• Title/Summary/Keyword: rehabilitation after stroke

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The Effect of PNF-Based Weight Support Exercise on Weight-Supporting Ability, Fear of Falling, and Stair-Walking Ability of Subacute Stroke Patients (PNF를 이용한 체중지지훈련이 아급성 뇌졸중 환자의 체중지지, 낙상에 대한 두려움 및 계단보행 기능에 미치는 영향 -증례보고-)

  • Kim, Chang-Beom
    • PNF and Movement
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    • v.15 no.1
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    • pp.105-113
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    • 2017
  • Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

The Effect of an Orofacial Exercise Program using PNF on Diadochokinesis in Subacute Stroke Patients with Dysarthria (PNF 구강안면 운동 프로그램이 마비말장애가 있는 아급성 뇌졸중 환자의 교대운동속도와 연속운동속도에 미치는 효과)

  • Won, Young-Sik;Lee, Soon-Hyun;Kim, Kye-Ho;Moon, Jong-Hoon
    • PNF and Movement
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    • v.16 no.3
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    • pp.475-484
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    • 2018
  • Purpose: The aim of the present study was to investigate the effect of a PNF orofacial exercise program on diadochokinesis in subacute stroke patients with dysarthria. Methods: Thirteen subacute stroke inpatients with dysarthria were recruited for the study. All participants were randomly assigned to two groups: an experimental group (n=7) and a control group (n=6). The experimental group performed a PNF orofacial exercise program, and the control group carried out an orofacial self-exercise. Both groups received the treatments 30 minutes per day, 5 days per week, for 4 weeks. The outcome measures were assessed before and after the intervention, including an alternating motion rate (AMR) and sequential motion rate for diadochokinesis. Results: After the intervention, both groups showed significant improvement in diadochokinesis (p<0.05). In the change values for both groups, the experimental group showed a more significant improvement than the control group did in /pə/ of AMR (p<0.05). Conclusion: These findings suggest that PNF orofacial exercise programs may have positive effects on the improvement of diadochokinesis in subacute stroke patients with dysarthria.

Effects of Computerized Neurocognitive Function Program Induced Memory and Attention for Patients with Stroke (전산화 신경인지기능 프로그램(COMCOG, CNT)을 이용한 뇌졸중 환자의 기억력과 주의력 증진효과)

  • Shim, Jae-Myoung;Kim, Hwan-Hee;Lee, Yong-Seok
    • The Journal of Korean Physical Therapy
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    • v.19 no.4
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    • pp.25-32
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    • 2007
  • Purpose: The purpose of this study was to evaluate the effect of computerized neurocognitive function program on cognitive function about memory and attention with stroke. Methods: 24subjects with stroke were recruited. Twelve of subjects received conventional therapy including physical therapy, occupational therapy and language therapy. Another subjects received additional computer assisted cognitive training using Computer-aided Cognitive rehabilitation training system(COMCOG, MaxMedica Inc., 2004). All patients were assessed their cognitive function of memory and attention using Computerized Neurocognitive Function Test(CNT, MaxMedica Inc., 2004) before treatment and 6 weeks after treatment. Results: Before the treatment, two groups showed no difference in cognitive function(p>0.05). After 6 weeks, two groups showed significantly difference in digit span (forward, backward), verbal learning(A5, $A1{\sim}A5$), auditory CPT(n), visual CPT(n)(p<0.05). After treatment, the experimental group showed a significant improvement of digit span(forward, backward), verbal learning(A5, $A1{\sim}A5$), visual span (forward, backward), auditory CPT(n, sec), visual CPT(n, sec), and trail-making (A, B)(p<0.05). Conclusion: Computerized neurocognitive function program would be improved cognitive function of memory and attention in patients with stoke.

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Electromyographic analysis of gait cycle in hemiplegic patients after stroke (뇌졸중 이후 편마비 환자의 보행에서 근전도 분석)

  • Kwon Young-Shil;Jung Byong-Ok;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.11 no.1
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    • pp.129-136
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    • 1999
  • The purpode of this study was to determine the EMG characteristies of 7 subjects with hemiplegic gait receiving therapeautic exercise after stroke. The akin electrode and gait analysis system were used. The normal gait of 6 health volunteers was analysised. The results were following. 1. Gluteus maximus, the extensor of hip joint had high level of activity compared to normal, and had two peak in late stance phase and early Swing phase. 2. Medial hamstring, the flexor of knee joint had low level of activity compared to normal, and had continuous low amplitude pattern. 3. Vastus lateralis, the extensor of knee joint had high level of activity compared to normal, and had not continuous high amplitude. From early stance phase and mid stance phase, activity had high level but after swing phase. similar to normal. 4. Gastrocnemius, plantar flexor of ankle joint had low level of activity compared to normal and had continuous low amplitude. 5. Tibialis anterior, dorsiflexor of ankle joint had similar muscle activity to normal and had continuous low amplitude.

