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Journal of the Korean Academy of Rehabilitation Medicine 2007;31(2):162-168.
The Subjective and Objective Evaluations of Autonomic Nervous System Function in Stroke Patients.
Im, Sang Hee , Park, Yoon Ghil , Moon, Jae Ho , Nam, Hee Seong , Lee, Sang Chul , Park, Jin Hee
Department of Rehabilitation Medicine and Rehabilitation Institute of Muscular Disease, Yonsei University College of Medicine, Korea. drtlc@yumc.yonsei.ac.kr
뇌졸중 환자에서 자율신경계 기능의 주관적 및 객관적 평가
임상희, 박윤길, 문재호, 남희승, 이상철, 박진희
연세대학교 의과대학 재활의학교실 및 근육병 재활연구소
Abstract
Objective
To evaluate autonomic function in stroke patients and to explore the relationship between patient's subjective symptoms and the results of objective tests regarding autonomic dysfunction.
Method
Twenty stroke patients and 27 controls were recruited. Autonomic function was accessed by subjective checklist and by objective tests such as sympathetic skin response (SSR) and blood pressure (BP) response to positional change and to sustained hand-grip. Motor function was classified using the Brunnstrom stages: Group 1, stage 1 and 2; Group 2, stage 3 and 4; Group 3, stage 5 and 6.
Results
Seventy percent of patients had subjective changes in autonomic function after stroke. 50% and 65.5% of patients revealed autonomic insufficiency by BP response tests and SSR, respectively. More than half of the patients who didn't have any subjective changes in autonomic function revealed autonomic insufficiency by objective tests. Group 1 of Brunnstrom stage in upper extremity showed significantly longer SSR latencies (p<0.05) and lower amplitudes than the controls (p<0.05). Group 1 and 2 of Brunnstrom stage in lower extremity showed significantly longer SSR latencies (p<0.05) and lower amplitudes than the controls (p<0.05).
Conclusion
Although stroke patients don't complain any subjective symptoms of autonomic dysfunction, they need to undergo objective autonomic function evaluations such as SSR and BP responses. (J Korean Acad Rehab Med 2007; 31: 162-168)
Key Words: Stroke, Autonomic nervous system function, Subjective checklist, Objective test


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