Objective: Participation restrictions are serious problems that stroke survivors experience while reintegrating into family, work, community, and social situations after participating in rehabilitation programs. The purpose of this study was to explore the factors affecting participation in activities of daily living (ADL), as well as social and leisure activities of individuals with hemiparetic stroke. Design: Cross-sectional study. Methods: The study involved 96 participants who were diagnosed with a first stroke 6 months before the study (58 men, 38 women; $60.3{\pm}14.3years$). The Berg Balance Scale, Modified Barthel Index, Manual Function test, and Activity Card Sort were used to assess static and dynamic balance function, upper limb function, level of independence, and their level of participation within the community. A regression analysis was used to identify the influence of factors affecting participation in ADL, social and recreational activities. Results: The Activity Card Sort scores were significantly affected by the Manual Function test and Modified Barthel Index scores (p<0.05). Participation in leisure activities was affected by the level of independence. Participation in social activities was affected by the balance function and level of independence of the participants. Conclusions: The results of this study have shown that participation restrictions are affected by upper limb function, balance function, and the level of independence in individuals with hemiparetic stroke.
Objective: The purpose of this study was to investigate the effect of treadmill exercise on the posture and walking speed of chronic stroke survivors with an ankle-foot orthosis. Design: Randomized controlled trial. Methods: Twenty-four chronic persons with chronic stroke admitted to Bobath Memorial Hospital in Seongnam city were divided into two groups by random blind method. Treadmill exercise with an elastic ankle-foot orthosis was performed in the experimental group and treadmill exercise was performed in the control group. The experiment was carried out for 6 weeks, and the experiment was carried out three times a week for 20 minutes per session. To measure the effect, static balance was measured using the MTD system before and after training, and the Berg Balance Scale (BBS) was used to measure functional balance. Results: There was a statistically significant difference between the 2 groups in the BBS measurement results for confirming the functional balance (p<0.05). Also, there was a significant difference between the 2 groups in single limb support time, step time and step length (p<0.05). Conclusions: In this study, it was found that treadmill exercise with an elastic ankle-foot orthosis in persons with chronic stroke was effective in maintaining functional balance, walking ability, step length, and step time. Therefore, it is necessary to use a flexible ankle-foot orthosis with proper treadmill exercise as a method of improving balance and walking speed of chronic stroke survivors.
Objective: The purpose of this study was to investigate the effect of the side-step tasks based circular training program (STCT) on balance and gait characteristics in stroke patients. Design: A randomized controlled trial Methods: Twenty-four stroke patients were randomly divided into two groups of twelve patients each. One group was applied with the STCT whereas the other group was treated with conservative physiotherapy (CP). The ability of gait was measured in 10m walking test and stride length on both side using BTS G-WALK (BTS Bioengineering S.p.A, Italy) and the ability of balance was measured in Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Results: The STCT group was significant differences in the balance parameters of BBS and TUG (p<0.05) and showed significant differences in gait variables in 10m walking speed, stride length of affected and non-affected side after the experiment before and after the experiment (p<0.05). In addition, the STCT group showed a significant difference in BBS compared to the control group (p<0.05). Conclusions: The results of this study confirmed that the side-step tasks based circular training program (STCT) improves balance and walking ability in stroke patients. STCT is expected to be used as a useful intervention method for stroke rehabilitation.
A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression, powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale, Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24% were from 31 to 50 years old. Most of them (72%) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction, individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information, and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results, the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.
Background: The purpose of this study was to provide the basis for the treatment intervention by identifying the treatment effect when rehabilitation intervention is applied to patients with dysphagia due to stroke and by comparing the results of the treatment mediation according to the differences of the treatment methods and frequency. Design: Randomized Controlled Trial. Methods: 30 people diagnosed with dysphagia due to stroke were divided in accordance with the differences in treatment mediation techniques and treatment frequency- traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group/ 5 times per week group and 2 times per week group, and ten weeks of treatment intervention was performed. Paired t test was employed to show the efficacy of treatment intervention, Independent sample t test was used to compare the results according to difference and number of treatment intervention techniques. Results: There was a significant positive effect of treatment on traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group, only neuromuscular electrical stimulation group, 5 times per week group and 2 times per week group (p<0.05). There was no statistically significant difference in treatment effect between traditional swallowing rehabilitation coupled with neuromuscular electrical stimulation group and only neuromuscular electrical stimulation group (p<0.05). There was no statistically significant difference in treatment effect between 5 times per week group and 2 times per week group (p<0.05). Conclusion: There was no significant difference according to the technique or number of treatments of swallowing rehabilitation treatment interventions, but it was confirmed that rehabilitation intervention for dysphagia showed positive treatment effect.
