• Title/Summary/Keyword: Stroke Rehabilitation

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Translation and Validation of the Korean Version Revised Nottingham Sensory Assessment (한국판 수정된 노팅엄 감각평가의 신뢰도 타당도 연구)

  • Ji, Eun-Kyu;Lee, Sang-Heon
    • The Journal of the Korea Contents Association
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    • v.20 no.9
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    • pp.511-519
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    • 2020
  • The aim of this study was to translate and validate the revised Nottingham Sensory Assessment(rNSA) in Republic of Korea. A cross-sectional study was conducted to translate the rNSA into Korean using a modified forward/backward translation procedure. Inter-rater and intra-rater reliability, internal consistency, and concurrent validity were investigated to validate the Korean version rNSA. The Korean version rNSA showed excellent inter-rater reliability (r=0.92-1.00) and intra-rater reliability (r=0.93-1.00). Significant correlations were found between sensory assessment results of the Korean version of the rNSA and the Korean Fugl Meyer Assessment Sensory subscales (r=0.96). The Cronbach α value of internal consistency of Korean version rNSA was ranged from 0.73 to 0.90, the value of K-FMA-S was ranged from 0.70 to 0.88. In these results, psychometric properties of the Korean version of the rNSA achieved the standard level and can be feasible in clinical practice to assess sensory function following stroke in Republic of Korea.

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients (수정된 연하곤란사정도구와 비디오 연하영상 조영술의 흡인 위험 예측비교)

  • Moon, Kyung-Hee;Sohn, Hyun-Sook;Lee, Eun-Seok;Paek, Eun-Kyung;Kang, Eun-Ju;Lee, Seung-Hee;Han, Na-Ri;Lee, Meen-Hye;Kim, Deog-Young;Park, Chang-Gi;Yoo, Ji-Soo
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.359-366
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    • 2010
  • Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

Characteristics of Initiation and Termination of Tibialis Anterior Contraction in Adults With Hemiplegia: A Preliminary Study

  • Chung, Yi-Jung;Lee, Jung-Ah;Shin, Won-Seob;An, Seung-Heon;Lee, Eun-Woo;Jung, Kyoung-Sim
    • Physical Therapy Korea
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    • v.14 no.4
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    • pp.50-57
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    • 2007
  • The purpose of this study was to investigate the relationship between delays in initiation and termination of tibialis anterior contraction through surface electromyographic (sEMG) analysis in adults with hemiplegia and healthy subjects and clinical assessment of lower-limb mobility. EMG activity of 6 long-term survivors of stroke and 5 healthy subjects was recorded during maximal isometric ankle dorsiflexion in 3 seconds beeper signals. It must be done as fast and forcefully as possible. Lower limb mobility was assessed with Modified Emory Functional Ambulation Profile (mEFAP). Delay in initiation and termination of muscle contraction was significantly prolonged in the affected lower limb relative to the unaffected limb. Termination of muscle contraction in the hemiplegic lower limb was significantly delayed than the initiation on the affected sides. Delay in initiation and termination of muscle contraction correlated significantly with a few range of mEFAP. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in hemiparetic patients. Consequently, this study showed that abnormal delay of initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in adults with hemiplegia. Further studies are needed to demonstrate a treatment effect.

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The Effect of Functional Electrical Stimulation on the Spastic Plantar Flexor in Stroke Patients (기능적 전기자극이 뇌졸중 환자의 족저굴곡근 강직에 미치는 영향)

  • Son, Young-Sik;Park, Rea-Joon
    • The Journal of Korean Physical Therapy
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    • v.13 no.1
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    • pp.161-174
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    • 2001
  • The purpose of this study was to reduce the spasticity of plantarflexion. the subjects of this study were 30 hemiplegic patients with stroke who received of physical therapy in JinJu o o hospital from May to July 2000. the subjects were divided into three groups(FES groups 10, FES + tilt table-wedge board standing groups 10, & tilt table-wedge board standing groups 10). The result were as follow 1. FES therapy was a effective method to reduce the spasticity of plantarflexor. there was a significant difference in modified Ashworth scale(p<.01). there was a significant difference in weight bearing ratio between nonparetic and paretic side(p<.01). 2. Tilt table-wedge board standing therapy was a effective method to reduce the spasticity of plantarflexor to a degree but there was a no significant difference in modified Ashworth scale(p<.05). there was a significant difference in weight bearing ratio between nonparetic and paretic side(p<.01). 3. Tilt table-wedge board standing therapy + FES therapy was a effective method to reduce the spasticity of plantarflexor. there was a significant difference in modified Ashworth scale(p<.01). there was a significant difference in weight bearing ratio between nonparetic and paretic side(p<.01) 4. There was a significant difference in weight bearing ratio between nonparetic and paretic side according to the grade spasticity(p<.01). 5. For normal persons vs hemiplegic patients, there was a significant different in weight bearing ratio between nonparetic and paretic side(experimental subjects 1 p<.01, experimental subjects 2 p<.01, control subjects p<.05).

