• Title/Summary/Keyword: Chronic stroke

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Effects of a Group Exercise Program for the Upper Extremities on Sensory and Motor Function and Activities of Daily Living in Chronic Stroke Patients: A Case Series

  • Ko, Myung-Sook;Jeon, Yong-Jin
    • Physical Therapy Korea
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    • v.22 no.2
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    • pp.59-69
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    • 2015
  • The purpose of this study was to identify the effects of an upper extremities group exercise program based on motor learning in chronic stroke patients and to assess improvements in upper sensory motor function and activities of daily living (ADL). Five chronic stroke patients participated for the duration of 25 weeks. On the assessment of motor and process skills, there was a statistically significant improvement in motor area functioning in 4 of the subjects. In process area functioning, there was a statistically significant change in 3 of the subjects. Therefore, further studies are needed to assess sensorimotor area and ADL changes in chronic stroke patients to reduce medical cost and assess for positive psychological changes.

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

  • Kim, Chang-Beom;Choi, Jong-Duk
    • The Journal of Korean Physical Therapy
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    • v.23 no.5
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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.

Examining the Quality of Life Related to Fall Experience in Chronic Stroke Patients

  • Lee, Ju-Hwan;Park, Shin-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.3
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    • pp.73-80
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    • 2016
  • PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

Effects of Action Observational Physical Training Based on Mirror Neuron System on Upper Extremity function and Activities of Daily Living of Chronic Stroke Patients (거울신경세포시스템에 근간한 동작관찰-신체훈련이 만성 뇌졸중 환자의 상지기능과 일상생활활동에 미치는 영향)

  • Ko, Hyo-Eun
    • PNF and Movement
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    • v.13 no.4
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    • pp.175-180
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    • 2015
  • Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.

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The Effects of Proprioceptive Neuromuscular Facilitation on Lower Extremity Functions of Chronic Stroke Patients (고유수용성신경근촉진법이 만성 뇌졸중환자의 하지기능에 미치는 효과)

  • Song, Hyun-Seung;Kim, Seok-Hwan
    • PNF and Movement
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    • v.12 no.4
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    • pp.225-232
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    • 2014
  • Purpose: The purpose of this study is to determine the effects of proprioceptive neuromuscular facilitation on the lower extremity function of chronic stroke patients. Methods: The participants consist of 26 chronic stroke patients. They were randomly assigned to either an experimental group (n=13) or a control group (n=13) and engaged in exercise three times per week for eight weeks. The experimental group engaged in proprioceptive neuromuscular facilitation exercises and the control group engaged in general mat exercises. To measure lower extremity strength, the sit to stand test and the static balance test (standing on one leg) were used. To measure the stability index (SI) and weight distribution index (WDI), a Tetrax Portable Multiple System (Tetrax Ltd, Israel) was used in addition to a static balance test (standing on one leg). Results: : Lower extremity strength and static balance showed a significant improvement in the experimental group (p<.05). The SI and WDI were significantly improved in the experimental group (p<.05) for tests of standing with their eyes open, standing with their eyes closed, and standing on a sponge with their eyes open. Conclusion: Proprioceptive neuromuscular facilitation exercises have confirmed that lower extremity function improves after exercise interventions in chronic stroke patients.

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Effect of Robot-Assisted Hand Rehabilitation on Hand Function in Chronic Stroke Patients (손 재활 로봇의 적용이 만성 뇌졸중 환자의 손 기능 향상에 미치는 영향)

  • Park, Jin-Hyuck
    • The Journal of Korea Robotics Society
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    • v.8 no.4
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    • pp.273-282
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    • 2013
  • The purpose of this study was to investigate effect of robot-assisted hand rehabilitation(Amadeo(R)) on hand motor function in chronic stroke patients. This study used a single-subject experimental design with multiple baselines across individuals. Three chronic stroke survivors with mild to sever motor impairment took part in study. Each participants had 2 weeks interval of starting intervention. Participants received robot-assisted therapy(45min/session. 3session/wk for 6wks). Finger active range of motion(AROM) was assessed by Range of Assessment program in Amadeo(R), and test-retest reliability was verified using Pearson correlation analysis. To investigate effect of Amadeo(R), finger AROM was measured immediately after each sessions and Fugl-Meyer Assessment of Upper extremity, Motor Activity Log, Nine hole peg board test and Jebsen-Taylor hand motor function test were assessed at pre-post intervention. Results were analyzed by visual analysis and comparison of pre-post tests. The test-retest reliability of Range of Assessment was good(r=.99). After robot-assisted therapy, finger AROM of participant 1, 2, and 3 was respectively improved by 18%, 3.6%, and 6% each. Hand motor function of participant 1, 3 was improved on all four tests, but not effect in participant 2. Robot-assisted hand rehabilitation could improve finger AROM and effect on hand motor function in chronic stroke patients.

