• 제목/요약/키워드: rehabilitation after stroke

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Effect of Balance Exercise using a Combination of Isotonics for Proprioceptive Neuromuscular Facilitation on Balance and Walking Ability in Patients with Hemiplegia Due to Stroke

  • Kim, Beomryong;Kang, Taewoo
    • Physical Therapy Rehabilitation Science
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    • 제10권4호
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    • pp.470-478
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    • 2021
  • Objective: This study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) balance exercise on the ability to balance and walk in patients with hemiplegia caused by stroke. Design: A randomized controlled trial Methods: Following baseline measurements, patients (n=24) with hemiplegia caused by stroke were randomized into two groups: the PNF balance group (n=12) that received PNF balance exercise and the balance group (n=12) that received general balance exercise. Each group joined the intervention for 30 minutes, 5 times per week for 6 weeks. Both groups performed the Timed Up and Go test (TUG) and Berg Balance Scale (BBS) for balance, as well as the 10-meter walking test (10MWT) and 6-minute walk test (6MWT) for walking. The data were collected both before and after the intervention. The paired t-test was used to compare the post-intervention changes compared with pre-intervention data. An independent t-test was used to analyze the differences in the dependent variables between the two groups. Results: After the 6-week intervention, both groups showed significant improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) parameters (p<0.05). The patients in the PNF balance group showed greater improvements in balance (TUG, BBS) and walking (10MWT, 6MWT) than those in the balance group (p<0.05). Conclusions: PNF balance exercise shows improvements in balance and walking parameters in patients with hemiplegia caused by stroke.

PNF 목 패턴을 병행한 체간안정로봇훈련이 만성 뇌졸중 환자의 체간 안정성 및 균형능력에 미치는 영향 (The Effects of PNF and Trunk Stabilization Robot Training on Trunk Stability and Balance in Patients with Chronic Stroke)

  • 문현민;김동훈
    • PNF and Movement
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    • 제19권1호
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    • pp.67-77
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    • 2021
  • Purpose: The purpose of the study was to identify the effects of proprioceptive neuromuscular facilitation (PNF) training and robot rehabilitation training on trunk stability and standing balance in individuals with chronic stroke. Methods: There were 30 patients with chronic stroke, divided into two groups: 15 subjects who received PNF and robot training (the experimental group) and 15 subjects who received standard conservative training (the control group), that participated. The experimental group received treatment for 60 min: 30 min of conventional physical therapy, 15 min of PNF training, and 15 min of robot training. The control group received conventional physical therapy for 60 min. Trunk stabilization (trunk impairment scale) and standing balance (center of pressure, limit of stability, modified functional reach test, and Berg balance scale) were measured before and after intervention. Results: Within each group, both the experimental and control groups significantly improved after the intervention in all tests; however, the experimental group showed greater improvement in scores on the trunk impairment scale, the center of pressure, the limit of stability, the modified functional reach test, and the Berg balance scale. Conclusion: The study verified that PNF training and robot training had a positive influence on trunk stability and standing balance indices in patients with chronic stroke.

Effects of Therapeutic Climbing Training on the Balance and Gait Ability in Chronic Stroke Patients

  • Lee, Soin;Ko, Mingyun;Park, Seju
    • 국제물리치료학회지
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    • 제11권3호
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    • pp.2126-2134
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    • 2020
  • Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

뇌졸중 환자를 위한 팀접근 재활프로그램의 효과 (The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors)

  • 조복희
    • 재활간호학회지
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    • 제6권2호
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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Medical Exercise Therapy가 만성 뇌졸중 환자의 보행능력 및 족관절 근활성도에 미치는 영향 (Effects of Medical Exercise Therapy on Walking Ability and Ankle Muscles Activation after Chronic Stroke)

