• Title/Summary/Keyword: post-stroke rehabilitation

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The Effects of Robot-Assisted Gait Training for the Patient With Post Stroke: A Meta-Analysis (뇌졸중 환자에게 적용한 로봇보행 재활훈련의 효과: 메타분석)

  • Park, So-Yeon
    • Physical Therapy Korea
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    • v.22 no.2
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    • pp.30-40
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    • 2015
  • Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

The Effects of Visual·Auditory Rhythmic Stimulation(VARS) in Static Balance and Dynamic Balance with Chronic Stroke Patients (시·청각리듬자극이 만성 뇌졸중 환자의 정적균형과 동적균형에 미치는 영향)

  • Cho, Namjeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.4
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    • pp.9-14
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    • 2013
  • Purpose : The purpose of this study was to investigate the effect of visual Auditory rhythmic stimulation(VARS) in gait ability and proprioception with chronic stroke patients. Twenty-one persons after six months post stroke participated in pre test-post test control. Method : The subjects were randomly assigned to a visual Auditory rhythmic stimulation(VARS) group (n=10) and control group (n=11). Training process was practiced with exercise on thirty minutes a day, three days a week for four weeks. To find out the effect, inspected the FRT(functional reach test) by static balance and TUG(timed up and go test) by dynamic balance. Results : In static balance, FRT distance was significantly different between two group. In dynamic balance, TUG time was significantly different between two group. This study showed that the VARS training increase a balance by postural adjustment of chronic stroke patients more than control group. And so, the VARS training of hemiplegic patients was very important to successive rehabilitation. Conclusion : A continuous examination of VARS training could practical used of physical therapy with exercise.

The Effects of Plantar Foot Pressure and Muscular Activity on Treadmill Gait Training in Stroke Patients (트레드밀 보행훈련이 편마비 환자의 족저압과 하지 근활성도에 미치는 영향)

  • Kim, Eun-Jung;Jung, Jae-Min;Kim, Tae-Ho;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.3
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    • pp.165-174
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    • 2009
  • Purpose:This study was performed for effects of gait training on treadmill and stable surface which influenced on the lower limbs muscular activity needed in gait, plantar foot pressure with hemiplegic patients caused by cerebrovascular accident. Methods:Two groups of adult hemiplegia(n=20) were allocated randomly in this study: treadmill gait training group and control group. The gait training program was provided to experimental groups for 8 weeks (5 times a week). Measurements of pre and post experiment were plantar foot pressure. For measuring muscular activation rectus femoris, biceps femoris, tibialis anterior, gastrocnemius were detected. Results:The results of this study showed that in comparison of pre and post changes of gait training, the treadmill gait training group has noticeable changes than other groups in activity of rectus femoris and tibialis anterior, the control group revealed statistically significant differences in plantar foot pressure Toe2-5, M1, M3, M5, MF area, activity of gastrocnemius. Conclusion:These results mean gait training resulted by treadmill, stable surface provides effective muscle activation and plantar foot pressure with stroke.

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Contralateral Mirror Image Spreading in Post-Stroke Complex Regional Pain Syndrome (뇌졸중 후 복합부위통증증후군에서 반대측 거울상 확산)

  • Byun, Ki Hyun;Hwang, Chang Ho
    • Clinical Pain
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    • v.18 no.2
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    • pp.133-137
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    • 2019
  • The long-term prognosis of complex regional pain syndrome is difficult to predict because of its unclear pathophysiology. The syndrome can spontaneously spread to other regions in the body. We report a case in which a complex regional pain syndrome that occurred in a 75-year-old male patient after a stroke spread to the opposite side.

The Effects of Respiratory Muscle Training on Respiratory Function, Respiratory Muscle Strength, and Cough Capacity in Stroke Patients (호흡근 강화 훈련이 뇌졸중 환자의 호흡기능, 호흡근력과 기침능력에 미치는 영향)

  • Jo, Myeong-Rae;Kim, Nan-Soo;Jung, Ju-Hyeon
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.4
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    • pp.399-406
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    • 2014
  • PURPOSE: The purpose of this study was to examine the effects of respiratory muscle training on respiratory function, respiratory muscle strength, and cough capacity in stroke patients. METHODS: This study used a nonequivalent control group pre-post test design. We recruited thirty-four stroke patients(16male, 18female), who were assigned to intervention (n=17), or control (n=17) groups. Both groups participated in a conventional stroke rehabilitation program, with the intervention groups also receiving respiratory muscle training 20 minutes a day, three times a week, for 4 weeks. Respiratory function (forced vital capacity) and respiratory muscle strength (maximal inspiratory pressure, maximal expiratory pressure) were assessed by spirometry. Cough capacity (peak expiratory flow) was assessed using a peak flow meter. The collected data were analyzed by independent and paired t-tests. RESULTS: The intervention group showed a significant increase in the forced vital capacity (FVC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and peak expiratory flow (PEF) at the end of the program, while the control group showed no significant changes. CONCLUSION: This study showed that respiratory muscle training increased respiratory function, respiratory muscle strength, and cough capacity in stroke patients and prevented a decrease in cough capacity. These findings suggest that respiratory muscle training effect on respiratory function, respiratory muscle strength and cough capacity for rehabilitation in patients with stroke.

