• Title/Summary/Keyword: rehabilitation after stroke

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Effect of Arm Sling on Walk Speed and Energy Consumption in Patients with Stroke (팔걸이가 뇌졸중 환자의 보행속도 및 에너지 소모량에 미치는 영향)

  • Yoon, Seoung-Ic;Kim, Yoon-Shin;Shim, Jae-Hun;Oh, Kyung-Ah;Oh, Duck-Won;Chon, Seung-Chul
    • Journal of Korean Physical Therapy Science
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    • v.15 no.1
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    • pp.39-45
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    • 2008
  • This study was undertaken to identify the influence which affect on gait speed and energy consumption regarding putting on arm sling during gait of the 40 hemiplegic patients selected from University Hospital and rehabilitation center in seoul during two months. The analysis of data was performed using the paired samples ttest to compare the differences of gait velocity, heart rate, oxygen consumption and oxygen cost in gait of preand post- arm sling. The results of this study were as follows; 1. When comparing the result before putting on arm sling in the gait of hemiplegic patient, gait velocity after putting on arm sling was statistically significantly increased(p<.05). 2. When comparing the result before putting on arm sling in the gait of hemiplegic patient, heart rate after putting on arm sling was statistically significantly decreased(p<.05). 3. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption per weight after putting on arm sling was statistically significantly decreased(p<.05). 4. When comparing the result before putting on arm sling in the gait of hemiplegic patient, oxygen consumption rate per weight after putting on arm sling was statistically significantly decreased(p<.05). When putting together the above result, the gait with arm sling in comparison with the gait without arm sling was to increase gait velocity, decrease heart rate, decrease oxygen consumption and was finally to decrease energy consumption in the gait of hemiplegic patient.

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The Effect of Shoe Lift of the Paretic Limb on Dynamic Weight Bearing in Hemiplegics (편마비 환자의 신발 높이 조절이 동적체중부하율에 미치는 영향)

  • Yoon, Jung-Gyu;Kim, Byung-Wook
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1073-1080
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    • 2001
  • The purpose of this study was to determine the effect of lift to the shoe of the affected limb on gait patterns in subjects with hemiplegia. The subjects of this study were 18 post-stroke hemiplegics. For the study, insole of the paretic side was lifted 10 mm higher, and duration of dynamic weight bearing was measured. before and after the lift application. For the measurement of carry-over effect of lift, we got data of there three items prior to and 3 weeks after lift application and 3 days after removal of the lift. Dynamic weight bearing was significantly decreased in heel contact and footflat phases only when just after application of the lift, without any change after 3 weeks application. In heel-off phase, dynamic weight bearing did not show any significant difference between before and just after application of lift whereas significantly decreased after 3 weeks application. According to this study, lift applied to the shoe of the paretic limb was not significantly effect in inducing dynamic weight bearing, but changed a dynamic weight bearing.

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The Effects of Task-Oriented Functional Training on Standing Balance in Stroke Patients (과제 지향적 기능 훈련이 뇌졸중 환자의 균형에 미치는 영향)

  • Kim Jae-wook;Kim Soo-min;Park Rae-joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.65-81
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    • 2003
  • The purpose of this study was to investigate the balance of stroke patient appling Task-Oriented Functional training program. Sixteen subjects were recruited from KeiMyung university Dongsan Medical Center inpatient satisfying requirement for this study. They were divided into Task-Oriented Functional training group and Conventional therapy group. They were measured by Sensory organization test and Motor control test items using EquiTest Version 8.0 machine before and after the test. The result of this study were to follow: 1. In Sensory organization test, there were no significant differences in static eguibrium score in both groups(p<.05). 2. In Sensory organization test, there were significant differences in dynamic eguibrium score in both groups(p<.05). 3. In Motor control test, there were significant differences in both groups(p<.05). 4. In exercise group, there were no significant differences in static Sensory organization test(p<.05). 5. In exercise group, there were significant differences in dynamic Sensory organization test(p<.05). 6. In exercise group, there were significant differences in Motor control test(p<.05). 7. In control group, there were no significant differences in static Sensory organization test(p<.05). 8. In control group, there were no significant differences in dynamic Sensory organization test(p<.05). 9. In control group, there were no significant differences in Motor control test(p<.05).

