OBJECTIVE: To evaluate the effect of the biofeedback balance training using Interactive Balance System (IBS) in acute stroke patients. METHOD: We recruited 40 acute stroke patients who were able to stand independently. The patients were divided into two groups. One group received conventional balance training (control group) and the other group received biofeedback balance training using IBS (case group) for 2 weeks. After training, the effects were evaluated using 3 parameters: indices from IBS (stability score, weight distribution index, and distance form zero point to body's center of pressure (COP) in coordinate), balance assessments (Berg balance scale and postural assessment scale for stroke patients), and functional outcome (the Korean version of modified Barthel index). RESULTS: There were no differences in age and time since onset between the two groups. All parameters were significantly improved in both groups after training. However, the distribution of COP of the case group was significantly closer to the zero point than that of the control group in coordinate after training (p=0.005). CONCLUSION: Biofeedback balance training using IBS has a better effect on the symmetry in static condition on evaluation using IBS than conventional balance training for acute stroke patients.
Biofeedback, Psychology ; Humans ; Stroke

OBJECTIVE: To investigate the effect of dynamic balance training with center of pressure (COP) games using visual biofeedback of COP movement in stroke patients. METHOD: Thirty-eight stroke patients were randomly as signed to the static or dynamic balance training group, or control group. Static group received weight-shift training with visual biofeedback of weight distribution bar. Dynamic group received dynamic balance training using COP games. Each training session lasted 30 minutes, 3 times in a week during 3 weeks. Control group received traditional rehabilitation only. The ability of balance control was assessed using posturography by total path distance, frequency of sway, and COP weight-spectrums during standing, and during presentation of virtual moving surround. Total patherror was also assessed during sine curve and dynamic circle trace test. RESULTS: In static group, there were significant improvement in the total path distance during comfortable standing and path error during sine curve tracing. In dynamic group, significant improvements were found in the path error during sine curve and dynamic circle tracing. CONCLUSION: Dynamic training group showed more improvement in dynamic balance ability, whereas static group showed more changes in the static balance ability. The visual biofeedback training is more specified for balance rehabilitation in stroke patients.
Biofeedback, Psychology* ; Humans ; Rehabilitation ; Stroke*

BACKGROUND: The aims of this study were to develop and internally and externally validate a prognostic model that can predict the benefit and harm of thrombolysis in patients with acute ischemic stroke and that may be used promptly in an emergency setting. METHODS: The data of a consecutive series of patients who were hospitalized to Seoul National University Bundang Hospital within 12 hours of stroke onset between January 2004 and March 2008 and with relevant ischemic lesions on diffusion-weighted MRI were used to develop and internally validate the prognostic model. The external validation was performed using the data of patients from five participating centers of the Clinical Research Center for Stroke that had been collected between April 2008 and September 2009. The score on the modified Rankin Disability Scale at 3 months was selected to determine the efficacy outcome, and the occurrence of symptomatic hemorrhagic transformation was used to evaluate the safety outcome. Prognostic models were constructed with logistic regression, and both internal and external validations were performed. RESULTS: The discriminative abilities of the efficacy model (C statistic=0.880) and the safety prognostic model (C statistic=0.864) were confirmed. External validation of both models revealed remarkably little degradation in the discrimination power (C statistic=0.835 and 0.822 for the efficacy and safety models, respectively). CONCLUSIONS: This study shows that the efficacy and safety prognostic models developed with basic clinical variables were reliably validated with independent data. Both models may be helpful to clinicians in the emergency setting to identify patients who would benefit from thrombolysis.
Discrimination (Psychology) ; Emergencies ; Humans ; Logistic Models ; Stroke

