• Journal of East-West Nursing Research
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• v.1 no.1
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• pp.82-98
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• 1997

The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.82-89
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• 2010

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

• Journal of Korean Medicine for Obesity Research
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• v.6 no.2
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• pp.17-27
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• 2006

Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.115-125
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• 2010

Objectives : The purpose of this study is to determine the effect of Bee-venom Acupuncture on upper limb spasticity control in stroke patients. Methods : Ten stroke patients with upper limb spasticity were randomly divided into two groups, a Bee-Venom Acupuncture group(group I) and a normal saline group(group II). After 1 week resting phase, this trial was used a cross-over trial. The numbers of Pharmacopuncture treatment were 3 times a week for 3 weeks. Modified Ashworth Scale(MAS), WMFT(Wolf Motor Function Test), The 10-second Test were used for evaluation of spasticity control before experiment, after 1 week, 2 weeks, 3 weeks. Results : Group I showed significant improvement(p<.05) in MAS, WMFT, The 10-second Test. But Group II showed no significant improvement(p<.05) in MAS, WMFT, The 10-second Test. The results showed significant difference in WMFT, The 10-second Test, but no significant difference in MAS between two groups. Conclusions : These results showed that Bee-venom Acupuncture might decrease upper limb spasticity and increase arm motor function in stroke patients. Further studies will be required to examine more cases in the long period for the effect on upper limb in spasticity by Bee-Venom Acupuncture.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• Journal of Korean Physical Therapy Science
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• v.9 no.2
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• pp.17-26
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• 2002

This study is aimed to compare the effect of visuo-perceptual biofeedback sitting balance training and conventional sitting balance training using Balance Master on stroke patients with that of program in order to analyze the effect it has on dynamic postural balance. The subjects are twenty-four stroke patients who are receiving physical therapy in Ilsan Paik Hospital and can maintain sitting posture by themselves. These patients were divided to control group and experimental group randomly. In order to compare to control and experimental group before and after the balance training, they were tested with Mann-Whitney U test and in order to compared the changes before and after the balance training, they were tested with Wilcoxon signed-ranks test. The results are as follows: we measured the ability of dynamic posture balance control with limit of stability(LOS) test and rhythmic weight shift test. There was an increasing improvement in the ability of dynamic posture balance control of the experimental group that had visuo-perceptual biofeedback sitting balance control training using the Balance Master(p<0.05, p<0.01). According to the results from above, compared to conventional sitting balance training programs, visuo-perceptual biofeedback sitting balance control training using the Balance Master is considered to be a more valuable therapy in balance control improvement and physical function improvement. It is considered that if the weak points are made up, the training with Balance Master will give help to stroke patients and to patients with balance control disabilities and will further more contribute to successful rehabilitation therapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.498-507
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• 2020

The purpose of this study was to examine the effects of thoracic flexibility exercise on sitting balance, static standing balance, gait parameters, and the fall risk of patients with chronic stroke. The participants were randomized into the control (n=12) and thoracic flexibility exercise groups (n=12). Both groups received standard rehabilitation therapy for 30 minutes per session. The subjects in the experimental group performed additional thoracic flexibility exercises 3 times a week for 6 weeks. The trunk impairment scale, static standing balance, gait speed, cadence, and fall risk were assessed for all the participants before and after the intervention. The thoracic flexibility exercise group showed greater improvement than did the control group on the trunk impairment scale (t=-3.57, p=.002), static standing balance (t=5.37, p<.001), gait speed (t=-3.29, p=.003), cadence (t=-2.77, p=.011), and fall risk (t=6.33, p<.001). Furthermore, the thoracic flexibility exercise group significantly improved all the outcomes compared to the baseline values (P<.05). This study showed that the thoracic flexibility exercise improved the functional ability of patients with chronic stroke.

• Journal of Life Science
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• v.19 no.9
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• pp.1299-1303
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• 2009

The purpose of this study was to analyse the gait characteristics of stroke patients walking on a Zebris system, through quantitative three-dimensional biomechanical analysis. They underwent a continuous rehabilitation training program (RTP). A comparison was made between 3 month and 6 month RTP participants. Their ages were between 60 and 65. The data were analyzed by t-test. The result of comparative analysis of the two groups can be summarized as below. Temporal-spatial data, sagittal plane angular kinematics data, and peak ground reaction force and max pressure data showed that there were no significant differences between the 3 month RTP group and the 6month RTP group (Table 2, Table3, Table 4). It can be suggested that patients with hemiplegia after stroke can improve their walking function through continuous RTP participation.

• Journal of Music and Human Behavior
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• v.11 no.1
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• pp.1-19
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• 2014

The purpose of this study was to investigate the immediate effect of Patterned Sensory Enhancement (PSE) technique on the motor function of the affected upper limb in hemiplegic stroke patients by comparing the use of PSE and simple rhythmic cue. A total of 16 stroke patients were recruited from rehabilitative hospitals. The participants were assigned to the experimental group (n = 8) and control group (n = 8). While performing six different upper limb motions, musical stimuli applying the PSE technique was presented for the experimental group and simple rhythmic cue using the metronome was applied for the control group. The results showed that while the significantly increased range of motion (ROM) was found in the experimental group with the immediate use of PSE (p < .05), the control group did not show no significant change. This study implies that the use of musical elements in cueing for upper limb motion immediately leads to significant improvement in ROM by providing sufficient temporal, spatial, and dynamic information for expected motor performance.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.2
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• pp.85-96
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• 2016

Objectives This study was performed to evaluate the effects of acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy on upper extremity of healthy people and hemiplegic patients by D.I.T.I.. Methods 20 healthy people and 20 hemiplegic patients caused by stroke were selected. They have been treated three different types of treatment; acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy. And skin temperature of upper extremity has been measured before and after each treatment by D.I.T.I.. The thermographic data was analyzed by 'Independent T-test' and 'Repeated measures ANOVA test'. Results 1. In healthy group, there was very statistical significant difference (p<0.001) of the amount of thermal change by each treatment, and the amount of change was arranged in descending order; acupuncture with pulsed electromagnetic, acupuncture and electro-acupuncture. 2. In hemiplegic group, the skin temperature of hemiplegic side was $0.97^{\circ}C$ cooler than non-hemiplegic side. 3. Skin temperature of all hemiplegic patients was increased after acupuncture treatment. 4. In hemiplegic group, there was statistical significant difference (p<0.05) of the amount of thermal change by each treatment, and the amount of change was arranged in descending order; acupuncture with pulsed electromagnetic, acupuncture and electro-acupuncture. Conclusions The results indicate that acupuncture, electro-acupuncture and acupuncture with pulsed electromagnetic therapy had good effect on the change of skin temperature by stimulating sympathetic nervous system.