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Pathological Laughing and Crying following Midbrain Infarction: Case Report and Literature Review (중뇌 경색 이후 발생한 병적 웃음과 울음 환자: 증례 보고 및 문헌 고찰)

  • Moon, So-Ri;Park, Seo-Hyun;An, Seon-Joo;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.103-112
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    • 2018
  • Pathological laughing and crying (PLC) is a condition defined by relatively uncontrollable episodes of laughter, crying or both. PLC is an uncommon symptom usually caused by cerebral lesions. Midbrain involvement causing PLC is extremely unusual and the exact mechanism by which this condition develops is poorly understood. We recently experienced a 51-year-old woman who were diagnosed as PLC after midbrain infarction. She was treated by acupuncture, pulsed electromagnetic therapy (PEMT). After 6 weeks treatment, Pathological Laughter and Crying Scale (PLACS), Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) are decreased and Korean version of Modified Barthel Index (K-MBI) is increased. Treatment of traditional Korean Medicine could be effective for stoke rehabilitation including post-stroke PLC. And we have considered mechanism of PLC associated with midbrain lesion, dysfunction of cortex-thalamus-hypothalamus-basal ganglia-mesencephalon and faciorespiratory nuclei pathways, cerebro-ponto-cerebellar pathways and damaged serotonergic neurotransmission can cause this based on recent neurobiology of emotion. To define exact mechanism and find effective treatment, further studies are needed.

Performance of Activities of Daily Living in Adult Hemiplegic Patients (성인 편마비 환자의 일상생활동작 수행능력 평가)

  • Kim, Sang-Su;Kwon, Mi-Ji
    • Journal of Korean Physical Therapy Science
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    • v.2 no.3
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    • pp.645-651
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    • 1995
  • The purpose of study was that the functional gains achieved by stroke patients after rehabilitation in the acute phase have been documented. Sixty stroke inpatients who were at least 3.57 month postonset participated;32 males and 28 females;mean age, 57.4 years. By the classification of diagnosis, 20 subjects were cerebral infarction and 27 subjects were cerebral hemorrhage. Activities of daily living(ADL) performance was investigated using the Klein-Bell ADL Scale. ADL test was practiced within physical therapy room. The outcome variables were first analyzed using frequency statistics. The functional gains of the patients with sex and hemiplegic site were then using an ANOVA. Mean score of dressing, elimination, mobility, bathing/hygiene, eating, and telephone use, 26.6, 56.0, 41.4, 36.5, 82.0, and 56.7. Mean score of total, 43.0. There was no significant difference in sex and hemiplegic site.

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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.

Driving State of the stroke patients after Cognitive Perceptual Assessment for Driving evaluation at the National Rehabilitation Center (국립재활원에서 운전인지평가를 받은 뇌졸중 환자의 운전 실태조사)

  • Lee, J.A.;Choi, H.;Lee, S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.2
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    • pp.117-124
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    • 2013
  • Objective : To investigate the actual driving state of the stroke patients who had assessed CPAD. Methods : We conducted a follow-up survey with 48 stroke patients who had assessed CPAD. First, we reviewed the medical chart and then carried out the telephone survey. Results : Of the 48 subjects, 12 were driving and 36 were not driving. Current drivers' CPAD score, it was 54.13, was higher than non-drivers' CPAD score(p<0.05). Those who passed the CPAD were driving more than who failed(OR=8.3, 95%CI=1.931-35.558). Conclusion : The pass group of CPAD have higher chance of driving than fail group and have lower chance of car accidence than fail group. Thus we can apply the CPAD for driving cognitive evaluation tests.

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Clinical Practice Guideline for acupuncture in Post-stroke urinary retention (뇌졸중후 요저류에 대한 침치료 임상진료지침)

  • Lee, Ji-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Cho, Chung-Sik;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.37 no.1
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    • pp.1-9
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    • 2016
  • Objectives: Objectives : This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with Post-stroke Urinary Retention; PSUR. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUR compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: 4 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUR. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as SP6, CV3, CV6, CV4, SP9, BL28, BL23, BL22, KI3 or BL67, for 15-30 minutes. 20-140Hz frequency and 10-20 minutes of treatment is suggested if electro-acupuncture treatment is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for PSUR.

The Influence of Auditory-Feedback Device Using Wearable Air-Pressure Insole on Spatiotemporal Gait Symmetry in Chronic Hemplegia

  • Heo, Ji-Hun;Song, Changho;Jung, Sangwoo
    • Physical Therapy Rehabilitation Science
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    • v.10 no.3
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    • pp.311-319
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    • 2021
  • Objective: To investigate the effect of emphasized initial contact by using a wearable air-pressure insole to provide auditory-feedback with variations of maximum peak pressure (MPP) of the affected side on spatiotemporal gait parameters and gait symmetry of stroke patients Design: A cross-sectional study Methods: Eighteen stroke patients participated in this study. All subjects walked five trials using an air-pressure insole that provides auditory feedback with different thresholds set on the insole. First, subjects walked without any auditory feedback. Then, the MPP threshold on the affected side was set from 70% and increase threshold by 10% after each trial until 100%. They walked three times or more on the gait analyzer for each trial, and the average values were measured. Before starting the experiment, subjects measured body weight, initial gait abilities and affected side MPP without auditory feedback. Results: Temporal and spatial variables were significantly increased in trials with auditory feedback from air-pressure insole except for non-paralyzed single support time and spatial gait symmetry compared to trials without auditory feedback(p<0.05). Among the four different thresholds, the walking speed, unaffected side single support time, affected and unaffected side stride, and affected side step length were greatest at 80% threshold of maximum peak, while affected single support time, temporal gait symmetry, and unaffected step length were greatest at the maximum peak of 100% threshold. Conclusions: These results indicate that auditory feedback gait using air-pressure insoles can be an effective way to improve walking speed, single support time, step length, stride, and temporal gait symmetry in stroke patients.