• 제목/요약/키워드: rehabilitation after stroke

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A case report of the intervention strategy & documentation in a patient with post stroke applied a International Classification of Functioning, Disability and Health (ICF를 적용한 뇌졸중 환자의 문서 기록과 중재 전략의 실례)

  • Lee, Sun-Ui;Kim, Tae-Yoon
    • PNF and Movement
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    • v.8 no.2
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    • pp.57-67
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    • 2010
  • Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

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Effects of Proprioceptive Neuromuscular Facilitation Neck Flexion Exercise and the Shaker Exercise on the Activities of the Suprahyoid Muscles in Chronic Stroke Patients with Dysphagia

  • Hwangbo, Gak;Kim, Kyoung-Don
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.43-50
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    • 2018
  • PURPOSE: The purpose of this study is to examine the effect of proprioceptive neuromuscular facilitation (PNF) neck flexion exercise and the Shaker exercises on the activity of the suprahyoid muscles in chronic stroke patients with dysphagia and to show what exercise methods are effective for swallowing rehabilitation. METHODS: This study was conducted at F hospital in Daegu from August 2014 to February 2017 with 60 participants who understood the purpose of the study and desired to participate. The 60 participants were randomly divided into an experimental group (PNF neck flexion exercise) (n=30) and a control group (Shaker exercise) (n=30). PNF neck flexion exercise was performed in the experimental group and the Shaker exercise was performed in the control group for 30 minutes, 5 times a week for 6 weeks. The activity of the suprahyoid muscles was measured before and after treatment. RESULTS: Both the experimental group and the control group showed a statistically significant change in the activity of the suprahyoid muscles before and after the treatment. The changes were also statistically significant when compared by group. CONCLUSION: In conclusion, PNF neck flexion exercise should be used in addition to Shaker exercise when rehabilitating a patient with a swallowing disability.

The Effects of Robot Assisted Gait Training on Kinematic Factors of the Stroke Patients (로봇보조 보행훈련이 뇌졸중 환자의 운동학적 요인에 미치는 효과)

  • Kim, Sung-Chul;Kim, Mi-Kyong;Yang, Dae-Jung
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.91-99
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    • 2022
  • Purpose : The goal of this study is to examine the effect of robot assisted gait training (RAGT) on the kinematic factors (temporospatial gait parameters, gait cycle ratio, and gait line length) of gait in stroke patients. Methods : The subjects of this study were 24 stroke patients selected by inclusion criteria. Participants were randomly allocated to two groups: robot assisted gait training (n=11) and general neurological physical therapy group (n=11). In the robot-assisted gait training group, robot-assisted gait training was mediated for 30 minutes a day in addition to general neurological physical therapy. The general neurological physical therapy group was mediated by general neurological physical therapy for 30 minutes a day in addition to general neurological physical therapy. The number of interventions was 5 times a week for 5 weeks. In order to compare the kinematic factors of walking between the two groups, gait analysis was performed before and after 5 weeks of training using the Zebris gait analysis system. Results : As a result of the gait analysis of the two groups, there were significant differences in temporospatial gait variables (step length, stride length, step width, step time, stride time), gait cycle ratio (swing phase, stance phase) and gait line length. However, there was no significant difference in the cadence (temporospatial gait parameters) in the robot assisted gait training group compared to general neurological physical therapy group. Conclusion : It is considered to be a useful treatment for stroke patients to promote the recovery of gait function in stroke patients. Based on the results of this study, continuous robot assisted gait training treatment is considered to have a positive effect on gait ability, the goal of stroke rehabilitation. In the future, additional studies should be conducted on many subjects of stroke patients, the kinematic factors of the legs according to the severity of stroke and treatment period, and the effect of gait training.

The Effects of Treadmill Obstacle-Stepping on Physical Activity in Ambulatory Patients After Stroke

  • Kim, Jeong-soo;Jeong, Yeon-gyu
    • Physical Therapy Korea
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    • v.22 no.4
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    • pp.71-78
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    • 2015
  • Previous studies have investigated stepping over obstacles in treadmill walking training (TWT-OS) and treadmill walking training (TWT) alone for walking capacity not considering real physical activity. As such, we investigated the effects of TWT-OS on physical activity and changes in different levels of physical activity based on community ambulation in stroke patients. Thirty subjects were randomly assigned to either the experimental group or the control group, with 15 and 15 subjects, respectively. However, one subject from the control group was excluded because of inadequate treatment sessions. All subjects underwent routine physical therapy in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-stepping while walking on the treadmill for 30 min/day, five times/week, for four weeks. Subjects were given a three-axis accelerometer to wear at the hip on a belt for one-week pre- and post-training physical activity. Step counts for seven days, average daily step counts, and the average of minutes spent in sedentary, light, and above moderate activity were chosen as outcome measures of physical activity. No significant differences between the groups were found in terms of step counts for seven days, average daily activity, or daily activity spent at sedentary levels after four-week interventions. However, the average daily activity spent at light levels (-42.60 min vs. -6.71 min) was significantly lower in the experimental group than in the controls. Conversely, average daily activity spent at above moderate levels was higher (19.86 min vs. 11.07 min) (p<.05) after adjusting for each baseline value. Significant pre- and post-training differences were found in all variables of the experimental group (p<.05). Thus, TWT-OS could improve physical levels above moderate activity as a community-oriented task more than simple repetitive waking on a treadmill, and it could provide an opportunity for patients ambulatory after stroke to participate in the community again.

