• Title/Summary/Keyword: rehabilitation after stroke

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The Relationship Between Postural Control and Functional Performance Ability in Subacute Stroke Patients (아급성기 뇌졸중 환자의 체간 조절과 기능적 수행능력과의 관계)

  • An, Seung-heon;Cho, Gyu-Haeng
    • PNF and Movement
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    • v.10 no.3
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    • pp.7-18
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    • 2012
  • Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

Task-oriented Approach using Percussion Instruments in Chronic Stroke Patients Effect on Upper Limb Function: a Randomized Controlled Trial (타악기를 활용한 과제지향운동이 만성 뇌졸중 환자의 상지 기능에 미치는 영향)

  • Kim, Ju-Hak;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.4
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    • pp.103-116
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    • 2021
  • PURPOSE: This study examined the effects on the upper extremity function, muscle strength, and hand function of a task-oriented training approach using a percussion instrument for patients with chronic stroke. METHODS: Twenty-four chronic stroke patients accompanied with upper extremity hemiplegia were selected for research and were classified randomly into 12 experimental groups and 12 control groups. The experimental group performed a task-oriented approach, and the control group performed upper extremity occupational therapy. Stroke upper extremity test, Jebsen-Taylor Hand Function test, upper extremity muscle strength test, and hand muscle strength test were measured before and after training in the evaluation process. RESULTS: In the upper extremity test and Jebsen-Taylor test, there were no significant differences between the groups. In the upper extremity muscle strength test, there were significant differences in shoulder flexion, internal rotation, and elbow flexion in the experimental group. In the hand muscle strength test, there were significant differences in the grip, tip Pinch, lateral Pinch, and 3-jaw chuck in the experimental group and significant differences in only grip, tip pinch, and lateral pinch in the control group. In addition, there were significant differences in the lateral pinch compared to the amount of change. CONCLUSION: Task-oriented approach using percussion instruments for upper extremity rehabilitation in stroke patients is effective in the upper extremity function and strength, hand function, and strength.

The Effect of Joint Taping and Muscle Taping on Dynamic Balance and Gait in Patents with Chronic Stroke (관절 테이핑과 근육 테이핑이 만성 뇌졸중 환자의 동적 균형과 보행에 미치는 영향)

  • Joo, Mincheol;Lee, Yangjin;Hwang, Junhyun;Kim, Seongryeol
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.2
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    • pp.77-84
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    • 2019
  • Purpose : Elastic taping is a therapeutic method, used for treatment of various musculoskeletal and neuromuscular deficits. However, there is limited evidence, of the effects of ankle elastic taping in neurologic patients. The purpose of this study, was to investigate the effect of elastic taping on gait, in the affected ankle area of chronic stroke patients. Methods : Subjects were randomized to receive 30 chronic stroke patients, who were 6 months old from the date of onset according to screening criteria. Group I showed ankle joint taping, and Group II had ankle muscle taping. Dynamic balance and temporal and spatial gait, were measured before taping application, and after 30 minutes of taping application. Results : Dynamic balance was measured using the Time up & Go test (TUG). There was statistically significant difference, between Group I and Group II (p<.05). There was no statistically significant difference, between Group I and Group II. Temporal and spatial gait were measured using GaitRite. In Group I, there was significant difference, before and after taping (p<.05). In Group II, there was no significant difference, before and after taping (p>.05). There was significant difference in Group I, between Group I and Group II (p<.05). Conclusion : Results suggest that intervention using elastic taping, may have a positive effect, on rehabilitation diversity and function in stroke patients. Based on this, it can be used for rehabilitation of stroke patients. Various studies on the application method, and effect of the application site as well as application time, should be continued with stroke patients.

The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life (뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계)

  • Lee, Dong-Jin;An, Seung-Heon
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.3
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    • pp.257-266
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    • 2011
  • Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

The Effect of Bilateral Arm Training for the Chronic Phase After Stroke in Activities of Daily Living (양측성 상지 활동이 만성 뇌졸중 환자의 일상생활활동에 미치는 영향)

  • Lee, Hyun-Jin;Kwon, Hyuk-Cheol;Chang, Moon-Young
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.36-47
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    • 2013
  • Objective : To identify the effect of bilateral arm training for activities of daily living(ADL) of the chronic phase after stroke. Methods : 20 patients with stroke, randomized to an experimental group(n=10) and a control group(n=10). Both groups received the usual occupational therapy. In addition, an experimental group received an bilateral arm training, 30-min sessions per a day for 6 weeks. The Functional Independence Measure(FIM) was used to evaluate ADL for both groups. Results : First, there is a significant difference before and after receiving the bilateral arm training(p <.05). Second, there are significant differences in all ADL areas of Self-care, Transfer, Social cognition after bilateral arm training(p<.05). Third, there are significant differences in all sub-areas of Self-care, only stairs of Locomotion, and only Problem solving of Social cognition by comparing sub-areas as bilateral arm activity(before and after) and occupational therapy intervention(before and after). Conclusion : Using bilateral arm training for the chronic phase after stroke improved their abilities of ADL. Therefore, there are an expectation to use bilateral activity training for the chronic after stroke clinically and a need of further study about bilateral arm training related to ADL in the future.

