• 제목/요약/키워드: rehabilitation after stroke

검색결과 620건 처리시간 0.025초

뇌졸중의 운동신경기능 회복 (Motor Recovery in Stroke Patients)

  • 장성호;권용현
    • Journal of Yeungnam Medical Science
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    • 제22권2호
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    • pp.119-130
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    • 2005
  • Stroke is a leading cause of chronic physical disability. The recent randomized controlled trials have that motor function of chronic stroke survivors could be improved through physical or pharmacologic intervention in the stroke rehabilitation setting. In addition, several functional neuroimaging techniques have recently developed, it is available to study the functional topography of sensorimotor area of the brain. However, the mechanisms involved in motor recovery after stroke, are still poorly understood. Four motor recovery mechanisms have been suggested, such as reorganization into areas adjacent to the injured primary motor cortex (M1), unmasking of the motor pathway from the unaffected motor cortex to the affected hand, attribution of secondary motor areas, and recovery of the damaged contralateral corticospinal tract. Understanding the motor recovery mechanisms would provide neurorehabilitation specialists with more information to allow for precise prognosis and therapeutic strategies based on the scientific evidence; this may help promote recovery of motor function. This review introduces several methodologies for neuroimaging techniques and discusses theoretical issues that impact interpretation of functional imaging studies of motor recovery after stroke. Perspectives, for future research are presented.

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The Effect of Side-Step Tasks Based Circular Training Program on Balance and Gait in Stroke Patients

  • Sang Jun Son;Joong-Hwi Kim
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.384-390
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of the side-step tasks based circular training program (STCT) on balance and gait characteristics in stroke patients. Design: A randomized controlled trial Methods: Twenty-four stroke patients were randomly divided into two groups of twelve patients each. One group was applied with the STCT whereas the other group was treated with conservative physiotherapy (CP). The ability of gait was measured in 10m walking test and stride length on both side using BTS G-WALK (BTS Bioengineering S.p.A, Italy) and the ability of balance was measured in Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Results: The STCT group was significant differences in the balance parameters of BBS and TUG (p<0.05) and showed significant differences in gait variables in 10m walking speed, stride length of affected and non-affected side after the experiment before and after the experiment (p<0.05). In addition, the STCT group showed a significant difference in BBS compared to the control group (p<0.05). Conclusions: The results of this study confirmed that the side-step tasks based circular training program (STCT) improves balance and walking ability in stroke patients. STCT is expected to be used as a useful intervention method for stroke rehabilitation.

아급성과 만성 뇌졸중 환자 및 정상인의 심폐와 보행 기능 비교 (Comparison of Pulmonary and Gait Function in Subacute or Chronic Stroke Patients and Healthy Subjects)

  • 김창범;최종덕
    • The Journal of Korean Physical Therapy
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    • 제23권5호
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    • pp.23-28
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    • 2011
  • Purpose: The aim of this study was to evaluate functional gait and pulmonary function of patients with subacute or chronic stroke for aperiod after the onset of stroke. Healthy people of similar ages served as a control group. The study focused on the clinical importance of intervention with cardiopulmonary rehabilitation treatment in patients with stroke. Methods: The standard time period used to differentiate the subacute and the chronic stroke groups was six months. Each group, including the control, was allocated 11 subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume at one second ($FEV_1$) were measured with a spirometer for each subject. Walk tests (10 m and 6 min) and functional gait tests were then conducted. Results: Significant differences were noted for VC, FVC, and $FEV_1$ between the subacute stroke group and the normal group and between the chronic stroke group and the normal group (p<0.05), but no significant difference was evident between the subacute stroke group and the chronic stroke group (p>0.05). No significant difference was seen between the subacute stroke group and the chronic stroke group in the 6min walk test (p>0.05), whereas a significant difference was observed between the subacute stroke group and the chronic stroke group in the 10 m walk test (p<0.05). Conclusion: The general rehabilitation treatment is effective with respect to functional aspects, but it has limited effect in improving pulmonary function and muscular endurance. Therefore, additional intervention of cardiopulmonary rehabilitation is necessary in the rehabilitation treatment process of patients with stroke.

