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Annals of Rehabilitation Medicine
Number of Followers: 2  Open Access journalISSN (Print) 2234-0645 - ISSN (Online) 2234-0653 Published by Korean Academy of Rehabilitation Medicine  [1 journal]
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- Immediate Effects of a Single Exercise on Behavior and Memory in the Early
Period of Traumatic ...
Abstract: Objective To evaluate the immediate effect of single exercise on physical performance and memory in the early stage of traumatic brain injury (TBI) in rats.Methods Ninety TBI rats were randomly assigned to T0 (sedentary), T10 (treadmill 10 m/min for 30 minutes), or T20 (treadmill 20 m/min for 30 minutes) groups, on day 3 (D3), D7, and D14 after TBI, respectively. Rotarod (RR), Barnes maze (BM), brain magnetic resonance imaging (MRI) and MR spectroscopy were performed immediately before and 6 hours after exercise. Rats were sacrificed for immunohistochemistry with heat shock protein 70 (Hsp70) and glial fibrillary acidic protein (GFAP).Results On D3, the T10 and T20 groups demonstrated significant improvement in RR (p
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Comparison Between Neuromuscular Electrical Stimulation to Abdominal and
Back Muscles on ...
Abstract: Objective To compare the effects of neuromuscular electrical stimulation (NMES) to abdominal muscles and back muscles on postural balance in post-stroke hemiplegic patients.Methods Thirty post-stroke hemiplegic patients were prospectively enrolled and randomly assigned to one of the three groups: core muscle-strengthening exercise (CME) with NMES to abdominal muscles (group A), CME with NMES to back muscles (group B), and CME alone (group C). All subjects underwent their targeted interventions for 30 minutes each day, 5 days per week for 3 weeks under a conventional stroke rehabilitation program. Subjects were evaluated using Korean version of Berg Balance Scale (K-BBS), Trunk Impairment Scale (TIS), Korean version of Modified Barthel Index (K-MBI), Weight Distribution Index (WDI), and Stability Index (SI) just before and 3 weeks after intervention.Results Changes in K-BBS (p
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Predictors of Community Participation Among Individuals With First Stroke:
A Thailand Study
Abstract: Objective To describe perceived participation among persons with first stroke and to identify the predictors based on the International Classification of Functioning, Disability and Health (ICF) concept of participation after stroke.Methods A total of 121 participants completed 4 questionnaires: the Impact on Participation and Autonomy (IPA), Personal Resource Questionnaire (PRQ2000), Hospital Anxiety and Depression Scale (HADS), and personal history. They were evaluated for their balance, motor function, functional and walking ability.Results The majority of participants perceived participation restriction in family role as poor to very poor. The best predictors of participation included social support, walking and balance, functional ability, number of secondary health problems and affected side, account for 66.6% of the variances in participation.Conclusion The study highlights the importance of social support, walking and balance performance, functional ability in daily living, and number of secondary health problems after stroke. These factors that facilitate participation after stroke should be addressed by health personnel during rehabilitation.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Long-Term Outcomes of FIM Motor Items Predicted From Acute Stage NIHSS of
Patients With Middle ...
Abstract: Objective To outline the association between the National Institutes of Health Stroke Scale (NIHSS) in the acute stage and the Functional Independence Measure (FIM) of motor items several months later.Methods Seventy-nine infarct cases with middle-cerebral-artery region transferred to long-term rehabilitation facilities were analyzed. Patients were allocated to either the model-development group or the confirmatory group at a 2:1 ratio. Independent variables were based on the NIHSS during the acute care and on demographic factors such as age and modified Rankin Scale (mRS) before onset. Multivariate logistic analyses were performed to predict the independence of each FIM motor item. These models were evaluated in the confirmatory group.Results Multivariate logistic analyses in the model-development group (n=53) indicated that at least one NIHSS item was statistically significantly associated with the functional independence of a single FIM motor item. Of the NIHSS items, the affected lower extremity item was the most widely associated with 11 of the FIM motor items, except for eating and shower transfer. The affected upper extremity function was the second widely involved factor associated with 7 of the FIM motor items including eating, grooming, bathing, toileting, bed transfer, toilet transfer, and shower transfer. Age and mRS were also statistically significant contributing factors. The obtained predictive models were assessed in the confirmatory group (n=26); these were successful except for the stairs climb item.Conclusion In combination with age and pre-stroke status, the NIHSS items (especially the affected extremity items) may be useful for the prediction of long-term outcome in terms of activities in daily living.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation
Abstract: Objective To investigate whether fracture type, surgical procedure, or fracture grade affect knee pain during postoperative rehabilitation after a hip fracture.Methods We conducted a retrospective case-controlled study of 139 patients during postoperative rehabilitation after surgery for hip fractures. Patients were divided into two groups: patients experiencing knee pain during the first week of postoperative rehabilitation, and patients without knee pain. We compared the types of fracture, surgical procedure, and fracture grade between the two groups.Results We enrolled 52 patients (37.4%) with knee pain during the first weeks of postoperative rehabilitation. For type of fracture, knee pain was more common with intertrochanteric fracture than with femur neck fracture (48.8% vs. 21.1%, respectively; p=0.001). For the surgical procedure, there was no significant difference between the groups. For the fracture grade, the grades classified as unstable fractures were more common in the group of intertrochanteric fracture patients with knee pain than in those without knee pain (74.1% vs. 36.4%, respectively; p=0.002).Conclusion Intertrochanteric fracture affected knee pain after hip fracture surgery more than did femur neck fracture, particularly in unstable fractures. Furthermore, there was no difference in each fracture type according to the surgical procedure. Careful examination and management for knee pain is needed in patients with hip fracture surgery.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- A New Functional Scale and Ambulatory Functional Classification of
Duchenne Muscular Dystrophy: ...
Abstract: Objective To develop a simplified functional scale and classification system to evaluate the functional abilities of patients with Duchenne muscular dystrophy (DMD).Methods A Comprehensive Functional Scale for DMD (CFSD) was developed using the modified Delphi method. The accompanying Ambulatory Functional Classification System for DMD (AFCSD) was developed based on previously published classification systems.Results The CFSD consists of 21 items and 78 sub-items, assessing body structure and function, activities, and participation. Inter-rater intraclass correlation coefficient values were above 0.7 for 17 items. The overall limits of agreement between the two examiners ranged from -6.21 to 3.11. The Spearman correlation coefficient between the total score on the AFCSD and the Vignos Functional Scale was 0.833, and 0.714 between the total score of the AFCSD and the Brooke scale. Significant negative correlations existed between the total score for each functional level of the AFCSD and each functional grade of the Vignos and Brooke scales. The total scores of the CFSD varied significantly between the functional grades of the Vignos scale, and specific grades of the Brooke scale. For the AFCSD, total scores of the CFSD varied significantly between the functional levels.Conclusion We have developed a new scale and the associated classification system, to assess the functional ability of children diagnosed with DMD. Preliminary evaluation of the psychometric properties of the functional scale and classification systems indicate sufficient reliability and concurrent validity.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Psychometric Properties of Three Fatigue Rating Scales in Individuals With
Late Effects of Polio
Abstract: Objective To evaluate the psychometric properties of the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), and the Multidimensional Fatigue Inventory (MFI-20) in persons with late effects of polio (LEoP). More specifically, we explored the data completeness, scaling assumptions, targeting, reliability, and convergent validity.Methods A postal survey including FSS, FIS, and MFI-20 was administered to 77 persons with LEoP. Responders received a second survey after 3 weeks to enable test-retest reliability analyses.Results Sixty-one persons (mean age, 68 years; 54% women) responded to the survey (response rate 79%). Data quality of the rating scales was high (with 0%'0.5% missing item responses), the corrected item-total correlations exceeded 0.4 and the scales showed very little floor or ceiling effects (0%'6.6%). All scales had an acceptable reliability (Cronbach
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Golf Swing Rotational Velocity: The Essential Follow-Through
Abstract: Objective To evaluate if shoulder and pelvic angular velocities differ at impact or peak magnitude between professional and amateur golfers. Golf swing rotational biomechanics are a key determinant of power generation, driving distance, and injury prevention. We hypothesize that shoulder and pelvic angular velocities would be highly consistent in professionals.Methods Rotational velocities of the upper-torso and pelvis throughout the golf swing and in relation to phases of the golf swing were examined in 11 professionals and compared to 5 amateurs using three-dimensional motion analysis.Results Peak rotational velocities of professionals were highly consistent, demonstrating low variability (coefficient of variation [COV]), particularly upper-torso rotational velocity (COV=0.086) and pelvic rotational velocity (COV=0.079) during down swing. Peak upper-torso rotational velocity and peak X-prime, the relative rotational velocity of uppertorso versus pelvis, occurred after impact in follow-through, were reduced in amateurs compared to professionals (p=0.005 and p=0.005, respectively) and differentiated professionals from most (4/5) amateurs. In contrast, peak pelvic rotational velocity occurred in down swing. Pelvic velocity at impact was reduced in amateurs compared to professionals (p=0.019) and differentiated professionals from most (4/5) amateurs.Conclusion Golf swing rotational velocity of professionals was consistent in pattern and magnitude, offering benchmarks for amateurs. Understanding golf swing rotational biomechanics can guide swing modifications to help optimize performance and prevent injury.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Cost of Rehabilitation Treatment of Patients With Cerebral Palsy in Korea
Abstract: Objective To investigate rehabilitation treatment cost of patients with cerebral palsy (CP) according to age.Methods We analyzed the cost of rehabilitation treatment from 2007 to 2013 for patients diagnosed with CP by sourcing data from the National Health Information Database.Results While the number of recently born children requiring rehabilitation treatment has decreased, the number of patients requiring this treatment in other age groups has gradually increased. In addition, annual physical therapy, occupational therapy, hydrotherapy, and botulinum toxin injection treatment costs per person have increased. On the other hand, the number of orthopedic surgeries and selective dorsal rhizotomy performed has decreased.Conclusion This study investigated trends in the cost of treatment for patients with CP. This study can be used as a basis to provide treatment support for patients with CP.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Disability Registration State of Children With Cerebral Palsy in Korea
Abstract: Objective To investigate the disability registration state of children with cerebral palsy (CP) in Korea.Methods Based on the National Health Information Database, the disability registration state was examined for brain lesion disability and other possible complicated disabilities accompanying brain disorder in children diagnosed with CP aged up to 5 years old who were born between 2002 and 2008.Results Of children diagnosed with CP, 73.1% were registered as having brain lesion disability for the first time before they turned 2 years old. The younger the children, the more likely they will have 1st and 2nd degree disability. However, when the age of children is increased, such likelihood is decreased. The percentage of children registered as having overlapping disabilities was 7%?20%.Conclusion It is important to establish a more accurate standard to rate disability and provide national support systems for children with CP with various severities and multiple disabilities. By reorganizing the current disability registration system for pediatric brain lesions, the system could serve as a classification standard to provide medical and social welfare services.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Parents' Perspectives and Clinical Effectiveness of Cranial-Molding
Orthoses in Infants With ...
Abstract: Objective To investigate the clinical effectiveness of and parents
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Effect of Type D Personality on Short-Term Cardiac Rehabilitation in
Patients With Coronary ...
