• Title/Summary/Keyword: Gait

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Survey About Current Status of Pediatric and Adolescent Physical Therapy: Focus on Pediatric and Adolescent Rehabilitation Hospitals in Seoul and Gyeonggi Province (소아 청소년 물리치료 실태 조사: 서울 경기 지역 소아 청소년 재활병원을 중심으로)

  • Kim, Jeong-soo;Min, Kyoung-chul
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.67-80
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    • 2023
  • Objective : This study aimed to investigate the current status of physical therapy in children and adolescents. Methods : Sixty questionnaires from physical therapists treating children and adolescents with disabilities were analyzed. The questionnaire consisted of questions on physical therapy, participants, satisfaction, and the assessment of pediatric and adolescent physical therapy. Descriptive statistics and frequencies were used to investigate the current status, participants, and satisfaction. Differences between physical therapy participation difficulty, importance-ability of major aspects of pediatric and adolescent physical therapy, and therapy goal frequency were analyzed using paired T-test. Results : 11 to 15 cases (66.7%) and one-on-one treatment (95.0%) were performed independently (95.0%). The main ages of the subjects were preschool and school, the diagnoses were brain lesions and developmental delay, and treatment was conducted for up to 20 years or older. Satisfaction with pediatric and adolescent physical therapy was high (70.0%), as was the intensity of work (71.7%). Neurodevelopmental therapy, gait training, and goal-directed rehabilitation were the main treatments, and Gross Motor Function Measures of 88 and 66, respectively, were used. Respondents said that current fee system is inadequate (66.1%) and appropriate fee system is needed. Conclusion : This study extensively investigated the content of and factors related to pediatric and adolescent physical therapy. Based on the current situation, efforts to improve the expertise and continuity of pediatric and adolescent physical therapists and apply the latest treatment techniques are required.

Case Study on Physical Activity Guidance Experience to Maintain Balance in Adults with Cerebellar Ataxia (소뇌성 운동실조증 성인의 균형 유지를 위한 신체활동 지도 경험 사례 연구)

  • Jeonghyeon Kim
    • Journal of Industrial Convergence
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    • v.22 no.3
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    • pp.51-65
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    • 2024
  • This study aims to understand positive changes in balance and gait function and difficulties in the instructor's guidance process through repetitive basic motor skill-based physical activities targeting people with cerebellar ataxia. For this purpose, five adults with cerebellar ataxia were selected as research subjects, and their three instructors participated as research participants. To collect quantitative data, the average and standard deviation were examined through pre-and post-evaluation of the research participants' physical activity classes for 16 weeks. The mean and standard deviation of the collected data were calculated using the Shapiro-Wilk test in the SAS 9.1 statistical program (p<.05). As a qualitative data collection method, the cultural description method of developmental research(DSR) proposed by Spradley(1980) was adopted, and the collected data were analyzed inductively according to the analysis method of Mertens(1990). Through this, 31 concepts, 10 subcategories, and 4 categories were discovered. As a result, the difficulties experienced by the research participants included insufficient guidance environment, dissatisfaction of consumers, difficulty in guidance, and non-cooperation of colleagues. Based on these research results, it was found that institutional, legal, and policy support should be provided not only to public institutions but also to private physical activity institutions that can use vouchers in order to maintain the balance of adults with cerebellar ataxia as well as to guide their physical activities.

Osteoid Osteoma Around the Hip Joint (고관절 주위에 발생한 유골 골종)

  • Kim, Tai-Seung;Kim, Jong-Heon;Lee, Bong-Gun;Kim, Soon-Myung
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.168-174
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    • 2005
  • Purpose: We experienced 8 cases of osteoid osteoma arising around hip joint which had some characteristics that differ from those arising on long bone. we reports the characteristics of osteoid osteoma arising around the hip joint. Materials and Methods: 8 cases of osteoid osteoma were diagnosed during 1985 to 2004 at hanyang university hospital. all cases were comfirmed patholgically. 6 cases were male, 2 cases were female patients. The mean age was 17 years old (ranged from 8 to 29). They occurred in intertrochanteric area (4 cases), subtrochanteric area (2 cases), acetabulum (1 case) and femoral neck (1 case). We used radiologic tools including magnetic resonance image, computed tomography, bone scintigraphy. clinicopathologic test including erythrocyte sedimentation rate and Creactive protein. Results: The patients expressed various symptoms including thigh pain, knee pain, low back pain and radiating pain respectively. 2 patients had experienced operation on knee joint. 3 patients showed limping gait. Aspirin relieved the pain in 3 patients. The difference in circumference was 1cm between both thighs in 2 cases. Conclusion: Patients with osteoid osteoma arising around hip joint which have various symptoms such as severe knee pain and claudication, differ from infectious disease by clinicopathologic test including erythrocyte sedimentation rate and C- reactive protein and had better diagnostic result in computed tomography.

