• Title/Summary/Keyword: rehabilitation after stroke

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The Effect of Task-Oriented Training on Upper Extremity Function, and Activities of Daily Living for Stroke Patients - Comparative of Group Training and Individual Training - (과제 지향적 훈련이 뇌졸중 환자의 상지 기능, 인지 기능과 일상생활 수행에 미치는 효과 - 개별 훈련과 집단 훈련의 비교 -)

  • Park, Eun-Jung;Yoo, Chan Uk;Yong, Mi Hyun
    • Therapeutic Science for Rehabilitation
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    • v.2 no.2
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    • pp.47-59
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    • 2013
  • Objective : This study is conducted to find the influence on upper extremity function, cognitive function and activities of daily living when stroke patients receive task-oriented training in group or individually. Methods : Twenty-six inpatients are assigned to two groups(task training group and individual training group) randomly, who receive rehabilitation therapy after stroke diagnosis for 5 months(june to november, 2012) in a hospital. Both groups receive a task-oriented training for 30 minutes a day for 3 weeks. FMA were used to measure upper extremity function, K-MMSE were used to measure cognition, and MBI for ADL. Results : Before training. two groups were not different significantly in upper extremity function and cognitive function. But in activities of daily living, bathing self(p<.001), feeding, personal hygiene and total score(p<.05) are higher in group training group. After training, upper extremity function is higher in individual training group(p<.001). In both training group, upper extremity function, feeding, personal hygiene, bathing self, dressing, toilet, chair/bed transfers, ambulation and stair climbing, total score are improved significantly(p<.05). In comparing of variation before and after training, upper extremity function(p<.001), feeding and total score of activities of daily living are more improved significantly in individual training group(p<.05). Conclusion : The outcome shows that task-oriented training can improve upper extremity function and activities of daily living in both training group. Especially, the more upper extremity function is improved, the more activities of daily living is improved. In the future, it will be necessary longitudinal study for a long time for more patients.

Effect of taping method on ADL, range of motion, hand function & quality of life in post - stroke Patients for 5 weeks (테이핑요법이 재가 뇌졸중환자의 일상생활동작, 근관절각도, 손기능에 미치는 효과)

  • Kim, Keum-Soon;Seo, Hyun-Mi;Lee, Hae-Derk
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.1
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    • pp.7-17
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    • 2002
  • The purpose of this study was to investigate the effect of taping therapy on activities of daily livings (ADL), hand function and range of motion in poststroke-hemiplegic patients. Sample were selected from 20 poststroke-hemiplegic patients at public health center in the period from September 5 to November 21, 2001. The research design was one group pretest-posttest design. The hemiplegia period of the participants was from one year to five years. The pretest and posttest included measuring activity of daily livings(ADL), instrumental activity of daily livings(IADL), hand function, range of motion, quality of life. In this research design, a treatment were to expose taping therapy who were received self-help management program. This self-help management program was composed of five sessions and each session had health education on stroke, diet, risk factor, ROM exercise and recreation. 20 patients were treated with kinesio taping(Nippon Sigmax Co., Ltd., Benefact(r), width 50mm). Tapes were applied to the Deltoid, Supraspinatus, Infraspinatus, Brachioradialis with paralyzed upper extremity. The taping therapy was performed once a week for 5 weeks. SPSS Win 8.0 was used for the data analysis. The results of this study were as follows: 1) The score of BADL was increased from 30.5 to 33.95 after program, and that was statistically significant(p=.019). 2) The score of IADL was increased from 11.6 to 12.75 after program, but that was statistically insignificant(p=.161). 3) The score of hand function was increased from 17 to 20.35 after program, and that was statistically significant(p=.026). 4) The shoulder's ROM(p=.000) and wrist's ROM(p= .004) were significantly increased. According to the results of this study, taping therapy is effective for improving ADL, hand function, ROM, quality of life. However, this study found no significant differences in IADL. Consequently, these findings showed that the taping therapy was effective in improvement of physical aspects(BADL, hand function, upper extremity's ROM) in poststroke-hemiplegic patients.

