• Title/Summary/Keyword: Stroke rehabilitation

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Effect of tDCS Stimulation for Improving Working Memory on Stroke Patients' EEG Variation (작업기억의 향상을 위한 tDCS 자극이 뇌졸중 환자의 뇌파변화에 미치는 영향)

  • Bae, Si-Jeol;Jeong, Woo-Sik;Lee, Hong-Gyun;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.261-272
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    • 2012
  • This study was conducted so as to examine which change tDCS (Transcranial Direct Current Stimulation) for improving working memory can make on the EEC of stroke patients. Among the patients who suffered for more than 6 months by hemiparalysis caused by stroke, 20 patients selected by MMSE and DST were randomly divided into I group (10 patients) fulfilled by only CCT and II group (10 patients) fulfilled by both tDCS and CCT for total 4 weeks, 30 minutes per a day, three times per a week. For examining EEC variation, the absolute spectrum power was calculated by three bands (${\theta}$; 4~8 Hz, lower ${\alpha}$; 8~10.5 Hz, upper ${\alpha}$;10.5~13 Hz) during the task of words, photos and mental calculation with EEC test, before the arbitration, after 2 weeks and after 4 weeks, so the rate of increase and decrease (%) for the reference EEC was obtained. As the results, the first, particular aspects different one another in three bands were detected according to the measuring period and task. The second, in the forth week, there was only a significant difference in lower ${\alpha}$-power of all tasks. Therefore, through the procedure measuring EEC of this study, the degree of working memory's damage can be expressed by numerical value and tDCS should be additionally helpful for brain damaged patients' perception rehabilitation.

Clinical Study on the Effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain (뇌졸중 후 중추성 통증 환자에 대한 봉독약침요법약침 치료 효과에 대한 임상적 연구)

  • Jeoung, Kyoung-suk;Kim, Su-hyun;Park, Seon-kyeong;Lim, Ho-jae;Yoon, Hyoung-seon;Ahn, Ho-jin
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.69-75
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    • 2005
  • Objective : This study is designed to find out the effect of Bee Venom Acupuncture Therapy on the Post-stroke Pain. Methods : Bee venom solution was injected on Seven Points of CVA-GB2l(肩井), LI15(肩隅), Ll11(曲池), GB31(風市), ST36(足三里), GB39(絶骨), ect- every other day for 3 weeks, in twenty patients who were admitted in Dong-Seo Oriental Medical Hospital, as diagnosed by their typical pain characteristics of central pain from stroke. Result : After 3 weeks treatment, visual analogue scale of pain severity showed significant decrease.

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The Verification of Korean Version Swallowing Disturbance Questionnaire (K-SDQ) (한국판 삼킴 곤란 척도(K-SDQ)의 번안본 검증)

  • Jung, SoWoon;Kim, JungWan
    • 재활복지
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    • v.22 no.4
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    • pp.43-58
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    • 2018
  • Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.

The Effects of Emotional Awareness Level and Stress on Social Participation in Stroke Disabled Persons Living in the Community (지역사회에 거주하는 뇌졸중 장애인의 정서적 자각 수준과 스트레스가 지역사회 참여에 미치는 영향)

  • Lim, Young-Myoung;Yoo, Doo-Han
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.323-331
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    • 2019
  • The purpose of this study was to identify the emotional and stress factors of the stroke victims living in the community and to investigate the effect of these factors on the level of social participation. Data collection collected data on the level of emotional awareness, stress, and social participation in welfare centers, public health centers, and stroke disabled people using community services. The level of social participation according to general characteristics was analyzed by descriptive statistics and one-way ANOVA. Emotional factors, stress factors, and social participation levels were analyzed by pearson correlation analysis and multiple regression analysis. As a result, there were no statistically significant factors in the sub-domains of emotional factors that affect social participation performance and satisfaction. In the sub-areas of stress factors, personal internal stress and interpersonal stress were statistically significant variables. The explanatory power showed social participation accomplishment was 34% and satisfaction was 33%. Therefore, various approaches should be made considering stressful factors to achieve rehabilitation into the local community, and additional research is needed to identify psychosocial variables that affect social participation.

