Journal of the Korean Society of Physical Medicine
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v.8
no.4
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pp.549-558
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2013
PURPOSE: This study is designed as a retrospective study, and identified the clinical usability of Sit to Stand (STS) test for predicting of fall incidence in stroke patients who experienced a fall within 1 year. METHODS: Between July 2011 and November 2012, 69 inpatients with stroke in K rehabilitation hospital were participated under voluntarily signing the informed consent form. STS test and 10m walk test (10MWT) were used to assess the muscle strength of lower-extremity and walking velocity, respectively. Also, we tested dynamic balance and motor function of lower-extremity in affected-side using with the Berg balance scale (BBS) and the Fugl-Meyer assessment of lower extremity (FM-L/E). METHODS: There were significant differences between subjects with fall-experienced group and without subjects without fall-experienced group in STS test, 10MWT, BBS scores and FM-L/E. STS test significantly showed a negative correlation between 10MWT (r=-.657), BBS (r=-.512), and FM-L/E (r=-.563). And, 10MWT have a influence on the performance of STS test (the capacity of explanation = 20%). The cut-off value of STS performance predicting falls experience is ${\geq}14.36$ seconds (sensitivity=76%; specificity=79%, area under curve=.785). According to logistic regression analysis of falls experience, subjects ${\geq}14.36$ s showed that 4.164 times (odd ratio) increased in falls than subjects < 14.36 s in STS test. CONCLUSION: This study demonstrated that STS test may be a useful tool predicting and measuring falls in patients with stroke. Further study will be needed to elucidate the kinematic analysis of STS test and the relationship between physical activity level and falls in stroke patients.
Objective: This study conducted in order to investigate the correlations between fall experience, balance, mobility, and confidence. We examined the difference between fall experience, and Berg Balance Scale (BBS), Timed-Up-and-Go test (TUG), Tinetti balance assessment (Tinetti balance [TiB], Tinetti gait [TiG]), and Activities-specific Balance Confidence (ABC) scale scores to see how fall experience, balance, mobility, and confidence of the persons with stroke affects their balance. Design: Cross-sectional study. Methods: Forty-one subjects participated in this study. The BBS includes 14 items, consisting of a 5-point scale from 0 to 4, totaling up to 56 points. The Timed Up and Go-Alone (TUGA) was used to measure the average time to take a 3 m round-trip by getting up and down from a 46-cm high chair with an armrest on a flat floor. The Timed-Up-and-Go-Cognitive (TUGC) was performed by counting backwards and the Timed Up and Go-Manual (TUGM) is performed by holding a cup full of water. The total score for the TiB is 16 points, and the TiG is 12 points, making a total of 28 points. There are 16 items total for the ABC scale. Results: According to the fall experience, BBS, the TUGA and TUGC values were significantly higher in the inexperienced group compared to the experienced group (p<0.05). The number of falls was significantly correlated with BBS, TUGA, TUGC, TUGM, TiB, TiG, TiB+TiG (p<0.05). Conclusions: This study supports that falls experience is strongly related to balance, mobility, and confidence. Optimal balance training programs for fall prevention is still insufficient and must be developed.
Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.
Background: Many studies have reported positive results of the various mirror training and virtual reality games in improving dynamic standing balance and posture adjustment in chronic stroke patients. However, no systematic study has been conducted to compare the effects of virtual reality games and the mirror balance training. Objects: The purpose of this study was to compare the effectiveness of Wii balance games and Mirror Self-Balancing Exercises in improving proprioception of knee joint and standing balance of people with chronic stroke. Methods: Twenty patients with chronic stroke volunteered for this study. The subjects were randomly divided into a Wii balance games group and a Mirror Self-Balancing Exercises group with 10 patients in each group. Each training was performed for 30 mins a day for 4 days. In addition to the balance training, 30 mins neuro-developmental-treatment based routine physical therapy was given to both groups. Proprioception was measured using two continuous passive motion devices, and static balance was measured using a Wii balance board. Dynamic balance assessment tools included the Berg Balance Scale, Dynamic Gait Index, and Timed Up-and-Go test. Results: All measured variables before and after the experimental results showed a significant improvement in both groups (p<.05). Only the improvement of the affected knee proprioception appeared to be significantly greater in the Wii balance game group (p<.05). However, other variables did not differ between the groups (p>.05). Conclusion: The findings suggest that both Wii balance games and Mirror Self-Balancing Exercises may be helpful for improving the proprioception of knee joint and the balance of patients with chronic stroke.
