• 제목/요약/키워드: hemiplegic patients after stroke

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팔걸이가 뇌졸중 환자의 보행속도 및 에너지 소모량에 미치는 영향 (Effect of Arm Sling on Walk Speed and Energy Consumption in Patients with Stroke)

  • 윤성익;김윤신;심재훈;오경아;오덕원;천승철
    • 대한물리치료과학회지
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    • 제15권1호
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    • pp.39-45
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    • 2008
  • This study was undertaken to identify the influence which affect on gait speed and energy consumption regarding putting on arm sling during gait of the 40 hemiplegic patients selected from University Hospital and rehabilitation center in seoul during two months. The analysis of data was performed using the paired samples ttest to compare the differences of gait velocity, heart rate, oxygen consumption and oxygen cost in gait of preand post- arm sling. The results of this study were as follows; 1. When comparing the result before putting on arm sling in the gait of hemiplegic patient, gait velocity after putting on arm sling was statistically significantly increased(p<.05). 2. When comparing the result before putting on arm sling in the gait of hemiplegic patient, heart rate after putting on arm sling was statistically significantly decreased(p<.05). 3. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption per weight after putting on arm sling was statistically significantly decreased(p<.05). 4. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption rate per weight after putting on arm sling was statistically significantly decreased(p<.05). When putting together the above result, the gait with arm sling in comparison with the gait without arm sling was to increase gait velocity, decrease heart rate, decrease oxygen consumption and was finally to decrease energy consumption in the gait of hemiplegic patient.

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뇌졸중 편마비 환자의 견관절 통증에 대한 추나요법의 효과: 체계적 문헌고찰 및 메타분석 (The Effect of Chuna Manual Therapy for Shoulder Pain in Hemiplegic Patients after Stroke: A Systematic Review and Meta-Analysis)

  • 오은미;이은정
    • 한방재활의학과학회지
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    • 제30권3호
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    • pp.89-101
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    • 2020
  • Objectives The purpose of this study is to assess the effectiveness of Chuna manual therapy for shoulder pain in hemiplegic patients after stroke. Methods For a systematic review and meta-analysis, we set a key question in accordance with participants, intervention, comparison, outcome, study design (PICO-SD). we searched for clinical studies that conducted chuna manual therapy for shoulder pain in hemiplegic patients after stroke 7 databases until September 2019. Only randomized controlled trials were chosen. Results Total 14 randomized controlled trials were chosen for systematic review and meta-analysis. 9 studies used efficacy rate as evaluation tool, and 8 used visual analogue scale. Pressure method (壓力型) was used in 11 studies, followed by osteopathy method (整骨型) and wave motion method (波動型) in 9 studies. Chuna manual therapy showed statistically significant pain reduction effect. Through meta analysis, Chuna manual therapy showed significant pain reducing effect except the study with Chuna manual therapy and electroacupuncture compared to electroacupuncture only. Conclusion As a result, Chuna manual therapy showed statistically significant effect in pain reduction. However, almost studies were evaluated in a state of having probable high risk of bias. This suggests that it requires attention to make an interpretation in this study. Furthermore, more clinical research need to be accomplished in the future.

뇌졸중 환자의 견관절 통증에 대한 봉독약침의 임상효과 (Effectiveness of Bee Venom Acupuncture on Shoulder Pain after Stroke)

  • 고창남;박성욱;정우상;문상관;박정미;조기호;김영석;배형섭;민인규
    • 대한한의학회지
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    • 제28권1호통권69호
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    • pp.11-24
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    • 2007
  • Objectives : Hemiplegic shoulder pain is one of the common sequelae of stroke. Although many different methods of treatment are applied, none have yet been proved to be effective. In this study we assessed the effectiveness of bee venom in patients with shoulder pain after stroke. Methods : This study was a double blinded, randomized, placebo-controlled clinical trial. All subjects received either 0.6 ml bee venom injection (venom:saline = 1:10000) or 0.6ml physiological saline solution (placebo) at three acupoints. The effectiveness was assessed by visual analogue scale, pain rating score, Fugl-Meyer assessment and passive external rotation. Results : There were 24 patients in the venom group and 22 patients in the placebo group. The venom group5,hewed more effectiveness in VAS and PRS than the placebo group. Conclusions : This study suggests that bee venom injection has significant analgesic effect on hemiplegic shoulder pain. Further study based on multi-centers, larger population, and long term 1311ow-up is needed to confirm this suggestion.

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중풍 환자의 상지마비에 대한 전침치료의 효과 (Effects of Electroacupuncture on the Hemiplegic Upper Extremity after Stroke)

  • 류순현;이경섭;김태경;최요섭;윤상필;장종철;문상관;고창남;조기호
    • 대한한의학회지
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    • 제23권2호
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    • pp.180-189
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    • 2002
  • Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

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Applications of Diffusion Tensor MRI to Predict Motor Recovery of Stroke Patients in the Chronic Stages

  • Tae, Ki-Sik;Song, Sung-Jae;Kim, Young-Ho
    • 대한의용생체공학회:의공학회지
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    • 제29권2호
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    • pp.114-121
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    • 2008
  • Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation. In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that tractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.