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Systematic Review of the Literatures on Music Intervention for Neurological Patients in Korea (신경계 질환자 대상의 국내 음악중재연구에 대한 체계적 문헌고찰)

  • Jeong, Seong Hee
    • Journal of Korean Biological Nursing Science
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    • v.15 no.2
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    • pp.65-73
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    • 2013
  • Purpose: The purpose of this study was to review the literature on music intervention for neurological patients in Korea and to explore the effect of music intervention on functional rehabilitation of neurological patients. Methods: This systematic review examined literature from 2005 to 2010. The existing literature was searched in the electronic databases of RISS and KISS using the following keywords: music, rhythmic movement, stroke, brain injury, dementia, Parkinson, spinal cord injury. Seventy-seven studies were founded through the database. After The exclusion of duplicates, case studies, literature review, and irrelevant studies, nine studies were included for analysis. Results: They included nine quasi-experimental studies. The medical diagnoses of the study participants were stroke, dementia, brain injury, and spinal cord injury. Among nine studies, only two studies were conducted in the nursing area. Eight studies used comprehensive music programs composed of health education, gait training, vocal training, or relaxation therapy, and these comprehensive programs were effective in the areas of physical and psychosocial treatment. Seventeen sessions were provided on average throughout intervention, and the average duration of each session was 49.4 minutes. Conclusion: Comprehensive music intervention can be implemented in nursing care for patients with neurological problem.

Electromyography Triggered Training System for Wrist Rehabilitation (근전도 트리거 손목 재활 훈련 시스템 개발)

  • Kim, Younghoon;Le, DuyKhoa;Chee, Youngjoon;Ahn, Kyoungkwan;Hwang, Changho
    • Journal of Biomedical Engineering Research
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    • v.34 no.3
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    • pp.148-155
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    • 2013
  • This study is about the development of the wrist rehabilitation system for the patient who has limited capability of movement after stroke. Electromyography triggered training system (ETTS) can play the role between complete passive training and patient activating training system. Surface EMG was measured on pronator teres muscle and biceps brachii muscle for wrist pronation and supination. Our system detects whether the subject makes muscular effort for pronation or supination or nothing in every 50 ms. When the effort level exceeds the preset percentage of maximal voluntary contraction, the motor rotates according to the direction of the intention of the subject. EMG triggers the motor rotation for the wrist rehabilitation training until the preset angle. To evaluate its performance, the maximum voluntary contraction level was measured for 4 subjects at first. With the audio-visual instruction to rotate the wrist (pronation or supination) the subjects made effort to follow the instruction. After calculating root mean square (RMS) for 50 ms, the controller determines whether there was muscular effort to rotate while holding the motor. When there was an effort to rotate, the controller rotates the motor 0.8 degree. By comparing the RMS values from two channels of EMG, the controller determines the rotational direction. The onset delay is $0.76{\pm}0.24$ s and offset delay is $0.65{\pm}0.22$ s for pronation. For supination the onset delay is $1.24{\pm}0.41$ s and offset delay is $0.77{\pm}0.22$ s. The system responded fast enough to be used for rehabilitation training. The controller perceived the direction of rotation 100% correctly for the pronation and 97.5% correctly for supination. ETTS was developed and the fundamental functions were validated for normal subjects. The clinical validation should be done with patients for real world application. With ETTS, the subjects can train voluntarily over the limitation of the range of motion which increases the effectiveness of the rehabilitation training.

The Usefulness of Video Fluoroscopic Swallowing Study in Post-Stroke Dysphagia Patients (뇌졸중 후 연하장애 환자에서 비디오 투시 연하 조영검사의 유용성)

  • Eun, Sung-Jong;Kim, Sung-Gil;Hong, Jea-Ran
    • Journal of the Korean Society of Radiology
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    • v.4 no.3
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    • pp.19-25
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    • 2010
  • Dysphagia is common and serious problems in post-stroke patients. The post-stroke dysphagia with aspiration is associated with dehydration, malnutrition, pneumonia, sepsis and death. Up to date, gag reflex and choking history used to decide the aspiration in clinical. The purpose of this study was to evaluate the aspiration and to choice the proper meal formation using by video fluoroscpic swallowing study(VFSS) with post-stroke dysphagia patients. 58 post-stroke patients and ten normal person participated to perform the VFSS with liquid type, puding, yoplait, rice mixed with barium(Ba). Two rehabilitation medicine doctors and a radiological technologist analysed the phase(oral, pharyngeal, esophageal phase)with video film, and checked the pharyngeal transition time(PTT). 38 patients showed abnormality in pharyngeal phase, 13 patients in oral and pharyngeal phase, 3 patients in oral phase, and 2 patients in pharyngeal and esophageal phase. 43 patients(65.2%) occured the aspiration, but 23 of 43 patients improved by the chin tuck position. Aspiration occured 34 patients in liquid type, 2patients in rice gruel and nothing in boiled rice. After VFSS, 13 of 23 patients change the intaking pathway from nasogastric tube(NGT) to oral, On the contrary with 3 of 42 patients from oral to NGT. Consequently VFSS is clearly effective to evaluate the aspiration with post-stroke dysphagia patients.

