• Physical Therapy Korea
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• v.17 no.2
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• pp.51-59
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• 2010

The Functional Independence Measure (FIM) is widely used to determine the dependency of activity of daily living in rehabilitation patients. The purposes of this study were to evaluate the unidimentionality of the FIM physical items and to analyze the validity of cross-functional levels in stroke survivors in Korea. Thirteen physical items of FIM were rated according to an ordinal scale of a 7-level classification. Two hundred and seventy-nine patients participated in the study (age range 18~92 years and 57% male). Six items-eating, bladder control, bowel control, transfer to and from the bed/wheelchair, transfer to and from the toilet, and bathing-showed misfits with the Rasch model. The most difficult item was 'bathing', the easiest item was 'bowel control'. Although there were several differences within functional levels, the hierarchical order of item measures was rather similar. 'Bathing' was the most difficult in high level patients (above 60), however 'stairs' was most difficult in the middle level (41~60) group. In the low level group (below 40), 'toileting' was the most difficult. In conclusion, the present study has shown several differences of item difficulty among functional levels. This result will be useful in planning interventions, and developing rehabilitation programs for stroke survivors.

• Physical Therapy Korea
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• v.14 no.1
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• pp.46-54
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• 2007

The purposes of the present study were to determine the difference of functional outcome, and to identify factors associated with functional difference in patients with stroke. The sample consisted of 56 stroke patients who had received physical therapy at the physical therapy unit of the Dongeui Medical Center in Busan city between January 2000 and June 2002. Stroke patients were evaluated by physical therapists 3 times; The first day in physical therapy (PT) (T1), one month after the first day in PT (T2), and two months after the first day in PT (T3). Functional status was assessed with the Functional Independence Measure (FIM) instrument, a validated instrument for documenting the severity of disability and assessing the outcome of rehabilitation treatment. Functional gain was calculated over T2-T1, T3-T1, and T3-T2. SAS statistical software was used for the analysis. The Student's t-test, paired t-test, analysis of variance (ANOVA/Tukey and Scheffe), and analysis of covariance (ANCOVA) were used to examine the functional difference in variables. Repeated measures ANOVA was also used to analyze the functional difference by time (T1, T2, and T3). Multiple regression analysis was performed to determine the effects of independent variables on the difference of functional outcome as defined by the FIM score. A total of 56 stroke patients were evaluated, their average age${\pm}$standard deviation was $61.6{\pm}9.3$ years (range: 40~81 yr). The functional status of patients who received physical therapy for about 2~3 months was significantly improved (mean FIM scores, $20.5{\pm}1.8$, $28.9{\pm}1.9$, and $8.41{\pm}1.1$ points for each time period, respectively) (p<.0001). Diabetes was significantly associated with the FIM score for T2-T1 (p<.05). The type of diagnosis was significantly associated with the FIM score for T3-T1 (p<.05). Gender, smoking, and the FIM score on admission were significantly associated with the FIM score for T3-T2 (p<.05). In conclusion, gender, smoking, diabetes, the type of diagnosis, and the FIM score on admission were significantly associated with improved FIM scores. We recommend that further research should explore the functional outcome by using larger sample sizes, longer follow-up periods, and more sensitive assessment instruments.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.777-786
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• 2020

Background: This study is a report on a case of a Wernicke's encephalopathy with quadriplegia, ataxia, and impaired cognition, whose condition was improved by Korean medicine treatment. Case report: A 51-year-old man diagnosed with Wernicke's encephalopathy was treated with acupuncture, Banhabakchulchunma-tang mixed with Ondam-tang-gami (半夏白朮天麻湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Berg Balance Scale (BBS), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and a numeric rating scale (NRS). After 22 days of treatment, his clinical symptoms showed improvement. The motor function improved (MMT Rt. side Gr. 4+G/4+G, Lt. side Gr. 4G/4+G → Rt. side Gr. 5-N/4+G, Lt. side Gr. 5-N/4+G), Ataxia was relieved (BBS 3→33), cognition improved (K-MMSE 15→27), ADL scores showed improvement (FIM 58→90, MBI 40→75), and the NRS score decreased for headache (3→0). Conclusion: Korean medicine treatment could be effective in the treatment of patients with Wernicke's encephalopathy.