Abstract: Objective To investigate the effect of type D personality on cardiac rehabilitation (CR) participation rates and the effect of a short-term CR program.Methods Study participants included patients diagnosed with acute coronary syndrome who underwent percutaneous coronary intervention. Patients completed the Type D personality Scale (DS-14) and the Hospital Anxiety and Depression Scale (HADS) at program entry. Subjects were recommended participation in 6 weeks of CR exercise training. Cardiopulmonary exercise test (CPET) was conducted before and after completion of the training. CR participation refers to completion of the 6-week CR exercise program and performance of the secondary CPET. Drop-out refers to the subjects who were unable to participate in the 6-week CR exercise program or to perform the secondary CPET.Results At baseline, type D personality was evident in 21 of 63 patients (33.3%). Type D patients were more often depressed (57.1%) and anxious (38.1%) than non-type D patients (31.0% and 9.5%, respectively). At baseline, participants with type D personality showed a decreased body mass index (24.6 vs. 26.1 kg/m2, p=0.025). The type D group displayed a lower CR participation rate (5/21, 23.8%) compared with the non-type D group of (22/42, 52.4%). Logistic regression analysis revealed the association of type D personality with CR drop-out rate (odds ratio=3.87; 95% confidence interval, 1.2'12.5; p
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Evaluating Korean Personal Assistance Services Classification System
Abstract: Objective To evaluate the utility of using the Personal Assistance Services classification system (PAS-CS) that examines individuals with disabilities for services and government funding. To this end, this study also tests for significant differences in PAS-CS scores across disability grades and disability types.Methods A retrospective analysis was conducted using the 2014 National Survey on People with Disabilities (NSPD) data set. We selected patients with three types of disabilities (physical disabilities, brain lesions, and visual impairments). We compared the average PAS-CS scores of patients with different disability types and grades using general linear models with multiple comparisons.Results A total of 4,810 patients were included in the analysis. Patients with brain lesions had the highest average PAS-CS scores in activities of daily living (ADL) and instrumental activities of daily living (IADL) domains. Patients with visual impairments had the highest average scores in
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Limitation of Intraoperative Transcranial Electrical Stimulation-Motor
Evoked Potential ...
Abstract: Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection. Although no significant change in TES-MEP was observed during surgery, study subjects experienced muscle weakness after surgery. Deep axonal stimulation of TES could give false-negative results. Therefore, a combined method of TES-MEP and direct cortical stimulation-motor evoked potential (DCS-MEP) or direct subcortical stimulation should be considered to overcome the limitation of TES-MEP.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Spinal Accessory Nerve Injury Induced by Manipulation Therapy: A Case
Report
Abstract: Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.
PubDate: Wed, 31 Oct 2018 00:00:01 +010
- Changes in Intracortical Excitability of Affected and Unaffected
Hemispheres After Stroke ...
Abstract: Objective To assess the altered pattern of intracortical excitability of the affected and unaffected hemispheres in stroke patients using paired-pulse transcranial magnetic stimulation (TMS).Methods We evaluated intracortical inhibition (ICI) and intracortical facilitation (ICF) in both hemispheres at acute and subacute stages of 103 stroke patients using paired-pulse TMS. The patients were divided into two groups: mild-to-moderate patients whose motor evoked potential (MEP) was recorded in the affected hemisphere; and severe patients whose MEP was not recorded in the affected hemisphere.Results In mild-to-moderate patients, the value of ICI in the affected hemisphere was increased from 70.3% to 77.9% and the value of ICI in the unaffected hemisphere was decreased from 74.8% to 70.3% with eventual progression in acute to subacute stages of stroke. In severe patients, the value of ICI in the unaffected hemisphere was increased from 65.4% to 75.6%. The changes in ICF were not significantly different in this study.Conclusion We conclude that the unaffected hemisphere was more disinhibited than the affected hemisphere in acute phase of mild-to-moderate stroke, and the affected hemisphere was more disinhibited in the subacute stage. The unaffected hemisphere was inhibited in severe cases in acute-to-subacute phases of stroke. This finding facilitates appropriate neuromodulation of acute-to-subacute phases in mild-to-severe stroke patients.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Effects of Electric Cortical Stimulation (ECS) and Transcranial Direct
Current Stimulation ...
Abstract: Objective To evaluate the effects of electric cortical stimulation (ECS) and transcranial direct current stimulation (tDCS) on motor and cognitive function recovery and brain plasticity in focal traumatic brain injury (TBI) of rats model.Methods Forty rats were pre-trained to perform a single pellet reaching task (SPRT), rotarod test (RRT), and Y-maze test for 14 days, then a focal TBI was induced by a weight drop model on the motor cortex. All rats were randomly assigned to one of the three groups: anodal ECS (50 Hz and 194
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Investigating the Dose-Related Effects of Video Game Trunk Control
Training in Chronic Stroke ...
Abstract: Objective To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance.Methods This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training.Results After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Effects of Hand Training During the Aftereffect Period of Low-Frequency
rTMS in Subacute Stroke ...
Abstract: Objective To investigate the effects of hand training using low-frequency repetitive transcranial magnetic stimulation (rTMS) within the aftereffect period on hand function in patients with subacute stroke.Methods The subacute stroke patients with hand weaknesses were divided randomly into two groups. Patients in the intervention group underwent hand training within the aftereffect period, that is, immediately after receiving low-frequency rTMS treatment. Patients in the control group underwent hand training 2 hours after the lowfrequency rTMS treatment. A manual function test (MFT) for
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Status of Rehabilitation After Ischemic Stroke: A Korean Nationwide Study
Abstract: Objective To investigate the post-stroke rehabilitation status according to stroke severity using the database of the Korean Health Insurance Review and Assessment Service.Methods The data of patients admitted to the neurology departments of 12 hospitals within 7 days of onset of ischemic stroke were collected. A total of 2,895 patients hospitalized between November 2010 and December 2011 were included. The patients were classified into three groups according to their initial National Institutes of Health Stroke Scale (NIHSS) scores (mild,
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Validation of Korean Version of Coma Recovery Scale-Revised (K-CRSR)
Abstract: Objective To determine the validity and reliability of the Korean version of the Coma Recovery Scale-Revised (K-CRSR) for evaluation of patients with a severe brain lesion.Methods With permission from Giacino, the developer of the Coma Recovery Scale Revised (CRSR), the scale was translated into Korean and back-translated into English by a Korean physiatrist highly proficient in English, and then verified by the original developer. Adult patients with a severe brain lesion following traumatic brain injury, stroke, or hypoxic brain injury were examined. To assess the inter-rater reliability, all patients were tested with K-CRSR by two physiatrists individually. To determine intra-rater reliability, the same test was re-administered by the same physiatrists after three days.Results Inter-rater reliability (k=0.929, p
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Efficacy of a 4-Week Swallowing Rehabilitation Program Combined With
Pyriform Sinus Ballooning ...
Abstract: Objective To assess the efficacy of a 4-week swallowing rehabilitation program combined with pyriform sinus ballooning in patients with post-stroke dysphagia (PSD).Methods We evaluated a total of 30 patients (n=30) with PSD who were admitted to our medical institution between May of 2014 and October of 2016. These patients were randomly assigned to either the trial group (n=15; a 20-minute conventional rehabilitation followed by a 10-minute pyriform sinus ballooning) or the control group (n=15; a 30-minute conventional rehabilitation). In these patients, the efficacy outcome measures were pharyngeal remnant, the pharyngeal transit time, the Penetration Aspiration Scale (PAS) scores and the Videofluoroscopic Dysphagia Scale (VDS) scores. We compared the differences in efficacy outcome measures at 4 weeks from baseline between the two groups.Results There were significant changes in the pharyngeal remnant, the pharyngeal transit time, the PAS scores and the VDS scores at 4 weeks from baseline between the two groups (p
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Influence of Nasogastric Tubes on Swallowing in Stroke Patients: Measuring
Hyoid Bone Movement ...
Abstract: Objective To investigate the influence of a nasogastric tube (NGT) on swallowing simulated saliva in stroke patients.Methods Three groups of participants were enrolled into the study: group A (20 stroke patients with a NGT), a control group B (25 stroke patients without a NGT), and group C (25 healthy adults with no brain lesions or dysphagia). Participants swallowed 1 mL of water to simulate saliva. Patients in group A were tested twice: once with a NGT (group A1) and once after the NGT was removed (group A2). The distance of hyoid bone movement was measured by subtracting the shortest distance between the mandible and hyoid bone (S) from the distance at resting state (R) measured with ultrasonography. The degree of the movement was calculated by (R'S)/R. The trajectory area of hyoid bone movement (Area) and the interval between the beginning of hyoid bone movement and the moment of the shortest hyoid'mandible approximation (Interval) was calculated by a computer program.Results From group A: R'S and (R'S)/R of group A2 at 1.14
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Association of Brain Lesions and Videofluoroscopic Dysphagia Scale
Parameters on Patients With ...
Abstract: Objective To investigate the characteristics and risk factors of dysphagia using the videofluoroscopic dysphagia scale (VDS) with a videofluoroscopic swallowing study (VFSS) in patients with acute cerebral infarctions.Methods In this retrospective study, the baseline VFSS in 275 stroke patients was analyzed. We divided patients into 8 groups according to lesion areas commonly observed on brain magnetic resonance imaging. Dysphagia characteristics and severity were evaluated using the VDS. We also analyzed the relationship between clinical and functional parameters based on medical records and VDS scores.Results In comparison studies of lesions associated with swallowing dysfunction, several groups with significant differences were identified. Apraxia was more closely associated with cortical middle cerebral artery territory lesions. Vallecular and pyriform sinus residue was more common with lesions in the medulla or pons. In addition, the results for the Korean version of the Modified Barthel Index (K-MBI), a functional assessment tool, corresponded to those in the quantitative evaluation of swallowing dysfunctions.Conclusion A large cohort of patients with cerebral infarction was evaluated to determine the association between brain lesions and swallowing dysfunction. The results can be used to establish a specific treatment plan. In addition, the characteristic factors associated with swallowing dysfunctions were also confirmed.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Correlation Between Walking Ability and Monthly Care Costs in Elderly
Patients After Surgical ...
Abstract: Objective To validate the relationship between residual walking ability and monthly care cost as well as long-term care insurance (LTCI) certification level in elderly patients after surgical treatment for hip fractures in Japan.Methods Elderly patients aged >75 years who underwent surgical treatment for hip fractures in our hospital were included. The preand post-surgical (6-month) walking ability and LTCI certification and the presence or absence of dementia was determined from medical records and questionnaires. Walking ability was classified into 6 levels used in our daily medical practice. Based on these data, we correlated the relationship between walking ability and the LTCI certification level. Further, based on the official statistics pertaining to the average monthly costs per person at each LTCI certification level, we evaluated the relationship between walking ability and monthly care cost.Results A total of 105 cases (mean age, 80.2 years; 16 men; 39 patients with dementia) were included. The correlation between walking ability and average monthly cost per person as well as LTCI certification level at 6 months postoperatively (r=0.58) was demonstrated. The correlation was found in both groups with and without dementia.Conclusion The ability to walk reduced the cost of care in elderly patients who experienced hip fracture, regardless of the presence of dementia.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Effects of Long-Distance Running on Cardiac Markers and Biomarkers in
Exercise-Induced ...
Abstract: Objective To investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race).Methods In this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- A Dynamic Magnetic Resonance Imaging Study of Changes in Severity of
Cervical Spinal Stenosis ...
Abstract: Objective To evaluate changes in the severity of cervical spinal stenosis (CSS) in flexion and extension and determine whether the rate of change with motion varied with severity.Methods The study included 92 symptomatic patients with a mean age of 57.80
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- The Nutritional Status and the Clinical Outcomes of Patients With a Spinal
Cord Injury Using ...