There is a growing interest in the use of music therapy in neurological rehabilitation. Of all the major neurological illnesses, stroke rehabilitation has been observed to have some of the strongest potential for music therapy's beneficial effect. The current burden of stroke has raised the need to embrace novel, cost-effective, rehabilitation designs that will enhance the existing physical, occupation, and speech therapies. Music therapy addresses a broad spectrum of motor, speech, and cognitive deficits, as well as behavioral and emotional issues. Several music therapy designs have focused on gait, cognitive, and speech rehabilitation, but most of the existing randomized controlled trials based on these interventions have a high risk of bias and are statistically insignificant. More randomized controlled trials with greater number of participants are required to strengthen the current data. Fostering an open and informed dialogue between patients, healthcare providers, and music therapists may help increase quality of life, dispel fallacies, and guide patients to specific musical interventions.
Humans ; Music/psychology* ; Music Therapy ; Quality of Life/psychology* ; Stroke/therapy* ; Stroke Rehabilitation

BACKGROUND: The aim of this study is to evaluate the effect of electromyographically triggered electrical stimulation (ETES) on shoulder subluxation in stroke patients. METHOD: Twenty-three patients, who had hemiplegic shoulder subluxation within 3 months after stroke attack, were included. They were assigned randomly to either a control group (11 subjects) or a study group (12 subjects), and divided clinically to mild and severe subgroups by the degree in subluxation. Patients in both groups were received physical therapy and used an arm-sling. Subjects in the study group were taken ETES using biofeedback training on posterior deltoid and the supraspinatus muscle of hemiplegic subluxation side, daily 30 minutes a session, five days a week for 6 weeks. Electromyographic signals, which are derived from patient's voluntary muscle contraction, that exceeded a preset threshold trigger an immediate stimulation to force movement completion. The effect of ETES was assessed by the degree of subluxation using radiologic measurements at pre-treatment and 6 weeks post-treatment. RESULTS: In the control group, the degree of subluxation was increased after 6 weeks (p>0.05). In the study group, the subluxation was significantly reduced (p<0.05). The significant difference after treatment 6 weeks in mild and severe subgroups implied similar improvement between subgroups. CONCLUSION: The ETES may be the one of effective treatment methods for reducing the severity of hemiplegic shoulder subluxation in stroke patients.
Biofeedback, Psychology ; Electric Stimulation* ; Hemiplegia ; Humans ; Muscle, Skeletal ; Shoulder* ; Stroke*

BACKGROUND: Limited information about the effects of stroke on sexual functioning is available. The purpose of this study was to assess the influences of ischemic stroke on sexual functioning and to evaluate the clinical and psychological factors related to poststroke sexual dysfunctions. METHODS:Sixty-six male post-ischemic stroke patients and fifty-one age-matched healthy controls completed a self-administered questionnaire on sexual functioning. The localization of ischemic stroke was determined by neuroimaging findings as well as focal neurological signs. The degree of disability and the degree of depression were also assessed. RESULTS: All domains of sexual functioning, including erectile functions, orgas-mic functions, sexual desire, intercourse satisfaction, and overall satisfaction were decreased in poststroke patients. Patients with occipital lesions had a lesser degree of sexual dysfunctions than those with lesions affecting other areas (p<0.05). Also, sexual dysfunctions in stroke patients were related to the degree of physical disability and the presence of depression (p<0.05). CONCLUSIONS Sexual dysfunctions are common in stroke patients. The reasons for sexual dysfunc-tions after stroke are multifaceted, which include stroke lesion site, physiological factors, and psychosocial factors. (J Korean Neurol Assoc 19(4):342~348, 2001)
Depression ; Humans ; Male ; Neuroimaging ; Psychology ; Surveys and Questionnaires ; Stroke*

PURPOSE: The purpose of this study was to develop an empowerment program as a nursing intervention for the patients having an acute stroke and to determine the effects of the program on their motivation, depression, and activities of daily living(ADLs). METHODS: An non-equivalent control group pretest-posttest design was used in this study. Sixty subjects were recruited from two separated institutions: 31 patients were allocated into experimental group and 29 were into control group. Six week empowerment program was provided to the experimental group. The study was conducted from November 2006 to March 2007. RESULTS: After 6 week empowerment program, rehabilitation motivation was significantly increased in the experimental group in comparison to the control group(t=-2.173, p=.036). There were no significant differences in depression and ADLs between experimental and control groups. CONCLUSION: The empowerment program effectively increased rehabilitation motivation of patients with stroke, while did not improve the levels of depression and ADLs. Future long-term intervention may benefit the patients more in terms of depression and ADLs when considering the acute stage of the patients in this study.
Activities of Daily Living ; Depression ; Humans ; Motivation ; Power (Psychology) ; Stroke