The Usefulness of Video Fluoroscopic Swallowing Study in Post-Stroke Dysphagia Patients (뇌졸중 후 연하장애 환자에서 비디오 투시 연하 조영검사의 유용성)

  • Eun, Sung-Jong;Kim, Sung-Gil;Hong, Jea-Ran
    • Journal of the Korean Society of Radiology
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    • v.4 no.3
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    • pp.19-25
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    • 2010
  • Dysphagia is common and serious problems in post-stroke patients. The post-stroke dysphagia with aspiration is associated with dehydration, malnutrition, pneumonia, sepsis and death. Up to date, gag reflex and choking history used to decide the aspiration in clinical. The purpose of this study was to evaluate the aspiration and to choice the proper meal formation using by video fluoroscpic swallowing study(VFSS) with post-stroke dysphagia patients. 58 post-stroke patients and ten normal person participated to perform the VFSS with liquid type, puding, yoplait, rice mixed with barium(Ba). Two rehabilitation medicine doctors and a radiological technologist analysed the phase(oral, pharyngeal, esophageal phase)with video film, and checked the pharyngeal transition time(PTT). 38 patients showed abnormality in pharyngeal phase, 13 patients in oral and pharyngeal phase, 3 patients in oral phase, and 2 patients in pharyngeal and esophageal phase. 43 patients(65.2%) occured the aspiration, but 23 of 43 patients improved by the chin tuck position. Aspiration occured 34 patients in liquid type, 2patients in rice gruel and nothing in boiled rice. After VFSS, 13 of 23 patients change the intaking pathway from nasogastric tube(NGT) to oral, On the contrary with 3 of 42 patients from oral to NGT. Consequently VFSS is clearly effective to evaluate the aspiration with post-stroke dysphagia patients.

Readjustment and Social Support of the Post Hospitalized Stroke Patients (퇴원후 뇌졸중환자의 재적응과 사회적 지지와의 관계분석)

  • ;Samuel Noh;Gerald M. Devins
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.639-655
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    • 1999
  • An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

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The Effect of Lightly Gripping a Cane on Sit-to-stand Transfer in Post-stroke Patients

  • Choi, Young-eun;An, Duk-hyun
    • Physical Therapy Korea
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    • v.24 no.4
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    • pp.54-59
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    • 2017
  • Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was $52.73{\pm}2.13%$ without a cane, $42.75{\pm}3.26%$ with a strong grip, and $43.00{\pm}2.55%$ with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects' centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

A Case Report of Central Post-stroke Pain and Hemiparesis due to Anterior Cerebral Artery and Middle Cerebral Artery Infarction That Improved Following Treatment with Korean Medicine, Including Moxibustion (간접구 중심의 한의복합치료로 전대뇌동맥 및 중대뇌동맥 경색 환자의 중추성 통증과 하지마비에 개선을 보인 증례보고 1례)

  • Seong-hyeon Jeon;Da-dam Kim;Yu-bin Kim;Han-song Park
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.246-258
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    • 2024
  • This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

Comparison of Effects on Static Balance in Stroke Patients According to Visual Biofeedback Methods

  • Kyu-Seong Choi;Il-Ho Kwon;Won-Seob Shin
    • Physical Therapy Rehabilitation Science
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    • v.12 no.3
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    • pp.320-326
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    • 2023
  • Objective: The purpose of this study is to investigate the impact of visual biofeedback methods utilizing pressure sensors on the static balance of stroke patients. Design: Randomized crossover study. Methods: A total of 27 patients with hemiparesis participated in this study. The following three feedback conditions were considered: condition 1 (Knowledge of performance feedback), condition 2 (Knowledge of result feedback), and condition 3 (None feedback). A force plate was used to measure static balance. The total sway length, average sway velocity, x-axis excursion, and y-axis excursion of the center of pressure were measured. One-way repeated-measures analysis of variance was employed for comparisons of variables between each condition. The statistical significance level was set at α = 0.05 for all analyses. Results: There was a significant difference in the static balance results between each feedback condition (p<0.05). In the post-hoc results, it was confirmed that the static balance was significant in the order of knowledge of performance feedback, knowledge of result feedback, and none feedback. Conclusions: When comparing the three conditions, it was observed that knowledge of performance feedback showed the most improved effect on static balance ability. As further research progresses, that this approach could be used as an effective intervention method in clinical settings.