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PERIPHERAL NERVE REGENERATION USING POLYGLYCOLIC ACID CONDUIT AND BRAIN-DERIVED NEUROTROPHIC FACTOR GENE TRANSFECTED SCHWANN CELLS IN RAT SCIATIC NERVE (BDNF 유전자 이입 슈반세포와 PGA 도관을 이용한 백서 좌골신경 재생에 관한 연구)

  • Choi, Won-Jae;Ahn, Kang-Min;Gao, En-Feng;Shin, Young-Min;Kim, Yoon-Tae;Hwang, Soon-Jeong;Kim, Nam-Yeol;Kim, Myung-Jin;Jo, Seung-Woo;Kim, Byung-Soo;Kim, Yun-Hee;Kim, Soung-Min;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.465-473
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    • 2004
  • Purpose : The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. Materials and methods : Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNF-Adenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. Results : Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was $-53.66{\pm}13.43$ which was the best among three groups. The threshold of compound action potential was between 800 to $1000{\mu}A$ in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. Conclusion : BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.

Functional Outcomes of Internal Pelvectomy without Reconstruction for Periacetabular Maligmant Tumors (비구주변 골반골 악성 골종양에서 재건술을 시행하지 않은 내골반골 절제술의 기능적 결과)

  • Chung, Yang-Guk;Kang, Yong-Koo;Lee, Seung-Koo;Bahk, Won-Jong;Lee, An-Hi;Park, Jung-Mi;Lee, Kyo-Sun;Lee, Hyung-Ju
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.60-66
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    • 2007
  • Purpose: The purpose of this study was to evaluate the functional outcomes of periacetabular malignant bone tumors treated by internal pelvectomy without reconstruction. Materials and methods: Between January 1996 and December 2005, eight patients with primary malignant or metastatic periacetabular bone tumors were treated by internal pelvectomy without reconstruction. There were 6 men and 2 women. Mean age was 42 years old. There were 3 osteosarcomas, 3 chondrosarcomas and 2 metastatic carcinomas. The type of pelvic resections were 6 type I+II+III, 1 type I+II and 1 type II+II resection. The functional outcomes were evaluated with ISOLS revised criteria. The follow up period ranged from 6 to 84 months. Results: At last follow up, 5 patients showed CDF, 2 patients, AWD and the remained 1, DOD. The mean functional score for pain, functional activity, emotional acceptance, use of external support, walking ability and gait were 4.9, 2.9, 2.9, 1.5, 2.3 and 2.5 respectively. The total functional score ranged from 37% to 70%(average: 56%). There were three temporary nerve palsies. Conclusion: The internal pelvectomy without reconstruction for selective difficult periacetabular malignant tumors could be a viable option with fewer complications and fair functional outcomes.

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Human Parechovirus as an Important Cause of Central Nervous System Infection in Childhood (소아청소년기 중추신경 감염의 주요 원인으로서 Human Parechovirus의 의의)