Increase of Spoken Number of Syllables Using MIT(Melody Intonation Therapy) : Case Studies on older adult with stroke and aphasia (MIT(Melodic Intonation Therapy) 중심의 음악활동을 이용한 실어증을 가진 뇌졸중 노인의 음절 수 증가에 대한 사례 연구)

  • Hong, Do Kyoung
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.57-67
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    • 2005
  • Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.

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Myocardial atrophy in children with mitochondrial disease and Duchenne muscular dystrophy

  • Lee, Tae Ho;Eun, Lucy Youngmin;Choi, Jae Young;Kwon, Hye Eun;Lee, Young-Mock;Kim, Heung Dong;Kang, Seong-Woong
    • Clinical and Experimental Pediatrics
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    • v.57 no.5
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    • pp.232-239
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    • 2014
  • Purpose: Mitochondrial disease (MD) and Duchenne muscular dystrophy (DMD) are often associated with cardiomyopathy, but the myocardial variability has not been isolated to a specific characteristic. We evaluated the left ventricular (LV) mass by echocardiography to identify the general distribution and functional changes of the myocardium in patients with MD or DMD. Methods: We retrospectively evaluated the echocardiographic data of 90 children with MD and 42 with DMD. Using two-dimensional echocardiography, including time-motion (M) mode and Doppler measurements, we estimated the LV mass, ratio of early to late mitral filling velocities (E/A), ratio of early mitral filling velocity to early diastolic mitral annular velocity (E/Ea), stroke volume, and cardiac output. A "z score" was generated using the lambda-mu-sigma method to standardize the LV mass with respect to body size. Results: The LV mass-for-height z scores were significantly below normal in children with MD ($-1.02{\pm}1.52$, P<0.001) or DMD ($-0.82{\pm}1.61$, P =0.002), as were the LV mass-for-lean body-mass z scores. The body mass index (BMI)-for-age z scores were far below normal and were directly proportional to the LV mass-for-height z scores in both patients with MD (R =0.377, P<0.001) and those with DMD (R =0.330, P=0.033). The LV mass-for-height z score correlated positively with the stroke volume index (R =0.462, P<0.001) and cardiac index (R =0.358, P<0.001). Conclusion: LV myocardial atrophy is present in patients with MD and those with DMD and may be closely associated with low BMI. The insufficient LV mass for body size might indicate deterioration of systolic function in these patients.

Need Survey of Home Modification on Outpatient with Stroke and Spinal Cord Injury in Rehabilitation Center (재활치료를 받는 뇌졸중과 척추손상 외래환자들의 주거환경개선에 대한 요구도 조사)

  • Lim, Kyung-Min;Lee, Yu-Na
    • The Journal of the Korea Contents Association
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    • v.13 no.8
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    • pp.324-333
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    • 2013
  • The purpose of this study was to investigate the need of home modification for outpatient with stroke and spinal cord injury. The subjects of this study were 54 outpatients who have experience in rehabilitation therapy at hospitals in Seoul and Gyeonggi-do. A questionnaire was distributed and collected form January 2th to February 4th, 2012. Descriptive statistics and $x^2$-test were used to analyze data. There were statistically significant difference in stairs of access, in width of front door, in bathroom, space of room according diagnosis. There were statistically significant difference in light of sensor, tissue holder and socket cover in bathroom for the comparison of demands for home modification by living type. There were statistically significant difference in width and threshold of front door, tissue holder and towel bar, nonslip floor in bathroom, space and table, chair of kitchen, space and threshold of porch, light for the comparison of demands for home modification according score of MBI. Based on the results of the survey, needs of home modification is different according disability level, diagnosis, living type, ADL performance. The results of this study show a need for the further occupational therapy of home modification and supporting policies in home modification.

The effects of Meridian Massage on the functions of upper limbs and depression of hemiplegic patients (경락마사지가 편마비환자의 상지 기능과 우울에 미치는 효과)

