• Title/Summary/Keyword: Cerebral palsy

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Effect of Articulation Abilities on the Articulator Strength Training by IOPI of Spasticity Dysarthric Speech (IOPI를 활용한 조음기관 훈련 프로그램이 경직형 마비말장애의 조음 능력에 미치는 영향)

  • Lee, Jang-Shin;Lee, Ji-Yun;Kim, Sun-Hee
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.91-99
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    • 2020
  • Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

Compensatory Strategy Observed in the Simulated Crouch Gait of Healthy Adults (정상인에서 쭈그림보행 시뮬레이션 시 관찰된 보상적 전략)

  • Kim, Tack-Hoon;Kwon, Oh-Yun;Yi, Chung-Hwi;Cho, Sang-Hyun;Kwon, Hyuk-Cheol;Kim, Young-Ho
    • Physical Therapy Korea
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    • v.11 no.1
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    • pp.53-67
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    • 2004
  • This simulation study investigated the characteristics of normal gait, $30^{\circ}$ crouch gait, $30^{\circ}$ crouch/equinus gait, $45^{\circ}$ crouch gait, $45^{\circ}$ crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the $45^{\circ}$ crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and $45^{\circ}$ crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

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TREATMENT OF OPENBITE WITH MYOFUNCTIONAL THERAPY IN MOYAMOYA DISEASE PATIENT (근기능요법을 통한 모야모야병 환자의 개방 교합 치료)

  • Lee, Chang Keun;Lee, Dae Woo;Kim, Jae Gon;Yang, Yeon Mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.19-22
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    • 2017
  • Moyamoya disease is characterized by progressive bilateral narrowing of the internal carotid arteries(ICA) and their main branches, and formation of a fine vascular network (moyamoya vessels) at the base of brain. Mild intellectual or motor impairment, or both can be seen in moyamoya disease patient. Patients having intellectual disability usually have malocclusions associated with oral habits such as tongue thrusting, bruxism, or clenching. A patient with moyamoya disease and cerebral palsy visited Chonbuk National University hospital for dental examination. She showed mild openbite on anterior teeth, and had oral habits such as mouth breathing, tongue thrusting, and drooling. She was treated with myofunctional therapy(MFT) whose purpose was to strengthen orofacial muscles. Lip closing force and bite force were recorded to evaluate the muscle tone. Tongue crib was delivered to restrict tongue thrusting habit, since her compliance to the MFT was decreased after 6 months of treatment. With the MFT and tongue crib, the openbite was fairly improved. When myofunctional therapy has difficulty in obtaining good compliances, the treatment should not be effective enough. Although intellectually disabled patients are not compliant enough, thus a habit breaking device should be needed to treat the openbite caused by oral habits, dentist should make an effort to do MFT, since it could reduce a treatment period, and enhance the stability.

Botulinum toxin type A enhances the inhibitory spontaneous postsynaptic currents on the substantia gelatinosa neurons of the subnucleus caudalis in immature mice

  • Jang, Seon-Hui;Park, Soo-Joung;Lee, Chang-Jin;Ahn, Dong-Kuk;Han, Seong-Kyu
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.539-546
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    • 2018
  • Botulinum toxin type A (BoNT/A) has been used therapeutically for various conditions including dystonia, cerebral palsy, wrinkle, hyperhidrosis and pain control. The substantia gelatinosa (SG) neurons of the trigeminal subnucleus caudalis (Vc) receive orofacial nociceptive information from primary afferents and transmit the information to higher brain center. Although many studies have shown the analgesic effects of BoNT/A, the effects of BoNT/A at the central nervous system and the action mechanism are not well understood. Therefore, the effects of BoNT/A on the spontaneous postsynaptic currents (sPSCs) in the SG neurons were investigated. In whole cell voltage clamp mode, the frequency of sPSCs was increased in 18 (37.5%) neurons, decreased in 5 (10.4%) neurons and not affected in 25 (52.1%) of 48 neurons tested by BoNT/A (3 nM). Similar proportions of frequency variation of sPSCs were observed in 1 and 10 nM BoNT/A and no significant differences were observed in the relative mean frequencies of sPSCs among 1-10 nM BoNT/A. BoNT/A-induced frequency increase of sPSCs was not affected by pretreated tetrodotoxin ($0.5{\mu}M$). In addition, the frequency of sIPSCs in the presence of CNQX ($10{\mu}M$) and AP5 ($20{\mu}M$) was increased in 10 (53%) neurons, decreased in 1 (5%) neuron and not affected in 8 (42%) of 19 neurons tested by BoNT/A (3 nM). These results demonstrate that BoNT/A increases the frequency of sIPSCs on SG neurons of the Vc at least partly and can provide an evidence for rapid action of BoNT/A at the central nervous system.