Effect of Electric Stimulation Training on Walking Ability of Patients with Foot Drop after Stroke

  • Choi, Jongbae;Ma, Sungryoung;Yang, Jongeun
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1903-1906
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    • 2019
  • Background: Foot drop is a common symptom after stroke and causes walking disorders. Therefore, its proper treatment is important for improving the walking ability of patients with foot drop. Objective: This study aimed to investigate the effects of electrostimulation during walking on the walking ability of patients with foot drop after stroke. Design: Quasi-experial study. Methods: The study enrolled 18 patients with foot drop after stroke. All subjects were assigned to the experimental or control group. The experimental group underwent electric stimulation during walking, while the control group used ankle foot orthoses. Both groups received treatment 20 minutes a day 5 times a week for 4 weeks. Outcome measures were assessed for walking and balance ability using the 10-m walking test (10MWT), 6-min walking test (6MWT), and Timed Up and Go test (TUG) Results: After the intervention, both groups showed significant improvements in 6MWT and TUG results. However, the experimental group showed significantly better improvement on all tests than the control group. Conclusion: The foot drop stimulator effectively improved the walking and balance ability of patients with foot drop after stroke.

A Comparative Study on Recovery of Motor Function in Stroke Patients with Corona Radiata Infarcts and Intracerebral Hemorrhage

  • Kim, Chung-Sun;Park, Sang-Young;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • v.22 no.6
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    • pp.53-58
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    • 2010
  • Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

Effects of Electroacupuncture and Therapeutic Exercise on Skeletal Muscle in the Ischemic Stoke Rats (전침자극과 운동치료가 허혈성 뇌졸중 백서모델의 골격근에 미치는 영향)

  • Yoo, Young-Dae;Kim, So-Youl;Min, Soon-Gyu
    • The Journal of Korean Physical Therapy
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    • v.18 no.3
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    • pp.9-21
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    • 2006
  • Purpose: This study was intended to examine the effects of electroacupuncture and therapeutic exercise on muscle atrophy and exercise function in an ischemic stroke model induced by middle cerebral artery occlusion. Methods: This study selected 120 Sprangue-Dawley rats, 8-week of age, divided them into six groups, and assigned 5 rats to each group. Experiments were conducted for 1, 3 days, 1, and 8 weeks, respectively. Group I was a group of electroacupuncture and therapeutic exercise after inducing ischemic stroke; Group II was a group of therapeutic exercise after inducing ischemic stroke; Group III was a group of electroacupuncture after inducing ischemic stroke; Group IV was a sham group of electroacupuncture after inducing ischemic stroke; Group V was a control group and Group VI was a sham group without ischemic stroke. In each group, changes in weight of muscle and relative muscle of TA muscle, neurologic motor behavior test, histologic observations were observed and analyzed. Results: For the changes in muscle weight of unaffected and affected sides of TA muscle, muscle atrophy was seen in an affected side 3 days after ischemic stroke was induced. There was statistically significant difference in Group I 1 week and 8 weeks after ischemic stroke was induced, compared to Group V (p<0.05). For the changes in relative muscle weight of unaffected and affected sides of tibial anterior muscle, there was significant decrease in each group 3 days after ischemic stroke was induced, compared to Group IV, while there was statistically significant increase in Group I 1 week after ischemic stroke was induced, compared to Group V (p<0.05). For neuologic exercise behavior test, Group I generally had the highest score, compared to other groups. Conclusion: electroacupuncture and therapeutic exercise may improve muscle atrophy and change in histologic observations expression of ischemic stroke rats and contribute to the improvement of exercise function.

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Effect of Mirror Therapy Combined with Lower Extremity Muscle Strength Exercise on Gait and Balance of Patients with Chronic Stroke

  • Kim, Myoung-Kwon;Shin, Young-Jun;Choi, Eun-Hong
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.1
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    • pp.81-88
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    • 2018
  • PURPOSE: The present study aims to determine the effect of lower extremity muscle strength exercise at the non-paralyzed side of patients of stroke using a mirror on gait and balance. METHODS: Subjects were assigned randomly to a group of lower extremity exercise without using a mirror (n=10), a group of lower extremity motion exercise using a mirror (n=10), and a group of lower extremity muscle strength exercise using a mirror (n=10). The exercise is added to a physiotherapy program conducted at the hospital and subjects conducted their designed lower extremity exercises 30 times a day (5 sets), five days per week for four weeks. RESULTS: The study result showed that BBS(Berg balance scale)(p<.05) and TUG(timed up and go test)(p<.05) had a significant difference. In the comparison on gait ability, stride length, step length, step width and single support was a significant difference within two groups using a mirror before and after the intervention(p<.05). CONCLUSION: Conclusively, low extremity motion exercise using a mirror and low extremity muscle strength exercise using a mirror conducted along with general physiotherapy exercises had a positive effect on functions of lower extremity in patients with stroke and the recovery of paralyzed side thereby incurring a significant difference in balance and gait abilities.

Functional Improvement Following Revision Surgery in a Patient with the Dual Disability of a Complicated Residual Limb and Contralateral Hemiplegia: A Case Report

  • Byun, Ki Hyun;Yang, Dong Seok;Jang, Baek Hee
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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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.