  • Jung, Hyun Joo;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.165-171
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    • 2016
  • Purpose: Human parechovirus (HPeV) is an increasingly recognized pathogenic cause of central nervous system (CNS) infection in neonates. However, HPeV infections have not been studied in older children. This study determined the prevalence and clinical features of HPeV CNS infection in children in Korea. Methods: Reverse transcription polymerase chain reaction assays were performed using HPeV-specific, 5' untranslated, region-targeted primers to detect HPeV in cerebrospinal fluid (CSF) samples from children presenting with fever or neurologic symptoms from January 1, 2013, to July 31, 2014. HPeV genotyping was performed by sequencing the viral protein 3/1 region. Clinical and laboratory data were retrospectively abstracted from medical records and compared with those of enterovirus (EV)-positive patients from the same period. Results: Of 102 CSF samples, six (5.9%) were positive for HPeV; two of 21 EV-positive samples were co-infected with HPeV. All samples were genotype HPeV3. Two HPeV-positive patients were <3 months of age and four others were over 1 year old. While HPeV-positive infants under 1 year of age presented with sepsis-like illness without definite neurologic abnormalities, HPeV-positive children over 1 year of age presented with fever and neurologic symptoms such as seizures, loss of consciousness, and gait disturbance. The CSF findings of HPeV-positive patients were mostly within the normal range, whereas most (73.7%) EV-positive patients had pleocytosis. Conclusions: Although HPeV is typically associated with disease in young infants, the results of this study suggest that HPeV is an emerging pathogen of CNS infection with neurologic symptoms in older childhood.

Arthroscopic Treatment for Lateral Discoid Meniscus in Children: Clinical Symptoms & Treatment Results According to Meniscus Type (소아의 외측 원판형 반월상 연골의 슬관절경 치료: 유형에 따른 임상증상 및 치료 결과)

  • Shin, Sung-Il;Hyun, Yoon-Suk;Kang, Jung-Woo;Oh, Bum-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.7-12
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    • 2011
  • Purpose: We purposed to evaluate clinical results after undergoing arthrocopic surgery of lateral discoid meniscus in children. Materials and Methods: Retrospective evaluation was executed for the 21 cases which showed abnormal findings of knee joint due to lateral discoid meniscus, from Janunary 1 1999 to December 30 2007. Average observation period was 38.4 months (14months~60 months), and average age was 9.5 years old (7~12 years old). The major clinical findings for knee joint extension limitations were the most common with 11 cases, and there were 8 cases of knee joint pain, 6 cases of snapping, and 10 cases of gait abnormality. The forms of lateral discoid meniscus were 14 cases of complete type, 5 cases of incomplete type, and 2 cases of Wrisberg type. All patient had arthroscopic partial menisectomy and some patient who had meniscus tear had arthroscopic meniscus repair. The clinical results were evaluated using Ikeuchi grading system, and the change of knee joint was observed through routine radiography. Results: The peripheral hypermobility of lateral disciform meniscus was observed in 7 cases. The peripheral tear was observed in 4 cases, where partial menisectomy was along with suture at the same time. The final clinical results were 5 cases of Excellent, 12 cases of Good, 4 cases of Fair. Radiologically, there were 5 cases of subchondral sclerosis and narrowness of hardness at the lateral knee joint, and osteochondritis occurred at the joint facet of external femur in 1 case. In clinical result, meanwhile, there were 20 cases of normal or almost normal and only 1 case of abnormal in IKDC score. Conclusion: Knee joint arthroscopic partial menisectomy for treatment of lateral discoid meniscus is useful, and when accompanied by peripheral disruption, suture is thought to be necessary.

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Effects of 12-week Combined Exercise Program on Short Physical Performance Battery, Bone Mineral Density and Parathyroid Hormone in the Elderly Women (12주간 복합운동이 여성 노인의 신체수행능력, 골밀도 및 부갑상선호르몬에 미치는 영향)

  • Kim, Jung-Sook;Kim, Ji-Hyeon;Ha, Soo-Min;Hynn, Su-Jin;Yoon, Byeong-Kon;Kim, Do-Yeon
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.2
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    • pp.519-531
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    • 2018
  • The purpose of this study was to investigate the effects of combined exercise program on short physical performance battery, bone mineral density and parathyroid hormone levels in elderly women. This study subjects were 22 elderly female volunteers, aged 65-75 years and they divided into the combined exercise group(n=11) and the "no exercise" control group(n=11). The combined exercise included the line dance program performed twice per week for 60 minutes and the resistance exercise program performed once per week during 12 weeks. Exercise intensity was progressively increased from RPE "fairly light" to "slightly hard" (from 11 to 14). The findings of this study were as follows; Short physical performance battery(Balance test, gait speed, and rising from a chair five times) and bone mineral density (lumbar spine L2~L4 bone densities, and the T-score) were significantly increased after 12 weeks in the exercise group compared to the baseline. The PTH level was significantly decreased in the exercise group compared to the baseline. In conclusion, regular and continuous physical activity was effective for improving short physical performance and had a positive effect on bone mineral density and parathyroid hormone. With aging, women have decreased muscle strength and bone density and therefore, it is strongly recommended that women need to carry out continuous physical activity to prevent disease and ensure a healthy retirement.