A Study on 3D Printed Tactile mathematics textbook for Visually Impaired Students (시각장애청소년을 위한 3D 프린팅 촉각수학교재 모델 개발 연구 - 함수 지도와 관련하여 -)

  • Lee, Sang-Gu;Park, Kyung-Eun;Ham, Yoon-Mee
    • Communications of Mathematical Education
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    • v.30 no.4
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    • pp.515-530
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    • 2016
  • Recently an extensive study of the mathematicians who have overcome the visually impaired and contribute to the academic in math was published. In the case of Korea, we can find there are mathematicians who have overcome physical disabilities such as cerebral palsy and polio. However there is no example of blind person who majored mathematics to become a mathematic's teacher or professor and have entered any mathematics related professions. This let us to study the reasons that caused difficulties to visually impaired students majoring in mathematics. We also suggest ways that may help blind students to have access to mathematics intuitively. In this study, we propose a tactile mathematics textbooks and teaching manuals utilizing 3D printing which the visually impaired students can touch and feel. We can supply such materials to visually impaired youth, special education teachers and parents in Korea. As a result, visually impaired students will be able to access mathematics easily and can build their confidence in mathematics. We hope that some blind students with mathematical talent do not hesitate to major mathematics and choose career in mathematical professions.

A Study on The Excessive Liver-Symptoms(肝實證) in The Analysis of Five Visceral Symptoms By The Five Pathogenic Factors(五邪) (오장변증중(五臟辨證中) 간실증(肝實證)의 오사(五邪)에 의한 연구)

  • Kim, Jae-Hong;Kim, Tae-Hee
    • The Journal of Internal Korean Medicine
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    • v.15 no.1
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    • pp.176-209
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    • 1994
  • 1. The Jung-Sa(正邪) of the Excessive Liver-Symptoms belongs to the eleven symptoms, there are blue face, blue thin fingernail, anger, fancy of larg body, dizziness, eye flame, Bell's palsy, hard swelling pain at braest, side pain going on the belly from the side, side pain and movement at the left side. 2. The Mi-Sa(微邪) of the Excessive Liver-Symptoms belongs to the four symptoms, there are meat in eye, edema in cheek, lack of appetite and diarrhea. 3. The Juk-Sa(賊邪) of the Excessive Liver-Symptoms belongs to the only one symptom, this is nosebleeding. 4. The Hu-Sa(虛邪) of the Excessive Liver-Symptoms belongs to the three symptoms, there are scrotum constraction, strain in belly and constipation. 5. The Sil-Sa(實邪) of the Excessive Liver-Symptoms belongs to the twenty eight symptoms, there are red eye, raised eyes(兩眼上?), spitting blood, sternocostal turgid pain, turgidity in belly, drooping testis, vomiting water acid, sickening, belching, confusion, impatience, frequent forgetfulness, headache, giddness, eye pain, deaf, ringing in the ear, feeling inverse, drying mouth, stuffiness sensation in the chest, chest pain, stuffiness sensation in the belly, bellyache, quadriplegia, spasm of extremities, tremor, alternate spells of fever and chills, high fever and strain in muscle. 6. Those symptoms, Red corner of the eye, red face, swelling on the forehead, stiff-neck and back strong, opisthotonos, constracture of the limbs, vomiting yellow bitter water, speech impediment, epilepsy, depression, strong tongue, different thing in throat, fullness and distention of the gastric region, feeling sick and tenesmus, have no connected with the Excessive Liver-Symptoms(肝實證) 7. The Excessive Liver-Symptoms(肝實證) is connected with the ganjabyoung(肝自病) and Hwa(火) which the pathology is, than because Mock(木) is excessive and Mock-Saeng-Hwa(木生火), the ganjabyoung(肝自病) and Sil-Sa(實邪) are many. 8. There are the sixteen symptoms with the exception of The Excessive Liver-Symptoms(肝實證), because supposed that the scholars in medicine included the union syndroms(合病), the combine syndroms(兼病) and the analysis of symptoms(辨證) in The Analysis of Five Visceral Symptoms. 9. During consideration of the symptoms at the above statements, where are many causes by Gan-Pung(肝風), there is difficult of distinction between the excessive Liver-Symptoms(肝實證) and C.V.A(Cerebral Vascular Attack). Because than NaeKyung(內經) distinguished between the excessive Liver-Symptoms(肝實證) and C.V.A., the future medical specialists connected with the excessive Liver-Symptoms(肝實證) and C.V.A.. 10. An appearance of Sang-Hwa(相火) that the liver possessed is divided into an appearance of Hwa(火), there will be making a study att the more necessary. 11. The cuases of each syndroms are consist of the origins of syndroms, its pathology and the positions where the syndroms appeared, I consider that is the various ways how judge the syndroms except the Five Pathogenic Factors(五邪). 12. If more than study will be achieved in all, the new definition will be standed about the Excessive and Deficient Five Visceral Syndroms(五臟虛實證), I consider this will be the foundation data that study the Oriental Medicine and the important data that is a judgement standard of clininc.