The Immediate Effects of Neck and Trunk Stabilization Exercises on Balance and Gait in Chronic Stroke Patients

  • Choe, Yu-Won;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.4
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    • pp.37-45
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    • 2020
  • PURPOSE: The purpose of this study was to identify the effects of neck stabilization exercise combined with trunk stabilization exercise on balance and gait function in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The experimental group subjects (n = 11) performed neck stabilization (15 min) and trunk stabilization (15 min) exercises, while the control group subjects (n = 11) performed trunk stabilization exercise only for 30 min. Before and after the intervention, the subjects underwent static balance and gait testing. RESULTS: The 95% confidence ellipse area, center of pressure (COP) path length, and COP average velocity were significantly lower in both groups after the intervention compared to before intervention (p < .05). The average stance force on the affected side increased significantly in both groups after the intervention (p < .05). The changes in the static balance variables were larger in the experimental group than in the control group. The cadence, gait velocity, and single leg support increased significantly in both groups after intervention (p < .05). The changes in the gait variables were larger in the experimental group than in the control group. CONCLUSION: Trunk stabilization is a beneficial intervention, but the combination of neck stabilization with trunk stabilization is a more effective method to increase the gait and static balance in chronic stroke patients.

Influence of Walking Capacity and Environment on the Outcomes of Short- and Long-distance Walking Velocity Tests in Individuals with Chronic Stroke (보행 능력과 환경이 만성 뇌졸중 환자의 단거리 및 장거리 보행속도검사 결과에 미치는 영향)

  • Jeong, Hye-rim;Oh, Duck-won
    • Physical Therapy Korea
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    • v.24 no.3
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    • pp.1-9
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    • 2017
  • Background: The method of measuring the walking function of patients with chronic stroke differs depending on patients walking capability and environmental conditions. Objects: This study aimed to demonstrate the influences of walking capacity and environmental conditions on the results of short- and long-distance walk tests in patients with chronic stroke. Methods: Forty patients with chronic stroke volunteered for this study, and allocated to group-1 (<.4m/s, household walking, $n_1=13$), group-2 (.4~.8m/s, limited community ambulation, $n_2=16$), and group-3 (>.8m/s, community ambulation, $n_3=11$) according to their walking capacity. The 10-meter walk test (10MWT) and 6-min walk tests, (6MWT) were used to compare the short- and long-distance walk tests results, which were randomly performed under indoor and outdoor environmental conditions. Results: The comparison of the results obtained under the indoor and outdoor conditions revealed statistically significant differences between the groups in the 6MWT and 10MWT (p<.05). Post-hoc tests' results showed significant differences between groups-1 and -2 and between groups-1 and -3 in the 10MWT, and between group-1 and -3 in the 6MWT. Furthermore, in group-2 the 10MWT and 6MWT results significantly differed between the indoor and outdoor conditions, and the values measured under the indoor and outdoor conditions significantly differed between 10MWT and 6MWT (p<.05). Group-3 showed a significant difference in 10MWT results between the indoor and outdoor conditions (p<.05). Conclusion: These findings suggest that the results of the short- and long-distance walk tests may differ depending on the walking capacity of patients with chronic stroke and the environmental condition under which the measurement is made, and these effects were greatest for the patients with the limited community ambulation capacity.

Comparison of Abdominal Muscle Thickness Between the Nonparetic and Paretic Side During Quiet Breathing in Patients With Chronic Stroke (만성 뇌졸중 환자에서 편안한 호흡 시 건측과 마비측으로 복근 두께 비교)

  • Lee, Young-Jung;Lee, Gyu-Wan;Yi, Chung-Hwi;Cynn, Heon-Seock
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.8-15
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    • 2011
  • Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

Comparison of the Effects of Wii Balance Games and Mirror Self-Balancing Exercises on Knee Joint Proprioception and Balance in Chronic Stroke Patients (Wii 균형 게임과 자가 거울 균형 운동이 만성 뇌졸중 환자의 균형 및 무릎관절 고유수용성 감각에 미치는 효과 비교)

  • Sim, Gyeong-seop;Jeon, Hye-seon
    • Physical Therapy Korea
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    • v.24 no.1
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    • pp.30-40
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    • 2017
  • Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.