Abstract: Objective To assess the nutritional status of Korean patients with spinal cord injury (SCI), identify the predictors of undernutrition, and investigate the relationship between undernutrition and clinical outcomes.Methods A retrospective study design was used to determine the nutritional status of 130 patients over 19 years old admitted to the rehabilitation hospital of Yonsei University Health System between June 2015 and February 2017. The nutritional status was assessed using the malnutrition universal screening tool (MUST) and the spinal nutrition screening tool (SNST). The relationship between undernutrition and clinical outcomes was examined by comparing a low-risk group with an at-risk group using a t-test.Results Among the SCI patients, 70 (50.8%) were confirmed with undernutrition based on the MUST scores, while 60 (46.2%) had undernutrition based on the SNST scores. It was found that undernutrition has an effect on functional outcomes.Conclusion We assessed the undernutrition risk in Korean SCI patients, and found that approximately 50% of the patients were at risk of undernutrition. We also found that undernutrition can affect functional recovery.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Investigation of the Diagnostic Value of Ultrasonography for Radial
Neuropathy Located at the ...
Abstract: Objective To determine a diagnostic cut-off value for the cross-sectional area (CSA) of the radial nerve using ultrasonography for radial neuropathy located at the spiral groove (SG).Methods Seventeen patients with electrodiagnostic evidence of radial neuropathy at the SG and 30 healthy controls underwent ultrasonography of the radial nerve at the SG . The CSAs at the SG were compared in the patient and control groups. The CSA at the SG between the symptomatic and asymptomatic sides (
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Differences in Gait Patterns of Unilateral Transtibial Amputees With Two
Types of Energy ...
Abstract: Objective To evaluate if there is a difference in gait pattern when applying two different shapes of energy storing prosthetic feet for trainstibial amputation we conducted a comparative study. Energy storing prosthetic feet for transtibial amputation are increasing in use, but there are few studies that evaluate the effects of the shape of energy storing feet on gait patterns.Methods Ten unilateral transtibial amputees were recruited. Two different shapes of dynamic response feet were applied to each subject either 1C30 Trias or 1C60 Triton. The main differences between the two are a split forefoot and the presence of a heel wedge. Spatiotemporal, kinematic, and kinetic data was obtained through gait analysis. Differences between intact and prosthetic side and differences between the two prosthetics were assessed.Results On a side to side comparison, cadence asymmetry with 1C30 Trias was observed. Ankle plantarflexion at the end of stance and ankle supination at the onset of preswing was smaller with both prosthetic feet compared to the intact side. Other spatiotemporal, kinematic, and kinetic data showed no significant differences in a side to side comparison. In a comparison between the two prosthetics, stance and swing ratio and ankle dorsiflexion through mid-stance was closer to normal with 1C60 Triton than 1C30 Trias. Other spatiotemporal, kinematic, and kinetic data showed no statistically significant differences between prosthetics.Conclusion Both energy storing feet implants showed symmetric gait in unilateral transtibial amputees who are functionally independent in daily living. And 1C60 Triton showed closer to normal gait patterns than 1C30 Trias in our study.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Which Neural Tract Plays a Major Role in Memory Impairment After Multiple
Cerebral Infarcts' A ...
Abstract: Injury to the thalamocortical tract (one in the Papez circuit) that leads to memory impairment following brain injury is very rare. In this study, we present a case of partial injury to the thalamocortical tract that causes memory impairment after concurrent thalamic and hippocampal infarct. A 20-year-old male complained of memory impairment 1 month after partial injury to the thalamocortical tract. Using a probabilistic diffusing tensor tractography, it was found that the right thalamocortical tract was thinner than the left thalamocortical tract. However, all other neural tracts including the fornix, cingulum, and mammillothalamic tract were intact on both hemispheres. Therefore, the memory impairment in this patient was considered as being due to thalamic infarct based on the observation that the fornix from hippocampal infarct was intact. This case suggests that the assessment of lesions in the neural tracts of the Papez circuit might be useful for understanding the mechanism of memory impairment following cerebral infarction.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Posterior Epidural Migration of a Lumbar Intervertebral Disc Fragment
Resembling a Spinal ...
Abstract: Posterior epidural migration of a lumbar intervertebral disc fragment (PEMLIF) is uncommon because of anatomical barriers. It is difficult to diagnose PEMLIF definitively because of its relatively rare incidence and the ambiguity of radiological findings resembling spinal tumors. This case report describes a 76-year-old man with sudden-onset weakness and pain in both legs. Electromyography revealed bilateral lumbosacral polyradiculopathy with a mass-like lesion in L2-3 dorsal epidural space on lumbosacral magnetic resonance imaging (MRI). The lesion showed peripheral rim enhancement on T1-weighted MRI with gadolinium administration. The patient underwent decompressive L2-3 central laminectomy, to remove the mass-like lesion. The excised lesion was confirmed as an intervertebral disc. The possibility of PEMLIF should be considered when rim enhancement is observed in the epidural space on MRI scans and electrodiagnostic features of polyradiculopathy with sudden symptoms of cauda equina syndrome.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Late-Onset Post-radiation Lymphedema Provoked by Bee Venom Therapy: A Case
Report
Abstract: Lymphedema is a common complication associated with cancer itself or with cancer treatment. Lymphedema infrequently occurs after drug therapy. Bee venom is one of the materials used in acupuncture, and it has been used in the treatment of a variety of inflammatory diseases including arthritis. We report a 74-year-old male patient with late-onset post-radiation lymphedema provoked by bee venom therapy. He was free of lymphedema for 5 years after the complete remission of prostate cancer which had been treated with transurethral resection and radiation therapy. The patient developed left leg swelling after undergoing bee venom therapy for left hip pain. Computed tomography and lymphoscintigraphy showed lymphedema without tumor recurrence or infection. The lymphatic system was suspected to be injured by bee venom therapy and lymphedema was provoked. Bee venom therapy should be used cautiously in patients prone to lymphedema.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- The Effect of Polydeoxyribonucleotide on Chronic Non-healing Wound of an
Amputee: A Case Report
Abstract: Polydeoxyribonucleotide (PDRN) is safe and effective in wound healing, cellular growth, synthesis of extracellular matrix protein, and inflammation reduction via activation of adenosine A2 receptors. We report a 28-year-old male patient treated with PDRN injections for chronic non-healing wound refractory to negative pressure wound therapy, skin graft, or growth factors. Three injections of PDRN were administered at the wound site into the anterior and medial sides of the left stump on the 1st, 4th, and 9th days of hospitalization. The PDRN ameliorated wound healing by enhancing cell growth, tissue repair, and angiogenesis. PDRN application represents a potential treatment for non-healing wounds obviating the need for additional therapies, and hospitalization, as well as improve patient
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- The Application of Three-Dimensional Printed Finger Splints for Post Hand
Burn Patients: A Case ...
Abstract: The application of three-dimensional (3D) printing is growing explosively in the medical field, and is especially widespread in the clinical use of fabricating upper limb orthosis and prosthesis. Advantages of 3D-printed orthosis compared to conventional ones include its lower cost, easier modification, and faster fabrication. Hands are the most common body parts involved with burn victims and one of the main complications of hand burns are finger joint contractures. Applying orthotic devices such as finger splints are a well-established essential element of burn care. In spite of the rapid evolution of the clinical use of 3D printing, to our knowledge, its application to hand burn patients has not yet been reported. In this study, the authors present a series of patients with hand burn injuries whose orthotic needs were fulfilled with the application of 3D-printed finger splints.
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Injury of the Lower Ascending Reticular Activating System by Subfalcine
Herniation in a Patient ...
Abstract:
PubDate: Fri, 31 Aug 2018 00:00:01 +010
- Evaluation of Ataxia in Mild Ischemic Stroke Patients Using the Scale for
the Assessment and ...
Abstract: Objective To demonstrate the utility of Scale for the Assessment and Rating of Ataxia (SARA) for evaluation of posterior circulation-related features in patients with mild stroke.Methods Forty-five subjects, diagnosed with acute infarction in the cerebellum, basis pontis, thalamus, corona radiata, posterior limb of internal capsule, and their National Institutes of Health Stroke Scale (NIHSS) scores
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Quantitative Evaluation of Post-stroke Spasticity Using Neurophysiological
and Radiological ...
Abstract: Objective To determine the possibility of a new measurement tool using electromyography and ultrasonographyfor quantitative spasticity assessment in post-stroke patients.Methods Eight hemiplegic stroke patients with ankle plantarflexor spasticity confirmed by a Modified AshworthScale (MAS) were enrolled. Spasticity was evaluated using the MAS and Modified Tardieu Scale (MTS). Each subject underwent surface electromyography (sEMG) using the Brain Motor Control Assessment (BMCA) protocol and was compared with a healthy control group. Using ultrasonography, muscle architecture and elasticity index were measured from the medial gastrocnemius muscle (GCM) on the affected and unaffected sides. Results MAS and MTS revealed significant correlation with sEMG activity. The fascicle length and pennation angle were significantly decreased in the medial GCM on the hemiplegic side compared with the unaffected side. The elasticity index of the spastic medial GCM was significantly increased compared with the unaffected side. The MTS X and R2?R1 values were significantly correlated with the elasticity index in the hemiplegic GCM. The relationship between clinical evaluation tools and both BMCA and sonoelastography was linear, but not statistically significant in the multiple regression analysis.Conclusion The BMCA protocol and ultrasonographic evaluation provide objective assessment of post-stroke spasticity. Further studies are necessary to conduct accurate assessment and treatment of spasticity.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Changes in Diffusion Metrics of the Red Nucleus in Chronic Stroke Patients
With Severe ...
