• 제목/요약/키워드: Motor recovery

검색결과 59건 처리시간 0.133초

뇌졸중의 운동신경기능 회복 (Motor Recovery in Stroke Patients)

  • 장성호;권용현
    • Yeungnam University Journal of Medicine
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    • v.22 no.2
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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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자하거약침(紫河車藥鍼)의 Bell's palsy에 대한 치험보고(治驗報告) (The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy)

  • 윤정훈;육태한;송범룡
    • 대한약침학회지
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    • v.3 no.1
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    • pp.89-99
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    • 2000
  • This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. In herbal acupuncture group, 100% motor recovery was 7 case, 75% was 1 case, and 25% motor recovery term was $7.38{\pm}5.21$ days, 50% was $11.00{\pm}6.16$ days, 75% was $15.13{\pm}9.55$ days, 100% was $23.14{\pm}7.97$ days. In control group, 100% motor recovery was 4 case, 75% was 2 case, 25% below was 2 case and 25% motor recovery term was $11.17{\pm}4.96$days, 50% was $18.17{\pm}6.82$ days, 75% was $29.50{\pm}6.95$ days, 100% was $44.00{\pm}11.49$ days. The above results indicate that Hominis placenta herbal acupuncture is a useful effect on Bell's palsy. thus, continuous herbal acupunture study will be needed for more clinical application on Bell' palsy.

A Comparative Study on Recovery of Motor Function in Stroke Patients with Corona Radiata Infarcts and Intracerebral Hemorrhage

  • Kim, Chung-Sun;Park, Sang-Young;Kwon, Jung-Won
    • The Journal of Korean Physical Therapy
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    • v.22 no.6
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    • pp.53-58
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    • 2010
  • Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

Estimation of Motor Recovery using Characteristics of EMG during Isometric Muscle Contraction in Hemiparetic Wrist

  • Tae, Ki-Sik;Song, Sung-Jae;Kim, Young-Ho
    • 대한의용생체공학회:의공학회지
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    • v.29 no.1
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    • pp.8-16
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    • 2008
  • The aim of this study was to evaluate the motor recovery in 4 chronic hemiparetic patients with Fugl-Meyer (FM) and EMG characteristics before and after the training program. The training was performed at 1hr/day, 5days/week during 6 weeks in 4 chronic stroke patients. Electromyographic activities of the affected hand were recorded during isometric wrist flexion/ extension movements. In all patients, FM was significantly improved after the 6-week training. Onset/offset delay of muscle contraction significantly decreased in the affected wrist after the training. The co-contraction ratio of flexor/extensor muscles decreased significantly. Also, onset/offset delay of muscle contraction and co-contraction ratio correlates significantly with upper limb motor impairment and motor recovery. This EMG technique allows an objective evaluation of changes in muscle activity in post-stroke patients, providing easily measurable, quantitative indices of muscle characteristics.

불안 및 우울이 급성기 벨마비 환자의 안면근 운동기능 회복에 미치는 영향 (A Study of Psychological Distress, Anxiety and Depression on Motor Recovery of Acute Bell's Palsy Patients' Facial Muscle)

  • 김은석;이상훈;남상수;김용석
    • Journal of Acupuncture Research
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    • v.31 no.1
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    • pp.149-158
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    • 2014
  • Objectives : The aim of this study is to investigate the influence of anxiety and depression on motor recovery of acute Bell's palsy to estimate how much psychological factors affect the clinical prognosis. Methods : A total of 20 inpatients with acute unilateral Bell's palsy within 1 week of onset participated in this study. The severity of participants' facial palsy was measured by Yanagihara(Y-system) score, FDI and House-Brackmann scale at the time of 1 week and 3 weeks from the onset. The motor recovery of acute Bell's palsy is defined as ${\Delta}Y$-system during 2 weeks. Beck anxiety scale(BAI) and the center for epidermiologic studies depression scale(CES-D) were adopted to assess anxiety and depression, respectively. Correlation analysis and linear regression analysis were conducted between ${\Delta}Y$-system and prognostic factors including anxiety and depression. Results : Significant associations were found between ${\Delta}Y$-system and depression(CES-D) but no significant associations were found between ${\Delta}Y$-system and other prognostic factors, hypertension, diabetes, postauricular pain, disgeusia, age, degree of initial palsy and anxiety(BAI). And a regression equation with 0.295 for coefficient of determination was obtained. Through this analysis, the ${\Delta}Y$-system can be predicted using regression equation which cover 29.5 % of depression index(CES-D). Conclusion : Depression is a significant clinical prognostic factor on motor recovery of acute Bell's palsy. So, Bell's palsy treatment should be combined with psychological care and support.