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Effects of Backward Walking Training in the Gait ability and Foot Pressure of Hemiplegia Patients (편마비 환자의 후방보행훈련이 보행능력과 족저압에 미치는 영향)

  • Lee, Byung-Hoon;Jeong, Jin-Gyu;Kim, Chan-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.12
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    • pp.7259-7265
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    • 2014
  • This study examined the gait ability and foot pressure after backward walking training in hemiplegia patients after stroke to provide evidence for the application of backward walking to the rehabilitation of those patients. Twenty hemiplegia patients hospitalized at one rehabilitation hospital were enrolled in this study, which was conducted from 23 April to 18 May, 2012. The subjects were randomized into either the experimental group or control group. The control group received general physical therapy for 30 minutes and the experimental group received 20 minutes of physical therapy and 10 minutes of backwards walking training five times a week for four weeks. The gait ability and foot pressure of both feet were measured quantitatively and compared. The results showed the weight bearing (entire foot, anterior and posterior of foot) of the paralyzed foot during the stance phase showed a significant difference (p<.05). The difference in the foot pressure of right and left feet was more significant in the experimental group than that of the control group (p<.05). Therefore, this study confirmed that backward walking training in a rehabilitation program would be helpful for improving the gait ability of hemiplegia patients after stroke.

Effects of the trunk stabilization exercise on muscle activity in lumbar region and balance in the patients with hemiplegia (중추신경발달치료를 이용한 몸통 안정화 운동이 뇌졸중 환자의 허리부위 근 활성도와 균형에 미치는 효과)

  • Shim, Hyun-Bo;Cho, Hwi-young;Choi, Won-Ho
    • The Journal of Korean Physical Therapy
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    • v.26 no.1
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    • pp.33-40
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    • 2014
  • Purpose: The aim of this study was to identify the effects of the lower trunk stabilization exercise using neurodevelopmental technique (NDT) on muscle activity in lumbar region and balance in the patients with hemiplegia. Methods: Fifteen participants were allocated in two groups: NDT group (n=8) or control group (n=7). NDT group performed NDT exercise program, while control group conducted walking exercise. Both interventions were given for 30 minutes a day, 3 times a week, for 5 weeks. To measure the muscle activity in rectus abdominis (RA), external oblique (EO) and internal oblique (IO), electromyography (EMG) was used. And, Timed-Up and Go (TUG) test and Berg-Balance Scale (BBS) were performed to assess balance before and after intervention. Results: NDT group showed a significant improvement of muscle activity in RA and EO, while control group did not show significant changes in three muscles. Also, there was a significant difference in muscle activity of RA and EO between two groups. In BBS and TUG test, participants in two groups showed significant improvements after intervention. Especially, significant difference was observed in TUG test between two groups (p<.05). Conclusion: This study demonstrated that NDT exercise is an effective intervention to improve the muscle activity in trunk region and to increase balance in patients with stroke. Thus, we suggested that NDT exercise program would be a treatment intervention in stroke rehabilitation.

Review of Prevention of Hemipelegic Shoulder Subluxation After Stroke (뇌졸중 편마비환자의 견관절 아탈구 예방에 관한 고찰)

  • Han, Jin-Tae;Kweon, Oh-Hyun;Shin, Hyung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.243-250
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    • 2007
  • Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

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Three Case Reports of Postural Instability and Gait Difficulty in Parkinson's Disease Patients Treated with Korean and Western Medicine (파킨슨병 환자의 자세 불안정과 보행장애에 대한 한양방 복합치료 3예)

  • Lee, Young-Eun;Lee, Dong-Hyuk;Lee, Ji-Hyun;Lu, Hsu-Yuan;Cho, Seung-Yeon;Park, Jung-Mi;Ko, Chang-Nam;Bae, Hyung-Sup;Park, Seong-Uk
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.40-47
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    • 2014
  • Objectives : Postural instability and gait difficulty(PIGD) can develop in all Parkinson's disease patients, especially late in the disease course, but does not respond well to conventional dopamine treatment. This study aimed to report three cases of PIGD in Parkinson's disease patients treated with Korean and Western medicine treatment. Methods : We used acupuncture, bee venom acupuncture, herbal medicine and moxibustion to treat patients during hospitalization. They continued Western medication and received rehabilitation treatment. We observed the changes of PIGD using the Unified Parkinson's Disease Rating Scale(UPDRS). Results : After treatment, PIGD symptoms improved and UPDRS scores were decreased. Especially, scores of falling, walking, gait and postural stability subsections related with PIGD were decreased. In addition, general conditions of patients were improved. Conclusions : This study suggests that Korean medicine treatment could be effective in the treatment of PIGD in Parkinson's disease patients.