Journal of the Korean Society of Physical Medicine
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v.18
no.2
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pp.41-48
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2023
PURPOSE: Falls are caused by a decline in physical and cognitive function. A quantitative evaluation tool that can comprehensively evaluate motor and cognitive functions for elderly people with an impaired physical function. This study assessed the clinical application potential by confirming the correlation between the physical function tests, cognitive and the stepping trail-making test (S-TMT). METHODS: Fourteen community-dwelling older patients (65-75 years) were recruited. The study conducted cognitive function tests with the trail-making test (TMT-A, B), and physical function tests (6-minute walking test (6MWT), short physical performance battery (SPPB), and timed up and go (TUG)). The results of were analyzed using SPSS version 21.0. Descriptive statistics were used for the general characteristics of the study subjects, and the correlations between S-TMT, other functional tests were examined through Pearson's correlation analysis. The statistical significance was set to .05. RESULTS: S-TMT had a significant positive correlation with the TUG (r = .588*) and trail-making test-B (TMT-B) (r = .689*, p < .05). Furthermore, S-TMT showed a negative correlation between SPPB (r = -.397) and 6MWT (r = -.422), but it was not statistically significant. CONCLUSION: S-TMT is a cognitive-gait dual-task performance evaluation tool that can be performed safely. A significant correlation was confirmed between the TUG test and the TMT-B. S-TMT is a dual-task screening tool that can evaluate both physical and cognitive functions simultaneously.
Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.
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.
Park, Se-Jin;Lee, Seung-Yong;Kim, Jung-Hoon;Seok, Seong-Hoon;Park, Tae-Yeong;Kim, Hyun-Jin;Kim, Jun-Min;Lee, Hee-Chun;Yeon, Seong-Chan
Journal of Veterinary Clinics
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v.33
no.3
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pp.172-175
/
2016
An 11-month-old, 19.5 kg, intact male Border collie was referred with intermittent left forelimb lameness to the Gyeongsang Animal Medical Center. The symptom was first discovered about 6 months ago, and it has gotten worse for the last 10 days with non-weight bearing on the left forelimb. During the physical examination, the patient showed painful reaction when the left shoulder was abducted. On radiographic assessment, a radiolucent line and some osteophytes were found in both humeral heads. Based on patient's clinical signs and radiographic findings, osteochondritis dissecans (OCD) was very suspicious. So, we decided to perform an arthroscopic surgery on left shoulder for definitive diagnosis and treatment because the right forelimb revealed no clinical signs. During arthroscopic technique, we found a large OCD flap on the caudo-central area of humeral head, and observed severe synovitis over a wide range on posterior area of the articular capsule. The large OCD flap was removed by a grasping forceps, and many joint mice were removed either. Curettage was performed using a curette on the articular surface until hemorrhage occurred, and articular capsule flushed with a lactated-ringer's solution. The patient was discharged on the same day without any specific abnormal status. Antibiotic, anti-inflammatory and analgesic drugs were administered. Mild lameness on left forelimb was observed in 2 weeks after surgery, but after 4 weeks, the patient showed complete normal gait without any lameness. Although surgical removal of OCD flap with arthroscopic was previously reported, We would like note that a large OCD flap can also be removed by arthroscopic surgery in this report.
Patients with cerebral palsy or arthritis have deformities in lower limb which cause unstable gait or posture and pains. Surgeons perform a deformity correction osteotomy with surgical plan. But sometimes they find the unexpected angular or rotational deformation after surgery. The problems are that there is no method to predict the result of a surgical plan and also there are so many factors to must consider in surgical planning step such as clinical measurements, rotation angle, wedge angle, morphology of lower limb, etc. This paper presents new methods for planning the deformity correction osteotomy efficiently. There are two approaches based on the 3D mesh model and the accurate assessment of the patient's lower limb. One is the manual pre-simulation of surgery using forward kinematics. And the other is the automatic surgical planning using inverse kinematics and nonlinear optimization. Using these methods, we can predict and verify the results of various surgical treatments and also we can find a more effective surgical plan easily compared to conventional methods.
This study is to look into the effectiveness of fall-preventive occupational therapy of elderly by clarifying the influence of occupational therapy applied to female elderly in the community upon balance ability. A 6-week occupational therapy program including both training and exercise for prevention of fall down was applied by dividing into 13 persons of experimental group and 13 persons of control group for female elderly aged more than 65 years who were capable of independence gait and have not taken any drug to adversely affect balance. For balance ability assessment, the Berg balance scale and the Tetrax fall index were used. The Berg balance scale in experimental group was shown to be 48.38 to 50.69 through the 6-week program, indicating changes in significance level(p=.017). The Tetrax fall index in experimental group was shown to be 46.77 to 35.54 through the 6-week program(p=.000). Changes in significance level were not found for both the Berg balance scale and the Tetrax fall index in control group. As seen from the results of this study, it is found that 6-week application of the fall-preventive occupational therapy program including fall prevention training and exercise was effective for promotion of elderly's balance ability, and further studies just on the effect of fall prevention training are required to be made.
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