Abstract: Objective To explore plastic changes in the red nucleus (RN) of stroke patients with severe corticospinal tract (CST)injury as a compensatory mechanism for recovery of hand function.Methods The moderate group (MG) comprised 5 patients with synergistic hand grasp movement combined with limited extension, and the severe group (SG) included 5 patients with synergistic hand grasp movement alone. The control group (CG) included 5 healthy subjects. Motor assessment was measured by Motricity Index (MI). Diffusion tensor imaging was analyzed using fractional anisotropy (FA) and radial diffusivity (RD) in the individual regions of interest (ROIs)?bilateral internal capsule and anterior pons for CST injury and bilateral RN for rubrospinal tract (RST) injury.Results The SG showed a significantly lower MI score than the MG mainly due to differences in hand subscores. Significantly reduced FA was observed in both MG and SG compared with CG, while SG showed increased MD and RD in the affected ROIs of CST, and increased FA on the unaffected side compared with CG. However, in the RN ROI, a significantly increased FA and decreased RD on the unaffected side similar to the affected side were found only in the SG. The relative index of FA was lower and RD in SG was higher than in CG in RST. Conclusion The diffusion metrics of RST showed changes in patients with severe CST injury, suggesting that RSTmay play a role in the recovery of hand function in patients with severe CST injury.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Efficacy and Safety of Caregiver-Mediated Exercise in Post-stroke
Rehabilitation
Abstract: Objective To assess the efficacy and safety of our 4-week caregiver-mediated exercise (CME) in improving trunkcontrol capacity, gait, and balance and in decreasing concerns about post-stroke falls when there is an increase in its efficacy.Methods Acute or subacute stroke survivors were assigned to either the trial group (n=35) or the control group (n=37). Changes in Modified Barthel Index (MBI), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), and Trunk Impairment Scale (TIS) scores at 4 weeks from baseline served as primary outcome measures. Correlations of primary outcome measures with changes in Fall Efficacy Scale-International (FES-I) scores at 4 weeks from baseline in the trial group served as secondary outcome measures. Treatment-emergent adverse events (TEAEs) served as safety outcome measures.Results There were significant differences in changes in MBI, FAC, BBS, TIS-T, TIS-D, TIS-C, and FES-I scores at 4 weeks from baseline between the two groups (all p
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Changes in Hyolaryngeal Movement During Swallowing in the Lateral
Decubitus Posture
Abstract: Objective To investigate the differences in hyolaryngeal kinematics at rest and during swallowing in the upright sitting (UP) and the lateral decubitus (LD) postures in healthy adults, and delineating any potential advantages of swallowing while in the LD posture.Methods Swallowing was videofluoroscopically evaluated in 20 healthy volunteers in UP and LD postures, based on the movements of hyoid bone, vocal folds, and the bolus head. Parameters included the Penetration-Aspiration Scale (PAS), horizontal and vertical displacement, horizontal and vertical initial position, horizontal and vertical peak position, time to peak position of the hyoid bone and vocal folds, and pharyngeal transit time (PTT).Results Nine participants were rated PAS 2 in the UP and 1 was rated PAS 2 in the LD (p=0.003) at least 1 out of 3 swallows each posture. The hyoid and vocal folds showed more anterior and superior peak and initial positions in the LD. In addition, swallowing resulted in greater vertical and smaller horizontal displacement of the hyoid in LD posture compared with UP. Time to peak position of the hyoid was shorter in LD. The maximal vertical and horizontal displacement of the vocal folds, and PTT were comparable between postures.Conclusion The results showed that the peak and initial positions of the hyoid and larynx and the pattern of hyoid movement varied significantly depending on the body postures. This study suggests that the LD posture was one of the safe feeding postures without any increased risk compared with UP posture.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Relationship Between Swallowing Function and Maximum Phonation Time in
Patients With Parkinsonism
Abstract: Objective To identify the relationship between maximum phonation time (MPT) and swallowing function, as well as the elements of swallowing, in order to provide a rationale for speech therapy in patients with Parkinsonism manifesting dysphagia.Methods Thirty patients with Parkinsonism who underwent speech evaluation and videofluoroscopic swallowing study (VFSS) were recruited. The MPT, the longest periods of sustained pronunciation of /aa/, was evaluated. The VFSS was evaluated using Penetration Aspiration Scale (PAS), National Institutes of Health-Swallowing Safety Scale (NIH-SSS), and Videofluoroscopic Dysphagia Scale (VDS). The relationship between dysphagia scales and MPT was analyzed using Pearson correlation. The difference in VDS variables between subgroups (Parkinson disease or Parkinsonian syndrome, independent or dependent ambulation, and normal or abnormal MPT) and the difference in MPT between subgroups based on the VDS variables were analyzed using the independent t-test.Results Bolus formation and laryngeal elevation functions were significantly higher in the normal MPT groupcompared with the impaired group. In the VDS variables, patients with intact bolus formation, oral transit time,pharyngeal swallow triggering, and laryngeal elevation showed significantly longer MPTs compared with theimpaired groups. In addition, MPT was significantly correlated with the VDS and modestly correlated with theNIH-SSS, but not the PAS, suggesting that phonatory function is related to the oropharyngeal swallowing function, but not directly to the aspiration itself.Conclusion The correlation between MPT and several swallowing-related elements was identified, indicating aninteractive correlation between swallowing and phonation. This result justifies voice therapy as a treatment fordysphagia in patients with Parkinsonism.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- The Availability of Quantitative Assessment of Pain Perception in Patients
With Diabetic ...
Abstract: Objective To evaluate the usefulness of the quantitative assessment of pain perception (QAPP) in diabetic polyneuropathy (DPN) patients.Methods Thirty-two subjects with DPN were enrolled in this study. The subjects
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- The Changes of CTX, DPD, Osteocalcin, and Bone Mineral Density During the
Postmenopausal Period
Abstract: Objective To investigate appropriate treatment time and useful bone turnover markers (BTMs) for monitoringbone turnover during the postmenopausal period, we analyzed changes of two bone resorption markers; serumcarboxyterminal telopeptide of collagen I (s-CTX), urine deoxypyridinoline (u-DPD), one bone formation marker;serum osteocalcin (s-OC), and bone mineral density (BMD) in Korean postmenopausal women.Methods Seventy-eight menopausal women were divided into three groups according to postmenopausal period: group I (0'5 years), group II (6'10 years), group III (
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Clinical and Radiological Evaluation After Chemical Synovectomy With
Rifampicin in Hemophilic ...
Abstract: Objective To assess the clinical outcome of chemical synovectomy with rifampicin in hemophilic arthropathy by using the World Federation of Hemophilia (WFH) scoring system and plain radiograph.Methods We performed rifampicin synovectomy (RS) on 30 joints of 28 hemophilic patients diagnosed as hemophilic arthropathy stage I?III (based on Fernandez-Palazzi clinical classification). Clinical status (bleeding frequency, pain, joint physical status) and radiological staging were evaluated as parts of the WFH scoring system before and 1 year after RS. The patients were divided into two groups by the Arnold-Hilgartner scale of the initial X-ray as stage 3 or less for the low-stage group (n=17) and over 3 for the high-stage group (n=13).Results Total WFH joint physical scores were reduced after injection, and the number of bleeding episodes and pain showed especially significant improvement. For other subscores of the WFH joint physical score, only swelling, range of motion, and crepitus showed statistically significant improvement. According to the severity of the radiologic finding, the WFH joint physical score of both the low-stage and high-stage groups showed significant improvement. In the radiological aspect, the low-stage group, without joint space narrowing at the initial plain radiograph, showed no further aggravation after injection. However, in the high-stage group, radiology found aggravation regardless of the procedure.Conclusion It is suggested that chemical synovectomy with rifampicin may prevent hemarthrosis and improve clinical symptoms. Especially in the early stage of arthropathy without joint-space narrowing, it seems to have anadditional benefit that delays radiological aggravation and preserves joint status.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Motor and Sensory Function as a Predictor of Respiratory Function
Associated With Ventilator ...
Abstract: Objective To analyze the respiratory function of high cervical cord injury according to ventilator dependenceand to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motorfunctions.Methods A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.Results Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence.Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.Conclusion The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Needs for Medical and Rehabilitation Services in Adults With Cerebral
Palsy in Korea
Abstract: Objective To investigate medical comorbidities and needs for medical and rehabilitation services of adults withcerebral palsy (CP) in Korea.Methods This was a prospective cross-sectional study. One hundred fifty-four adults with CP were enrolled in the study between February 2014 and December 2014. Information was obtained from participants regarding functional status, demographic and socioeconomic data, medical problems, and requirements for and utilizationof medical and rehabilitation services.Results The participants included 93 males and 61 females with a mean age of 40.18
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Optimal Placement of Needle Electromyography in Extensor Indicis: A
Cadaveric Study
Abstract: Objective To identify the center of extensor indicis (EI) muscle through cadaver dissection and compare theaccuracy of different techniques for needle electromyography (EMG) electrode insertion.Methods Eighteen upper limbs of 10 adult cadavers were dissected. The center of trigonal EI muscle was defined as the point where the three medians of the triangle intersect. Three different needle electrode insertion techniques were introduced: M1, 2.5 cm above the lower border of ulnar styloid process (USP), lateral aspect of the ulna; M2, 2 finger breadths (FB) proximal to USP, lateral aspect of the ulna; and M3, distal fourth of the forearm, lateral aspect of the ulna. The distance from USP to the center (X) parallel to the line between radial head to USP, and from medial border of ulna to the center (Y) were measured. The distances between 3 different points (M1? M3) and the center were measured (marked as D1, D2, and D3, respectively).Results The median value of X was 48.3 mm and that of Y was 7.2 mm. The median values of D1, D2 and D3 were 23.3 mm, 13.3 mm and 9.0 mm, respectively.Conclusion The center of EI muscle is located approximately 4.8 cm proximal to USP level and 7.2 mm lateral to the medial border of the ulna. Among the three methods, the technique placing the needle electrode at distal fourth of the forearm and lateral to the radial side of the ulna bone (M3) is the most accurate and closest to the center of the EI muscle.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Factors Associated With Discharge Destination in Advanced Cancer Patients
With Bone Metastasis ...
Abstract: Objective To analyze patient characteristics of cancer rehabilitation and outcomes at our hospital.Methods This retrospective study analyzed 580 patients, who underwent cancer rehabilitation at our hospital and rehabilitation outcome after therapy were investigated. The relationship between the initial Barthel index and discharge outcomes was investigated, with a special focus on cancer patients with bone metastasis. The Barthel index and performance status (Eastern Cooperative Oncology Group) before and after rehabilitation were analyzed, and threshold value of home discharge was calculated from a receiver operating characteristic curve (ROC). General criteria for home discharge from our hospital included independence in performing basic activities of daily living such as bathing, feeding, and toileting or availability of home support from a family member/caregiver.Results The outcomes after rehabilitation among all the patients were as follows: discharge home 59%, death 13%, and others 27%. Statistical differences were observed between the initial and final values of the Barthel index in patients with bone metastasis, who could be discharged home (p=0.012). ROC analysis of the initial Barthel index for predicting home discharge revealed a threshold value of 60, sensitivity of 0.76, and specificity of 0.72.Conclusion The patients with bone metastasis had a lower rate of home discharge and a higher rate of mortality than all the study patients who underwent cancer rehabilitation at our hospital. It is proposed that at the time of initiation of rehabilitation for patients with bone metastasis, an initial Barthel index lower than 60 might predict a worse outcome than home discharge.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Diagnosis of Pure Ulnar Sensory Neuropathy Around the Hypothenar Area
Using Orthodromic Inching ...
Abstract: Ulnar neuropathy at the wrist is an uncommon disease and pure ulnar sensory neuropathy at the wrist is evenrarer. It is difficult to diagnose pure ulnar sensory neuropathy at the wrist by conventional methods. We report acase of pure ulnar sensory neuropathy at the hypothenar area. The lesion was localized between 3 cm and 5 cmdistal to pisiform using orthodromic inching test of ulnar sensory nerve to stimulate at three points around thehypothenar area. Ultrasonographic examination confirmed compression of superficial sensory branch of the ulnarnerve. Further, surgical exploration reconfirmed compression of the ulnar nerve. This case report demonstratesthe utility of orthodromic ulnar sensory inching test.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Femoral Neuropathy Secondary to Autosomal Dominant Polycystic Kidney
Disease: A Case Report
Abstract: Compressive femoral neuropathy is a disabling condition accompanied by difficulty in hip flexion and knee extension. It may result from retroperitoneal hematoma or bleeding, or from complications associated with pelvic,hip surgery, and renal transplants. A 55-year-old female with autosomal dominant polycystic kidney disease presented with proximal muscle weakness in lower extremities. The patient experienced recurrent renal cyst infection, with aggravated weakness during each event. Electromyography and nerve conduction study revealedbilateral femoral neuropathy. Computed tomography and magnetic resonance images were added to further identify the cause. As a result, a diagnosis of femoral neuropathy caused by enlarged polycystic kidney was made.Cyst infection was managed with antibiotics. Renal function was maintained by frequent regular hemodialysis. While avoiding activities that may increase abdominal pressure, rehabilitation exercises were provided. Motorstrength in hip flexion and knee extension improved, and was confirmed via electrodiagnostic studies.
PubDate: Wed, 27 Jun 2018 00:00:01 +010
- Effect of Caregiver Driven Robot-Assisted In-Ward Training in Subacute
Stroke Patients: A Case ...