  • 조영환;박종항;김경윤;남기원
    • 대한물리의학회지
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    • 제6권3호
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    • pp.311-321
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    • 2011
  • Purpose : The purpose of this study was to determine effect of Medical Exercise therapy on walking ability and ankle muscles activation after stroke. Method : Participants were randomly divided into either MET training group(n=12) and control group(n=12). All of participants had been receving a traditional rehabilitation program, 5 days a week. MET training group have additionally undergone for six weeks, 3 days a week, the MET program. But control group was not received any additional program except the traditional rehabilitation program. The 10 mWT, F8WT and 2 MWT to measure walking ability were carried out twice before and after training. Muscular activity of the ankle was estimated by analyzing the RMS of action potential for EMG in terms of tibialis anterior muscle(TA), soleus(SO), gastrocnemius medial head(GM), gastrocnemius lateral head(GL). Rresults : At the walking ability, MET training group demonstrated a significant improvememt in the score of the 10 mWT(p<0.001), 2 MWT(p<0.05), but F8WT was not significant improvement(p>0.05). At the ankle muscle activation, MET training group demonstrated a significant improvememt in the RMS of the TA(p<0.01) and SO(p<0.05) but GM(p>0.05) and GL(p>0.05) were not significant improvement. Conclusion : From these results of this study, MET training for 6 weeks has an effect on improvement of walking ability and ankle muscles activation after stroke.

뇌졸중 후유증 환자에서 발병한 견관절 아탈구 치료 2례 (A Clinical cases Study of Shoulder Dislocation in Patients Undergoing Stroke)

  • 한주원;오민석
    • 혜화의학회지
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    • 제17권1호
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    • pp.145-155
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    • 2008
  • Objective: There are some case reports on treatment of shoulder dislocation in Patients Undergoing Stroke. We report the electronic needle and the Bee venom Acupunure Theraphy about under using shoulder dislocation in patients Undergoing Stroke got a good remedial value. Methods : The patients diagnosed as shoulder dislocation and treated mainly with Bee venom Acupunture Therapy and electronic needle Results & Conclusions : Symptoms of the patientes such as shoulder pain, Range Of Motion(ROM) were improved after above treatments. The interval in X-ray film comes to be narrow. So, it is suggested that oriental medical treatment are effective on post stroke with shoulder dislocation.

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Severe MCA Stenosis로 인한 TIA 환자 1례 (A Case Report of a TIA Patient with Severe MCA Stenosis)

  • 윤창준;김종화;이수길
    • 대한중풍순환신경학회지
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    • 제9권1호
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    • pp.54-58
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    • 2008
  • Transient Ischemic Attack(TIA) is an important risk factor of stroke but often underestimated by clinicians. In this case, we administered oriental-western cooperative therapy to a 72 years old female TIA patient with severe MCA stenosis. After treatment, all symptoms were disappeared and has not reappeared until 1 year follow-up.

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가상현실재활시스템 적용에 따른 뇌졸중 환자의 일상생활활동, 인지기능, 자아존중감의 개선효과 (The Effect of The Virtual Reality Rehabilitation System on Activities of daily living, cognitive function, self-esteem in Stroke)

  • 김영근
    • 한국산학기술학회논문지
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    • 제16권8호
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    • pp.5476-5484
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    • 2015
  • 본 연구의 목적은 산학연 공동기술개발사업으로 개발한 가상현실재활시스템이 뇌졸중 환자에게 긍정적인 영향을 주는지 임상 실험으로 알아보고 이를 통해 개발제품의 임상적 사용 가능성을 검증하기 위함이다. 임상실험을 통해 검증하고자 가상현실재활시스템을 재활병원에 입원하고 있는 뇌졸중 24명(뇌출혈 13명, 뇌경색 11명)에게 제공하였다. 실험군(13명)에는 가상현실재활시스템 위주의 훈련을 실시하였고, 대조군(11명)에는 재활치료의 유형인 보편적 기능훈련으로 일상생활활동 훈련, 지필물과 테이블 탑 위주의 인지재활 훈련, 운동조절 훈련을 실시하였다. 실험군과 대조군 모두 주 3회 하루 2회씩 총 8주간 실시하였다. 두 집단 모두 사전사후 기능적 독립 측정(Functional Independent Measure; FIM), 한국형 간이정신상태 검사(Mini-Mental State Examination for Korean; MMSE-K), 자아존중감척도 평가를 실시하였다. 실험결과 가상현실재활시스템을 제공한 집단과 보편적 재활치료를 받은 집단이 일상생활활동, 기초인지, 자아존중감척도에서 유사한 결과를 보였다. 중재 전후를 비교해 본 결과 가상현실재활시스템을 제공한 집단이 중재 전보다 중재 후에 일상생활활동, 기초인지, 자아존중감에서 모두 의미 있는 향상이 있었다(P<.05). 산학공동으로 개발한 가상현실재활시스템이 뇌졸중 환자의 일상생활 기능과 기초 인지능력을 회복시키고, 삶의 만족과 인간행동의 원인이 되는 자아존중감에 긍정적인 영향을 보여 주었기 때문에 가상현실재활시스템의 임상 적용 가능성을 긍정적으로 확인하였다. 추후 연구에서는 가상현실재활시스템을 뇌손상 환자와 치매 환자의 다양한 기능 회복에 대한 임상적 유용성을 검증할 필요가 있다.

