• Title/Summary/Keyword: Stroke Rehabilitation

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The change of gait pattern according to different walking speeds in a patient with Parkinson disease (파킨슨환자의 보행 속도에 따른 보행 양상 변화)

  • Oh, Jaegun;Park, Kee-eon;Jung, Byongjun;Lee, Ilsuk;Choi, Sanho;Lee, Sangkwan;Sung, Kang-keyng
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.90-101
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    • 2013
  • ■ Objectives The goal of this study was to observe the gait patterns from a patient with Parkinson disease under three different walking speeds. ■ Methods The patient walked on a treadmill and we measured gait parameters using a treadmill gait analysis system for 2 minutes. The Parkinson patients walked under three different conditions, first, at the preferred walking speed, second, at slower speed than the preferred walking speed, and, third, at faster speed than the preferred walking speed. ■ Results In terms of temporal gait parameters, as speed of treadmill increased, stance phase and total double support decreased, and swing phase increased. In terms of spatial parameters, as speed of treadmill increased, step and stride length increased. In terms of kinetic parameters, max pressure increased as speed of treadmill increased. ■ Conclusion According to different walking speeds, some gait parameters of spatiotemporal and kinetic was changed.

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Correlation Between Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2) and Clinical Dementia Rating (CDR) of Patients with Stroke (뇌졸중 환자를 대상으로 한 인지선별검사(CIST), 한국판 간이정신상태검사 2판(K-MMSE~2) 및 임상치매척도(CDR)의 상관성)

  • Hwang, Do-Yeon;Ryu, Sung-Hyun;Kwon, Ki-Hyun;Choi, Cho-Rong;Kim, Soo-A
    • Therapeutic Science for Rehabilitation
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    • v.11 no.2
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    • pp.53-62
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    • 2022
  • Objective : This study aimed to present basic data that could help in selecting or using evaluation tools in clinical settings. Methods : This study included 51 patients with stroke. The Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2), and Clinical Dementia Rating (CDR) were used as evaluation tools. The correlation between evaluation tool scores was analyzed using Spearman's rank correlation coefficient, and the comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores was analyzed using the Wilcoxon signed-rank test. Results : The correlation between the total CIST and K-MMSE~2 scores and global CDR scores was statistically significant (p<.01). The correlation between the sub-scores of the CIST and K-MMSE~2 showed a statistically significant correlation for all sub-scores (p<.01). The comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores showed no statistically significant differences in all global CDR scores. Conclusion : This study showed that there was a correlation between CIST, K-MMSE~2, and CDR in patients with stroke. In the future, we hope that the results of this study will help to select or use cognitive function evaluation tools in clinical settings.

Effect of East-West pain treatment for Central Poststroke Pain on alleviation of pain and Rehabilitation (뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향)

  • Lee, Hyun-jong;Kim, Su-young;Lee, Sang-hoon;Seo, Dong-min;Lee, Doo-ik;Kim, Keun-sik;Lee, Jae-dong;Lee, Yun-ho;Yang, Hyung-in;Park, Jae-kyung;Choi, Do-young
    • Journal of Acupuncture Research
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    • v.20 no.2
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    • pp.42-49
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    • 2003
  • Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP patients who were treated with eletroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain form stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from $7.7{\pm}1.7$ to $4.4{\pm}2.0$ with pain treatment(p<0.05). In accordance with improvement of ain scores, RS and MBI scores ere also improved from $2.88{\pm}0.95$ to $2.13{\pm}1.01$ and from $83.0{\pm}16.9$ to $94.7{\pm}9.5$(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

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A Literatural Study on the Traditional Korean Medical Physiotherapy (한방물리요법에 대한 문헌적 고찰)

  • Choi, Bo-Mi;Hong, Seo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.211-226
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    • 2011
  • Objectives : The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods : Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in "Hwang-je-nae-gyung(黃帝內經)", "Yumun-sa-chin(儒門事親)", "Geum-guei-yo-ryack(金匱要略)", "Eui-hack-ip-mun(醫學入門)", "Gyung-ack-jeon-seo(景岳全書)", "Eui-hack-gang-mock(醫學綱目)", "Dong-eui-bo-gam(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results : 1. Theromtherapy is originated from yu(熨), hot hand, warm, water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self's care and cure inflammatory skin disease. Magnet's matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions : Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy's expectation.