The Effect of Task-Oriented Training After Botulinum Toxin Injection on Upper Extremity Function and Activities of Daily Living For Patients with Stroke: Case Study (보툴리눔 독소 주사 후 과제 지향적 훈련이 뇌졸중 환자의 상지기능 및 일상생활활동에 미치는 효과: 사례연구)

  • Lee, Min-Jae
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.67-75
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    • 2016
  • Objective : This study was examined the effects of task-oriented training therapy after botulinum toxin injection, upper extremity function and activities of daily living for stroke patient. Methods : The subject was a 44 year old male who suffered from hemiplegic patient received a task-oriented training therapy after botulinum toxin injection on involved upper extremity for 30-min sessions 5 times every week during 8 weeks. The scores were obtained before the injection, at 4 weeks, and 8 weeks after the injection. The upper extremity function was assessed using a Manual Function Test and Box and Block Test, and also Modified Barthel Index was applied for evaluation of Activities of Daily Living performance ability. Results : The results of this study show that the subject's In-hand manipulation and dexterity function increase significantly. Also, In activities of daily living, personal hygiene area, feeding area, toilet area, dressing area scores are improved significantly. Conclusion : Through this study, task-oriented training after botulinum toxin injection can improve upper extremity function and Activities of Daily Living performance ability of patient with stroke.

Effects of Coptidis Rhizoma on the Anti-inflammation and Motor Recovery in Photothrombotic Brain Infarction Model in Rats (광화학적 뇌경색 백서 모델에서 황련의 항염증 및 운동기능 회복에 미치는 효과)

  • Lee, Su-Kyung;Lee, In;Shin, Sun-Ho;Kim, Eun-Young;Shin, Byung-Cheul
    • The Korea Journal of Herbology
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    • v.24 no.1
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    • pp.179-189
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    • 2009
  • Objectives : Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it's mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods : Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-$\alpha$, IL-6, IL-1$\beta$), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results : CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1$\beta$, IL-6 and TNF-$\alpha$. In serum, CR 500 decreased the amount of IL-1$\beta$, 12h, 24h and 48h respectively (p < 0.05), also decreased that of IL-6 and TNF-$\alpha$, 12h respectively (p < 0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions : This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.

The Effects of Mirror Therapy with Functional Electrical Stimulation Therapy on Upper Extremity Motor Function and Activities of Daily Living for the Stroke Patients (뇌졸중 환자에 대한 기능적 전기 자극치료를 병행한 거울치료가 상지 기능수행과 일상생활활동에 미치는 효과)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.3
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    • pp.123-130
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    • 2018
  • Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.

Report on the Korean Standard Pattern Identifications for Stroke-III (한의 중풍변증표준안-III에 대한 보고)

  • Lee, Ju-Ah;Lee, Jung-Sup;Kang, Byung-Kab;Ko, Mi-Mi;Mun, Tae-Ung;Cho, Ki-Ho;Bang, Ok-Sun
    • The Journal of Internal Korean Medicine
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    • v.32 no.2
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    • pp.232-242
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    • 2011
  • Objectives : The purpose of this study was to develop the Korean standard pattern identifications for stroke-III (KSPIS-III). KSPIS-III includes 4 major pattern identifications (PIs) and clinical indicators for each. Methods : To extract the indicators for 4 major PIs, we analyzed 1548 clinical data from 15 traditional Korean medicine hospitals. Patients got acute stroke within 30 days from onset. Two physicians independently checked 65 indicators and performed pattern diagnosis. If the PI were diagnosed the same, PI would be confirmed. First we built an assumption model that set up the relationship among pattern identifications. Second, we extracted the indicators for fire-heat pattern and qi deficiency pattern by comparison between excessive and deficiency group, heat and non-heat group. By comparing yin deficiency pattern and 3 other patterns respectively, we extracted the indicators for yin deficiency pattern. Dampness-phlegm pattern indicators were extracted by the same method. Results : After cross tabulation with 65 indicators on the basis of our assumption model, we finally extracted 19 indicators for fire-heat pattern, 11 for qi deficiency pattern, 7 for yin deficiency pattern, and 7 for dampness-phlegm pattern. Conclusions : KSPIS-III was more improved than KSPIS-II because it was based on more clinical data. Further study to establish the PI diagnostic model would be required for practical use in the clinical field.