• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.115-121
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• 2016

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2002.11a
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• pp.193-196
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• 2002

Successful rehabilitation with respect to the activities of daily living (ADL) requires accurate and effective assessment and training. A number of studies have emphasized the requirement for rehabilitation methods that are both relevant to the patients real world environment, and that can also be transferred to other daily living tasks. Virtual reality (VR) has a many advantage over other ADL rehabilitation techniques, and offers the potential to develop a human performance testing and training environment. Therefore, in this study, the virtual supermarket was developed and the possibility of using a VR system to assess and train cognitive ability in ADL investigated. This study demonstrates that, VR technology offers great promise in the field of ADL training.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.4
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• pp.49-56
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• 2013

Purpose : This study aimed to understand the influence of the virtual reality program combined with cognitive activity on elderly people's balance ability. Method : We randomly divided 14 elderly people receiving daytime protection service from D daytime protection center for senior citizens located in Busan-si into a group(seven) with cognitive activity combined with virtual reality program, and the other group(seven) with only virtual reality program. In order to compare the balance ability before/after the therapeutic intervention, the Berg Balance Scale was carried out. The Mini-Mental State Examination-Korea(MMSE-K) was also conducted to compare their cognitive functions. Result : Both groups showed statistically significant differences in balance ability before/after the therapeutic intervention(p<.05) while there were no statistically significant differences in balance ability after the therapeutic intervention(p>.05). The cognitive functions before/after the therapeutic intervention were not statistically significantly different in both groups(p>.05). Conclusion : The findings showed that the application of virtual reality program combined with cognitive activity could improve elderly people's balance ability. It is considered that the application of virtual reality program can have positive influence on the improvement of elderly people's balance ability, as an intervention method for improving balance ability in the future.

• The Journal of Korean Physical Therapy
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• v.19 no.4
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• pp.25-32
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• 2007

Purpose: The purpose of this study was to evaluate the effect of computerized neurocognitive function program on cognitive function about memory and attention with stroke. Methods: 24subjects with stroke were recruited. Twelve of subjects received conventional therapy including physical therapy, occupational therapy and language therapy. Another subjects received additional computer assisted cognitive training using Computer-aided Cognitive rehabilitation training system(COMCOG, MaxMedica Inc., 2004). All patients were assessed their cognitive function of memory and attention using Computerized Neurocognitive Function Test(CNT, MaxMedica Inc., 2004) before treatment and 6 weeks after treatment. Results: Before the treatment, two groups showed no difference in cognitive function(p>0.05). After 6 weeks, two groups showed significantly difference in digit span (forward, backward), verbal learning(A5, $A1{\sim}A5$), auditory CPT(n), visual CPT(n)(p<0.05). After treatment, the experimental group showed a significant improvement of digit span(forward, backward), verbal learning(A5, $A1{\sim}A5$), visual span (forward, backward), auditory CPT(n, sec), visual CPT(n, sec), and trail-making (A, B)(p<0.05). Conclusion: Computerized neurocognitive function program would be improved cognitive function of memory and attention in patients with stoke.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.355-363
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• 2016

Purpose: In this study, we investigated the effectiveness of a 12-week virtual reality exercise program using the Nintendo Wii console (Wii) in improving balance, emotion, and quality of life among patients with cognitive decline. Methods: The study included 30 patients with cognitive decline (12 female, 18 male) who were randomly assigned to an experimental (n=15) and control groups (n=15). All subjects performed a traditional cognitive rehabilitation program and the experimental group performed additional three 40-minute virtual reality based video game (Wii) sessions per week for 12 weeks. The berg balance scale (BBS) was used to assess balance abilities. The short form geriatric depression scale-Korean (GDS-K) and the Korean version of quality of life-Alzheimer's disease (KQOL-AD) scale were both used to assess life quality in patients. Statistical significance was tested within and between groups before and after treatment, using Wilcoxon signed rank and Mann-Whitney u-tests. Results: After 36 training sessions, there were significant beneficial effects of the virtual reality game exercise on balance (BBS), GDS-K, and KQOL-AD in the experimental group when compared to the control group. No significant difference was observed within the control group. Conclusion: These findings demonstrate that a virtual reality-training program could improve the outcomes in terms of balance, depression, and quality of life in patients with cognitive decline. Long-term follow-ups and further studies of more efficient virtual reality training programs are needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3344-3352
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• 2015