Aging-Related Changes in Hand Intrinsic and Extrinsic Muscles and Hand Dexterity : an MRI Investigation

  • Hsu, Jeffrey;Koh, Kyung;Park, Yang-Sun;Kwon, Hyun-Joon;Kim, Yoon-Hyuk;Shin, Joon-Ho;Shim, Jae-Kun
    • Korean Journal of Applied Biomechanics
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    • v.25 no.4
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    • pp.371-381
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    • 2015
  • Object : The purpose of this study was to investigate aging-related changes of intrinsic and extrinsic hand muscles in their strength, cross-sectional area and volume, force control, and multi-digit synergies. It was hypothesized that aging would negatively affect distal muscles (intrinsic muscles) more than proximal muscles (extrinsic muscles). Method : Nine young and eleven older right-handed participants underwent MRI scans of the hand and forearm. Muscle cross-sectional areas and volumes of the intrinsic and extrinsic hand muscles were determined. Result : Muscle volume of the intrinsic muscles were larger in the younger group than the older group while muscle volume of the extrinsic muscles did not differ. For the cross-sectional area, both the intrinsic and extrinsic muscles of the younger group were larger than the older group. The maximum strength of the intrinsic muscles of the young group was 31% greater than the older group ($399.1{\pm}26.4$ vs $270.2{\pm}22.9Ncm$, p < 0.05) while the extrinsic muscles showed no significant difference. Although the elderly group showed a trend of decreased force control and multi-digit synergies, no statistical differences were found. These findings indicate aging-related decreases in hand muscle size and strength affect intrinsic muscles more than extrinsic muscles, thus supporting the hypothesis that sarcopenia affects the muscle size and strength of distal muscles more than proximal muscles. Conclusion : The aging-related decreases in hand muscle size and function were more apparent in intrinsic hand muscles, located more distally, than extrinsic muscles, located more proximally.

Analysis of Corticospinal Tract Injury by Using the Diffusion Tensor Imaging of 3.0 T Magnetic Resonance in Patients with Hypertensive Intracerebral Hemorrhage

  • Cho, Hee-Cheol;Son, Eun-Ik;Lee, So-Young;Park, Gi-Young;Sohn, Chul-Ho;Yim, Man-Bin
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.331-337
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    • 2005
  • Objective : The purpose of this study is to identify correlations between diffusion tensor imaging[DTI] and motor improvement by quantifying and visualizing the corticospinal tract on DTI to predict motor impairment in patients with hypertensive intracerebral hemorrhage[ICH]. Methods : Fifteen normal subjects and 7 patients with hypertensive ICH were examined and the latter were treated surgically. DTI was performed with a 3.0 T MRI. The region of interest[ROI] from the posterior limbs of both internal capsules was measured on a fractional anisotropy[FA] map, and the ratios of ROIs were calculated. Tractography, 3-dimensional DTI was then constructed. Motor impairment was assessed on admission and 2weeks after stroke by the Motricity Index[MI]. The FA ratio, tractography and score on MI were analyzed for correlations. Results : The FA ratio from the initial DTI did not show a linear correlation with motor impairment. However, after 2weeks, patients with high FA ratios showed high degrees of motor recovery, regardless of the initial severity, and patients with low FA ratios showed low recovery rates. Otherwise, a relationship between the amount of hematoma and the degree of motor recovery could not be determined. On tractography, injury of the corticospinal tract could be visualized and estimated 3-dimensionally. Conclusion : FA ratio analysis and tractography constructed from DTI may be useful in understanding corticospinal tract injury and in predicting the recovery from motor impairment in patients.

Depression and Quality of Life among Family Caregivers of Patients with Parkinson's Disease in South Korea (파킨슨병 환자 가족의 우울과 삶의 질)

  • Kim, Keum-Soon;Choe, Myung-Ae;Hah, Yang-Sook;Yi, Myung-Sun;Kim, Bog-Ja;Kim, Sung-Reul;Kim, Kyung-Hee;Kwon, So-Hi;Hwang, Young-Ran
    • The Korean Journal of Rehabilitation Nursing
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    • v.10 no.2
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    • pp.90-98
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    • 2007
  • ression and quality of life of family caregivers of patients with Parkinson's disease(PD). Methods: A cross-sectional descriptive study was conducted in one neurology outpatient clinic in Seoul, Korea from March to June, 2006. Sixty eight family caregivers of PD patients were participated to the study, using CES-D and SF-36. Results: Mean scores of depression were $16.18{\pm}8.39$ (range: 0-48) and it was a little lower than caregiver's who took care of Dementia patients and were higher than primary caregivers of the patients with Stroke. Time for caregiving, perceived severity, duration of PD were significantly related with depression respectively. Higher ADL scores which mean greater motor disabilities were related to higher caregiver depression. Lower income and greater medical expenditure were closely related with the depression of family caregivers respectively. The mean scores of total QOL were $435.5{\pm}96.5$ and the mean scores of PF, SF, RE and MH were lower than general population. Time for caregiving, depression, patients' ADL scores were significantly associated with QOL respectively. People who were older and had lower educational background showed lower QOL scores respectively. Conclusion: Healthcare professionals should pay more attention to emotional aspects of caregivers who take care of PD patients, and develop comprehensive management strategies both for patients and their caregivers.

