• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.81-94
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• 2024

PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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• pp.354-363
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• 2024

Objective : This study aims to determine the optimal dose of recombinant-human bone morphogenic protein-2 (rhBMP-2) for successful bone fusion in minimally invasive lateral lumbar interbody fusion (MIS LLIF). Previous studies show that rhBMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rhBMP doses to provide a recommendation for the optimal dose in MIS LLIF. Methods : Ninety-three patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage : group A, only DBM was used (n=27); group B, 1 mg of rhBMP-2 per 5 mL of DBM paste (n=41); and group C, 2 mg of rhBMP-2 per 5 mL of DBM paste (n=25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. Results : At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Groups B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The groups B and C showed significant improvement in back pain and Oswestry disability index compared to the group A. The incidence of screw loosening was decreased in groups B and C, but there was no significant difference in the occurrence of other complications. Conclusion : Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1 mg/5 mL and 2 mg/5 mL of rhBMP-2. Therefore, it is recommended to use 1 mg of rhBMP-2 with 5 mL of DBM, taking both economic and clinical aspects into consideration.

• The Journal of the Convergence on Culture Technology
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• v.10 no.1
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• pp.11-18
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• 2024

The purpose of this study was to investigate the effects of an animal-mediated therapy program on children with developmental disabilities on social skills related to social-emotional development and learning, which are important in modern society. The subjects of the study were children with developmental disabilities at a special school, and the animal-mediated therapy program consisted of 12 sessions. The study was divided into experimental and control groups and conducted pre- and post-test by measurement items. SPSS 25.0 was used to analyze the data. First, children with developmental disabilities in the experimental group who participated in the animal-mediated therapy program showed a significant difference (z=-2.20, p<.05) in the overall social-emotional development compared to the control group, and statistically significant values were found in the subfactors of non-dependence on teachers, interaction with peers, and achievement motivation. Second, the experimental group who received animal-mediated therapy showed a significant effect (z=-2.20, p<.05) in all factors of learning-related social skills. In conclusion, animal-mediated therapy was found to have a positive effect on the social-emotional development and learning-related social skills of children with developmental disabilities. Based on the results of this study, it is recommended that more specific and systematic programs should be developed and applied to enhance the social-emotional development and learning-related social skills of children with developmental disabilities for a healthy life.

• Journal of Pharmacopuncture
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• v.27 no.1
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• pp.14-20
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• 2024

Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.

• Journal of Advanced Technology Convergence
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• v.3 no.3
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• pp.17-27
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• 2024

This study focuses on the development and evaluation of a chatbot system based on the International Classification of Functioning, Disability, and Health (ICF) framework to enhance community participation among elderly individuals with mild dementia in South Korea. The study involved 12 elderly participants who were living alone and had been diagnosed with mild dementia, along with 15 caregivers who were actively involved in their daily care. The development process included a comprehensive needs assessment, system design, content creation, natural language processing using Transformer Attention Algorithm, and usability testing. The chatbot is designed to offer personalized activity recommendations, reminders, and information that support physical, social, and cognitive engagement. Usability testing revealed high levels of user satisfaction and perceived usefulness, with significant improvements in community activities and social interactions. Quantitative analysis showed a 92% increase in weekly community activities and an 84% increase in social interactions. Qualitative feedback highlighted the chatbot's user-friendly interface, relevance of suggested activities, and its role in reducing caregiver burden. The study demonstrates that an ICF-based chatbot system can effectively promote community participation and improve the quality of life for elderly individuals with mild dementia. Future research should focus on refining the system and evaluating its long-term impact.