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The improvement of gait asymmetry ratio for hemiplegic patients by forceful respiratory exercise (노력성 호흡운동에 의한 편마비환자의 보행 비대칭율 개선)

  • Kim Byung-Jo;Lee Hyun-Ok;Ahn So-Youn
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.38-58
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    • 2004
  • The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

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The effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia (닫힌 사슬운동과 열린 사슬운동이 편마비 환자의 균형에 미치는 영향)

  • Kim, Yong-Jeong;Kim, Taek-Yean;Oh, Duck-Won
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.22-31
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    • 2009
  • Purpose The purpose of this study was to compare the effects of closed kinetic chain exercise and open kinetic chain exercise in improving the balance of patients with hemiplegia. Methods Ten patients with stroke were randomly allocated to either a closed kinetic chain exercise (CKC) group(n=5) or an open kinetic chain exercise(OKC) group(n=5). The subjects of each group followed the exercise regimen of their respective groups, and each exercise was performed for 50 mins per day, 3 days per week, for 4 weeks. Assessment was made using Berg Balance Scale (BBS), One Leg Standing(OLS) test, and Timed up and go(TUG) test. The 2 groups were assessed twice: before and after the intervention. Results The TUG test score was significantly different in the CKC group between before and after intervention (p<.05); however, there was no such deference in the OKC group (p>.05). Further, the scores of the BBS and OLS tests were not significantly different for the 2 groups between before and after intervention (p>.05). The hanges in these BBS and OLS score were not significantly different(p>.05); however, there was a significant difference in the change in the TUG scores (p<.05). Conclusion On the basis of the results of this study, we found that the closed kinetic chain exercise is more effective in improving the walking ability and dynamic balance in patients with stroke. Future studies are warranted in this regard.

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The Effect of Shoe Lift of the Paretic Limb on Gait Patterns in Hemiplegics (환측 신발 높이기가 편마비 환자의 보행 특성에 미치는 영향)

  • Yoon, Jung-Gyu;Park, Jeong-Mee;Kim, Jong-Man
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.83-96
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    • 2002
  • The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10mm higher, and duration of static weight bearing, dynamic weight bearing and stance phase were measured from one cycle of the gait, before and after the lift application. For the measurement of carry-over effect of lift, we got data of those three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Static weight bearing was significantly increased both just after and continuous application of lift for 3 weeks than before. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. Duration of stance phase was not changed among anytime of application. According to this study, lift applied to the shoe of the peretic limb was effective in inducing static weight bearing in the paretic limb, but did not significantly effect dynamic weight bearing on gait patterns. This study suggests that symmetry, induced by shoe lift applied to the paretic limb, could help correct abnormal posture that would be caused in standing and prevent development of abnormal muscle tone in subjects with hemiplegia caused by unilateral stroke.

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The Effects of Meta-cognition Strategy Task Training on Occupational Performance and High-Level Function of Chronic Stroke Patient with Cognitive Damage (인지손상을 동반한 만성 뇌졸중환자의 메타인지전략 과제훈련의 적용이 작업수행과 고위인지기능에 미치는 영향)