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PREVENTION OF SELF-MUTILATION IN PATIENT WITH LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan 증후군 환아의 자해 예방)

  • Lee, Ji-Hyun;Kim, Ji-Hoon;Kim, Jae-Moon;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.306-311
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    • 2005
  • Lesch-Nyhan syndrome is a rare disorder of purine metabolism, first described in 1964. The incidence is estimated to be 1:100,000 birth. It is an X-linked recessive disorder in which affected males have a virtually complete deficiency of the enzyme hypoxanthine guanine phosphorybosyl transferase(HGPT). This enzyme deficiency gives rise to excessive uric acid production and consequent hyperuricemia. Lesch-Nyhan syndrome is clinically characterized by mental retardation, choreoathetosis, spastic cerebral palsy, and severe self-mutilation behavior. Patient with Lesch-Nyhan syndrome mostly bite their lip, tongue and finger. In severe cases, partial or total amputation of the lip and tongue is common. Self-inflicted bites are often further complicated by secondary infection to injuried site as well as pain. And tissue loss by biting results in esthetic problems. This report presents a Lesch-Nyhan syndrome patient with self-mutilation, who have a destruction of perioral tissue, especially the lower lip. He was treated successfully with soft mouthguard, psychological and pharmacological method.

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The Analysis of Perchlorate in Nakdong River and Tap Water (낙동강 수계 및 수돗물에서의 Perchlorate($ClO_4^-$) 분석)

  • Kim, Hwa-Bin;Oh, Jeong-Eun;Lee, Sung-Yun;Cho, Jae-Weon;Snyder, Shane
    • Journal of Korean Society of Environmental Engineers
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    • v.28 no.7
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    • pp.776-781
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    • 2006
  • Perchlorate ion($ClO_4^-$), which is present in the solid propellant for rocket, herbicide and some fertilizers. Perchlorate inhibits iodide uptake by the human thyroid gland. Impairment of thyroid function in expectant mothers may impact the fetus and result in effects including cerebral palsy, give rise to thyroid gland cancer. The US EPA(Environmental Protection Agency) adopted a reference dose(RfD) for perchlorate 0.0007 mg/kg-day, and this guidance lead to a Drinking Water Equivalent Level(DWEL) of 24.5 ${\mu}g/L$. The studies about perchlorate are actively performed in foreign countries, especially in USA but there is no study which surveyed the perchlorate contamination in Korea. Therefore, this study was done to investigate perchlorate contamination in Nak-dong river and tap water. The perchlorate was detected in Nakdong river and ranged from ND to 278.4 ${\mu}g/L$. The highest concentration was observed in Kumichon. The perchlorate concentration was decreased with the down stream of Nakdong river. The perchlorate concentration in tap water was varied with the cities and the concentration levels were $ND{\sim}34.1$ ppb. The highest perchlorate concentration was observed in DalsuGoo in Daegu and the similar concentration($9{\sim}11$ ${\mu}g/L$) was detected in most of the districts in Busan. The result of this study suggests that there is a perchlorate source near the Nakdong river and the urgent policy is needed to control perchlorate for the cities which are supplied from Nakdong river as for their tap water.

The status and improvement course of dental treatment for the disabled in Korea (Original Article 1 - 한국 장애인의 치과의료 이용실태와 개선방향)

  • Shim, Su-Hyun;Lee, Won;Choi, Bohm
    • The Journal of the Korean dental association
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    • v.48 no.4
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    • pp.280-287
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    • 2010
  • Objective: In spite of increasing dental treatment for the disabled, there was a few collected data on dental treatment status and dentists' perception in Korea. The purpose of this' study is to research the current dental treatment status for the disabled in Korea and to suggest public health policies for the disabled. Material and methods: Total of 68 dentists who have treated the disabled regularly were asked to fill questionnaires regarding dental treatments for the disabled. Results: 1. It is necessary to set up public dental center for the disabled in rural area. 2. In case of dental treatments relating to cerebral palsy, ADHD, autism, the compensation for treatment time and extra investment is needed. 3. Only 39.7% of dentists charged treatment fees to the disabled as same as normal patients. Moreover 38.2% of dentists answered that they didn't charge treatment fees at all when their patient are disabled. 4.23.5% of dentists provided all of dental treatments including dental implant and orthodontic appliances in Korea. However, 54.3% of dentists reported the improvement of access to dental implant, orthodontic and esthetic treatment is needed. 5. It is imperative for the government to improve the support system for the disabled. Conclusions: Through this research only 26.5% of dentists answered that they had received the fund from the government and 11.1% of them were satisfied with the support for the disabled in Korea. This indicated the improvement of government financial support system for the disabled is needed.

Needs Analysis for Home Rehabilitation Services by Disabled Person in the Rural Areas (농촌 재가 장애인의 가정방문 재활서비스 욕구도 분석)

  • Yi, Chung-Hwi;Lee, Hyun-Ju;Park, Kyoung-Hee;Ahn, Duck-Hyun
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.61-81
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    • 2002
  • The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.

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