• 중환자간호학회지
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• 제14권1호
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• pp.50-62
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• 2021

Purpose : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke. Methods : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks. Results : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group. Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.

• 대한통합의학회지
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• 제11권4호
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• pp.105-114
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• 2023

Purpose : This study systematically reviewed occupational therapy programs for upper extremity functions in subacute patients implemented over the last decade at home and abroad to utilize the findings as the basis for intervention protocols. Methods : This study was conducted with domestic and foreign randomized controlled experimental studies published from January 2013 to May 2023. Acute or subacute, CVA or stroke, upper extremity function, and program or therapy were used as search keywords in the search databases Scopus, PubMed, Riss, and DBpia. A total of 3,723 documents were retrieved, and 1,007 duplicate papers were excluded. In addition, 2,640 papers that did not meet the inclusion and exclusion criteria were excluded by the researcher examining the titles and abstracts. Thereafter, the full texts were checked. Consequently, 67 documents were excluded, and nine documents were finally used for analysis. Results : Due to the evaluation of the quality of the documents of nine studies, five items were rated "low," and two items were rated "unclear" in many studies. Males predominated the genders, and infarction predominated the types. The average age was over 50 but under 60 years, and the number of days after onset was predominantly fewer than one month. Occupational therapy programs were classified into mental programs, mirror therapy, music programs, and virtual reality programs, and virtual reality programs were frequently used. The intervention periods were predominantly 15-30 sessions for less than 30 minutes, and the Fugl-Meyer assessment-upper extremity was predominantly applied as an evaluation tool. Conclusion : This study is significant because it attempted to present the direction of intervention protocols for upper extremity functions in subacute stroke patients in clinical settings. Studies should be conducted with an expanded scope for a literature review.

• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.851-859
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• 2013

본 연구는 뇌졸중 편마비 환자를 대상으로 비마비측과 상지부종이 있는 마비측의 정량적 감각 평가(QST)를 비교함으로서 부종 관리 및 치료에 대한 기초자료를 제공하고자 하였다. 연구의 목적에 맞는 아급성기 뇌졸중 환자I군(n=15)과 만성기 뇌졸중 환자II군(n=17)을 대상으로 비마비측과 마비측에 대한 상지용적의 차이, 기계적 동통 역치(MPT), 냉감역치(CST), 온감역치(WST), 냉통증역치(CPT), 온통증역치(WPT), 진동감각 역치(VST)에 대한 정량적 감각 평가(QST)를 실시하였다. 그 결과, 각 군내 비교 시 모든 측정 항목에서 유의한 차이가 나타났고(p<.001), I군과 II군의 군간 마비측 감각 평가 비교에서는 기계적 동통 역치(MPT)를 제외한 모든 측정 항목에서 유의한 차이가 나타났다(p<.05). 아급성기에는 만성기에 비해 상지부종으로 감각역치 증가로 인한 감각저하가 초래되었음을 확인할 수 있었다. 뇌졸중 환자의 부종에 따른 감각적 특성 차이를 정량적 평가를 통해 알아보고자 하였다.

• 대한물리의학회지
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• 제18권3호
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• pp.55-64
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• 2023

PURPOSE: Examine the effects of auditory feedback and functional electrical stimulation on balance, walking ability, and lower extremity function of subacute stroke patients. METHODS: Twenty-seven subjects diagnosed with subacute stroke within six months were randomly divided into three groups: test group 1, which performed walking exercises with auditory feedback and functional electrical stimulation; test group 2, which performed walking exercises only with functional electrical stimulation; control group applied only functional electrical stimulation, with nine subjects each. RESULTS: There were significant pre- to post-intervention differences in BBS in the gait training group with auditory feedback and functional electrical stimulation treatment, and significant pre- to post-intervention differences in BBS, sit-to-stand time, and average step speed in the gait training group with functional electrical stimulation, but no statistically significant differences in between-group comparisons. CONCLUSION: Gait training with auditory feedback and functional electrical stimulation can improve the balance and gait performance in stroke patients. Therefore, in the future, gait training with auditory feedback and functional electrical stimulation therapy may be suggested as a gait rehabilitation training tool for stroke patients.

• 대한물리의학회지
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• 제18권4호
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• pp.133-144
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• 2023

PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.

