• Title/Summary/Keyword: rehabilitation after stroke

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The Effect of Treadmill Exercise on Ischemic Neuronal Injury in the Stroke Animal Model: Potentiation of Cerebral Vascular Integrity (중풍 동물 모델에서의 트레드밀 운동이 허혈성 신경손상에 미치는 효과: 뇌혈관 통합성 강화)

  • Kang, Kyoung-Ah;Seong, Ho-Hyun;Jin, Han-Byeol;Park, Jong-Min;Lee, Jong-Min;Jeon, Jae-Yong;Kim, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.41 no.2
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    • pp.197-203
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    • 2011
  • Purpose: This study was done to identify whether pre-conditioning exercise has neuroprotective effects against cerebral ischemia, through enhance brain microvascular integrity. Methods: Adult male Sprague-Dawley rats were randomly divided into four groups: 1) Normal (n=10); 2) Exercise (n=10); 3) Middle cerebral artery occlusion (MCAo), n=10); 4) Exercise+MCAo (n= 10). Both exercise groups ran on a treadmill at a speed of 15 m/min, 30 min/day for 4 weeks, then, MCAo was performed for 90 min. Brain infarction was measured by Nissl staining. Examination of the remaining neuronal cell after MCAo, and microvascular protein expression on the motor cortex, showed the expression of Neuronal Nuclei (NeuN), Vascular endothelial growth factor (VEGF) & laminin. Results: After 48 hr of MCAo, the infarct volume was significantly reduced in the Ex+MCAo group ($15.6{\pm}2.7%$) compared to the MCAo group ($44.9{\pm}3.8%$) (p<.05), and many neuronal cells were detected in the Ex+ MCAo group ($70.8{\pm}3.9%$) compared to the MCAo group ($43.4{\pm}5.1%$) (p<.05). The immunoreactivity of laminin, as a marker of microvessels and Vascular endothelial growth factor (VEGF) were intensively increased in the Ex+MCAo group compared to the MCAo group. Conclusion: These findings suggest that the neuroprotective effects of exercise pre-conditioning reduce ischemic brain injury through strengthening the microvascular integrity after cerebral ischemia.

Therapeutic Intervention to Reduce Spasticity (경련성 감소를 위한 치료적 중재 연구)

  • Lee, Jung-Ho
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.9 no.5
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    • pp.427-436
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    • 2019
  • This study investigated the effect of extracorporeal shock wave therapy on the knee angle, MAS, and TUG of the affected side in patients with hemiplegic strokes. This study selected 20 patients who received rehabilitation treatment at a hospital after having been diagnosed with stroke. The control group (n=10) received the general physiotherapy (proprioceptive neuromuscular facilitation), and the experimental group (n=10) applied the extracorporeal shock wave therapy (ESWT) to the injured limb after PNF treatment. This study used an integrated kinematics analyzer (4D-MT, Relive, Korea) to analyze walking, timed up and go test to evaluate the dynamic balance ability of patients, and MAS to evaluate the spasticity. In the study results, knee angle were significantly different in all groups(p<0.05) but there was no significant difference between the groups(p>0.05). In the study results, TUG were significantly different in all groups(p<0.05) but there was no significant difference between the groups(p>0.05). Based on the results of this study, I hope that more detailed research will proceed.

Effect of a Motor Imagery Program on Upper Extremity Strength and Activities of Daily Living of Chronic Cervical Spinal Cord Injury Patients (운동심상이 만성 경수 손상 환자의 근활성도와 일상생활에 미치는 영향)

  • Park, Young-Chan;Kim, Jung-Yeon;Park, Hee-Su
    • The Journal of Korean Physical Therapy
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    • v.25 no.5
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    • pp.273-281
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    • 2013
  • Purpose: The purpose of this study is to determine the effect of motor imagery training on residual upper extremity strength and activities of daily living of chronic cervical spinal cord injury patients. Methods: Twelve ASIA A B patients, who had more than a 12-month duration of illness and C5 or 6 motor nerve injury level, were randomly divided into experimental group (n=6) and control group (n=6). Patients in the experimental group performed motor imagery training for five minutes prior to general muscle strengthening training, while those in the control group performed general muscle strengthening training only. The training was performed five times per week, 30 minutes per day, for a period of four weeks. General muscle strengthening training consisted of a progressive resistive exercise for residual upper extremity. Motor imagery training consisted of imagining this task performance. Before and after the training, EMG activity using BTS Pocket Electromyography and Spinal Cord Independent Measure III(SCIM III) were compared and analyzed. Results: The residual upper extremity muscle strengths showed improvement in both groups after training. Comparison of muscle strength improvement between the two groups showed a statistically significant improvement in the experimental group compared to the control group (p<0.05). SCIM III measurements showed significant improvement in the scores for Self-care and Transfer items in the experimental group. Conclusion: Motor imagery training was more effective than general muscle strengthening training in improving the residual upper extremity muscle strength and activities of daily living of patients with chronic cervical spinal cord injury.