  • Han, Ga-ram;Kim, Gyu-Yong;Choi, Young-Eun;Ko, Tae-Sung
    • Journal of Korean Academy of Medicine & Therapy Science
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    • v.10 no.2
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    • pp.59-71
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    • 2018
  • Objective: The purpose of this study is to compare the effects of the CO-OP program using cognitive strategy on the satisfaction and high-level cognitive function of chronic stroke patients with cognitive impairment with the existing task-oriented approach training method. Method: The group randomly selects the experimental group and control group from 30 patients who suffer cognitive damage due to brain damage, and then randomly presents the Cognitive Orientation to daily Occupative Performance (CO-OP) Results: The results of the study showed a significant increase in patient performance and satisfaction, task performance, and high-level cognitive functions in comparison to those before training (p<).05) There was no significant difference in CNT testing in controls; Although there were no significant differences in overall CNT testing between the two groups, the COPM, AMPS tests showed a significant increase in the experimental group compared to the comparators (p <.05). Conclusion: The Cognitive Orientation to Daily Occupative Performance (CO-OP) Intervention Act, which uses meta-in strategies, was previously used. We were able to confirm that it could be a more effective intervention in task performance and high-level cognitive function than in the Meaningful Task-Specific Training Program (MTST).

Effects of Biofeedback Training on the Suprahyoid Muscle Activity of Stroke with Swallowing Disorder (바이오피드백 훈련이 삼킴장애가 있는 뇌졸중환자의 설골상근 근활성도에 미치는 영향)

  • Shin, Yoona;Kwon, Hyakcheol;Lee, Sunmin
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.1
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    • pp.27-36
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    • 2019
  • Purpose : The purpose of this study figures out how the biofeedback exercise combined with a Shaker exercise and a jaw-opening exercise affects the suprahyoid muscle activation of stroke with a swallowing disorder. Methods : The study period was from June, 2018 to September, 2018, to 45 patients who were suitable for selection criteria. Participants were divided into three groups: a visuoauditory biofeedback group (VABG), and a visual biofeedback group (VBG), and a self-exercise group (SG). The three groups were divided into the Shaker exercise and the jaw-opening exercise, and the biofeedback training by themselves. Three groups performed an intervention three times a day, five times a week, and four weeks long. Also, suprahyoid muscle activity was measured with a pre-test, a post-test and a follow-up test. Results : To know the suprahyoid muscle activity after the intervention, there were statistically significant differences between the pre-test and the post-intervention (p< .01). All three groups showed the improvement with the mean comparing followed by VABG, VBG and SG. Comparing between the post- test and the follow-up test, all three groups showed the reduction of suprahyoid muscle activity with the mean comparing, followed VABG, VBG and SG. Conclusion : It found that it was more effective when providing a double-sensory biofeedback than when training with a single-sensory biofeedback. Therefore, it is necessary to provide a multi-sensory input when applying the biofeedback in rehabilitation of the swallowing disorder.

A Comparison between Executed and Imagined Movements in Phase Synchrony of EEG in humans with Stroke: A Preliminary Study (뇌졸중 환자의 EEG phase synchrony에 따른 움직임 및 운동의지비교: 예비 결과 분석)

  • Kim, Da-Hye;Park, Wanjoo;Kim, Yun-Hee;Kim, Sung-Phil;Kim, Leahyun;Kwon, Gyu-Hyun
    • Proceedings of the Korea Information Processing Society Conference
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    • 2013.11a
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    • pp.1661-1664
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    • 2013
  • 본 연구는 만성 뇌졸중 환자 5 명을 대상으로 상지 운동(Affected hand의 주먹 쥐기/펴기운동)시 참가자의 운동의지와 운동 수행의 유무에 따라 차이가 있을 것을 가정하고, 운동 수행 및 운동의지가 존재하는 Active movement와 운동 수행을 하지만 운동의지가 없는 Passive movement, 운동 수행은 없지만 운동의지가 있는 Motor Imagery(MI)의 세가지 task에 따른 뇌파의 연결성을 비교하고자 한다. 이 때 EEG 영역 간의 연결성을 보기 위한 분석 방식 중 하나인 Phase locking value(PLV)를 통해 각 task 간의 차이를 비교 및 분석했다. 운동 수행은 동일하지만 운동의지 유무에 따른 차이는 Passive movement가 전반적으로 뇌 영역간 연결이 감소하고 Active movement가 motor task 시작 후 375ms를 기점으로 급격히 증가함을 보이는 데에서 발견할 수 있었으며, 운동 수행 유무에 따른 차이는 687.5ms 이후 Active movement에 비해 MI에서 뇌 영역 간 연결 수가 확연히 감소하는 데에서 큰 차이를 나타내었다. 이에 따라 본 연구에서는 만성 뇌졸중 환자의 상지운동 시의 motor task에 따른 EEG 영역간의 연결성을 토대로 운동의지 검출이 가능성이 있음을 밝혔다.