Relationships among Activity of Daily Living, Depression, and Quality of Life(QOL) in Patients with Stroke (뇌졸중 환자의 일상생활동작, 우울과 삶의 질의 관계)

  • Kim, Won-Ock;Kang, Hyun-Sook;Wang, Myoung-Ja;Kim, Jeong-Hwa;Choi, Jin-Yi
    • Journal of East-West Nursing Research
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    • v.13 no.2
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    • pp.138-146
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    • 2007
  • Introduction: The purpose of this study was to examine relationships among stroke patients' activities of daily living(ADL), depression, and quality of life(QOL). Methods: Data were collected by questionnaires from 251 stroke patients at 5 hospitals and 2 public health centers in Seoul and Kyonggi-Do. The following Questionnaires were utilized for this study: Functional independence measure(FIM) from Grange, Hamilton, and Sherwin(1986), the Korean CES-D scale from Randloff(1977), and quality of life scale from Bang, Hwal-Lan(1991). Results: Data were analyzed using the pearson correlation, t-test, and ANOVA with SPSS/WIN 12.0. The results of this study were as follow; The subjects consisted of 110 fern ales and 141 m ales. The mean score of activity of daily living was 87.2(range 18-126). Age, family history, comorbidity, paralysis site, and duration after diagnosis were significantly associated with activity of daily living. The mean score of depression was 23.8(range 11-44). Age, gender, education, and job were significantly associated with depression. The mean score of quality of life scale was 3.0(range 1-5). Gender, religion, education, job, economic status, and duration after diagnosis were significantly associated with quality of life. Relationships among activity daily living, depression, and quality of life scale: The activity of daily living had a negative relationship with depression score. The activity of daily living had a positive relationship with QOL score. The depression had a negative relationship with QOL score. Conclusion: Based on these results, it is necessary to run rehabilitation programs to improve stroke patients' ADL, depression. Also, it research for of identifying stroke patients' quality of life according to rehabilitation program.

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Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke (국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석)

  • Yoo, Eun-Young;Park, Ji-Hyuk;Kwon, Jae-Sung;Cho, Sang-Yoon;Lee, Bo-Mi;Kim, Yeong-Jo;Kim, Jae-Nam;Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.79-88
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    • 2018
  • Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.

Effects of a Tongue Self-Resistance Exercise on the Swallowing Function of Patients With Stroke: Case Report (자발적 혀 저항 운동이 뇌졸중 환자의 삼킴기능에 미치는 효과: 사례연구)

  • Nam, Kyung-Wan
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.43-55
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    • 2018
  • Objective: This study aims to discover how tongue self-resistance exercise affects the swallowing function of patients with stroke. Method: The subjects of this study were two patients who were treated at the Y hospital in Gyeonggido. Data were gathered by VFSS regarding the degree of swallowing disability and oral intake before and after intervention. This study analyzed case studies of two patients. One patient's intervention was applied in September 2012 for three weeks. The other's intervention was applied in February 2014 for three weeks. At the first session, the VFSS examination was administered. Then, intervention began after the patients gave their consent for participation. Each session was practiced 10 times per set, but one session had 3 sets. Intervention frequency consisted of five sessions per week, and it was conducted for three weeks. Tongue self-resistance exercise included tongue protrusion, tongue lateralization, and tongue elevation on the hard palate. Results: The first tongue self-resistance exercise had a positive effect on swallowing function because of the decrease in VFS score. The second tongue self-resistance exercise showed improved oral intake based on FOIS scores. Conclusion: This study's results suggest that there are many benefits of tongue self-resistance exercise on the swallowing function when it is applied to patients with stroke.

