The fatigue behavior of LIPCA was so sensitive to the manufacturing condition, the environmental factors and the change of the test apparatus. Therefore, we could be considering not only the relationship between the stroke range $({\Delta}h)$ and actuating frequency but also the relationship between the stroke range $({\Delta}h)$ and the total effective moment $(M^E)$. Thus, this study proposed the calculation method of the applying $M^E$ when the $({\Delta}h)$ of LIPCA was increased from 1.mm to 20mm. To estimate the relationship between the total effective moment $(M^E)$ and the Bernoulli-Euler bending moment (M) was reviewed. And the residual stress distribution of LIPCA and THUNDER using the CLT was evaluated. In conclusions, converting the $({\Delta}h)$ of LIPCA to the radius of curvature (p) and calculating the $(M^E)$, it was found that the p by the $M^E$ changed similarly as the $({\Delta}h)$. It was found that the $M^E$ was 2.2 times as the M. While CFRP and PZT of LIPCA, which had the superior compressive characteristic, had the compressive residual stress, GFRP was subject to the tensile residual stress. Since this reversed configuration between the compressive residuals stress and the tensile one was made, the requirement of the stroke range $({\Delta}h)$ increase was satisfied.
Background : Treadmill training has been proposed as a useful adjunct to conventional physical therapy to restore ability to walk after stroke. The purpose of this study to inform clinical practise by evaluating the research evidence for the effectiveness of treadmill training after stroke. Methods : We searched to the effectiveness of any form of intervention for effect of treadmill training by Dankook University electronic library databases of Medline, Embase, Cinahl, Amed and PEDro combined with a hand search of papers published in relevant peer-reviewed journals. Any type of study relevant to the topic published in English during time period from 1980 to 2007 was included. Results : The literature search identified 35 studies. The included studies enrolled a total of 374 subjects. 1. Treadmill retraining without partial body weight support might be more effective than no treatment at improving gait velocity, get up and go time, gait endurance and step length symmetry. 2. Treadmill retraining with partial body weight support might be more effective than no treatment in improving step length symmetry, gait velocity, gait endurance and balance. 3. Treadmill retraining might be more effective with partial body weight support than without it at improving gait velocity and motor improvement as measured by The Stroke Rehabilitation Assessment of Movement(STREAM). 4. Treadmill retraining without partial body weight support may be no different from physiotherapy and increase gait velocity to conventional gait therapy. 5. Treadmill retraining with partial body weight support may be no different from physiotherapy for gait velocity, motor recovery and balance. Conclusion The review suggests that although treadmill training of gait, especially with partial body weight support, might Improve gait parameters and functional mobility, unless treadmill training is directed at Improving gait speed it might be no more effective than conventional physical therapy at improving gait parameters.
Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.
Purpose: This study was to suggest the direction to the exercise intervention development for the stroke survivors. Method: 12 domestic and 54 foreign research papers about the exercise intervention for the stroke patients published during 1998~2007 were analyzed. Result: Among the papers, quasi-experimental design(75.8%) and multidisciplinary approach(60.6%) were the most frequent ones. The mean age of the respondents was 63.3 and the intervention was supplied for 7.14 weeks. The frequency of exercise was 3.87 per week and the exercise time was 1.88 hours. And physical research variables - such as ambulation, muscle strength, activities of daily living and balance - were more than psychosocial variables. This study suggested that the exercise intervention for the stroke survivors need to include aerobic exercise, muscle strengthening exercise, flexible exercise, body coordination, balance exercise. In addition we confirmed that the exercise intervention was revealed as an effective physiological parameters; such as maximum oxygen uptake quantity, blood pressure. Conclusion: We suggest that the further researchs are needed which include the intensity of exercise into the quantity of the exercise. Also researchers need to extend the motion intervention time for an effective sociopsychological variable and to try the meta analysis for the effective exercise intervention for the stroke survivors.
PURPOSE: Strengthening training is effective at improving the function of stroke patients. This study was conducted to compare the effects of exercise intensity on walking, balancing ability, and blood glucose in stroke patients with type 2 diabetes mellitus and to suggest more effective exercise intensity for stroke patients. METHODS: Twenty-two patients with type 2 diabetes mellitus were divided into an experimental group (n=11) and a control group (n=11). In the experimental group, a 40-70% strength of 1RM exercise program was applied for 40 minutes a day, three times a week for 4 weeks. The control group received a 50% intensity of 1RM for the same number and duration of interventions as the experimental group. RESULTS: Both the experimental group and the control group showed significant improvement in the gait function, balance ability, and blood glucose level after the intervention compared to before the intervention. In the FGA (functional gait assessment), the experimental group showed a 52.4% greater increase than the control group, and the fasting blood glucose level was 16.7% greater in the experimental group than the control group. CONCLUSION: The strengthening exercise program, which gradually increases exercise intensity, seems to be effective at improving the function of stroke patients with type 2 diabetes.
Purpose: The purpose of this study was to examine the effects of self-help management program on knowledge about stroke, self-efficacy, self-esteem and family support in people with stroke. Methods: With a quasi-experimental design, 44 persons with stroke were assigned into an experimental group (n=21) or a control group (n=23). The knowledge about stroke, self-efficacy and self-esteem were measured at both before and after the self-help management program. Date were analyzed with SPSS/WIN using descriptive statistics, t-test, and $x^2$-test. Results: There was a significant increase in knowledge about stroke, self-efficacy and self-esteem in the experimental group. Conclusion: Self-help management program can be an effective nursing intervention to improve the knowledge about stroke, self-efficacy and self-esteem for patients with stroke.
Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.
Park, Jung-Soo;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
Journal of Korean Neurosurgical Society
/
제47권4호
/
pp.258-264
/
2010
Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.
Background : Prevalence of spasticity because of stroke are 40% patients after 12 month. Spasticity caused decrease of range of motor, motor function, and active daily living. Electroacupuncture widely used stroke. But it is been studied by systematic review between spasticity and electroacupuncture. This study is aimed to efficacy of electroacupuncture for spasticity because of stroke. Methods : We had used pubmed(www.pubmed.com) and cochrane library(www.thecochranelibrary.com) database. Limits are'human','randomized controlled trial'and'all adult 19+ years'in pubmed. The period was until 15, september, 2011. We used MeSH(Medical Subject Headings terms. The search words were'stroke'[mesh],'muscle spasticity'[mesh and 'electroacupuncture'[mesh]. In cochrane library, we used spasticity and electroacupuncture in cochrane library. We found 19 studies. But only 3 studies were included for inclusion criteria. Results : The appropriate 3 studies were different from subject, acupoint, duration of treatment, endpoint and etc. But these studies were effective for spasticity because of stroke. Conclusion : These studies were not meta analysis because of heterogeneity. But the above results might explain the electroacupuncture were effective for spasticity and further study needed to verify and standard electroacupuncture study for spasticity.
Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.
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