A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia.

Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires.

Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way.

It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.

The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E.

A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal.

After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups.

The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.

The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients.

A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the U/E motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality).

1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up.

The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease.

A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity.

The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups.

Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke.

For this study, the grounded theory method was utilized.

After constant comparative analysis, the core category emerged as ‘rebuilding the body which was ruined’. In addition, the causal conditions were ‘restriction of physical function’, and ‘loss of roles’. The adjustment process consisted of the ‘facing reality phase’, ‘overcoming depression phase’, ‘overcoming physical limits phase’ and ‘reestablishing roles phase’. The main strategies in the facing reality phase were ‘holding on to a glimmer of hope’, ‘getting away from the harsh reality’ and ‘facing up to the reality’. The main strategies in the overcoming depression phase were ‘soothing oneself’, ‘Self-introspection’ and ‘restoring self-esteem’. In addition, the main strategies in the self-initiative overcoming physical limits phase was ‘discovering personal strategies and striving to recover’. The main strategies in the reestablishing roles phase were ‘reestablishing a parents’ role’, ‘reestablishing a spouse's role’ and ‘reestablishing social roles’.

In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.