• 대한한방내과학회지
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• 제40권5호
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• pp.920-928
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• 2019

Objectives: After epidural hemorrhage, sequelae may cause cognitive impairments, such as attention, memory, and performance disturbances. This case study reports on the use of traditional Korean medicine in a patient with cognitive impairments after a traumatic epidural hemorrhage. Methods: During the 46-day hospitalization period, traditional Korean medicine treatments, including Sunkihwalhyul-tang-gamibang, Ukgan-san-gajinpibanha Granule, Kyungohk-go, acupuncture, and cupping, were administered. The degree of cognitive impairment was measured based on the Mini Mental State Examination-Korea (MMSE-K), Modified Barthel Index (MBI), and correct answer ratio. Results: After traditional Korean medicine treatment, the MMSE-K score increased from 13 to 19 and the MBI score increased from 63 to 71. The patient's conversations in daily life also proceeded more smoothly than before hospitalization, and the correct answer ratio rose. Conclusion: This case reports the improvement of cognitive impairment after traumatic epidural hemorrhage in response to traditional Korean medicine treatment; further study is needed.

• PNF and Movement
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• 제18권1호
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.

• 대한한방내과학회지
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• 제42권5호
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• pp.727-737
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• 2021

Objectives: This study investigated the effect of Korean medicine on an elderly patient with posterior circulation cerebral infarction, chronic kidney disease (CKD), and early neurological deterioration (END). Methods: The patient, who already had CKD, was treated with Korean medicine, comprising herbal medicine, acupuncture, moxa, and cupping combined with Western medicine (antiplatelet, diabetes) and physical therapy. A manual muscle test (MMT) and a modified Barthel index (MBI) were used to observe the treatment effects, and blood tests were performed to check estimated glomerular filtration rate (eGFR), creatinine and blood urea nitrogen (BUN), which represent renal function. Results: After the treatment, MMT, MBI, and renal function scores had increased. Conclusions: This study suggests that Korean medicine can effectively treat posterior circulation cerebral infarction with END in CKD, but further studies should be conducted.

• 대한한방내과학회지
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• 제42권5호
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• pp.904-915
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• 2021

This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G→Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.

• 대한한방내과학회지
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• 제42권5호
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• pp.1131-1141
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• 2021

Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

• PNF and Movement
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• 제16권3호
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• pp.405-414
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• 2018

Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.

• 한국콘텐츠학회논문지
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• 제19권8호
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• pp.293-302
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• 2019

이 연구의 목적은 Stroke Impact Scale 3.0(SIS 3.0)의 신뢰도와 타당도를 조사하는 것이었다. 연구에서 SIS 3.0은 125명의 뇌졸중 환자를 대상으로 측정하였다(평균 = 62.7, 표준 편차 = 9.43). SIS 3.0 하위 영역들 간에 상관 분석을 통해 구성타당도를 확인하였고, MBI(Modified Barthel Index)와 K-MMSE(Mini-Mental State Examination-Korean)간의 상관을 분석하여 수렴타당도를 조사하였다. 각 항목의 특성은 고전적 문항 이론을 바탕으로 내적 합치도와 문항 변별도를 분석하였다. 이 연구를 통해 SIS 3.0의 구성타당도와 수렴타당도가 확인되었다. 감정 영역에 포함된 i 항목은 문항 변별도가 낮았지만 이 항목을 제외하고는 모두 변별도가 높았다. 하위 영역의 문항내적합치도는 0.858~0.941로 나타났다. 이 연구는 지역사회에 거주하는 뇌졸중 환자를 대상으로 임상 현장에서 SIS 3.0 사용을 위한 신뢰도와 타당도를 확인하였다는데 그 의의가 있다.

• 한국융합학회논문지
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• 제10권6호
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• pp.325-335
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• 2019

본 연구는 한국 교사들의 탈진을 완화시키는데 신체활동이 어떠한 영향을 주는지 알아보는데 목적이 있다. 이러한 목적을 규명하기 위해 한국 교사 527명의 자료가 분석에 이용되었다. 자료처리는 탐색적 요인분석, 문항내적일관성분석을 실시하여 탈진설문지(MBI-ES)의 타당도와 신뢰도를 검증하였고, 성별, 학교급, 교직기간 특성에 따른 평균의 차이를 알아보기 위해 독립 t-test, one-way ANOVA를 실시하였다. 그리고 상관분석과 회귀분석을 통해 요인들 간의 미치는 영향을 검증하였다. 분석 결과, 첫째, 성별의 차이는 남교사보다 여교사가, 교직기간은 긴 것보다 짧을수록 탈진의 정도가 높고 신체활동이 낮은 것으로 나타났다. 둘째, 교사들의 중 고강도 신체활동은 탈진 하위요인들과 부적상관이 있는 것으로 나타났다. 셋째, 교사들의 고강도 신체활동은 비인격화 요인에 부적인 영향을 주는 것으로 나타났고, 교사들의 좌식행동은 비인격화 요인에 정적인 영향을 주는 것으로 나타났다.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.788-797
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• 2018

Objective To investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Patients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment. Results For each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups. Conclusion Treatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Results of this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

• 고령자･치매작업치료학회지
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• 제12권2호
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• pp.75-85
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• 2018

목적 본 연구는 라파엘 스마트 글러브가 경도인지장애 환자의 인지기능 및 일상생활 수행능력에 미치는 영향에 대해 알아보고자 하였다. 연구방법 라파엘 스마트글러브를 적용한 실험군 15명과 전통적인 인지재활을 적용한 대조군 15명으로 진행하였다. 두 집단의 중재 전 후 인지기능 및 일상생활 수행능력을 비교하기 위해 LOTCA, NCSE, MBI를 시행하였다. 연구결과 라파엘 스마트 글러브를 적용한 실험군과 대조군의 각 집단 내에서 중재 전 후 인지기능과 일상생활수행은 모두 통계학적으로 유의하게 향상되었으나(p>.05), 통계학적으로 실험군에서 유의하게 향상되었다. 결론 본 연구의 결과를 통하여 기존 재활치료와 같이 라파엘 스마트 글러브를 적용할 경우 경도인지장애 환자의 인지기능과 일상생활 수행능력 향상에 도움이 될 것으로 보인다.