• Archives of Plastic Surgery
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• v.51 no.3
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• pp.295-303
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• 2024

Background Dupuytren's disease decreases quality of life significantly and often requires surgical treatment, nevertheless there is no actual gold standard. The aim of this study was to introduce the use of minimally invasive pull-through technique. Methods From 2016 to 2020, 52 patients suffering from Dupuytren's contracture were treated with the minimally invasive pull-through technique. We evaluated the improvement in range of motion, pain, disability, and quality of life in the long term. Total extension deficit, quick disabilities of the arm, shoulder, and hand (QuickDASH), and EuroQol five dimensions-five levels index were systematically scored before each surgical intervention and reevaluated after 24 months. Results Fourteen patients (26.9%) had already received a previous intervention (percutaneous needle aponeurotomy or collagenase Clostridium histolyticum). The mean preoperative total active extension deficit was 84.0 ± 23.3 degrees (55-130 degrees). Mean follow-up was 36 months. There were no cases of tendon rupture or neurovascular injury. Total active extension deficit at the final follow-up was 3.4 ± 2.3 degrees (0-12 degrees). The mean active range of motion of the MCP and PIP joints were, respectively, 90.5 ± 3.3 degrees (85-96 degrees) and 82.7 ± 2.5 degrees (80-87 degrees). At 24 months after cord excision, a mean 10.7 points improvement in the QuickDASH questionnaire was registered (p < 0.001). Pull-through technique was equally effective both on patients with a primary or a recurrent disease. Eight patients (15.4%) had a recurrence of disease in the metacarpophalangeal joint or proximal interphalangeal joint. Conclusion The pull-through technique is a simple, accessible, and effective technique for the treatment of Dupuytren's contracture. The use of palmar mini-incisions combined with minimal dissection has a low risk of iatrogenic injury to the neurovascular bundles and tendons, and has a low risk of recurrence rate. This study reflects level of evidence IV.

• Journal of Music and Human Behavior
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• v.21 no.2
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• pp.51-75
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• 2024

This case study aimed to develop a therapeutic rap protocol based on narrative components for improving discourse skills of adolescents with mild intellectual disability (ID) and to explore its applicability. The protocol matched narrative elements (background, initiating event, internal response, attempts, and reaction) with rap components (verse, hook, and interjections), guiding participants to narrate their experiences in a connected discourse form. The protocol was also structured to gradually increase in difficulty, considering the developmental levels of adolescents with ID and it included steps for understanding discourse structures, applying narrative elements to content creation, and expanding narratives. Post-intervention analysis of the stories and rap lyrics created by participants to express their real-life experiences showed that participants increased the length of their stories and rap compositions, with notable improvements in rhythmicity and the inclusion of narrative elements. These findings suggest that, instead of constructing rap from random utterances, providing a structured framework reflecting discourse structure enhanced participants' understanding of event context and logical connections. Furthermore, the various elements and rhythmic features of rap can strengthen motivation and organization in discourse. This study highlights the therapeutic potential of rap in addressing the unique developmental needs of adolescents with mild ID, thereby diversifying and systematizing music therapy interventions for this population.

• Journal of Naturopathy
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• v.13 no.1
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• pp.1-13
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• 2024

Background: There is a need for the development of non-verbal music therapy programs to enhance the social skills of children with intellectual disabilities who face challenges in verbal communication. Objective: The purpose of this study is to propose a music therapy program aimed at improving the social skills of children with intellectual disabilities and to evaluate its clinical effectiveness. Method: This study designed a Social Skills Training based Musical Instrument performance (SST-MIP) intervention program that integrates existing musical instrument performance and social skills in music therapy and targeted children with intellectual disabilities. Clinical effectiveness was evaluated. A total of 51 participants were randomly assigned to either the experimental group (29 participants) or the control group (22 participants). The experimental group participated in the SST-MIP intervention program once a week for 50 minutes over 32 weeks. The level of social skills of the participants was measured using the Social Skills Rating System (SSRS - teacher form, elementary level). Results: The average SSRS score of the experimental group increased by 109.2% from 10.7 to 22.4 (p <.001), while the control group showed a relatively modest increase of 30.7% from 11.3 to 14.7 (p <.05). After the SST-MIP intervention, the SSRS score of the experimental group was 57.2% higher than that of the control group, with significant improvements in specific areas of social skills: self-control (79.6%), assertion (56.8%), and cooperation (43.2%). Conclusion: The SST-MIP has been found to significantly enhance the social skills of children with intellectual disabilities. The proposed SST-MIP intervention is expected to be a useful tool for training social skills in children with intellectual disabilities who struggle with verbal communication.