A pilot study of augmented reality-based postural control training in stroke rehabilitation

  • Park, Yu Hyung;Lee, Chi Ho;Kim, Hang Jin
    • Physical Therapy Rehabilitation Science
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    • 제3권1호
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    • pp.13-19
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    • 2014
  • Objective: The purpose of this study was to determine the effects of Augmented Reality-based Postural Control (ARPC) training on balance and gait function in patients with stroke. Design: Single-blind randomized controlled trial. Methods: Twenty participants who experienced a stroke were enrolled in the study and randomly assigned to the ARPC (n=10) or control group (n=10). Subjects in both groups received conventional physical therapy for 60 min per session, 5 days per week, for 4 weeks. In addition, subjects in the ARPC group received ARPC training for 30 min per day, 3 days per week, for 4 weeks. The participants watched established normal postural control patterns on a head-mounted display and repeated the movements in ARPC training. Outcome measurements were assessed using the Berg Balance Scale (BBS) and 10-Meter Walk Test (10MWT) before and after 4 weeks of training. Results: Of the 20 randomized participants, only 18 completed the 4-week training program. The ARPC group showed significant improvement in the BBS and 10MWT after training (p<0.05). Meanwhile, the control group did not exhibit improvement in either variable. In addition, the ARPC group showed significantly greater improvement than the control group in the 10MWT (p<0.05), whereas no significant difference was observed between the groups for the BBS. Conclusions: The results of this study confirmed the benefits of ARPC training on dynamic balance and functional gait ability. Additionally, this study may provide evidence supporting the use of an ARPC training program for improving balance and gait ability in patients after a chronic stroke.

영화기반 간호중재 프로그램이 뇌졸중 환자의 재활동기와 우울에 미치는 효과 (The Effect of a Movie-Based Nursing Intervention Program on Rehabilitation Motivation and Depression in Stroke Patients)

  • 권혜경;이숙자
    • 대한간호학회지
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    • 제47권3호
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    • pp.345-356
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    • 2017
  • Purpose: The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. Methods: The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. Results: After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. Conclusion: The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.

건측억제유도운동이 뇌졸중 환자의 손 기능과 일상생활능력에 미치는 영향 (The Effects of Constraint-induced Movement Therapy on the Involved Hand Function and ADL in Stroke Patients)

  • 김영미;황윤태;박래준
    • The Journal of Korean Physical Therapy
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    • 제17권4호
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    • pp.493-504
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    • 2005
  • The purpose of this study is to determine the effect of constraint-induced movement therapy on the involved hand function and ADL in stroke patients. Five subjects with fixing unaffected arms by CIMT were assigned to the experimental patient group and the other five patients to control group without fixing unaffected arms. The function of hand for both groups were evaluated by using Jebsen-Taylor hand function test and ADL for both groups were evaluated by FIM(Functional Independence Measure) before and after task practice. In conclusion, results of this study showed that improved hand function and ADL by CIMT in stroke patients. We concluded that CIMT can improved the involved hand function and ADL in stroke patients.

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The Effect of Cognitive Rehabilitation Program Combined with Physical Exercise on Cognitive Function, Depression, and Sleep in Chronic Stroke Patients

  • Kim, SoHyun;Cho, SungHyoun
    • Physical Therapy Rehabilitation Science
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    • 제11권1호
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    • pp.32-42
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    • 2022
  • Objective: This study was conducted to verify the effectiveness of a cognitive rehabilitation program consisting of physical exercises and mental activities for patients with chronic stroke with mild cognitive impairment (MCI). We aimed to investigate how this cognitive rehabilitation program affects patients' cognitive ability, depression, and sleep quality. Design: One group pretest-posttest design Methods: The study was conductedon 12 patients who participated in thecognitive rehabilitation complex exercise program for 16 weeks. The Korean version of the Montreal Cognitive Assessment (MoCA-K), Hamilton Depression Rating Scale (K-HDRS), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the measured variables before and after study participation. The cognitive rehabilitation complex exercise program included 30 minutes of cognitive exercise and 30 minutes of Brill Exercise. The Wilcoxon signed-rank test was used to compare the variables before and after program participation. Cronbach's ɑ was used to assess the reliability of the test variables. Results: The post-program assessment showed a statistically significant increase in the MoCA-K score, which measures cognitive function (Z=-2.628, P=0.009). For depression ratings, there was a statistically significant decrease in the K-HDRS score (Z=-2.041, P=0.041). For sleep quality, although there was a numerical increase in the PSQI score, the difference was not statistically significant (Z=-0.702, P=0.483). The reliability test confirmed that all the individual test variables exhibited high reliability (cognitive function, 0.859; depression, 0.872; sleep, 0.822). Conclusions: We found that cognitive rehabilitation program used in this study had a positive effect on the cognitive function and depression in patients with chronic stroke with MCI.