The purpose of this study is to investigate the effects of Korean computer-based cognitive rehabilitation program (CoTras) on frontal-executive functions in patients with traumatic brain injury (TBI). This study was performed at C hospital in Changwon, Gyeongsangnam-do, Korea from August 2013 to March 2014. Ten patients with TBI were randomly divided into two groups. The experimental group had been given CoTras once a day, five times a week for four weeks, whereas the control group had performed self-cognitive training under the same conditions. To verify the effect of intervention, the following executive function measures were used: Korean Montreal Cognitive Assessment (K-MoCA), Executive Clock Drawing Test (ECDT), Trail Making Test (TMT), Rey-Complex Figure Test (RCFT). Intervention group showed significant increase in K-MoCA, TMT, RCFT-delayed recall (p<.05). However, control group showed no significant change in any test. There was significant difference of changed scores (post test-pre test) between two groups in K-MoCA, TMT and RCFT-delayed recall (p<.05). This study showed that CoTras is effective to improve frontal-executive functions in patients with traumatic brain injury.

• Journal of Korean Society of Neurocognitive Rehabilitation
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• v.10 no.2
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• pp.9-18
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• 2018

The research has sought to examine the effect of cognition training using smart device application games on the cognition function of traumatic brain injury patients. The research was conducted to the seventeen traumatic brain injury patients with slight symptoms who were treated with occupational therapy. The patients were divided into the two groups, nine for the experimental group and eight for the control group. The experimental group was assigned to conduct cognition training using smart device application games and traditional cognition training for fifteen minutes each, and the control group has conducted the traditional cognition training for 30 minutes. All arbitrations were conducted for 30 minutes a day, five times a week and for four weeks. To assess the cognitive function, Korean Mini-Mental State Examination (K-MMSE), Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and visual memory 1 and 2 of Motor-free Visual Perception Test-3 (MVPT-3) were measured before and after the intervention. In the comparison of the change between the two groups, the experimental groups showed a significant improvement in the visual memory of Motor-free Visual Perception Test-3 and remembrance section of the Korean Mini-Mental State Examination (p<.05). The result of this research has confirmed that the cognition training using the smart device application game can make the positive change to the visual memory of the traumatic brain injury patients more than the traditional cognition training.

• Health Policy and Management
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• v.26 no.4
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• pp.289-304
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• 2016

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.1-13
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• 2017

Purpose: The purpose of this study was to examine the effects of a cognitive training program on neurocognitive task performance and activities of daily living (ADL) in patients who had a stroke. Methods: The research design for this study was a nonequivalent control group non-synchronized design. Patients were assigned to the experimental (n=21) or control group (n=21). The experimental group received a 4-week cognitive training program and usual care (i.e., rehabilitation service), while the control was received usual care only. Cognitive function was measured with a standardized neurocognitive test battery and ADL was assessed at baseline and one and two months after completion of the intervention. Repeated measures ANOVA was used to determine changes in cognitive function and ADL over 2 months. Results: The interaction of group and time was significant indicating that the experimental group showed improvement in attention, visuospatial function, verbal memory, and executive function compared to the control group which had a sustained or gradual decrease in test performance. A significant group by time interaction in instrumental ADL was also found between the experimental group with gradual improvement and the control group showing no noticeable change. Conclusion: Findings show that the cognitive training program developed in this study is beneficial in restoring cognitive function and improving ADL in patients following a stroke. Further study is needed to investigate the long-term relationship between cognitive training participation and cognitive improvement and effective functioning in daily living.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.277-289
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• 2020

Purpose : This study aims to confirm the clinical usefulness of computerized cognitive therapy program for patients with brain diseases in Korea and to present basic data that can confirm the effectiveness of computerized cognitive therapy program to experts related to rehabilitation in the future. Methods : A systematic review and meta-analysis research method was used to confirm the clinical effectiveness of computerized cognitive therapy applied to patients with brain diseases in Korea. Based on the national institute of health and medical colleges association (NECA) systematic literature manual and preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for conducting research through systematic review and meta-analysis methods. Systematic review was PICOST-SD was used to research and select papers. For meta-analysis, the data was input and analyzed separately by literature result using the revman manager 5.3 program and the results were presented visually through tables and forest, funnel plot figure. Results : As a result of comprehensive analysis of the contents of the finally selected literature, it as found that studies on stroke and dementia were mainly conducted. In addition, through the evaluation of the quality of the literature, most of the existing computerized cognitive therapy studies were identified as high-quality studies, but the results were insufficient for randomization and blinding. And through meta-analysis, the clinical effectiveness of computerized cognitive therapy on cognitive function, activities of daily living, and visual perception function of patients with brain disease was found. Conclusion : The research literature that applied computerized cognitive therapy to brain disease subjects was comprehensively analyzed and identified. It is thought that this could be used as basic data on the characteristics of cognitive therapy that should be applied to patients with brain diseases in the future and the usefulness of computerized cognitive therapy program in actual clinical practice.