Dysphagia and Oral Function in Chronic Stoke Patient: 3 Months Follow up Study (만성 뇌졸중 환자의 시간에 따른 삼킴 기능 변화)

  • Im, Ikjae;Ko, Myoung-Hwan
    • 재활복지
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    • v.22 no.1
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    • pp.141-156
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    • 2018
  • The purpose of this study was to examine changes in the swallowing function with chronic stroke patient. Ten chronic stroke patients with dysphagia followed up for 3 months. Eight normal age match subjects were also participated. A total of 18 participated in this study and they were classified into two groups (stroke patient group and normal control group). Participants underwent videofluoroscopic swallowing examination. The swallowing function was evaluated over time. Oral transit duration, pharyngeal transit duration, laryngeal response duration, Modified Barium Swallowing Impairment Profile ($MBSImP^{TM(c)}$), and Functional Oral Intake Scale (FOIS) were applied. Chronic stroke patient group were showed significantly longer oral transit duration, pharyngeal transit duration and laryngeal response duration than normal control group at baseline. After 3 months in stroke patient group, the mean oral components score of MBSImP (1~5) significantly decreased and the mean score on FOIS increased compared to baseline. In conclusion, oral swallowing function and oral intake function improved by the 3 month evaluation. These results describe changes in swallowing function with chronic stroke patients over time and provide basic informations to understand dysphagia.

The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Effectiveness of Focal Muscle Vibration on Upper Extremity Spasticity and Function for Stroke Patients : A Systematic Review (뇌졸중 환자의 상지 경직 감소와 기능 향상을 위한 국소 진동자극의 효과에 대한 체계적 고찰)

  • Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.23-33
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    • 2018
  • Objective : This systematic review aimed to investigate the effect of focal muscle vibration in patients with post-stroke spastic hemiplegia. Methods : We searched literature published between April 2009 and October 2017 using PubMed and RISS databases. The main search terms were Vibration therapy, Focal vibration, Somatosensory, Upper limb, and Spasticity after stroke. Based on inclusion/exclusion criteria, 6 articles were selected. Results : Articles on focal muscle vibration intervention ranged from evaluation of application-only vibration to muscle vibration with task-oriented activity. Intervention effects on upper extremity spasticity and function and activities of daily living were assessed. There were significant effects on upper extremity spasticity, function, and cortical excitability. Conclusions : This study can provide information on focal muscle vibration for use by clinical therapists. However, further studies are needed to identify the optimal stimulation site and frequency/amplitude of application to maximize the effects of focal muscle vibration.

Clinical Application of Ma Huang in the Obesity Treatment (비만처방에서 마황의 임상활용에 대한 고찰;용량, 효과, 부작용 등의 측면에서)

  • Song, Yun-Kyung;Lim, Hyung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.1
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    • pp.1-7
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    • 2007
  • Background : Use of Ma Huang is controversial. Multiple reports of adverse effects led the U.S. Federal Drug Administration (FDA) to announce about prohibiting dietary supplements containing ephedrine alkaloids/Ma Huang. Objective : The objective of the study was to review the evidence from literature and rigorous clinical trials on the dosage, effectiveness, and adverse effects. Methods : Literature searches were conducted in U.S. FDA database after 2003 and digital Uibujeonok(醫部全錄). Hand searches of medical journal and bibliographies of identified articles were conducted. Results : Ma Huang has been used in Korean Oriental Medicine to treatment asthma and other ailments. Recently, Ephedrine/Ma Huang are used for weight loss or to enhance athletic performance in Europe and America, Korea. Ephedrine/Ma Huang are associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. In addition to that, a risk of serious adverse events, including heart attack, stroke, epilepsy and psychiatric problem are also have been reported. Therefore, max dose of total alkaloids of ephedrine is studied in need of a specialist's part. Conclusion : In most reports, Ma Huang effectively promoted short-term weight loss and enhancement of athletic performance, But, safety with long-term use requires further investigation.

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