• Journal of Pharmacopuncture
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• v.27 no.3
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• pp.177-189
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• 2024

Objectives: Cupping therapy is a widely used complementary medicine for the treatment of migraine headaches globally. However, conflicting evidence exists on its effectiveness. To evaluate the safety and efficacy of cupping therapy in treating migraine headache disorder. Methods: Seven databases were systematically searched: PubMed/MEDLINE, Clinicaltrials.gov, Cochrane CENTRAL, ScienceDirect, ProQuest, SinoMed, and the National Science and Technology Library. The primary endpoints are the treatment success and the pain intensity reduction. The secondary endpoints were adverse events (AEs) risk and improvement in quality of life (QoL), which was based on the Migraine Disability Scale (MIDAS). Subgroup analyses were performed based on the cupping techniques (wet and dry cupping) and adjunctive complementary treatments (i.e. acupuncture and/or collateral pricking). Results: Eighteen trials out of 348 records were included, pooling 1,446 participants (n = 797 received cupping therapy). Treatment success was significantly higher among those with cupping therapy (risk ratio [RR] [95% CI] = 1.83 [1.52-2.21]); with significant improvement observed only with wet cupping (RR [95% CI] = 1.88 [1.53-2.30]). The adjunctive complementary therapy did not achieve a greater amplitude of treatment success compared to cupping therapy alone. Furthermore, cupping therapy showed significant pain reduction compared to baseline (standardized mean difference [SMD] [95% CI] = 0.55 [0.39-0.70]) and achieved fewer risks of AEs (RR [95% CI] = 1.88 [1.53-2.30]). However, cupping did not improve the overall QoL (MIDAS SMD [95% CI] = -0.79 [-3.55-1.98]). Conclusion: Cupping therapy was an effective complementary modality to treat migraine headaches. However, it did not demonstrate improvement in QoL (PROSPERO: CRD42024514509).

• Clinics in Shoulder and Elbow
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• v.27 no.3
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• pp.316-326
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• 2024

Background: This study sought to determine if preoperative forward elevation (FE) weakness affects outcomes of anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) for patients with rotator cuff-intact glenohumeral osteoarthritis (RCI-GHOA). Methods: A retrospective review of a single institution's prospectively collected shoulder arthroplasty database was performed between 2007 and 2020, including 333 aTSAs and 155 rTSAs for primary RCI-GHOA with a minimum 2-year follow-up. Defining preoperative weakness as FE strength ≤4.9 lb (2.2 kg), three cohorts were matched 1:1:1 by age, sex, and follow-up: weak (n=82) to normal aTSAs, weak (n=44) to normal rTSAs, and weak aTSAs (n=61) to weak rTSAs. Compared outcomes included range of motion, outcome scores, and complication and revision rates at latest follow-up. Results: Weak aTSAs and weak rTSAs achieved similar postoperative outcome measures to normal aTSAs and normal rTSAs, respectively (P>0.05). Compared to weak rTSAs, weak aTSAs achieved superior postoperative passive (P=0.006) and active external rotation (ER) (P=0.014) but less favorable postoperative Shoulder Pain and Disability Index (P=0.032), American Shoulder and Elbow Surgeons (P=0.024), and University of California, Los Angeles scores (P=0.008). Weak aTSAs achieved the minimal clinically important difference and substantial clinical benefit at a lower rate for abduction (P=0.045 and P=0.003) and FE (P=0.011 and P=0.001). Weak aTSAs had a higher revision rate (P=0.025) but a similar complication rate (P=0.291) compared to weak rTSAs. Conclusions: Patients with RCI-GHOA and preoperative FE weakness obtain postoperative outcomes similar to patients with normal preoperative strength after either aTSA or rTSA. Preoperatively, weak aTSAs achieved greater ER but lower rates of clinically relevant improvement in overhead motion compared to weak rTSAs.