• Annals of Clinical Neurophysiology
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• 제1권2호
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• pp.99-105
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• 1999

Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

• PNF and Movement
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• 제19권3호
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• pp.351-359
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• 2021

Purpose: This purpose of this study was to investigate the effects of initial cognitive status on the recovery of functional status in patients with subacute stroke. Methods: The participants were 111 patients with subacute stroke, divided into two groups: mini-mental state examination (MMSE) <20 (n=49) group and MMSE ≥20 (n=62) group. Clinical evaluation scores were collected before and after rehabilitation. The repeated measurements ANOVA was used to confirm the changes in functional status before and after intervention in the two groups. Changes in functional status within the group were examined through a paired test. A Pearson correlation coefficient analysis was performed to identify the correlation between MMSE change amount and functional status score. Results: In each of the two groups, according to the initial cognitive status, the clinical evaluation score increased statistically significantly, but there was no difference between the two groups in the degree of significant increase. When examining the correlation between the MMSE change amount, according to the initial cognitive state and the functional state score change amount, it was found, only in the group with MMSE <20, that the larger the change in the MMSE score, the greater the functional state change of Berg balance scale, Rivermead Mobility Index, and motor assessment scale. This did not apply to the group with MMSE ≥20. Conclusion: Initial cognitive status should be considered when setting the patient's goal, and considering cognitive improvement when constructing a rehabilitation program is thought to have a positive effect on rehabilitation services.

• 대한물리의학회지
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• 제8권3호
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• pp.327-335
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• 2013

PURPOSE: The purpose of this study is to investigate effects of trunk position sense through visual cue deprivation balance training in subacute stroke patients. METHODS: The subjects were randomly allocated to two groups: experimental(n=10) and control(n=10). Both groups performed balance training on sitting for 30minute after measurements. Trunk position sense test was assessed using the David back concept to determine trunk repositioning error for four movement(flexion, extension, affected side lateral flexion, non-affected side lateral flexion). Measurements on each test were assessed prior to the balance training and then immediately following the balance training. RESULTS: In comparison of the difference of the trunk position sense between groups, the experimental group decreased significantly in trunk repositioning error of flexion, extension and affected side lateral flexion than control group(p<.05). CONCLUSION: The trunk position sense of the experimental group showed more improvement after the balance training program compared to the control group, Therefore, these results suggest that visual cue deprivation training is considered an effective exercise method for individuals with subacute stroke.

• 대한정형도수물리치료학회지
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• 제25권1호
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• pp.63-70
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• 2019

Background: The purpose of this study was to determine the effects of a pelvic compression belt on gait abilities and balance in subacute stroke patients. Methods: Twenty two patients with subacute were recruited and randomly assigned into two group: Two group offered conventional physical therapy and occupational therapy for five day. The group was composed of twelve patients. Participants in the experimental group were given the pelvic compression belt and conventional physical therapy, conventional occupational therapy, although conventional physical therapy and occupational therapy provided in the subjects in the control group. To assess the gait ability, the GAITRITE system was used and the Balance system SD was used to test balance. All measurements were performed before and after intervention. Results: The experimental group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05) and show significant increase in the dynamic standing balance (p<.05). However, control group shows a significant improvement the cadence, velocity, step length and stride length in gait (p<.05), but shows no significant differences in dynamic standing balance. Furthermore, there were significant differences gait velocity, dynamic standing balance between two groups (p<.05). Conclusions: The results demonstrated that the elastic pelvic belt application is effective to improve gait velocity, dynamic balance in the subacute stroke patients. Thus, the elastic pelvic belt is seemed to be one of the potential methods to facilitate the active rehabilitation program for hemiplegia patients.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.167-174
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• 2021

Objective: Single leg bridge exercise (SLBE) improves trunk muscle activation and provides muscle stability by aligning joints related to posture. This preliminary study aimed to investigate the effects of SLBE on abdominal muscle activation in subacute stroke patients. Design: Cross-sectional study. Methods: Fifteen subacute stroke patients (9 males, 6 females) voluntarily participated in this study. SLBE was performed on the affected side. Each individual patient performed an SLBE ten times in three sets and was asked to hold their position for 5 s. Muscles activity was recorded using a surface electromyography (EMG) system before and after the SLBE. A surface EMG system was used to analyze the muscle activity during general bridge exercise, including the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) abdominal muscles. Results: Muscle activity of both EO and IO on the affected side significantly increased (p<0.05), whereas the muscle activity of the RA and the three muscles on the unaffected side did not show a significant difference. In addition, improvement in muscle asymmetry of the EO and IO showed a significant change after SLBE (p<0.05). Conclusions: SLBE is effective in activating the abdominal muscles of stroke patients on the affected side and is a helpful exercise intervention that activates the muscles to transform asymmetric abdominal muscles into symmetric patterns.