The Effect of Minocycline on Motor Neuron Recovery and Neuropathic Pain in a Rat Model of Spinal Cord Injury

  • Cho, Dong-Charn;Cheong, Jin-Hwan;Yang, Moon-Sul;Hwang, Se-Jin;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.83-91
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    • 2011
  • Objective : Minocycline, a second-generation tetracycline-class antibiotic, has been well established to exert a neuroprotective effect in animal models and neurodegenerative disease through the inhibition of microglia. Here, we investigated the effects of minocycline on motor recovery and neuropathic pain in a rat model of spinal cord injury. Methods : To simulate spinal cord injury, the rats' spinal cords were hemisected at the 10th thoracic level (T10). Minocycline was injected intraperitoneally, and was administered 30 minutes prior surgery and every second postoperative day until sacrifice 28 days after surgery. Motor recovery was assessed via the Basso-Beattie-Bresnahan test Mechanical hyperalgesia was measured throughout the 28-day post -operative course via the von Frey test Microglial and astrocyte activation was assessed by immunohistochemical staining for ionized calcium binding adaptor molecule 1 (lba1) and glial fibrillary acidic protein (GFAP) at two sites: at the level of hemisection and at the 5th lumbar level (L5). Results : In rats, spinal cord hemisection reduced locomotor function and induced a mechanical hyperalgesia of the ipsilateral hind limb. The expression of lba1 and GFAP was also increased in the dorsal and ventral horns of the spinal cord at the site of hemisection and at the L5 level. Intraperitoneal injection of minocycline facilitated overall motor recovery and attenuated mechanical hyperalgesia. The expression of lba1 and GFAP in the spinal cord was also reduced in rats treated with minocycline. Conclusion : By inhibiting microglia and astrocyte activation, minocycline may facilitate motor recovery and attenuate mechanical hyperalgesia in individuals with spinal cord injuries.

뇌졸중 환자에 있어서 Mini-Mental State Examination과 Motor Assessment Scale을 통한 인지기능과 기능적 회복의 상관관계 연구 (The Cognitive performance in relation to motor functio recovery in stroke patients)

  • 박창주;홍도선;최경욱
    • 대한물리치료과학회지
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    • v.7 no.1
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    • pp.333-352
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    • 2000
  • The objective of this study was to identify the effects of the cognitive performance of stroke patients on their motor function recovery after comprehensive rehabilitation management. The subjects of this study were 41 stroke in-patients of the Rehabilitation Hospital, College of Medicine, Yonsei University, hospitalized during the period from September 1, 1997 to May 5, 1998. The cognitive performance was measured using a Mini-Mental State Examination(MMSE) and the motor function recovery using Motor Assessment Scale(MAS). The data were analyzed by the paired t-test, independent t-test, a one way ANOVA, and Pearson's correlation coefficiency. The findings were as follows: 1. There was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 2. There was no significant difference found in relation to sex, age, cause of stroke, laterality of paralysis and the level of spasticity. However, there was a big difference between pre- and post-treatment regarding the treatment period. 3. In line with the cognitive performance level, there was a significant difference found in the motor function recovery level after the comprehensive rehabilitation management. 4. The correlation between the elements of the cognitive performance and the motor recovery was found to be high in orientation, attention, calculation, and language. Those elements were expected to give larger effects on motor recovery after the comprehensive rehabilitation management. Based on this study, the cognitive performance level was found to play an important role in bringing effects on motor recovery after the comprehensive rehabilitation management of stroke patients. And the evaluation on the motor recovery based on quality would be also expected to be examined, as well as the cognitive performance level test accompanied by Intelligence Quality(IQ) test.

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Effects of Repetitive Transcranial Magnetic Stimulation on Motor Recovery in Lower Extremities of Subacute Stage Incomplete Spinal Cord Injury Patients: A Randomized Controlled Trial

  • Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.4
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    • pp.427-431
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    • 2015
  • The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in the lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p < 0.05). However, no significant differences in the amplitude were observed between the two groups (p > 0.05). The results of this study indicate that rTMS may be beneficial in improving motor recovery in the lower extremities of subacute stage SCI patients.

Recovery of an Injured Corticospinal Tract in a Patient With Infarction on the Corona Radiata

  • Lee, Sook;Lim, Hyoung-Won;Yeo, Sang-Seok
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.78-80
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    • 2015
  • Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.

뇌손상 후 상지 운동기능 회복 평가: 임상적 평가 및 운동반응 근전도 분석 (Evaluation of Upper-Limb Motor Recovery after Brain Injury: The Clinical Assessment and Electromyographic Analysis)

  • 김영호;태기식;송성재
    • 한국전문물리치료학회지
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    • v.12 no.1
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    • pp.91-99
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    • 2005
  • We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

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