The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients

  • Song, Bo-Kyung
    • The Journal of Korean Physical Therapy
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    • 제23권3호
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    • pp.71-77
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    • 2011
  • Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

두침이 중풍환자의 단기간 NIHSS와 MBI에 미치는 영향 (Effects of Scalp Acupuncture on Short-term NIHSS and MBI in Stroke Patients)

  • 조태성;손인석;박인범;김상우;서정철;윤현민;장경전;송춘호;안창범
    • 대한한의학회지
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    • 제24권1호
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    • pp.65-73
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    • 2003
  • Objective: The aim of this study was to investigate the effect of scalp acupuncture on recovery from motor disorders in stroke patients. Methods: Twenty-two patients with post-stroke hemiplegia were randomized into two groups. Ten patients (test group) were treated by 2 methods: scalp acupuncture and general acupuncture. The other twelve patients (control group) were treated only with general acupuncture. The activity of daily living was measured with a National Institutes of Health stroke scale (NIHSS) and Modified Barthel Index (MBI). The therapy was performed once a day for 2 weeks. Results: In terms of NIHSS score, the test group showed statistically meaningful decrease after 2 weeks treatment, while the control group showed statistically meaningful decrease after 1 week (p<0.05). And in terms of score of MBI, the test group did not show statistically meaningful increase but the control group showed statistically meaningful increase after 1 week (p<0.05). There was no statistically meaningful difference after 1 and 2 weeks treatment between the groups. Conclusions: These results support that the test group has almost same the effectiveness compared with the control group in improvement of the activity of daily living of post-stroke hemiplegic patients.

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성인 편마비환자의 외적 되먹임 체중부하훈련이 낙상예방에 미치는 효과 (The Effect of External-feedback Weight-bearing Training Protecting a Fall in Hemiplegic Patients)

  • 나영현;구봉오;노민희;안소윤
    • 대한물리의학회지
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    • 제2권2호
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    • pp.143-150
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    • 2007
  • Purpose : This article was a quasi-experimental study that applies to external -feedback weight-bearing training among hemiplegic patients with a stoke. Methods : It examined whether position sense and balance can improve fall efficacy and prevent a fall. The subject of study was divided in two; Experimental group had 18 people and control group had 16 people. It took 8 weeks to finish training. Experimental group provides external-feedback weight-bearing training for ten minutes after neurological treatment for 20 minutes and control group provides nerves treatment for 30 minutes. To find the effect of a fall assessed position sense, balance and fall efficacy of the lower limbs before the fact, after 4 weeks and 8 weeks. Results : According to the conclusions, external-feedback weight-bearing training to prevent a fall was more effective intervention in experimental group than in control group. Conclusion : This study suggests that external-feedback weight-bearing training is a intervention to prevent the fall of hemiplegic patients with a stroke effectively.

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편마비 환자의 보행 동안 양하지 관절의 돌림힘과 일률 (Moment and power of lower extremities during hemiplegic gait)

  • 권영실;강기창;정병옥;박래준;김진상
    • The Journal of Korean Physical Therapy
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    • 제11권1호
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    • pp.55-61
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    • 1999
  • The purpose of this study was to compare the moment and power of affected Side and those of unaffected side during gait in hemiplegic patients after stroke. Force plate ana kinetic gait analysis was used. The following is resulted from this study. 1. In the hip joint, moment values had not difference between affected side and unaffected side. Power values had difference between affected and unafected side. 2. In the knee joint, moment values and power values had difference between affected side and unaffected side. 3. In the ankle feint, moment and power values had not, difference between affected side and unaffected side.

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가상현실 프로그램이 만성 뇌졸중 환자의 선자세 균형에 미치는 영향 (Effects of Virtual Reality Program on Standing Balance in Chronic Stroke Patients)

  • 김중휘;김중선
    • The Journal of Korean Physical Therapy
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    • 제17권3호
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    • pp.351-367
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    • 2005
  • The purpose of this study was to identity effects of virtual reality(VR) program related to standing postural control on balance, gait and brain activation patterns in chronic hemiplegic stroke patients. Subjects were assigned randomly to either VR group (n=12) or the control group (n=12) when the study began. Both groups received conventional physical therapy for 2 to 3 times per week. In addition to conventional physical therapies, VR group trained 3 types of virtual reality programs using IREX for standing postural control during 4 weeks (4 times/week, 30 minutes/time). Subjects were assessed for static and dynamic balance parameters using BPM, functional balance using Berg Balance Scale related to movement of paretic lower limb before and after 4 weeks of virtual reality training. The results of this study were as follows. 1. Following VR training, VR group demonstrated the marked improvement on dynamic mean balance, anteroposterior limits of stability (AP angle) and mediolateral limits of stability (ML angle). 2. Following VR training, both groups scored higher on Berg Balance Scale. However, a comparison of mean change revealed differences between groups. In conclusion, these data suggest that the postural control training using VR programs improve dynamic and functional balance performance in chronic hemiplegic stroke patients.

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