Occurrence of Constipation during the Rehabilitation Stage in Patient with Cerebral Vascular Disease (뇌손상 환자의 재활단계 변비발생과 영향요인)

  • Shin, Dongsoon;Kim, Sunglim;Jang, Insook;Kim, YoungJi;Han, Joohwan;Kim, Eunyoung;Do, Naryeong;Song, Youngshin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.3
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    • pp.200-208
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    • 2017
  • Purpose: The purpose of this study was to investigate the occurrence of first onset of constipation during the rehabilitation stage and risk factors for constipation in patients with cerebral vascular disease (CVD). Methods: Participants for this retrospective study were 214 CVD patients admitted to rehabilitation units. First onset of constipation and factors influencing constipation such as dependency level were recorded for 14 days during the rehabilitation stage. Survival analysis with Cox proportional hazard model and descriptive statistics were conducted. Results: Age, patients' severity, types of diet, and dependency level were different between constipation and non-constipation groups. In survival analysis, 99% of participants developed constipation within 14 days after admission to rehabilitation units. Median constipation occurrence time was 7.4 days. Patients who were immobile and had tube feedings were more likely to develop constipation 4.07 times (95% CI: 1.018~16.301, p=.047) and 2.09 times (95% CI: 1.001~4.377, p=.050) respectively compared to patients who were independent and had a regular diet, respectively. Conclusion: Most CVD patients experienced constipation within 2 weeks after entering the rehabilitation stage. Constipation was linked to types of diet and dependency level. These factors associated with constipation should be considered when caring for patients in rehabilitation.

The Effects of Ward Exercise Program on the Improvement of Activity of Daily Living in Patients Who have Stroke (뇌졸중환자의 일상생활동작 증진을 위한 침상운동 프로그램의 효과)

  • Sok So-Hyune;Kang Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.87-101
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    • 1995
  • This study was conducted with the subject of showing the importance of early rehabilitation and exercise therapy in patients who have stroke, of confirming the adavntage of ward exercise conducted by nurse, which had been conducted mainly by physical therapist only in physical thrapy room and of developing the exercise program as the independent rehabilitation nursing intervention. A total of 62 patients were selected as object from April, 5th, to May, 17th, 1995, who had been hospitalized in K medical center, and the half of them were assigned to Experimental group in ramdom assignment using a coin. It was ADL check list tool developed by Kang and Ward Exercise Program developed by the researcher that were used as a treatment. Ward Exercise Program was conducted by the reseacher and the physical therapist measured ADL score before and after Ward Exercise Program. The data were analyzed using ANOVA, pearson correlation, Chi-Square test and the effect of Ward Exercise Program was analyzed by t-tast. The result of this study is as follows. 1. The experimental group showed eminent improvement of ADL compared with the counter group with statistical significance. In eating(t=6.10, df=60, p=.000), personal hygiene performing(t=4.86, df=60, p=.000), wearing(t=5.86, df=60, p=.000), elimination(t=7.89, df=60, p=.000), mobility on the bed(t=13.36, df=60, p=.000), moving(t=9.11, df=60, p=.000), walking(t=7.45, df=60, p=.000) 2. There was no qualitative difference between experimental group and control group with the significance of $p{\le}.05$. 3. There was no relation between the general condition and the difference of ADL, while there was significant relation between the starting point of exercise and the difference of pre-exercise and post exercise ADL. As a result, it should be emphasized that the early rehabilitation and exercise therapy are important in patients who have stroke, and that it is necessary to extend the exercise therapy to the ward. Therefore, this Ward Exercise Program could be recommended as a independent clinical exercise nursing intervention in rehabilitation nursing of patients who have stroke.

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The Effect of Smartphone Video Educational Program on Educational Satisfaction of Patients in Rehabilitation Units at a University Hospital (스마트폰 동영상 교육 프로그램이 일개 대학병원에서의 재활병동 입원환자 교육 만족도에 미치는 영향)

  • Jung, Kyeong- Man;Joo, Min-Cheol;Jung, Yu-Jin;Kim, Hee-Han;Lee, Kyeong-Hwa;Lee, Dong-Sun;Choi, Jun-Wan
    • Quality Improvement in Health Care
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    • v.23 no.1
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    • pp.43-53
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    • 2017
  • Purpose: This study was to determine the effect of a smartphone video educational program on educational satisfaction of patients in rehabilitation units at a university hospital. Methods: The subjects of this study were 60 stroke patients recruited and divided into two groups; experimental group (n=30) and control group (n=30). Subjects in the experimental group and control group conducted conventional physical and occupational therapy. In addition, only the experimental group provided smartphone video information for a total of 15 sessions. The video consisted of five episodes (10 minutes each) viewed a total of 15 times (for each video three times). The outcome was assessed by educational satisfaction. Result: After inervention, both groups revealed significant increased awareness of prevention of infection educational satisfaction and prevention from falling educational satisfaction and exercise program educational satisfaction. However, the experimental group was more effective than the control group relative to heightened awareness of increasing prevention of infection prevention from falling and exercise program. Conclusion: We suggest that a smartphone video educational program may be effective in improving awareness of the prevention of infection, prevention from falling, and exercise program educational satisfaction. Therefore, video-based information is beneficial for such patients. Further studies are needed for better understanding of the effectiveness of a smartphone video educational program in rehabilitation units at a university hospital.