Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.
Lee, Hyun soo;Kim, You Lim;Lee, Hae ji;Lee, Byounghee
Journal of Korean Physical Therapy Science
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v.28
no.3
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pp.11-29
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2021
Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.
Journal of The Korean Society of Integrative Medicine
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v.7
no.4
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pp.119-130
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2019
Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.
Jaemin, Jang;Kang-Ho, Lee;Subin, Joo;Ohwon, Kwon;Hak, Yi;Dongkyu, Lee
Journal of Sensor Science and Technology
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v.31
no.6
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pp.433-440
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2022
Recently, owing to global warming, average summer temperatures are increasing and the number of hot days is increasing is increasing, which leads to an increase in heat stroke. In particular, outdoor workers directly exposed to the heat are at higher risk of heat stroke; therefore, preventing heat-related illnesses and managing safety have become important. Although various wearable devices have been developed to prevent heat stroke for outdoor workers, applying various sensors to the safety helmets that workers must wear is an excellent alternative. In this study, we developed a smart helmet that measures various vital signs of the wearer such as body temperature, heart rate, and sweat rate; external environmental signals such as temperature and humidity; and movement signals of the wearer such as roll and pitch angles. The smart helmet can acquire the various data by connecting with a smartphone application. Environmental data can check the status of heat wave advisory, and the individual vital signs can monitor the health of workers. In addition, we developed an algorithm that classifies the risk of heat-related illness as normal and abnormal by inputting a set of vital signs of the wearer using a support vector machine technique, which is a machine learning technique that allows for rapid binary classification with high reliability. Furthermore, the classified results suggest that the safety manager can supervise the prevention of heat stroke by receiving feedback from the control system.
Objectives: To develop a standardized diagnostic pattern identification equation for stroke patients, our group conducted a study to derive the predictive logistic equations. However, the sample size was relatively small. In the current study, we aimed to derive new predictive logistic equations for each diagnostic pattern using an expanded number of subjects. Methods: This study was a hospital-based multi-center trial recruited stroke patients within 30 days of symptom onset. Patients' general information, and the variables related to diagnostic pattern identification were measured. The diagnostic pattern of each patient was identified independently by two Korean Medicine Doctors. To derive a predictive model for pattern identification, binary logistic regression analysis was applied. Results: Among the 1,251 patients, 385 patients (30.8%) had the Fire Heat Pattern, 460 patients (36.8%) the Phlegm Dampness Pattern, 212 patients (16.9%) the Qi Deficiency Pattern, and 194 patients (15.5%) the Yin Deficiency Pattern. After the regression analysis, the predictive logistic equations for each pattern were determined. Conclusion: The predictive equations for Fire Heat, Phlegm Dampness, Qi Deficiency, and Yin Deficiency would be useful to determine individual stroke patients' pattern identification in the clinical setting. However, further studies using objective measurements are necessary to validate these data.
Journal of The Korean Society of Integrative Medicine
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v.10
no.4
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pp.35-47
/
2022
Purpose : As the number of patients with systemic diseases is increasing in the old, the relevance of oral health is gaining particular research interest. To provide fundamental resources for dental services, this study examined the relationship between doctors' diagnoses of circulatory diseases and patients' awareness of oral health and oral care behaviors. Methods : SPSS 26.0 was used to assess various variables, including doctor's diagnosis of circulatory diseases, gender, age, household income quintile, participation in economic activity, marital status, subjective level of oral health awareness, mastication discomfort, speaking and chewing discomfort, dental inspection, use of oral care goods, teeth brushing during the previous day, and untreated oral conditions. Results : The circulatory diseases suffered by the subjects were as follows: 56 % high blood pressure, 36 % dyslipidemia, 6 % stroke, and 8 % myocardial infarction or angina. A higher age meant a higher diagnosis rate of high blood pressure (p<.001) and stroke (p<.001). Those with dyslipidemia showed a higher rate of receiving oral inspection (p=.040), and an untreated oral condition was more frequently observed among those not diagnosed with the disease (p=.035). The subjects who were not diagnosed with stroke showed a higher rate of oral inspection (p<.001), while those who had a prior experience of stroke suffered a higher rate of mastication discomfort (p=.020). People who had high blood pressure showed a lower rate of using oral care goods (p<.001), and those diagnosed with stroke showed a lower rate of brushing teeth the previous day. Conclusion : This study found a correlation between the diagnosis of circulatory diseases and the awareness of oral health and oral care behavior. Consequently, oral health education should be included in mental health-related education, and customized training to teach teeth brushing and the use of oral care goods should be provided to patients with circulatory diseases during dentist visits.
Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.
Journal of the Korean Society of Physical Medicine
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v.13
no.1
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pp.89-98
/
2018
PURPOSE: While underwater, patients with hemiplegia experience unwanted limb flotation on their paretic side due to low muscle mass and high body fat. However, only a limited number of studies support the effectiveness of this practice. Therefore, the purpose of this study was to determine how the balance and walking abilities of patients with hemiplegia due to stroke were affected by wearing an aquatic cuff on their ankles during underwater treadmill walking. METHODS: Twenty stroke patients were divided into an experimental group comprised of 20 patients who would wear an aquatic cuff and a control group comprised of 10 patients without an aquatic cuff. Both groups underwent a six-week intervention for 30 minutes a day three times a week. To evaluate the groups' balance and walking abilities before and after the intervention, the 10 m walking test, timed up go test, Berg Balance Scale, functional reaching test, and the GAITRite system were used. RESULTS: The results of the 10 m walking test, timed up go test, differences between the left and right gait cycles, and functional reaching test showed statistically significant differences in the rates of change between the two groups (p<.05). CONCLUSION: The study results suggest that underwater treadmill training in stroke patients can be more effective when they wear an aquatic cuff on their ankles compared to wearing no aquatic cuff.
Journal of the Korean Academy of Clinical Electrophysiology
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v.10
no.1
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pp.29-37
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2012
Purpose : The purpose of this study was to establish intra-rater, inter-rater, test-retest reliability, and concurrent validity of figure-of-8 walk test in people with stroke. Methods : The subjects of this study were 17 patients who were diagnosed with a stroke. Subjects were tested twice by the same raters, with 1 day between tests. Subjects were assessed by two physical therapists. Test-retest reliability was calculated using intraclass correlation coefficients (ICC). The concurrent validity was demonstrated by spearman correlation of F8WT with 10m walking test (10MWT), timed up and go test (TUG), Berg balance scale (BBS), dynamic gait index (DGI) and four square step test (FSST). Results : Intra-rater, inter-rater, test- retest of F8WT time, showed high reliability. Intra-rater, inter-rater, test-retest of F8WT steps demonstrated high reliability. Intra-rater, inter-rater, test-retest of F8WT total smoothness score showed below moderate reliability. There was a significant positive correlation of F8WT time with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT time with DGI, BBS. There was a significant positive correlation of F8WT steps with 10MWT, TUG, FSST. There was a significant negative correlation of F8WT steps with DGI. There was a significant positive correlation of F8WT test total smoothness score with BBS. Conclusion : The time, and number of steps in F8WT show high inter, intra-rater, test-retest reliability. The F8WT smoothness shows below moderate reliability. The F8WT shows high concurrent validity with other comparable balance, and walking tests. The F8WT is a valid and reliable measure for assessing walking function in patients with a stroke.
Journal of the Korean Society for Aeronautical & Space Sciences
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v.35
no.9
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pp.753-760
/
2007
In a 3-D flapping motion, the spanwise flow is generated while the wing is moved on the stroke plane. And at the end of each stroke, the rotational circulation is generated due to a wing rotation. In this study, to evaluate the effect of spanwise flow and wing rotation on the aerodynamic characteristics in 3-D flap 753ping motion, a 3-D flapping motion was compared with a 2-D translating motion. In each flapping motion, the aerodynamic forces were measured with respect to the angles of attack and Reynolds number. The aerodynamic forces generated by 2-D translating motion were higher than those generated by 3-D flapping motion. While the lift of 3-D flapping motion was increased until the angle of attack $60^{\circ}$ at mid-stroke, the lift generated by 2-D translating motion was decreased above the angle of attack 40° at mid stroke. Also, at the end of each stroke, the aerodynamic forces were increased rapidly due to wing rotation.
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