Acoustic Voice Analysis in Patients with Penetration/Aspiration Via Videofluoroscopic Swallowing Study (비디오투시조영검사를 통한 침습/흡인에 따른 음성의 음향적 분석)

  • Kang, Young Ae;Jee, Sung Ju;Koo, Bon Seok
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.60 no.9
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    • pp.454-462
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    • 2017
  • Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders.

Effects of Eucommiae Cortex on Myofiber Type Transition and MyoD Expression in Hind Limb Muscle Atrophy of Rats (두충(杜沖) 이 근육위축 흰쥐의 후지 근섬유형 및 MyoD 발현에 미치는 영향)

  • Yun, Duk-Young;Park, Seong-Ha;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.1
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    • pp.47-63
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    • 2008
  • Objectives : Eucommiae cortex is reported that it helps bone and skeletal muscle stronger. In case of bone, many report is presented, but reports related to skeletal muscle are rarely existed. So in order to investigate effects of Eucommiae cortex on the skeletal muscle atrophy following stroke, cerebral infarct was induced by the middle cerebral artery occlusion (MCAO) in the rats. Methods : In order to induce MCAO rats, nylon suture was advanced and then blocked middle cerebral artery(MCA). Water extract of Eucommiae cortex was treated for 15 days, once a day orally, after the MCAO. Effects were evaluated with muscle weights, muscle fiber type composition, cross-sectioned area of muscle fibers in soleus and gastrocnemius of the unaffected and affected hind limbs. And MyoD protein expression in gastrocnemius was demonstrated with immunohistochemistry and western blotting. Results : In the affected hind limb of the MCAO rats, muscle weight loss of gastrocnemius and tibialis anterior muscles were attenuated by Eucommiae cortex treatment. In soleus muscle of the affected hind limb of the MCAO rats, increase of type-I fibers and decrease of type-II fibers were induced by Eucommiae cortex treatment. In soleus muscle of the affected hind limb of the MCAO rats, decrease of cross-sectioned areas of type-I fibers was attenuated by Eucommiae cortex treatment. In gastrocnemius muscle of the affected hind limb of the MCAO rats, increase of type-I fibers and decrease of type-II fibers were induced by Eucommiae cortex treatment. In gastrocnemius muscle of the affected hind limb of the MCAO rats, decreases of cross-sectioned areas of type-I and type-II fibers were attenuated by Eucommiae cortex treatment. In gastrocnemius muscle of the affected and unaffected hind limb of the MCAO rats, MyoD expressions were increased by Eucommiae cortex treatment. Conclusions : These results suggest that Eucommiae cortex has a protective effect against muscle atrophy, through the inhibition of the muscle cell apoptosis, following the central nervous system demage.

Oral rehabilitation with magnetic overdentures for an old patient with complex systemic diseases (복합적인 전신질환이 있는 안면마비 환자의 양악 자성 피개의치 수복 증례)

  • Ko, Eunjin;Ahn, Sujin;Lee, Sukwon;Park, Sujung;Lee, Richard Sungbok
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.150-156
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    • 2015
  • As dental implant treatment becomes popular for both partial and complete edentulous patients, old people with complex systemic diseases also tend to prefer implant-assisted-overdenture or implant-supported-fixed prostheses to conventional complete denture. In this case, 77-year-old female who was on medication for hypertension and osteoporosis and paralyzed on right side due to stroke visited for implant-assisted-overdenture on lower jaw. After oral and radiographic examination, root-assisted magnet overdenture on upper jaw and implant-assisted magnet overdenture on lower jaw are planned. Consequently, overdentures using self-adjusting magnetic attachment(SA) system on both jaws resulted in recovering satisfying function and retention, which is enable to insert and remove with only one hand.

