BACKGROUNDDepression is a common problem impeding post-stroke rehabilitation. Up to 70% of patients show depression symptoms during the first twelve months after stroke onset. However, the depression and its effect on functional recovery can be difficult to diagnose. The purpose of this study was to use gait analysis as a tool to compare the recovery after stroke in patients with and without depression and to assess the impact of the initiation time of rehabilitation after stroke onset.

METHODSOne hundred and forty five consecutive patients after first ever stroke admitted for designed rehabilitation program within 2 to 31 months after stroke onset participated. All patients received 4 weeks treatment program included comprehensive rehabilitation consisted of multipurpose activities 5 days a week. These included individual and group exercises, physiotherapy, occupational therapy and gait training. Gait analysis with Kistler force plates was employed to assess gait pattern symmetry before and after the treatment. Gait symmetry was evaluated based on seven gait parameters. Regaining of gait pattern symmetry was assumed as a measure of rehabilitation outcome.

RESULTSAfter rehabilitation program gait symmetry was regained in patients without depression. Gait asymmetry remained unchanged in patients diagnosed with depression. No major differences in outcome from rehabilitation were noted in regards to the initiation time of rehabilitation after the stroke onset.

CONCLUSIONSDepression limits gait recovery after stroke. The time of initiation of rehabilitation after stroke onset does not limit the motor recovery after rehabilitation program.

Adult ; Aged ; Depression ; physiopathology ; Female ; Gait ; physiology ; Humans ; Male ; Middle Aged ; Recovery of Function ; physiology ; Stroke ; physiopathology ; psychology ; Walking ; physiology

This Stroke Rehabilitation Apparatus uses the electromyography triggered neuromuscular electrical stimulation as the means of the major therapeutics, and the fastigial nucleus stimulation as the means of the assistant therapeutics. This paper introduces the overall structure of the apparatus, the principle of its component, the EMG processing based on local nonlinear projective filtering algorithm and the alternating treatment modes. The therapeutic apparatus has the features of non-invasiveness, safety, convenience and strong alternating capability.
Biofeedback, Psychology ; Electric Stimulation Therapy ; instrumentation ; Electromyography ; methods ; Humans ; Movement Disorders ; etiology ; physiopathology ; rehabilitation ; Psychomotor Performance ; physiology ; Recovery of Function ; Stroke ; physiopathology ; Stroke Rehabilitation

PURPOSE: The purpose of this research was to examine the relationship between sexual knowledge, frequency, satisfaction, marital intimacy, and depression levels in stroke survivors and their spouses. METHODS: This study was a convenience sample of Korean men who had experienced a stroke and their spouses. The subjects were discharged from the hospital and received physical therapy. Data such as sexual knowledge, frequency, satisfaction, marital intimacy, and depression levels were collected from November 2005 to April 2006. RESULTS: In a comparison of stroke survivors and their spouses, the survivors showed higher mean levels of sexual knowledge and marital intimacy. The levels of knowledge, frequency, satisfaction and marital intimacy were low and depression was mild in the subjects. There were significant correlations between sexual frequency, sexual satisfaction and marital intimacy. Also, subjects with lower levels of sexual satisfaction were more depressed. The spouses who possessed greater levels of sexual knowledge reported a higher frequency of sex and greater marital intimacy. In addition, spouses who reported feeling greater levels of marital intimacy experienced fewer depressive symptoms. CONCLUSION: These findings demonstrate a need for the development of sexual adaptation programs which could be effective in improving sexual knowledge, frequency, satisfaction, marital intimacy, and depression reported by stroke patients and their spouses. Ideally, these corrective programs should be administered before patients are discharged from the hospital.
Adult ; Aged ; *Depression ; Female ; Humans ; Interpersonal Relations ; Male ; Marriage ; Middle Aged ; Personal Satisfaction ; Sexual Behavior ; *Sexuality ; Spouses/*psychology ; Stroke/physiopathology/*psychology ; *Survivors

OBJECTIVETo explore the impacts on the fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture and motor imagery.