Abstract: ObjectiveTo evaluate the effect of caregiver driven robot-assisted in-ward training in subacute stroke patients.MethodsA retrospective evaluation was performed for patients treated with caregiver driven robot-assisted in-ward training to retain gait function from June 2014 and December 2016. All patients received more than 2 weeks of caregiver driven robot-assisted in-ward training after undergoing conventional programs. The robot was used as a sitting device, a standing frame, or a high-walker depending on functional status of the patient. Patients were evaluated before and after robot training. Patient records were assessed by Korean version of Modified Barthel Index (K-MBI), Functional Independence Measure (FIM), and Functional Ambulation Category (FAC).ResultsInitially, patients used the robot as a sitting device (n=6), a standing frame (n=7), or a partial body-weight support high-walker (n=2). As patient functions were improved, usage level of the robot was changed to the next level. At the end of the treatment, the robot was used as a sitting device (n=1), a standing frame (n=6), or high-walker (n=8). Scores of K-MBI (
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Characteristics of Cricopharyngeal Dysphagia After Ischemic Stroke
Abstract: ObjectiveTo evaluate the characteristics of cricopharyngeal dysfunction (CPD), the frequency, and correlation with a brain lesion in patients with first-ever ischemic stroke, and to provide basic data for developing a therapeutic protocol for dysphagia management.MethodsWe retrospectively reviewed the medical records of a series of subjects post-stroke who underwent a videofluoroscopic swallowing study (VFSS) from January 2009 to December 2015. VFSS images were recorded on videotape and analyzed. CPD was defined as the retention of more than 25% of residue in the pyriform sinus after swallowing. The location of the brain lesion was assessed using magnetic resonance imaging.ResultsAmong the 262 dysphagic patients with first-ever ischemic stroke, 15 (5.7%) showed CPD on the VFSS. Patients with an infratentorial lesion had a significantly higher proportion of CPD than those with a supratentorial lesion (p=0.003), and lateral medullary infarction was identified as the single independent predictor of CPD (multivariable analysis: odds ratio=19.417; confidence interval, 5.560?67.804; p<0.0001). Compared to patients without CPD, those with CPD had a significantly prolonged pharyngeal transit time, lower laryngeal elevation, and a higher pharyngeal constriction ratio and functional dysphagia scale score.ConclusionOverall, the results support the notion that an impaired upper esopharyngeal opening is likely related to the specific locations of brain lesions. The association of CPD with lateral medullary infarction can be explained based on the regulation of the pharyngolaryngeal motor system by the motor neurons present in the dorsal nucleus ambiguus. Overall, the results reveal the relation between CPD and the problems in the pharyngeal phase as well as the severity of dysphagia.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Predictive Variables for Sonographically Guided Corticosteroid Injection
in Mild-to-Moderate ...
Abstract: ObjectiveTo assess the predictive variables after sonographically guided corticosteroid injection in carpal tunnel syndrome.MethodsA prospective, observational study was carried out on 25 wrists of 20 consecutive patients with carpal tunnel syndrome, confirmed by the American Association of Neuromuscular and Electrodiagnostic Medicine criteria, which includes clinical history, symptoms, and evidence of slowing of distal median nerve conduction. Visual analogue scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were asked to the patients before and 4 weeks after the procedure. On a basis of VAS difference before and after the procedure, we divided the patients into two groups: more than 50% of VAS improving (good response group) and less than 50% of VAS improving (poor response group). Also, nerve conduction studies and ultrasound evaluations were performed prior to sonographically guided corticosteroid injection and at 4 weeks after the procedure. The cross-sectional area (CSA) of median nerve at maximal swelling point around wrist was measured by manual tracing using ultrasonography. With assessments mentioned above, we tried to assess predictive variables for prognosis after sonographically guided corticosteroid injection in carpal tunnel syndrome.ResultsThe CSA of median nerve at wrist measured before the procedure was significantly larger in good response group than in poor response group. Furthermore, the CSA of median nerve at wrist, symptom severity scale of BCTQ, motor/sensory latency and sensory amplitude were correlated with VAS improving.ConclusionThe CSA of median nerve at wrist is the strongest predictive value for sonographically guided corticosteroid injection in mild-to-moderate carpal tunnel syndrome.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Clinical and Biomechanical Effects of Low-Dye Taping and Figure-8
Modification of Low-Dye ...
Abstract: ObjectiveTo investigate and compare the effect of low-dye taping (LDT) and figure-8 modification of LDT (MLDT) on peak plantar pressure and heel pain in patients with heel pad atrophy.MethodsThere were reviewed 32 feet of 19 patients who have been diagnosed with heel pad atrophy who were enrolled in this study. The patients were diagnosed with heel pad atrophy with clinical findings, and loaded heel pad thickness measured by ultrasonography. At the first visit, patients were taught how to do LDT and MLDT. They were instructed to do daily living with barefoot, LDT and MLDT at least one time per day. Patients performed pedobarography with barefoot, LDT and MLDT within 2 weeks. The severity of heel pain was also checked with the visual analogue scale (VAS) during daily living with barefoot, LDT and MLDT.ResultsVAS of hindfoot were significantly decreased after LDT and MLDT (p<0.01). Peak plantar pressure under hindfoot were also decreased after LDT and MLDT (p<0.01). The effect of MLDT in decreasing peak plantar pressure of hindfoot (p<0.01) and pain relief (p=0.001) was better than the effect of LDT.ConclusionThe LDT technique is clinically useful for pain management and reducing peak plantar pressure of hindfoot in patients with heel pad atrophy. MLDT is more effective than LDT in reducing peak plantar pressure and heel pain in patients with heel pad atrophy.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Effects of Repetitive Peripheral Magnetic Stimulation on Patients With
Acute Low Back Pain: A ...
Abstract: ObjectiveTo investigate the effects of real repetitive peripheral magnetic stimulation (rPMS) treatment compared to sham rPMS treatment on pain reduction and functional recovery of patients with acute low back pain.MethodsA total of 26 patients with acute low back pain were randomly allocated to the real rPMS group and the sham rPMS group. Subjects were then administered a total of 10 treatment sessions. Visual analogue scale (VAS) was assessed before and after each session. Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ) were employed to assess functional recovery at baseline and after sessions 5 and 10.ResultsReal rPMS treatment showed significant pain reduction immediately after each session. Sustained and significant pain relief was observed after administering only one session in the real rPMS group. Significant functional improvement was observed in the real rPMS group compared to that in the sham rPMS group after sessions 5 and 10 based on ODI and after session 5 based on RMDQ.ConclusionReal rPMS treatment has immediate effect on pain reduction and sustained effect on pain relief for patients with acute low back pain compared to sham rPMS.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Gender-Related Differences in Reliability of Thorax, Lumbar, and Pelvis
Kinematics During Gait ...
Abstract: ObjectiveTo evaluate test-retest reliability of trunk kinematics relative to the pelvis during gait in two groups (males and females) of patients with non-specific chronic low back pain (NCLBP) using three-dimensional motion capture system.MethodsA convenience sample of 40 NCLBP participants (20 males and 20 females) was evaluated in two sessions. Participants were asked to walk with self-selected speed and kinematics of thorax and lumbar spine were captured using a 6-infrared-cameras motion-analyzer system. Peak amplitude of displacement and its measurement errors and minimal detectable change (MDC) were then calculated.ResultsIntraclass correlation coefficients (ICCs) were relatively constant but small for certain variables (lower lumbar peak flexion in female: inter-session ICC=0.51 and intra-session ICC=0.68; peak extension in male: inter-session ICC=0.67 and intra-session ICC=0.66). The measurement error remained constant and standard error of measurement (SEM) difference was large between males (generally
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Effects of Very High Stimulation Frequency and Wide-Pulse Duration on
Stimulated Force and ...
Abstract: ObjectiveTo determine the effect of very high stimulation frequency (150 and 200 Hz) with wide pulse duration versus 50 Hz with wide pulse duration on stimulated force and fatigue of quadriceps femoris in healthy participants.MethodsThirty-four healthy participants underwent fatigue test using three stimulation frequency conditions (50, 150, and 200 Hz) with pulse duration of 0.9 ms. Normalized force values at the end of each fatigue protocol and curve fitting patterns were compared among stimulated frequencies.ResultsVery high stimulation frequency (150 and 200 Hz) conditions showed a trend of having more decline in normalized stimulated force during fatigue test compared to a low stimulation frequency at 50 Hz. However, the difference was not statistically significant. Responder group showed the same slope of a linear fitting pattern, implying the same pattern of muscle fatigue among three stimulation frequency conditions (?3.32 in 50 Hz, ?2.88 in 150 Hz, and ?3.14 in 200 Hz, respectively).ConclusionThere were high inter-subject variations in the response to different frequency stimulation conditions. However, very high stimulation frequency generated the same fatigue pattern as the low stimulation frequency in the responder group. Further research is needed to explore the mechanism involved.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Quantitative Measurement of Muscle Atrophy and Fat Infiltration of the
Supraspinatus Muscle ...
Abstract: ObjectiveTo investigate the utility of ultrasonography to objectively examine morphological changes (i.e., muscle atrophy and fatty infiltration) of the supraspinatus muscle.MethodsThirty-four patients were prospectively enrolled in this study. The degrees of muscle atrophy and fat infiltration were measured using ultrasonography 3?4 months after arthroscopic supraspinatus tendon repair. Shoulder function (i.e., shoulder active range of motion, visual analogue scale, and constant score) was examined. Using the symmetricity of the muscles in the human body, the degrees of morphological changes of the supraspinatus muscle were quantitatively measured. The associations between the morphological changes of the supraspinatus muscle and shoulder function were identified.ResultsThere were statistically significant differences in the cross-sectional area (CSA) and echogenicity between the surgery and non-surgery sides (p<0.001). The CSA ratio, which represents the degree of muscle atrophy, was associated with shoulder forward flexion, external rotation, and constant score; however, the echogenicity ratio, which represents the degree of fat infiltration, was not associated with shoulder function after surgery.ConclusionThis study demonstrated that shoulder function could be predicted by evaluating the morphological changes of the supraspinatus muscle using ultrasonography and that objective evaluation is possible through quantitative measurement using the symmetricity of the human body.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Pressure Relieving Effect of Adding a Pelvic Well Pad to a Wheelchair
Cushion in Individuals ...
Abstract: ObjectiveTo identify the pressure relieving effect of adding a pelvic well pad, a firm pad that is cut in the ischial area, to a wheelchair cushion on the ischium.MethodsMedical records of 77 individuals with SCI, who underwent interface pressure mapping of the buttock-thigh area, were retrospectively reviewed. The pelvic well pad is a 2.5-cm thick firm pad and has a cut in the ischial area. Expecting additional pressure relief, it can be inserted under a wheelchair cushion. Subjects underwent interface pressure mapping in the subject's wheelchair utilizing the subject's pre-existing pressure relieving cushion and subsequently on a combination of a pelvic well pad and the cushion. The average pressure, peak pressure, and contact area of the buttock-thigh were evaluated.ResultsAdding a pelvic well pad, under the pressure relieving cushion, resulted in a decrease in the average and peak pressures and increase in the contact area of the buttock-thigh area when compared with applying only pressure relieving cushions (p<0.05). The mean of the average pressure decreased from 46.10
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Determinants of Hip and Femoral Deformities in Children With Spastic
Cerebral Palsy
Abstract: ObjectiveTo find factors affecting hip and femoral deformities in children with spastic cerebral palsy (CP) by comparing various clinical findings with imaging studies including plain radiography and computed tomography (CT) imaging.MethodsMedical records of 709 children with spastic CP who underwent thorough baseline physical examination and functional assessment between 2 to 6 years old were retrospectively reviewed. Fifty-seven children (31 boys and 26 girls) who had both plain radiography of the hip and three-dimensional CT of the lower extremities at least 5 years after baseline examination were included in this study.ResultsThe mean age at physical examination was 3.6 years (SD=1.6; range, 2?5.2 years) and the duration of follow-up imaging after baseline examination was 68.4 months (SD=22.0; range, 60?124 months). The migration percentage correlated with motor impairment and the severity of hip adductor spasticity (R1 angle of hip abduction with knee flexion). The femoral neck and shaft angle correlated with the ambulation ability and severity of hip adductor spasticity (R1 and R2 angles of hip abduction with both knee flexion and extension).ConclusionHip subluxation and coxa valga deformity correlated with both dynamic spasticity and shortening of hip adductor muscles. However, we found no correlation between femoral deformities such as femoral anteversion, coxa valga, and hip subluxation.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Relationship Between Functional Level and Muscle Thickness in Young
Children With Cerebral Palsy
Abstract: ObjectiveTo investigate the relationship between functional level and muscle thickness (MT) of the rectus femoris (RF) and the gastrocnemius (GCM) in young children with cerebral palsy (CP).MethodsThe study participants were comprised of 26 children (50 legs) with spastic CP, aged 3?6 years, and 25 age-matched children with typical development (TD, 50 legs). The MT of the RF, medial GCM, and lateral GCM was measured with ultrasound imaging. The functional level was evaluated using the Gross Motor Function Measurement-88 (GMFM-88), Gross Motor Function Classification System (GMFCS), and based on the mobility area of the Korean version of the Modified Barthel Index (K-MBI). The measurement of spasticity was evaluated with the Modified Ashworth Scale (MAS).ResultsWe note that the height, weight, body mass index, and MT of the RF, and the medial and lateral GCM were significantly higher in the TD group (p<0.05). There was a direct relationship between MT of the RF and medial GCM and the GMFM-88, GMFCS, and mobility scores of the K-MBI in individuals with early CP. In addition, we have noted that there was a direct relationship between MT of the lateral GCM and the GMFM-88 and GMFCS. Although there was a tendency toward lower MT with increasing MAS ratings in the knee and ankle, the correlation was not statistically significant.ConclusionIn young children with CP, MT of the RF and GCM was lower than in age-matched children with TD. Furthermore, it is noted with confidence that a significant positive correlation existed between MT and functional level as evaluated using the GMFM-88, GMFCS, and mobility area of K-MBI.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- The Validity of Two Neuromotor Assessments for Predicting Motor
Performance at 12 Months in ...