뇌졸중환자에서 재원기간과 퇴원장소 예측을 위한 K-MBI의 유용성 (Utility of Korean Modified Barthel Index (K-MBI) to Predict the Length of Hospital Stay and the Discharge Destinations in People With Stroke)

  • 노동국;김경호;강대희;이지선;남경완;신형익
    • 한국전문물리치료학회지
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    • 제14권3호
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    • pp.81-89
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    • 2007
  • The purpose of this study was to utilize the K-MBI (Korean Modified Barthel Index) and subscales of K-MBI in predicting the length of hospital stay (LOS) and the discharge destinations for stroke patients. The study population consisted of 97 stroke patients (57 men and 40 women) admitted to the Seoul National University at the Bundang Hospital. All participants were assessed by K-MBI at admission and discharge after rehabilitation therapy and the information available was investigated at admission. The data were analyzed by using the Mann-Whitney U test, the stepwise multiple regression and the logistic regression. The median LOS was 30 days (mean, 32.8 days; range, 22 to 43 days). The K-MBI score at initiation of rehabilitation therapy (p<.001), the type of stroke and living habits before a stroke were the main explanatory indicators for LOS (p<.05). Within the parameters of K-MBI measured at initiation for rehabilitation, feeding and chair/bed transfer were the explanatory factors for LOS prediction (p<.01). Confidence in the prediction of LOS was 20%. Significant predictors of discharge destination in a logistic regression model were the discharge K-MBI score, sex and hemiplegic side. Dressing in items of discharge K-MBI was the significant predictor of discharge destination. The K-MBI score was the most important factor to predict LOS and discharge destination. Knowledge of these predictors can contribute to more appropriate treatment and discharge planning.

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Effect of two types of muscle contraction training on muscle thickness, strength, and delayed onset of muscle soreness in persons with chronic stroke

  • Lim, Seung-yeop;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • 제7권4호
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    • pp.154-163
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    • 2018
  • Objective: The purpose of this study was to investigate the effects of eccentric contraction training (ECT) and concentric contraction training (CCT) on the muscle thickness (MT), muscle strength (MS) and delayed onset of muscle soreness (DOMS) of the lower extremities in persons with chronic stroke. Design: Randomized controlled trial. Methods: Thirty persons with chronic stroke were randomly assigned to the ECT or the CCT group. The ECT was performed in a specially designed system of eccentric contraction of both legs and, the CCT was performed using a traditional stepper system for concentric contraction of both legs. The training was performed for 30 min/times, 3 times/wk for 6 weeks. Rehabilitation ultrasound imaging was used to measure MT of the vastus medialis/lateralis (VL), and soleus (SOL), a digital muscle tester was used to measure MS, and a visual analog scale was used to assess DOMS. Results: In the ECT group, MT was significantly improved except for SOL resting (p<0.01). In the CCT group, the MT was significantly improved except for VL contraction (p<0.05). The MS was significantly improved in both groups, especially in the ECT group (p<0.01). In the ECT group, muscle soreness was highest in the first week after training but gradually decreased, and in the CCT group, it was highest in the second week of training but gradually decreased (p<0.01). Conclusions: ECT can improve lower limb MT, MS, and DOMS of chronic stroke survivors. Therefore, it is recommended that ECT be used in the rehabilitation of persons with chronic stroke.