Min, Sang Won;Oh, Se Hyun;Kim, Ghi Chan;Sim, Young Joo;Kim, Dong Kyu;Jeong, Ho Joong
Annals of Rehabilitation Medicine
/
v.42
no.6
/
pp.798-803
/
2018
Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke. Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups. Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups. Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.
Purpose : This article reviewed the advances in the understanding of the effect of motor rehabilitation and brain plasticity on functional recovery after CNS damage. Methods : This is literature study with Pubmed, Medline and Science journal. Results : The inability of CNS neurons to regenerate is largely associated with nonneuronal aspects of the CNS environment. Especially, this neuronal growth inhibition is mediated by myelin associated glycoprotein, olygodendrocyte-myelin glycoprotein, and NOGO. Enriched environment, motor learning, forced limb use have been utilized in scientific studies to promote functional reorganization and brain plasticity. Especially, enriched environment and motor enrichment may prime the brain to respond more adaptively to injury, in part by expressed neurotrophic factors. Conclusions : These reviews suggest that activity-induced neural plasticity occur in damaged brain areas in order to functional reorganization, where it could contribute to motor recovery, and represent a target for stroke rehabilitation.
Purpose : Investigate the effects of Horse-back riding Simulation Machine training on the Balance ability in Patients with Stroke. Method : The patients were divided to control group(n=18) with conventional rehabilitation conventional rehabilitation 60min/day and experimental group(n=17) with hippotherapy simulator 15 min/day after conventional rehabilitation 45min/day, 5 time/week for 4 weeks. Balance ability of both groups was assessed using Timed Up and Go(TUG), Berg balabce scale(BBS) and Center of pressure area(COPA). In the present result, there was a no significant(P>0.05) Results : The results of this study showed that Horse-back riding Simulation Machine training, after training, had meaningful difference of TUG, BBS and COPA. Conclusion : This study showed that Horse-back riding Simulation Machine training increased balance ability that resulted in enhancement of motor performance.
Purpose: Apraxia is characterized by loss of the ability to execute learned, skilled, sequential purposeful movements which cannot be accounted for by elementary disturbances of strength, coordination, sensory, lack of comprehension, attention, and willingness etc. For an accurate diagnosis and treatment of patients with apraxia, an understanding of the prevalence rate and clinical characteristics of apraxia is necessary. The purpose of this study was to estimate the apraxia prevalence rate. Methods: The apraxia prevalence rate was investigated via an apraxia assessment tool in 137 stroke patients, and the clinical characteristics of general stroke patients and stroke patients with apraxia were compared. Results: 14 (1 left hemiplegia, 8 right hemiplegia, 5 quadri hemiplegia) of a total of 137 stroke patients were diagnosed with apraxia. The group of stroke patients with apraxia showed lower values of mmt, mbc and fac than those of general stroke patients. Conclusion: The apraxia prevalence rate of stroke patients was approximately 10%, while the clinical function of stroke patients with apraxia was generally inferior to that of general stroke patients.
Objective: The purpose of this study was to investigate the effect of cervical range of motion training on the change in respiratory function growth rate at the group and individual level in stroke patients and stroke patients with tracheostomy tube. Design: A Multilevel Growth Model Methods: 8 general stroke patients and 6 stroke patients who had a tracheostomy tube inserted were subjected to cervical range of motion training 3 times a week for 4 weeks. Force vital capacity (FVC), Forced expiratory volume in the first second (FEV1), Forced expiration ratio (FEV1/FVC) and Manual assist peak cough flow (MPCF) were measured. Data were analyzed using descriptive statistics and multilevel analysis with HLM 8.0. Results: A significant difference was found in the respiratory function analysis growth rate of the entire group (p<0.05), and two groups were added to the research model. The linear growth rate of respiratory function in patients with general stroke increased with the exception of FEV1/FVC (p<0.05). Stroke patients with tracheostomy tube showed a decreasing pattern except for FVC. In particular, MPCF showed a significantly decreased result (p<0.05). Conclusions: This study found that the maintenance of improved respiratory function in stroke patients with tracheostomy tube decreased over time. However, cervical range of motion training is still a useful method for respiratory function in general stroke patients and stroke patients with tracheostomy tube.
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