Effect of Solid Side Chute Design for Individual Handling of Hanwoo (Korean Cattle) (한우의 개체관리를 위한 시각제어 유도로 효과)

  • 최재관;이창우;이용준;조광현;최연호;김형철;김시동
    • Journal of Animal Science and Technology
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    • v.48 no.2
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    • pp.331-336
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    • 2006
  • Moving behavior of groups of Hanwoo was observed when solid side was applied along the straight single file chute. Dark blue liners (PVC coated fabric) were hung on the outer side along the steel bars of chute to block vision of cattle. Ten animals were grouped together in a batch to move through chute to the restrainter. Movement of animals through chutes were significantly faster when solid side with liners were applied than when they had open vision of flight zone. And the difference in movement time between of solid side and open side was even greater in a longer chute than in a shorter one. From the experiment with longer chute, we could not find any significant differences between presence or absence of solid sides in the time spent for the leaading cattle to enter the squeeze chute from crowd pen. But the average time spent for movement from squeeze gait to restrainter was 22.78±1.15 seconds with solid sides, which was much shorter than with open sides (40.56±4.46 seconds). Time required for batch of animals to move from crowd pen to restrainter and exit was much faster with solid sides than with open sides: 96.33±3.98 seconds vs. 121.89±5.54 seconds from leading animal to enter the squeeze chute until the last animal of the batch to exit restrainter and 104.56±3.89 vs. 131.22±6.42 seconds for the whole batch of animals to enter the squeeze chute and exit restrainter. Another experiment with shorter chute showed that animals balked to right angled edge of the crowed pen before entering squeeze chute. We could not find any differences in time requred for the leading animal to enter the crowd pen from holding pen. Total time spent from entrance of leading animal to crowd pen until the last animal to exit restrainter was shorter with solid sides than with open sides: 177.44±5.20 seconds vs. 193.44±7.46 seconds.

Mutational Analysis of MECP2 Gene in 34 Rett Syndrome (Rett 증후군 34례의 MECP2 유전자 변이에 관한 연구)

  • Park, Sang Jo;Hwang, Tae Gyu;Son, Byeong Hee;Kim, Chul Min
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1263-1272
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    • 2002
  • Purpose : Rett syndrome(RTT) is an X-linked dominant neurodevelopmental disorder affecting 1 per 10,000-15,000 female births worldwide. It was initially described by Andreas Rett in 1966. RTT involves developmental regression characterized stereotypic hand movements, tremors, gait apraxia, seizures, deceleration of head growth after the age of 6-18 months. The disease-causing gene was identified as MECP2 on chromosome Xq28. We carried out mutational analysis of MECP2 genes in RTT patients. Methods : Whole blood(5 cc) of 34 sporadic RTT patients was collected in EDTA-anticoagulated tubes. Genomic DNA was extracted from peripheral blood using the E.Z.N.A. blood DNA kit. Four exons of the MECP2 gene were amplified by PCR in 34 Korean with RTT. We carried out PCR divided the exon three into two parts and the exon four into five parts. Primer sequences designed by Amir et al. in 1999 were almost used(AF030876). Sequencing primers used were the same as PCR. DNA sequencing reactions were performed using an ABI 377 DNA sequencer and ABI PRISM dye terminator cycle sequencing reaction kit(Perkin-elmer). The results were compared with the normal DNA sequence(X99686). To confirm the change of sequence on novel mutations, RFLP analysis was performed. Results : The MECP2 mutations were detected in 23(67.6%) of the 34 patients. The mutations consisted of 12 different types including nine missense and three nonsense mutations. Of these, three (L100V, G161E and T311M) mutations were newly identified. Most of the mutations discovered are located within MBD(39.1%) and TRD(39.1%). In this study, three(T158M, R270X, R306C) mutations were identified high frequency. Conclusion : MECP2 gene was also an important cause of Korean RTT patients. MECP2 gene study is an important tool for diagnosis of Korean RTT patients.