PURPOSE: The purpose of this meta-analysis isto identify social psychological factors related to quality of life and estimate the effect sizes of the factors among patients with strokes. METHODS: Thirteen studies with a total of 1,814 patients published from the earliest records to January 8, 2017 were selected through a systematic process of searching the literature, and evaluated against influencing factors of quality of life and their effect sizes. Pooled effect sizes were calculated using the random effect model. Meta-analysis was conducted by R software. RESULTS: The following influencing factors had a strong association with quality of life with stroke: depression (r=−.50; 95% CI: −0.63~−0.46), activities of daily living (r=.46; 95% CI: 0.35~0.56), and social support (r=.40; 95% CI: 0.24~0.53). CONCLUSION: The findings confirm that depression, activities of daily living and social support are associated with quality of life among patients with stroke survivors. We recommend that any intervention program to improve the quality of life with stroke patients consider addressing these modifiable influencing factors.
Activities of Daily Living ; Depression ; Humans ; Psychology ; Quality of Life ; Stroke ; Survivors

OBJECTIVE: This study was aimed to compare the effect of visuo-perceptual biofeedback sitting balance training using Balance Master in stroke patients with that of conventional sitting balance training. METHOD: The subjects were twenty-four stroke patients receiving rehabilitation therapy who could maintain sitting posture independently. These patients were randomly divided into a control and an experimental group. The ability of static postural balance control with the modified Clinical Test Sensory Interaction Balance (mCTSIB) and the weight bearing test was measured before and after the balance training. The ability of dynamic postural balance control was measured with the limit of stability (LOS) test and the rhythmic weight shift test. Motor assessment scale (MAS) and modified Barthel index (MBI) were also checked for measuring the effects. RESULT: There was significant improvement in both abilities of static and dynamic postural balance control in the experimental group that had visuo-perceptual biofeedback training using the Balance Master (p<0.05). MAS and MBI scores after the training showed a bigger increase in the experimental group than in the control group. CONCLUSION: The visuo-perceptual biofeedback sitting balance training using the Balance Master was considered to be more effective than the conventional training in the stroke patients.
Biofeedback, Psychology* ; Humans ; Postural Balance ; Posture ; Rehabilitation ; Stroke* ; Weight-Bearing

OBJECTIVE: This study is aimed at the pathoanatomic correlates of emotional problem in the patients with stroke. METHOD: Thirty patients with single, unilateral hemispheric lesion and no predisposing factors for psychiatric disorder were selected. Several neuropsychological assessments such as Mini- mental status examination-Korean (MMSE-K), Minnesota multiphasic personality inventory (MMPI), Symptom checklist-90-Revision (SCL-90-R) and Functional independence measure (FIM) were performed on all patients by a clinical psychologist and an occupational therapist. RESULTS: There were statistically significant differences between right and left hemisphere lesion group in emotional problems. Right hemispheric lesion group showed significantly higher scores of psychasthenia (MMPI), Obsessive-compulsive (SCL-90-R) and self care (FIM) than left hemispheric lesion group did. But there were no statistically significant differences between cortical and subcortical lesion group. Groups of left cortical lesion, right cortical lesion, left subcortical lesion and right subcortical lesion were not significantly different in their neuropsychological assessments and FIM except self care. CONCLUSION: Obsessive-compulsive and anxious emotional problems are more closely related with right hemispheric lesion. Therefore patients with right hemispheric lesion need more careful psychological and psychiatric evaluation. However, because of the small numbers of subjects involved in the study, the role of lesion location remains unclear so that consecutive follow-up studies are needed.
Causality ; Humans ; MMPI ; Neuroanatomy ; Neuropsychology ; Psychology ; Self Care ; Stroke*