가상현실을 이용한 조기 로봇보조 보행 훈련이 뇌졸중 환자에 미치는 영향 (Effect of early robot-assisted training using virtual reality program in patient with stroke)

  • 이동순;이경화;강태우;조성태
    • The Journal of Korean Physical Therapy
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    • 제25권4호
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    • pp.195-203
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    • 2013
  • Purpose: The purpose of this study was to determine the effect of early Robot-assisted training on gait ability, function and ADL in patients with stroke. Methods: 26 patients with stroke were recruited for this study. The subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with 13 patients in each group. All subjects received a routine physical therapy. The robot-assisted training was for 30 min in the case of the EG subjects. The assessment tools of this study involved the gait ability, balance ability, function and ADL. The measurements were recorded before the intervention and after the intervention. Results: EG subjects and CG subjects, the variables measured after the intervention significantly differed from gait ability, balance ability, function and ADL without the FMA (p<0.05). The FMA was only effective experimental group after intervention. Also, there were significant differences in gait ability, balance ability, function and ADL without the FMA at post-test between the 2 groups (p<0.05). Conclusion: The findings indicate that early robot-assisted training exerts a positive effect on gait ability, balance ability, function and ADL in patients with stroke. This result indicates the possibility of application of the early Robot-assisted training to the management for stroke patients. Further studies are required to generalize the result for this study.

Effects of Gaze Stabilization Exercise and Cognitive Training on Balance and Gait in Subacute Stroke Patients: Randomized Controlled Trial

  • Hye-Ryeon Jang;Ye-Ji Kim;Myoung-Kwon Kim
    • 대한물리의학회지
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    • 제19권1호
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    • pp.155-164
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    • 2024
  • PURPOSE: The purpose of this study was to evaluate the effects of simultaneous application of gaze stabilization exercise and cognitive training on the balance and gait ability in subacute stroke patients. METHODS: Thirty-five patients diagnosed with stroke within 3-6 months were randomly assigned, and the experimental group (n = 18) to which both gaze stabilization exercise and cognitive training were applied and the control group (n = 17) to which only gaze stabilization exercise was applied were targeted. It was performed for 30 minutes at a time, three times a week, for a total of 4 weeks. Berg Balance Scale, Timed Up and Go test, 10Meter Walking Test, and Walking symmetry were evaluated. RESULTS: In the comparison of changes between Berg Balance Scale, Time Up and Go test, 10 Meter Walking Test, and Gait symmetry, both experimental and control groups showed significant differences before and after the intervention, and in the evaluation of Gait symmetry, significant differences between groups. CONCLUSION: As a result of this study, when gaze stabilization exercise and cognitive training were allied simultaneously, it was possible to improve the balance and gait ability of subacute stroke patients, and had a more significant effect on gait ability. In considered that training that simultaneously applies gaze stabilization exercise and cognitive training can be presented as a balance and gait rehabilitation for stroke patients on the future.

뇌졸중 후 연하곤란 환자에서 기능적 전기자극 치료의 중복 적용 효과 (The Effect of Double Application of Functional Electrical Stimulation in Patients with Dysphgia after Stroke)

  • 양충용;신병철;정복희
    • 한방재활의학과학회지
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    • 제18권1호
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    • pp.111-123
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    • 2008
  • Objectives : The objective of this study was to investigate the outcomes of functional electrical stimulation (FES) which was applied twice a day in patients with dysphagia after stroke. Methods : Eleven patients with dysphagia after stroke were participated. The electrical stimulator with two channels was employed for forty minutes daily or forty minutes twice a day for fifteen days. Participants were divided into two groups by random method; The FES was performed twice a day for Twice-FES group (n=6), and once a day for Standard-FES group (n=5). For evaluation of dysphagia, the functional dysphagia scale by videofluoroscopic swallowing study, and swallow function scoring system by six clinical swallowing stage were assessed at pre- and post-treatment. Results : In both groups, there was a significant decrease of total functional dysphagia scales after FES treatment (p<0.05) and the results mainly affected the pharyngeal phase of deglutition. There was no significant difference between the two groups in total functional dysphagia scales, but the Twice-FES group had a decreased residue in oral cavity compared to the standard FES group. In both groups, there were significant improvements in swallow function scoring system (p<0.05). The twice-FES group had more high clinical swallowing stages. Conclusions : The results demonstrated that FES is a clinically effective intervention in treatment of stroke patients with dysphagia. Moreover, the treatment applied twice a day had relatively positive effects on the reduction of oral cavity residue and the improvement of clinical swallowing stage.