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The Effects of Foot and Knee Position on Electromyographic Activity of the Vastus Medialis and Vastus Lateralis for Hemiplegic Patients (발과 무릎관절 위치가 편마비 환자의 안쪽넓은근과 가쪽넓은근 근활성도에 미치는 영향)

  • Jang, Jun-Hyeok;Kim, Kyung-Hwan;Kim, Tae-Ho;Han, Dong-Wook
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.21-28
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    • 2010
  • Purpose: The purpose of this study was to evaluate the electromyographic (EMG) activity of vastus medialis oblique (VMO) and vastus lateralis (VL) muscles on foot position and knee angle for hemiplegia patients. Methods: Ten stroke subjects (10 males) participated in the study. Subjects were all right-hemiplegic patients. All subjects did $0^{\circ},\;20^{\circ}$ and $40^{\circ}$ knee flexion while maintaining the foot in a neutral position, or at $30^{\circ}$ adduction or at $30^{\circ}$ abduction. Surface EMG data were collected for VMO and VL muscles on the non-hemiplegic side and hemiplegic side. Collected data were analyzed using two-way ANOVA. Results: VMO and VL activities for the non-hemiplegic and the hemiplegic sides were highest for $40^{\circ}$ knee flexion while maintaining the three foot positions. There were no significant differences in EMG activity of the VMO and VL muscles with different foot positions. There were significant differences between VMO and VL activity for knee flexion angle while maintaining the foot in neutral (p<0.05), at $30^{\circ}$ adduction (p<0.05), or at $30^{\circ}$ abduction (p<0.05). Conclusion: Foot position does not influence VMO and VL activities. But, knee flexion exercise in a closed chain can increase VMO and VL muscle activity for hemiplegic patients. In particular, VMO and VL activities for both the non-hemi side and the hemi side were highest for $40^{\circ}$ knee flexion.

Effects of Melatonin on Improvement of Neurological Function in Focal Cerebral Ischemic Rats

  • Lee, Seung-Hoon;Shin, Jin-Hee;Lee, Min-Kyung;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • v.35 no.2
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    • pp.167-174
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    • 2011
  • Acute ischemic stroke results from sudden decrease or loss of blood supply to an area of the brain, resulting in a coinciding loss of neurological function. The antioxidant action of melatonin is an important mechanism among its known effects to protective activity during ischemic/reperfusion injury. The focus of this research, therapeutic efficacy of melatonin on recovery of neurological function following long term treatment in ischemic brain injured rats. Male Sprague-Dawley rats (n=40; 8 weeks old) were divided into the control group, and MCAo groups (Vehicle, MT7 : MCAo+ melatonin injection at 7:00, MT19 : MCAo+melatonin injection at 19:00, and MT7,19 : MCAo+melatonin injection at 7:00 and 19:00). Rat body weight and neurological function were measured every week for 8 weeks. After 8 weeks, the rats were anesthetized with a mixture of zoletil (40 mg/kg) and xylazine (10 mg/kg) and sacrificed for further analysis. Tissues were then collected for RNA isolation from brain tissue. Also, brain tissues were analyzed by histological procedures. We elucidated that melatonin was not toxic in vital organs. MT7,19 was the most rapidly got back to mild symptom on test of neurological parameter. Also, exogenous melatonin induces both the down-regulation of detrimental genes, such as NOSs and the up-regulation of beneficial gene, including BDNF during long term administration after focal cerebral ischemia. Melatonin treatment reduced the loss of primary motor cortex. Therefore, we suggest that melatonin could be act as prophylactic as well as therapeutic agent for neurorehabilitative intervention.

The Comparison Between CBS and Pencil and Paper Test in Patients With Unilateral Neglect (편측무시 환자에서 관찰을 통한 Catherine Bergego Scale과 지필 검사 간 비교)

  • Heo, Eun-Young;Kwon, Hyuk-Cheol;Hwang, Ki-Cheol
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.48-56
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    • 2013
  • Purpose : To identify the correlation between CBS and pencil and paper test, and to test the sensitivity of above tests about unilateral neglect. Mostly used tool of pencil and paper test is line bisection and albert test. CBS is behavioral neglect test. Methods : The subjects of study were 44 stroke patients with left hemiplegia. Data were analyzed for Pearson correlation, paired t-test and ANOVA using SPSS program. The significance level was ${\alpha}<.01$. Results : The results of the study was as follow: 1. CBS had a significant correlation of line bisection and Albert test. 2. CBS was more sensitive than the pencil and paper in unilateral neglect. 3. CBS had high correlations with ADL than the pencil and paper test. Conclusion : The result showed that CBS was more useful than a pencil and paper test to distinguish unilateral neglect and available to diagnose anosognosia. Therefore, it should be considered applying CBS to inspect and cure unilateral neglect.