• 대한간호학회지
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• 제36권6호
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• pp.1065-1075
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• 2006

Purpose: A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia. Method: Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires. Result: Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way. Conclusion: It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.

• 기본간호학회지
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• 제8권1호
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• pp.81-94
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• 2001

The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.388-411
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• 2003

The purpose of this study has been conducted to reduce the lower limbs' spasticity of the patients with hemiplegia caused by cerebral stroke of apoplexy and find differences about spasticity effects among each group. The objects of this study covered 24 patients with hemiplgia who are either in the oo hospital in Daegu or under treatment from home to hospital. The objects fall into three groups which are a group of neurological development treatment, a group of functional stimulus treatment and a group of neurological development treatment and functional stimulus treatment. The result of this study were as follows : 1) The neurological development treatment has been found to reduce the lower limbs' spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity has been shown to be statistically meaningful ,and gradually over the period of between 4 weeks and 8 weeks(P <.05). 2) The functional electric stimulus treatment has been shown to reduce the lower limb's spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity was statistically meaningful and compared to 4 weeks, even at the time of 8 weeks, the MAS value of spasticity have shown statistical meaningness. (P <.05) 3) When neurological development treatment and functional electric stimulus treatment was applied at the same time, the lower limbs' spasticity of patients with hemiplegia was reduced meaningfully(P <.05). Compared to before-treatment at the time of 4 weeks, the MAS value of spasticity was statistically meaningful and compared to 4 weeks at the time of 8 weeks the MAS value of spasticity was also statistically meaningful(P <.05) 4) In the case of time-based MAS value of each group, functional electric stimulus treatment reduced the spasticity more meaningfully than neurological development treatment, and the group of same application of functional electric stimulus treatment and neurological development treatment showed better statistical meaningness than functional electric stimulus treatment alone(P <.05) and finally the group of same application of neurological development treatment and functional electric stimulus treatment showed more meaningful difference than neurological development treatment alone(P <.05)

• The Journal of Korean Physical Therapy
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• 제30권5호
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• 대한물리의학회지
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• 제8권2호
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• pp.175-182
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• 2013

PURPOSE: The purpose of this study was to investigate the effects of task oriented ADL exercise in different environments in patients with chronic stroke. METHODS: A total of 28 patients with hemiplegia resulting from stroke were included in this study. The patients were randomized into two groups. The control group(n=14) was received neurodevelopment therapy + task oriented ADL exercise and experimental group(n=14) was received neurodevelopment therapy + home based task oriented ADL exercise for 30 minutes twice per week during 6weeks. A task oriented ADL exercise pretest and postest design was used examine the change of FIM(Functional Independent Measure) and K-MBI(Korea-Modified Bathel Index) at the completion of 6 weeks task oriented ADL exercise. RESULTS: After 6 weeks, the experimental group compared with control group showed a significant improvement (p<.05) in FIM and K-MBI scores. CONCLUSION: The results indicate that the home based task oriented ADL exercise improves functions in the persons with chronic stroke.

• 대한물리치료과학회지
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• 제10권1호
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• pp.30-37
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• 2003

Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.

• 대한간호학회지
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• 제24권1호
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• pp.18-32
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• 1994

It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2％). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.16-25
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• 2011

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

• 재활간호학회지
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• 제6권2호
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• pp.213-225
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• 2003

The purpose of this study is to develop and evaluate the health promotion program to increase the functional status of the in-house stroke patients. The subjects for the experiment are 38 in-house stroke patients in a health center and welfare centers suffering from hemiplegia. The experimental group consists of 19 stroke patients and the control group consists of another 19 stroke patients. The program was applied to the experimental group for 8 weeks. The subjects were given health education at the first week. At the second and the fifth week they were given counselling on health by home visit. At the third, the fourth, the sixth and the seventh week they were interviewed by phone about health, and at the last week they shared their experiences through group meeting. The results of the study are as follows: 1. The degree of ADL in the experimental group increased significantly, compared with that of the control group. 2. In the experimental group the degree of Range of Motion in shoulder abduction, elbow flexion, hip flexion and ankle dorsiflexion increased significantly, compared with that of the control group. 3. In the experimental group the degree of muscle strength in elbow flexion, knee extension, and ankle dorsiflexion increased significantly, compared with that of the control group. 4. Systolic pressure, diastolic pressure in the experimental group decreased significantly, compared with that the control group. 5. HWR in the experimental group didn't decreased significantly, compared with that the control group. 6. The degree of depression in the experimental group decreased significantly, compared with that the control group. 7. The degree of social adaptation in the experimental group increased significantly, compared with that the control group. The results above show that the health promotion program for this study was effective in promoting the performance of lifestyle for health improvement of the in-house stroke patients. Therefore, it is considered that the program can be used as an efficient nursing intervention for the in-house stroke patients who need continuous health-improving behaviors.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3023-3029
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• 2012

본 연구의 목적은 만성 편마비 뇌졸중 환자를 대상으로 상지 운동기능 회복을 위하여 적용한 가상현실 가정운동프로그램의 가능성을 알아보기 위함이다. 만성 뇌졸중 환자 2명을 대상으로, 한 명의 참여자는 가상현실운동프로그램을 가정운동프로그램으로 처방하여 실행하였고, 다른 한 명의 참여자는 강제-유도운동치료를 가정운동프로그램으로 처방하여 실행하였다. 치료기간은 4주간으로 1주일에 총, 5회로 1회에 4시간씩 실시하였다. 평가는 뇌졸중 기능회복평가(Fugl-Meyer Assessment; FMA), 운동활동척도검사(Motor Activity Log, MAL), 그리고 울프운동기능검사(Wolf Motor Function Test; WMFT)를 이용하였다. 가상현실 운동프로그램을 가정운동프로그램으로 실시한 대상자가 모든 운동기능평가에서 상당한 기능적 회복을 보여주었다. 특히, FMA 점수는 가상현실프로그램을 사용한 대상자는 17% 향상된 반면, 강제유도운동치료를 가정운동프로그램으로 실시한 대상자는 5% 증가하였다. 또한, MAL 점수의 환측 상지를 이용하는 양(Amount of Use; AOU)와 움직임의 질(Quality of Movement; QOM)점수에서도 가정중심 가상현실 프로그램을 이용한 대상자가 각 40%, 20% 향상된 반면, 강제유도운동치료를 받은 대상자는 각각 0%, 20% 증가하였다. 가상현실 프로그램을 사용한 대상자와 강제유도운동치료를 받은 대상자의 WMFT 점수가 모두 20%증가하였다. 본 연구결과, 만성 편마비 뇌졸중 환자의 상지 운동 기능 향상을 목적으로 가정운동프로그램을 설계할 때 가상현실 운동프로그램이 강제-유도운동치료보다 더욱 효과적인 것으로 사료된다.