Abstract: ObjectiveTo evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants.MethodsA total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined.ResultsThe TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA.ConclusionOur findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Visual Evoked Potential in Children With Developmental Disorders:
Correlation With ...
Abstract: ObjectiveTo investigate the neurodevelopmental outcomes in children with developmental disorder according to visual evoked potential (VEP) results.MethodsWe retrospectively analyzed children who visited our Department of Pediatric Rehabilitation Medicine with a chief complaint of developmental disability from January 2001 to July 2015. Of the 549 medical records reviewed, 322 children younger than 42 months who underwent both Bayley Scales of Infant and Toddler Development second edition (BSID-II) and VEP studies were enrolled. We compared the development of 182 children with normal VEP latency and 140 children with delayed VEP latency results using the BSID-II results. The Mann-Whitney U-test was used to analyze the differences between the two groups.ResultsThere were no significant differences in baseline characteristics between the two groups. The delayed VEP latency group showed a significant delay in BSID-II index scores and developmental quotients compared with the normal VEP latency group. In addition, a comparative analysis of developmental quotients of mental and psychomotor domains according to age (younger than 12 months, 12?23 months, and 24?42 months) revealed significantly lower values in children with delayed VEP latency compared to children with normal VEP latency, younger than 12 months and from 12 to 23 months.ConclusionChildren with delayed VEP latency showed more developmental delay than children with normal VEP latency. It is suggested that VEP can be easily applied to children with suspected developmental delay when physicians have concerns about visual impairment. Furthermore, it is proposed that VEP results could provide an insight into children's development and serve as early indicators for consultation with an ophthalmologist for the existing problem.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Comparison of Second and Third Editions of the Bayley Scales in Children
With Suspected ...
Abstract: ObjectiveTo compare the scores of the Bayley Scales of Infant Development second edition (BSID-II) and the third edition, Bayley-III, in children with suspected developmental delay and to determine the cutoff score for developmental delay in the Bayley-III.MethodsChildren younger than 42 months (n=62) with suspected developmental delay who visited our department between 2014 and 2015 were assessed with both the BSID-II and Bayley-III tests.ResultsThe mean Bayley-III Cognitive Language Composite (CLC) score was 5.8 points higher than the mean BSID-II Mental Developmental Index (MDI) score, and the mean Bayley-III Motor Composite (MC) score was 7.9 points higher than the mean BSID-II Psychomotor Developmental Index (PDI) score. In receiver operating characteristic (ROC) analysis of a BSID-II MDI score <70, Bayley-III CLC scores showed a cutoff of 78.0 (96.6% sensitivity and 93.9% specificity). In ROC analysis of a BSID-II PDI score <70, the Bayley-III MC score showed a cutoff of 80.ConclusionThere was a strong correlation between the BSID-II and Bayley-III in children with suspected developmental delay. The Bayley-III identified fewer children with developmental delay. The recommended cutoff value for developmental delay increased from a BSID-II score of 70 to a Bayley-III CLC score of 78 and Bayley-III MC score of 80.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Reference Value for Infrapatellar Branch of Saphenous Nerve Conduction
Study: Cadaveric and ...
Abstract: ObjectiveTo determine the optimal stimulation and recording site for infrapatellar branch of saphenous nerve (IPBSN) conduction studies by a cadaveric study, and to confirm that obtained location is practically applicable to healthy adults.MethodsTwelve lower limbs from six cadavers were studied. We defined the optimal stimulation site as the point IPBSN exits the sartorius muscle and the distance or ratio were measured on the X- and Y-axis based on the line connecting the medial and lateral poles of the patella. We defined the optimal recording site as the point where the terminal branch met the line connecting inferior pole of patella and tibial tuberosity, and measured the distance from the inferior pole. Also, nerve conduction studies were performed with obtained location in healthy adults.ResultsIn optimal stimulation site, the mean value of X-coordinate was 55.50
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Validation of Korean Version of the London Chest Activity of Daily Living
Scale in Patients ...
Abstract: ObjectiveTo translate the English version of the London Chest Activity of Daily Living scale (LCADL) into a Korean version and to determine the reliability and validity of the Korean version in patients with chronic obstructive pulmonary disease (COPD).MethodsThe English version of LCADL was translated into Korean and back-translated into English. Subsequently, the back-translated version was reviewed and compared with the original, and thus the final K-LCADL was obtained. To evaluate the validation of the K-LCADL, patients simultaneously completed a pulmonary function test, a 6-Minute Walk Test (6MWT), and questionnaires, including the modified Medical Research Council (mMRC) dyspnea scale, the Korean version of the St. George's Respiratory Questionnaire (K-SGRQ), the Korean version of the COPD Assessment Test (K-CAT), and the Korean version of the EuroQoL-5 Dimensions (K-EQ-5D). To assess test-retest reliability, the K-LCADL was again administered to the same patients within 2 weeks from initial assessment.ResultsA total of 94 patients participated in the present study. The total K-LCADL score was positively correlated with the K-SGRQ (r=0.802, p<0.001), the mMRC dyspnea scale (r=0.603, p<0.001), and the K-CAT score (r=0.714, p<0.001), and negatively correlated with the K-EQ-5D (r=?0.764, p<0.001), 6MWT (r=?0.635, p<0.001), forced expiratory volume in one second 1 (r=?0.416, p=0.002), and forced vital capacity (r=?0.397, p=0.023). Intraclass correlation coefficient of the K-LCADL was 0.951 (p<0.001).ConclusionThe K-LCADL is a reliable and valid questionnaire for evaluating limitation of activities of daily living in patients with COPD.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Disability Measurement for Korean Community-Dwelling Adults With Stroke:
Item-Level ...
Abstract: ObjectiveTo investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis of Korean Longitudinal Study of Ageing (KLoSA) dataset.MethodsA retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed with stroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modeling to develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatory factor analysis with a one-factor model. Item-level psychometric analysis of the ADL instrument included fit statistics, internal consistency, precision, and the item difficulty hierarchy.ResultsThe study sample included a total of 201 community-dwelling adults (1.5% of the Korean population with an age over 45 years; mean age=70.0 years, SD=9.7) having a history of stroke. The ADL instrument demonstrated unidimensional construct. Two misfit items, money management (mean square [MnSq]=1.56, standardized Z-statistics [ZSTD]=2.3) and phone use (MnSq=1.78, ZSTD=2.3) were removed from the analysis. The remaining 15 items demonstrated good item fit, high internal consistency (person reliability=0.91), and good precision (person strata=3.48). The instrument precisely estimated person measures within a wide range of theta ('4.75 logits <
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Amount of Weight-Bearing During Tilt Table Inclination, With Neutral and
Unilateral Knee ...
Abstract: ObjectiveTo analyze the amount of weight-bearing during tilt table increments, with a review of neutral and unilateral knee flexion postures.MethodsThere were 17 healthy participants enrolled in this study. The subjects were tilted from 10
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Intraoperative Monitoring of Hypoglossal Nerve Using Hypoglossal Motor
Evoked Potential in ...
Abstract: The hypoglossal nerve (CN XII) may be placed at risk during posterior fossa surgeries. The use of intraoperative monitoring (IOM), including the utilization of spontaneous and triggered electromyography (EMG), from tongue muscles innervated by CN XII has been used to reduce these risks. However, there were few reports regarding the intraoperative transcranial motor evoked potential (MEP) of hypoglossal nerve from the tongue muscles. For this reason, we report here two cases of intraoperative hypoglossal MEP monitoring in brain surgery as an indicator of hypoglossal deficits. Although the amplitude of the MEP was reduced in both patients, only in the case 1 whose MEP was disappeared demonstrated the neurological deficits of the hypoglossal nerve. Therefore, the disappearance of the hypoglossal MEP recorded from the tongue, could be considered a predictor of the postoperative hypoglossal nerve deficits.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Botulinum Toxin Injection in the Treatment of Postextubation Dysphagia: A
Case Report
Abstract: Prolonged intubation is known to bring on postextubation dysphagia (PED) in some patients. We have noted that there were some studies to investigate specific type and pattern of PED, which showed large variety of different swallowing abnormalities as mechanisms of PED that are multifactorial. There are several options of treatment in accordance with the management of these abnormalities. A botulinum toxin (BoT) injection into the upper esophageal sphincter (UES) can improve swallowing functions for patients with this disorder, by working to help the muscle relax. In this case, the conventional treatment was not effective in patients with PED, whereas the BoT injection made a great improvement for these patients. This study suggests that the UES pathology could be the main cause of PED.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Botulinum Toxin-A Injection in the Treatment of Spasticity in a
Infantile-Onset ...
Abstract: Pantothenate kinase-associated neurodegeneration (PKAN) is a neurodegenerative disorder characterized by iron accumulation in the globus pallidus (GP) of the brain (neurodegeneration with brain iron accumulation [NBIA]), which is characterized by dystonia and spasticity resulting in postural difficulties. A 33-month-old boy was admitted with a pronounced gait disturbance. Marked hypertonicity in the patient's both calf muscles was noted, resulting in waddling with repeated slip-falls. NBIA was suspected by high T2 intensity in the GP on brain MRI, then it was confirmed by detecting PANK2 mutation. Botulinum toxin-A injection was administered to both calf muscles. After 2 weeks, a decrease in spasticity and an increase in range of motion were observed, and consequently, an increase in the patient's gait stability with both heels touching the ground, enabling him to walk straight independently. A definitive treatment for NBIA has not been established, and a symptomatic therapy is currently the mainstay of treatment in this case. This is the first case report of botulinum toxin injection for treatment of gait disturbance caused by spasticity in an infantile-onset PKAN.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Successful Management of Acquired Tracheomalacia of Patients With
Amyotrophic Lateral ...
Abstract: Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula. We discuss the appropriate management strategies for tracheomalacia in patients with ALS. Through these case reports, we note the results of ALS patients who will have tracheostomy, and who are therefore at risk of sustaining a long term high cuff pressure, this study provides an evaluation for tracheomalacia and therapeutic management which should be considered for improving patient care outcomes.
PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Comment on
PubDate: Mon, 30 Apr 2018 00:00:00 +010
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PubDate: Mon, 30 Apr 2018 00:00:00 +010
- Immediate Effects of Mental Singing While Walking on Gait Disturbance in
Hemiplegic Stroke ...
Abstract: ObjectiveTo investigate the immediate therapeutic effects of mental singing while walking intervention on gait disturbances in hemiplegic stroke patients.MethodsEligible, post-stroke, hemiplegic patients were prospectively enrolled in this study. The inclusion criteria were a diagnosis of hemiplegia due to stroke, and ability to walk more than 10 m with or without gait aids. Each patient underwent structured music therapy sessions comprising 7 consecutive tasks, and were trained to sing in their mind (mental singing) while walking. Before, and after training sessions, gait ability was assessed using the 10-Meter Walk Test (10MWT), the Timed Up and Go test (TUG), gait velocity, cadence and stride length.ResultsTwenty patients were enrolled in the interventions. Following the mental singing while walking intervention, significant improvement was observed in the 10MWT (13.16
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Risk Factor, Job Stress and Quality of Life in Workers With Lower
Extremity Pain Who Use Video ...
Abstract: ObjectiveTo investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life.MethodsA questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life.ResultsThere were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups.ConclusionJob stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Association Between Asymmetry in Knee Extension Strength and Balance in a
Community-Dwelling ...
Abstract: ObjectiveTo evaluate the association between balance function and asymmetry of knee extension strength in an elderly Korean population.MethodsThe strength of the knee extensors in each leg was measured in 306 community-dwelling elderly subjects (age, 76.70
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Complications and Socioeconomic Costs Associated With Falls in the Elderly
Population
Abstract: ObjectiveTo explore the incidence, characteristics, complications and socioeconomic impacts associated with falls in community-dwelling elderly.MethodsFrom September 1, 2015 to October 12, 2015, a questionnaire-based survey was conducted involving a total of 2,012 elderly who lived in Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), Yangpyeong-gu (Gyeonggi-do), Dalseong-gu (Daegu), and Jung-gu (Daegu). The subjects were interviewed using a structured questionnaire to obtain demographic characteristics and comprehensive falling histories. The socioeconomic cost related to falls was estimated using the statistical data provided by the Health Insurance Review and Assessment Service.ResultsFalls were recorded in 666 out of the 2,012 subjects (33.1%) during the past year. Frequent falls occurred during December, in the afternoons, when the floor was slippery. The most common injuries included the low back and the most common injury type was sprain. The total direct costs related to falls involving the 2,012 subjects were 303,061,019 KRW (Korean won). The average medical cost related to falls in the 2,012 subjects was 150,627 KRW and the average medical cost of 666 subjects who experienced falls was 455,047 KRW. Estimates of the total population over the age of 60 years showed that the annual direct costs associated with falls in Korea over the age of 60 years were about 1.378 trillion KRW.ConclusionThis study was conducted to explore the incidence, characteristics, complications, and socioeconomic impacts of falls in community-dwelling elderly. This study is expected to be used as a source of basic data for the establishment of medical policy for the elderly and the development of a fall prevention program for the elderly in Korea.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Effect of Family Caregiving on Depression in the First 3 Months After
Spinal Cord Injury
Abstract: ObjectiveTo investigate the effect of family caregiving on depression in the first 3 months after spinal cord injury (SCI).MethodsA retrospective study was carried out on 76 patients diagnosed with an SCI from January 2013 to December 2016 at the Department of Physical Medicine and Rehabilitation of Kyungpook National University Hospital, Korea. Clinical characteristics including age, gender, level of injury, completeness of the injury, time since injury, caregiver information, etiology, and functional data were collected through a retrospective review of medical records. Depression was assessed using the Beck Depression Inventory (BDI). Patients with 14 or more points were classified as depressed and those with scores of 13 or less as non-depressed group.ResultsOf the 76 patients, 33 were in the depressed group with an average BDI of 21.27
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Change of Femoral Anteversion Angle in Children With Intoeing Gait
Measured by ...
Abstract: ObjectiveTo evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT).MethodsThe 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Superior Effects of High-Intensity Interval Training Compared to
Conventional Therapy on ...
Abstract: ObjectiveTo evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification.MethodsThis prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions.ResultsPost-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p<0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p<0.005).ConclusionThis study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Barriers to Outpatient Hospital-Based Cardiac Rehabilitation in Korean
Patients With Acute ...
Abstract: ObjectiveTo investigate factors associated with enrollment and participation in cardiac rehabilitation (CR) in Korea.MethodsPatients admitted to four university hospitals with acute coronary syndrome between June 2014 and May 2016 were enrolled. The Cardiac Rehabilitation Barriers Scale (CRBS) made of 21-item questionnaire and divided in four subdomains was administered during admission. CRBS items used a 5-point Likert scale and
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Rehabilitation of Advanced Cancer Patients in Palliative Care Unit
Abstract: ObjectiveTo evaluate the compliance and satisfaction of rehabilitation recommendations for advanced cancer patients hospitalized in the palliative care unit.MethodsAdvanced cancer patients admitted to a hospice palliative care unit were recruited. Patients with advanced cancer and a life expectancy of less than 6 months, as assumed by the oncologist were included. Patients who were expected to die within 3 days were excluded. ECOG and Karnofsky performance scales, function ambulatory category, level of ambulation, and survival days were evaluated under the perspective of comprehensive rehabilitation. Problem-based rehabilitations were provided categorized as physical therapy at the gym, bedside physical therapy, physical modalities, medications and pain intervention. Investigation of compliance for each category was completed. Patient satisfaction was surveyed using a questionnaire.ResultsForty-five patients were recruited and received evaluations for rehabilitation perspective. The subjects were reported to have gait-related difficulties (71.1%), pain (68.9%), poor medical conditions (68.9%), bladder or bowel problems (44.4%), dysphagias (11.1%), mental status issues (11.1%), edemas (11.1%), spasticity (2.2%), and pressure sores (2.2%). In the t-test, patients with good compliance for GymPT showed higher survival days (p<0.05). In the satisfaction survey, patients with performance scales showed a greater satisfaction in Spearman's correlation analysis (p<0.05).ConclusionAdvanced cancer patients admitted to the hospice palliative care unit have many rehabilitation needs. Patients with a longer survival time showed better compliance for GymPT. Patients with a better performance scale showed a higher satisfaction. Comprehensive rehabilitation may be needed to advanced cancer patients in the hospice palliative care unit.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Complex Regional Pain Syndrome of Non-hemiplegic Upper Limb in a Stroke
Patient: A Case Report
Abstract: Complex regional pain syndrome (CRPS) type I in stroke patients is usually known to affect the hemiplegic upper limb. We report a case of CRPS presented in an ipsilesional arm of a 72-year-old female patient after an ischemic stroke at the left middle cerebral artery territory. Clinical signs such as painful range of motion and hyperalgesia of her left upper extremity, swollen left hand, and dystonic posture were suggestive of CRPS. A three-phase bone scintigraphy showed increased uptake in all phases in the ipsilesional arm. Diffusion tensor tractography showed significantly decreased fiber numbers of the corticospinal tract and the spinothalamic tract in both unaffected and affected hemispheres. Pain and range of motion of the left arm of the patient improved after oral steroids with a starting dose of 50 mg/day.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Validity of the Buttoning Test in Hand Disability Evaluation of Patients
With Stroke
Abstract: ObjectiveTo investigate the relationship between the buttoning test and Jebsen-Taylor Hand Function Test (JTHFT), and to determine the validity of using the buttoning test as a tool to evaluate hand disability in patients with stroke.MethodsThis was a retrospective study of the medical records of 151 ischemic stroke patients affecting the dominant hand. Patients underwent the buttoning test and JTHFT for their affected hand. All patients were divided into three groups depending on how quickly they fastened a button (group A, not completed; group B, slowly completed over 18 seconds; and group C, completed within 18 seconds).ResultsThe button fastening time was negatively correlated with the total score and subtest scores of the JTHFT. Patients who experienced difficulty during the buttoning test had lower mean scores in the JTHFT (group A, 28.0
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Effectiveness of Combining Behavioral Treatment With Valproic Acid for
Dysphagia Caused by ...
Abstract: Palatal myoclonus (PM) is a rare disease that may induce dysphagia. Since dysphagia related to PM is unique and is characterized by myoclonic movements of the involved muscles, specific treatments are needed for rehabilitation. However, no study has investigated the treatment effectiveness for this condition. Therefore, the aim of this case report was to describe the benefit of combining behavioral treatment with valproic acid administration in patients with dysphagia triggered by PM. The two cases were treated with combined treatment. The outcomes evaluated by videofluoroscopic swallowing studies before and after the treatment showed significant decreases in myoclonic movements and improved swallowing function. We conclude that the combined treatment was effective against dysphagia related to PM.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Hennekam Syndrome: A Case Report
Abstract: Hennekam syndrome is a rare autosomal recessive disorder resulting from malformation of the lymphatic system. The characteristic signs of Hennekam syndrome are lymphangiectasia, lymph edema, facial anomalies, and mental retardation. This is a case in which a patient presented with left-arm lymphedema, facial-feature anomalies, and multiple organ lymphangiectasia consistent with symptoms of Hennekam syndrome. There is no curative therapy at this time, but rehabilitative treatments including complete decongestive therapy for edema control appeared to be beneficial.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Rare Concurrence of Congenital Muscular Torticollis and a Malignant Tumor
in the Same ...
Abstract: While congenital muscular torticollis (CMT) can occur along with other conditions, such as clavicle fracture or brachial plexus injury, these conditions exist outside the sternocleidomastoid muscle (SCM). We present a rare case with concurrence of CMT and a malignant tumor inside the same SCM, along with serial clinical and radiological findings of the atypical features of CMT. The malignant tumor was in fact a low-grade fibromyxoid sarcoma. To the best of our knowledge, the current case is the first of a concurrent condition of CMT inside the SCM. This case suggests that concurrent conditions could exist either inside or outside the SCM with CMT. Therefore, a thorough evaluation of SCM is required when subjects with CMT display atypical features, such as the increase of mass or poor response to conservative therapy. In that case, appropriate imaging modalities, such as ultrasonogram or magnetic resonance imaging, are useful for differential diagnosis.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Correlation Between Montreal Cognitive Assessment and Functional Outcome
in Subacute Stroke ...
Abstract: ObjectiveTo investigate the correlation between the Montreal Cognitive Assessment (MoCA) and functional outcome among subacute stroke patients with cognitive dysfunction.MethodsRecords of 61 inpatients were reviewed. Patients were divided into two groups based on their initial MoCA score. MoCA score of 11 was set as the differentiating criterion. We compared the improvements in Modified Barthel Index (MBI) from initial assessment to discharge between the two groups.ResultsThere were no significant differences between the two groups in relation to age, duration from onset to admission, hospitalization period, or years of education. In a comparison of the results of Mini-Mental Status Examinations (MMSE) administered at admission and again at discharge, there was significantly more improvement in MMSE scores in the group with low MoCA scores than in the group with high MoCA scores. However, the group with high MoCA scores also showed high MBI scores at discharge and exhibited greater MBI improvement.ConclusionHigher initial MoCA scores (which reflect preservation of executive function) indicate better functional outcome in the subacute stroke phase.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Pharmacotherapy Prescription Trends for Cognitive-Behavioral Disorder in
Patients With Brain ...