Analysis of Occupational Therapy Intervention Research for Improving Memory: Focus on Single-Subject Research Design in Korean Academic Journals (기억력 향상을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로)

  • Jung, Yu-Jin;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.10 no.4
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    • pp.39-52
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    • 2021
  • Objective : This study aimed to identify the characteristics and analyze the quality of studies on memory improvement using a single-subject research design. Methods : Six studies were selected through the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and National Digital Science Library (NDSL). Keywords were memory training, stroke, early dementia, mild cognitive impairment, and single-subject research design. The characteristics and quality levels were analyzed between January 2011 and October 2020. Results : Regarding the quality level, the middle level (7-10 points) was 66.7% of the four articles, and the high level (11-14 points) was 33.3% of the two articles. Reversal designs were used in all studies. Independent variables were errorless learning, smartphone application, cognitive training system (CoTras), spaced retrieval training (SRT) with errorless learning, spaced retrieval training, and iPad applications. The dependent variables included memory, attention, electroencephalogram, instrumental activities of daily living, depression etc., which increased after the intervention. The total session, study period, and intervention time were varied. Conclusion : In single-subject research design related to memory training, occupational therapy intervention was confirmed as an effective method for improving memory and attention. The quality level of single-subject research design was moderate or higher, and high-quality level of studies should be conducted by additional design to increase the validity in the future.

A Case Study of Chengsimyeonja-tang-gamibang Treatment of a Patient with a Pontine Hemorrhage, with Quadriparesis, Dysarthria, and Dysphagia (청심연자탕 가감방으로 호전된 교뇌 출혈 이후 발생한 양측 반신부전마비, 연하곤란, 언어장애 치험 1례)

  • Yang, Jee-yun;Jeong, Taek-su;Jeon, Gyeong-ryung;Ok, So-yoon;Sun, Jong-joo
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.217-225
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    • 2017
  • Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

A Case Report of Hemiparesis in a Patient with an Intracerebral Hemorrhage at the Basal Ganglia, Thalamus, and Internal Capsule Treated with a Combination of Traditional Korean Medicine and Western Medicine (기저핵, 시상, 속섬유막 뇌출혈로 인한 반신부전마비에 대해 한·양방 병행 치험 1례)

  • Son, Ah-hyun;Choi, Hyun-min;Go, Ji-yoon;Lee, Dong-keun;Shin, Hyeon-su
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.180-189
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    • 2017
  • Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia, thalamus, and posterior limb of the internal capsule. Methods: The patient was treated with acupuncture, moxibustion, Hyangsayukgunja-tang, and Samul-tang-gami. The effect of these treatments were evaluated using the manual muscle test (MMT), modified Barthel index (MBI), and National Institutes of Health Stroke Scale (NIHSS). Results: After the treatments, the patient's status improved, as shown by his MMT grade, which increased from 1/1 to 4/4. In addition, the patient's MBI score improved from 0 to 77, and his NIHSS score declined from 16 to 2. In addition, the patient's Levin tube and Foley catheter were removed. Conclusion: The results suggest that traditional Korean medicine may be effective in the treatment of patients with ICH.

Effect of Meridian Muscle Release and the Graston Technique on Pain and Functional Movement in Patients with Myofascial Pain Syndrome of the Shoulder Joint (경근 이완 기법과 그라스톤 기법이 어깨 관절 근막 통증 증후군 환자의 통증 및 기능 향상에 미치는 효과)

  • Heo, Hyo-Ryung;Jang, Ho-Young;Kim, Dong-Hoon;Kim, Ho-Young;Lee, Suk-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.85-94
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    • 2020
  • PURPOSE: This study examined the effects of the meridian muscle release technique on the pain and functional movement of patients with myofascial pain syndrome (MPS) of the shoulder joint. METHODS: The subjects of this study included 45 patients with MPS of the shoulder joint. The subjects were divided randomly into the following groups; the meridian muscle release technique group (n=15), the Graston technique group (n=15), and the control group (n=15). Both the meridian muscle release group and the Graston technique group received conventional therapy for 35 minutes initially and were then treated using the meridian muscle releases technique and Graston technique for 10 minutes, respectively. The control group received only conventional therapy for 35 minutes. All three groups underwent treatments three times a week for four weeks. Each subject was evaluated randomly using the VAS, PPT, SPADI and ROM both before and after treatment. RESULTS: The Graston technique group showed a significantly more substantial increase in functional movement (p<.05) than the meridian muscle release technique and control groups. The meridian muscle release technique group had significantly less pain (p<.05) compared to the Graston technique and control groups. CONCLUSION: These findings suggest that the meridian muscle release technique can be useful for decreasing pain and increasing the functional movement of patients with MPS of the shoulder joint.