  • Choi, Sun-Im;Kim, Hae-Kyung;Kim, Hee-Jeong;Suh, Mee-Kyung;Kim, Young-Hou;Kim, Mee-La;Kim, Mee-Jong;Choi, Mee-Sun;Jeong, Suk-Hee;Kim, Jeong-Hwa
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.228-242
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    • 2000
  • Meridian massage is originated from oriental medical manipulation, and it has been mainly applied to as pain and paralysis. The purpose was to develop new method of nursing care for help hemiplegic patients to recover their functions of upper limbs and to reduce depressions. This study was carried out between 8, March, and 8, June, 2000 and the subjects of the study were .60 hemiplegic stroke patients who were participants at a hospitalized in K oriental medical center. The experimental group(30) and the control group(30) were assigned by means of participation order. The experimental group took meridian massage on affected upper limb for 10 minutes daily for 2 weeks. We evaluated muscle power and endurance with band from AVIVA corp.; range of motion with goniometer; shoulder pain with visual analogue scale; swelling with Jeweiers ring measurement of Dirette; depression with self-rating depression scale translated into Korean by Yang(1982). Data were analyzed by SPSS PC and the results are described below. The experimental group showed better muscle power and endurance than control group. Range of motiont of affected shoulder improved significantly in experimental group. Also, the experimental group showed less shoulder pain, hand edema, depression than control group. In this study, we observed that meridian massage is an effective nursing care in improving the function of upper limb and managing depression of stroke patients.

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The Clinical Evaluation of East-West Medical Management for Central Poststroke Pain (뇌졸중후 중추성 통증에 대한 동서협진의 임상적 효율성 평가)

  • Cheong, Byung-Shik;Kim, Keon-Sik;Lee, Doo-Ik;Choi, Do-Young
    • Journal of Pharmacopuncture
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    • v.4 no.2
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    • pp.95-103
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    • 2001
  • Background : Central poststroke pain(CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulty in the social activities and daily life. In this study, we evaluate the clinical effectiveness of east-west medical management for CPSP through VAS(visual analogue scale), infrared themography, MBI(Moderfied Barthel Index) and Rankin scale. Methods : We treated thirty patients with oriental medical treatment method and western & oriental medical treatment method. Each group has fifteen patients of the CPSP. We evaluated their pain(characterizes tingling and burning sensation, aching, hyperalgesia, and allodynia) through VAS(visual analog scale) pain score, the skin temperature of pain site by infrared thermography and assessed their mobility & rehabilitation ability through MBI(Moderfied Barthel Index), Rankin scale before and after pain treatment. Results : The skin temperature of pain site was lower than non-pain site. The difference of skin temperature improved from $0.65{\pm}0.45^{\circ}C$ to $0.39{\pm}0.25^{\circ}C$ after oriental medical treatment and $0.68{\pm}0.54^{\circ}C$ to $0.27{\pm}0.24^{\circ}C$ after western & oriental medical treatment VAS scores improved from $7.9{\pm}1.4$ to $4.7{\pm}1.6$ after oriental medical treatment and $8.1{\pm}1.3$ to $4.6{\pm}1.2$ after western & oriental medical treatment. MBI scores improved from $61.40{\pm}13.58$ to $85.00{\pm}13.85$ after oriental medical treatment and $52.26{\pm}13.52$ to $77.13{\pm}12.04$ after western & oriental medical treatment. And Rankin scale scores improved from $3.33{\pm}0.72$ to $2.46{\pm}0.74$ after oriental medical treatment and $3.60{\pm}0.82$ to $2.66{\pm}0.81$ after western & oriental medical treatment Conclusion : The difference of skin temperature and Rankin scale scores more significantly improved after western & oriental medical treatment than oriental medical treatment. According to the results, we thought east-west medical management is very useful treatment for CPSP and rehabilitation of the patients with stroke.

Effects of Coptidis Rhizoma on the Anti-inflammation and Motor Recovery in Photothrombotic Brain Infarction Model in Rats (광화학적 뇌경색 백서 모델에서 황련의 항염증 및 운동기능 회복에 미치는 효과)

  • Lee, Su-Kyung;Lee, In;Shin, Sun-Ho;Kim, Eun-Young;Shin, Byung-Cheul
    • The Korea Journal of Herbology
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    • v.24 no.1
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    • pp.179-189
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    • 2009
  • Objectives : Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it's mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods : Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-$\alpha$, IL-6, IL-1$\beta$), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results : CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1$\beta$, IL-6 and TNF-$\alpha$. In serum, CR 500 decreased the amount of IL-1$\beta$, 12h, 24h and 48h respectively (p < 0.05), also decreased that of IL-6 and TNF-$\alpha$, 12h respectively (p < 0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions : This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.