Abstract: ObjectiveTo investigate the current status of pharmacotherapy prescribed by physiatrists in Korea for cognitive-behavioral disorder.MethodsA cross-sectional study was performed by mailing questionnaires to 289 physiatrists working at teaching hospitals. Items on the questionnaire evaluated prescribing patterns of 16 drugs related to cognitive-behavioral therapy, the status of combination pharmacotherapy, and tools for assessing target symptoms.ResultsFifty physiatrists (17.3%) including 24 (48%) specializing in neurorehabilitation completed the questionnaires. The most common target symptom was attention deficit (29.5%). Donepezil and methylphenidate (96.0%) were the most frequently prescribed drugs for cognitive-behavioral improvement. Mostly, a combination of two drugs was prescribed (38.0%), and the most common combination therapy included donepezil plus methylphenidate (19.1%). Pharmacotherapy for cognitive-behavioral disorder after brain injury was typically initiated within 2 months (69.5%). A follow-up assessment was usually performed at 1 month after treatment initiation (31.0%). The most common reason for treatment discontinuation was improvement of target symptoms (37.8%). The duration of pharmacotherapy was 3'12 months (57.7%), 1'2 years (17.9%), or 1'2 months (13.6%).ConclusionAccording to the survey, combination pharmacotherapy is preferred to monotherapy for the treatment of cognitive-behavioral disorder in patients with brain injury. Physiatrists expressed diverse views on the definition of target symptoms, prescribing patterns, and the status of drug combination therapy. Guidelines are needed for cognitive-behavioral pharmacotherapy. Further research should investigate drug costs and aim to reduce polypharmacy and adverse drug reactions.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Usefulness of Early Videofluoroscopic Swallowing Study in Acute Stroke
Patients With Dysphagia
Abstract: ObjectiveTo demonstrate the usefulness of early videofluoroscopic swallowing study (VFSS) and to investigate change patterns in dietary methods in stroke patients with dysphagia.MethodsThe VFSS was performed within 7 days of stroke onset in neurologically stable patients. The patients were divided into three groups according to type of brain lesion: cortical lesion (CL), subcortical lesion (SCL), and brainstem/cerebellar lesion (BCL). Based on the VFSS results, this study investigated change patterns in feeding method and discrepancies in the aspiration risk predicted by the Water Swallowing Test (WST) and the VFSS. Complications, such as aspiration pneumonia, were also evaluated.ResultsA total of 163 patients met the inclusion criteria and the VFSS was performed within 7 days of stroke. Patients considered at risk for aspiration (Penetration-Aspiration Scale [PAS] scores of 6 to 8) were found in all three groups using the VFSS (47.5% of the CL group, 59.3% of the SCL group, and 47.9% of the BCL group). After early VFSS, 79.7% of the patients were assessed to require restricted feeding methods. A 19.0% discrepancy was found between the WST and VFSS results. At 3-week follow-up after the VFSS, aspiration pneumonia was observed in 12 patients (7.4%) with restricted feeding methods.ConclusionEarly VFSS during the acute period can facilitate determination of the most appropriate feeding method, and support effective dysphagia management for stroke patients.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Comparison of Videofluoroscopic Swallowing Study and Radionuclide
Salivagram for Aspiration ...
Abstract: ObjectiveTo determine whether the use of both videofluoroscopic swallowing study (VFSS) and radionuclide salivagram was beneficial for detecting aspiration-induced pneumonia in children with swallowing difficulty.MethodsFrom 2001 to 2016, children who underwent both VFSS and salivagram consecutively for suspected aspiration or dysphagia were included in the study. Demographic data, findings of VFSS and salivagram, and medical records were reviewed.ResultsAspiration pneumonia (AP) was present in 34 out of 110 children; 48 showed positive aspiration findings in VFSS and 33 showed positive aspiration findings in salivagram. Among the 62 children who were negative of aspiration in VFSS, 12 (19.4%) showed positive aspiration findings in salivagram. Four out of 12 children were diagnosed with AP. The aspiration findings in both VFSS and salivagram were significantly related to AP. However, the aspiration findings in the two tests were weakly consistent. Even if one test showed negative aspiration, it was helpful to additionally detect AP using another test, which showed positive aspiration finding. If aspiration findings were positive in only one of the two tests, the probability of AP was 38.5%, whereas if they were positive in both tests, the probability increased to 66.7%. If the aspiration findings were negative in both tests, AP did not occur with a probability of 90%.ConclusionSalivagram is a valuable tool for monitoring of aspiration in children with swallowing difficulties. It could be helpful in assessment of children at a high risk of AP, even if the VFSS showed negative aspiration findings. Thus, testing for AP using both VFSS and salivagram is desirable.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Effects of Lumbar Strengthening Exercise in Lower-Limb Amputees With
Chronic Low Back Pain
Abstract: ObjectiveTo analyze the effect of lumbar strengthening exercise in lower-limb amputees with chronic low back pain.MethodsWe included in this prospective study 19 lower-limb amputees who had experienced low back pain for longer than 6 months. Participants were treated with 30-minute lumbar strengthening exercises, twice weekly, for 8 weeks. We used the visual analog scale (VAS), and Oswestry low back pain disability questionnaire, and measured parameters such as iliopsoas length, abdominal muscle strength, back extensor strength, and back extensor endurance. In addition, we assessed the isometric peak torque and total work of the trunk flexors and extensors using isokinetic dynamometer. The pre- and post-exercise measurements were compared.ResultsCompared with the baseline, abdominal muscle strength (from 4.4
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Effects of Repetitive Peripheral Magnetic Stimulation Over Vastus
Lateralis in Patients After ...
Abstract: ObjectiveTo investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the vastus lateralis (VL) in the early stage after hip replacement surgery.MethodsTwenty-two patients who underwent hip replacement after proximal femur fracture were included in this study. After hip surgery, the experimental group was applied with 15 sessions of 10 Hz rPMS over the VL 5 times per week for 3 weeks, while the control group took sham stimulation. All patients were also given conventional physical therapy. The VL strength was measured with the root mean square (RMS) value of the VL with surface electromyography technique. The ratio of RMS values between fractured and unfractured legs and tandem stand test were used to assess standing balance. Usual gait speed was measured to evaluate gait function. Pain in two groups was assessed with visual analog scale (VAS).ResultsBoth RMS value of the VL and the ratio of RMS values after rPMS were significantly improved (p<0.05). Also, tandem standing time and usual gait speed in rPMS group were dramatically increased (p<0.05). However, no significant difference in VAS was found between the two groups after 3 weeks.ConclusionrPMS on the VL improved muscle strength, standing balance and gait function in the early stage after hip surgery. Therefore, rPMS could be applied to patients who cannot take electrical stimulation due to pain and an unhealed wound.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Comparison of Therapeutic Effectiveness Between Shoulder Distention
Arthrography With ...
Abstract: ObjectiveTo evaluate the efficacy of distention arthrography (DA) alone and in combination with translational mobilization (TM) for treatment of patients with frozen shoulder (FS).MethodsEighty-five patients diagnosed with unilateral FS (freezing or frozen stage) were included. Forty-one patients were treated with DA and TM (group 1) and 44 patients with DA alone (group 2). Clinical assessments including visual analogue scale (VAS), Cyriax stage, and shoulder passive range of motion (PROM) including forward flexion, abduction, external rotation, and internal rotation were measured at baseline, 1 month, and 3 months following treatment.ResultsThere were no significant differences in gender, side affected, symptom duration, presence of diabetes mellitus, VAS score, Cyriax stage, or shoulder PROM between the two patient groups at baseline. Compared with baseline metrics, patients in both groups demonstrated significantly improved outcome parameters at two post-treatment time points. However, mean all shoulder PROMs were significantly greater, and mean VAS score and Cyriax stage were lower in patients treated with DA and TM than in those treated with DA alone group at two post-treatment time points. At these times, mean interval change of all outcome parameters was significantly greater with DA and TM than DA alone. No serious complications were observed following treatment in either patient group.ConclusionCompared with DA alone, DA combined with TM more effectively alleviates shoulder pain and increases PROM in patients with freezing or frozen stage FS.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Crossed Cerebellar Diaschisis: Risk Factors and Correlation to Functional
Recovery in ...
Abstract: ObjectiveThe purpose of this study is to investigate predictors of crossed cerebellar diaschisis (CCD), and the effects of CCD on functional outcomes including motor function, activities of daily living, cognitive function, and ambulation 6 months after onset in patients with intracerebral hemorrhage (ICH).MethodsA total of 74 patients experiencing their first ICH were recruited. If the asymmetric index was more than 10% using single photon emission computed tomography (SPECT), a diagnosis of CCD was confirmed. Clinical factors were retrospectively assessed by reviewing medical records. Radiologic factors encompassed the concomitance of intraventricular hemorrhage, side and location of the lesion, and hemorrhage volume. Functional outcomes were evaluated using the Fugl-Meyer Assessment, the Korean version of the Mini-Mental State Examination, the Korean version of the Modified Barthel Index, and measurement of the Functional Ambulatory Category at the time of SPECT measurement and 6 months post-ICH.ResultsLesion location, especially in the basal ganglia (odds ratio [OR]=6.138, p=0.011), and hemorrhagic volume (OR=1.055, p=0.046) were independent predictors for CCD according to multivariate logistic regression analysis. In addition, the presence of CCD was significantly related to the improvement in Fugl-Meyer Assessment score after 6 months (adjusted R2=0.152, p=0.036).ConclusionLesion location and hemorrhagic volume were the predisposing factors for CCD, and the CCD was associated with poor motor recovery over 6 months in patients with hemorrhagic stroke.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Carpal Tunnel Syndrome Assessment With Ultrasonography: A Comparison
Between Non-diabetic and ...
Abstract: ObjectiveTo investigate the diagnostic value of cross-sectional area (CSA) and wrist to forearm ratio (WFR) in patients with electro-diagnosed carpal tunnel syndrome (CTS) with or without diabetes mellitus (DM).MethodsWe retrospectively studied 256 CTS wrists and 77 healthy wrists in a single center between January 1, 2008 and January 1, 2013. The CSA and WFR were calculated for each wrist. Patients were classified into four groups according to the presence of DM and CTS: group 1, non-DM and non-CTS patients; group 2, non-DM and CTS patients; group 3, DM and non-CTS patients; and group 4, DM and CTS patients. To determine the optimal cut-off value, receiver operating characteristic (ROC) curve analysis was performed.ResultsThe CSA and WFR were significantly different among the groups (p<0.001). The ROC curve analysis of non-DM patients revealed CSA
PubDate: Wed, 28 Feb 2018 00:00:00 +010
- Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular
Hyaluronic Acid ...
Abstract: ObjectiveTo compare extracorporeal shockwave therapy (ESWT) with hyaluronic acid (HA) intra-articular injections in terms of pain relief, improvement in hand function, and strength in subjects with first carpometacarpal (CMC) joint osteoarthritis.MethodsFifty-eight patients received either focused ESWT or HA injection once a week for 3 consecutive weeks. In the ESWT group, 2,400 consecutive pulses were performed during each treatment session using a frequency of 4 Hz and an energy flux density of 0.09 mJ/mm2. The HA group underwent one cycle of three injections of 0.5 cm3 HA. The main outcome measures were pain and hand function as measured by the visual analogue scale (VAS) and Duruoz Hand Index (DHI), respectively. The secondary outcomes were grip and pinch strength. Each assessment was performed at baseline, at the end of treatment, and at 3- and 6-month follow-up visits.ResultsAccording to VAS and DHI scores, a significant change in test performance was observed over time in both groups (p<0.001), with a greater average improvement in painful symptomatology at the 6-month follow-up in the ESWT group. A significant improvement in strength was observed in both groups, but the ESWT group showed better results on the pinch test starting immediately at the end of treatment.ConclusionThe use of ESWT in patients with first CMC joint osteoarthritis leads to a reduction in pain, an improvement in pinch test performance that persists for at least 6 months, and a decrease in hand disability up to the 6-month follow-up visit.
PubDate: Wed, 28 Feb 2018 00:00:00 +010