METHODSSixty-two cases of flaccid paralysis of upper extremity in stroke were randomized into an observation group (30 cases) and a control group (32 cases). In the control group, the conventional western medication and the passive movement of the extremity were applied. Additionally, the penetrating needling technique was used at the head points [penetrating needling from Baihui (GV 20) to Taiyang (EX-HN 5)] and the local affected extremity [penetrating needling from Jianyu (LI 15) to Binao (LI1 14), from Quchi (LI 11) to Shaohai (HT 3), from Waiguan (TE 5) to Neiguan (PC 6), etc]. The needles were retained for 30 min. In the observation group, on the basic treatment as the control group, during the needle retaining, the motor imagery therapy was supplemented. The treatment was given once a day, 5 treatments a week, for 4 weeks totally in the either group. The scores in the action research arm test (ARAT) and the modified Fugl-Meyer assessment (FMA) were recorded at the moment of enrollment, in 2 and 4 weeks of treatment, in the 6th and 8th weeks, as well as after 90 days separately.

RESULTS(1) ARAT score: since the 2nd week, ARAT scores in the observation group were all improved significantly as compared with those in the control group at the each time points (all P<0. 05). In the observation group, the scores were improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, the score in the 2nd week was not different significantly as compared with that before treatment (P>0. 05), but the scores at the rest time points were improved significantly in the pair comparison (all P<0. 05); (2) FMA score: in the 2nd week and on the 90th day, FMA score in the observation group was higher significantly than those in the control group (both P < 0. 05). In the observation group, the scores were all improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, except that in comparison between the 90th day and the 8th week (P>0. 05), the results were all P<0. 05 at the rest time points.

CONCLUSIONThe early intervention of the combined therapy of acupuncture and motor imagery effectively promotes the recovery of the coordination function and the fine movement of upper extremity, especially the improvements of the fine movement in stroke at flaccid paralysis stage. The efficacy is better than the single acupuncture treatment.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Imagery (Psychotherapy) ; Imagination ; Male ; Middle Aged ; Motor Activity ; Paraplegia ; etiology ; physiopathology ; psychology ; therapy ; Stroke ; complications ; therapy ; Upper Extremity ; physiopathology

OBJECTIVETo investigate the clinical application value of Loewenstein Occupational Therapy Cognitive Assessment battery in Chinese patients with post-stroke aphasia.

METHODSCognitive functions of 59 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of LOTCA battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale, respectively. The Results of LOTCA were analyzed and compared across different groups, in the light of gender, age, educational background, the length of illness, and the degree of aphasia.

RESULTSNeither the score of subtests of the LOTCA nor the overall scores of LOTCA of aphasia patients with different gender and educational background differed (all P>0.05). In different age groups, apart from thinking operation (F=3.373, P=0.016), visuomotor organization (F=3.124, P=0.022), attention (F=3.729, P=0.009) and the total score (F=2.683, P=0.041), there was no difference in terms of the other subtest scores of LOTCA (all P>0.05). In the groups of different length of time with illness, apart from orientation (F=2.982, P=0.039) and attention (F=3.485, P=0.022), the score of other subtests and the total score of LOTCA were not different (all P>0.05). In the groups of different degree of aphasia, apart from attention (F=2.061, P=0.074), both the score of other subtests and the total score of LOTCA differed (all P<0.05).

CONCLUSIONLOTCA might be suitable to assessing the cognitive ability of post-stroke Chinese patients with aphasia.

Adult ; Aged ; Aged, 80 and over ; Aphasia ; etiology ; physiopathology ; psychology ; therapy ; Asian Continental Ancestry Group ; China ; Cognition ; Female ; Humans ; Male ; Middle Aged ; Occupational Therapy ; Retrospective Studies ; Stroke ; complications ; physiopathology ; psychology ; therapy

OBJECTIVES: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. METHODS: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. RESULTS: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. CONCLUSIONS: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage/physiopathology ; Female ; Humans ; Incidence ; Income/statistics & numerical data ; Male ; Middle Aged ; Republic of Korea ; Sex Factors ; *Social Class ; Stroke/classification/*epidemiology/psychology