p<.05). 4. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption rate per weight after putting on arm sling was statistically significantly decreased(p<.05). When putting together the above result, the gait with arm sling in comparison with the gait without arm sling was to increase gait velocity, decrease heart rate, decrease oxygen consumption and was finally to decrease energy consumption in the gait of hemiplegic patient.

• 한국전문물리치료학회지
• /
• 제19권3호
• /
• pp.20-30
• /
• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• 재활치료과학
• /
• 제3권2호
• /
• pp.83-89
• /
• 2014

목적 : 본 연구의 목적은 양쪽 눈을 반쪽씩 가린 안경착용 중재가 뇌졸중 환자의 좌측편측무시에 미치는 효과를 알아보는 것이다. 연구방법 : 연구 기간은 2014년 10월 뇌졸중 환자 1명을 대상으로 실시되었고 참가자는 자발적으로 연구에 동의하였다. 실험은 1일 1회씩 총 12회 실시하였다. A기간은 기초선 기간으로 안경을 착용하지 않고 3회의 자료를 수집하였다. B기간은 치료기간으로 안경을 세수할 때와 잠잘 때를 제외한 모든 시간 동안 착용하도록 하였다. A(withdrawal)는 안경을 제거하고 3회의 자료를 수집하였다. 모든 검사의 측정은 1일 1회씩 동일 시간과 동일 검사자에 의해서 이루어졌다. 결과 : 선나누기 검사의 오차 평균(mm) 앨버트 테스트의 오차평균은(개)는 크게 감소하지 않았다. 결론 : 이 치료가 편측무시를 감소시키는 방법이라고 할 수는 없었다. 앞으로의 연구에서는 좀더 여러 가지 편측무시 평가를 사용하여 치료의 효과를 알아보고 여러 사항을 고려한 연구가 필요하다고 생각된다.

• 동의생리병리학회지
• /
• 제22권4호
• /
• pp.975-981
• /
• 2008

Restless leg syndrome(RLS) is a sensorimotor disorder characterized by a distressing urge to move the legs and triggered by rest or inactivity. It is usually accompanied with insomnia. We experienced two cases of RLS among ischemic stroke patients. They complained uncomfortable sensation in their affected leg and urge to move the leg at night. We treated them with electro-acupuncture, moxibustion and herbal medicine until retiring. As a result, the symptoms including unpleasant sensation or pain, urge to move the leg and insomnia had withdrawn. These cases suggest the possibility that we can treat RLS with oriental medicine, especially in the case which is refractory to conventional medication or shows periodic leg movements during sleep.

• 대한물리의학회지
• /
• 제5권4호
• /
• pp.559-567
• /
• 2010

Purpose : The purpose of this study is to investigate the effects of motor function recovery and change of the heart function factors(ECG & Troponin I) with ischemic stroke patients by different amounts(times) exercise. Methods : Forty-six consecutive chronic hemiparetic patients with cerebral infarct were randomly assigned to two groups: Group 1 (exercise time 60 minutes/day) and Group 2 (exercise time 120 minutes/day). Types of exercise included static bicycle, isokinetic exercise, and standing or gait exercise on a treadmill. Outcome measures included the level of motor recovery (Fugl-Meyer Scale, FMS) and heart function (ECG and Troponin I), and measurements were performed three times: pre-test, 8 weeks and 12 weeks. Results : There was a significantly different change of motor function recovery and ECG between two groups during treatment period. Especially there were significantly change period of pre-test to 8 weeks on ECG and pre-test to 12 weeks on motor function recovery. But Troponin I has no significantly different change between two groups during treatment period. Also there was no significantly different change of motor function recovery and ECG and Troponin I with between two groups during treatment period. Conclusion : The exercise program improved motor function and change ECG without Troponin I in two groups. The result of this study shows that no matter how different amounts of exercise to effect of motor function recovery and heart function test in chronic patients with cerebral infarct.

• 대한한의학회지
• /
• 제30권3호
• /
• pp.70-78
• /
• 2009

Objectives : This study was aimed at examining the effects of the application of EA (electroacupuncture) at GV20 and LI4 in the early cerebral ischemia on the size of cerebral infarction, COX-2 and IL-6. Methods : For this experiment, 21, six-week-old male S-D (Sprague - Dawley) rats weighting 160g to 200g were selected and randomly classified into 3 groups, seven rats in each group. Brain ischemia was simulated using a modified Koizumi method which was performed on each rat. In the GV20 group, the GV20 of the SD rats was stimulated for thirty minutes with acupunctural electrode low frequency stimulator five hours after inducement of ischemia. For the LI4 group, the LI4 was stimulated as above, while for the Ischemia group, no stimulation was applied. Twenty-four hours after the experiment, stained cerebral tissues were examined and an immuno-histological test was done to examine inflammatory reaction Results : Out of the three groups, the LI4 group showed the smallest size of cerebral infarction and the Ischemia group showed the highest COX-2 (cyclooxygenase-2) expression value in the cortex of the cerebrum. In addition, the LI4 group showed the lowest COX-2 expression value in unknown putamen out of the three groups. Conclusions : We infer that EA, applied at LI4 and GV20 in early ischemia, is effective in delaying the expression of IL-6 (interleukin-6) and COX-2, the inflammatory agents manifested from stroke. In addition, application at LI4, rather than GV20, can lower the expression value of the inflammatory agents. Further, EA can be an effective way to block early inflammatory reaction in stroke.

• The Journal of Korean Physical Therapy
• /
• 제15권3호
• /
• pp.295-345
• /
• 2003

This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.