Journal of the Korean Society of Physical Medicine
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v.11
no.4
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pp.55-64
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2016
PURPOSE: The aim of this study was to examine the effect of air stacking exercise on lung capacity, activities of daily living, and walking ability in elderly adults. METHODS: A total of 27 subjects were randomly assigned to an experimental group (EG=13) or a control group (CG=14). Subjects in the experimental group participated in an active pulmonary rehabilitation program. 5 days a week for 4 weeks. The active pulmonary rehabilitation program was composed of an air stacking exercise with an oral nasal mask and manually assisted coughing. Conventional pulmonary rehabilitation exercises, such as, cough exercise, deep breathing, and abdominal muscle strengthening exercises were performed by both groups. Pulmonary function parameters, peak cough flow (PCF), and oxygen saturation were measured and the 6-minute walk test and Korean version of the modified Barthel index (K-MBI) scores were applied. RESULTS: Significant intergroup differences were observed for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) results after intervention (p<.05), and for 6 minute walk test and PCF results after intervention and at 2-week follow-up visits (p<.05). Post hoc test results showed significant differences in K-MBI, 6-minute walk test, and FEV1 in the experimental group after intervention (p<.05). FVC values were significantly higher after intervention and at 2-week follow-up visits versus pre-intervention (p<.05). PCF values were also significantly higher after intervention and remained significantly higher at 2-week follow-up visits (p<.05). CONCLUSION: Air stacking exercise in elderly adults improves lung capacity and exercise tolerance.
The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.
Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.
Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.
Purpose: The purpose of this study was to assess psychometric properties of the Korean version of the Stroke Impact Scale 3.0 (K-SIS 3.0) in patients with stroke. Methods: Patients with stroke longer than 3 months were invited to participate in the study at specialized rehabilitation centers in Busan. Information on patients was collected using Mini-Mental State Examination (MMSE), Modified Bathel Index (MBI), Beck Depression Index (BDI), WHODAS 2.0-12 item, and K-SIS. Floor and ceiling effects of each domain of K-SIS were examined. The internal consistency of each domain of the K-SIS was calculated using Cronbach's ${\alpha}$. Correlation between K-SIS and each scale was assessed using Spearman's correlation coefficient. Results: Ninety subjects participated in the study. The K-SIS was found to have excellent internal consistency (Cronbach's ${\alpha}=0.93$). Each domain of the consistency ranged from 0.86 to 0.94, except the emotion (${\alpha}=0.51$). Significant correlations were observed between MMSE and domains of memory and thinking, and communication (r=0.48 and 0.52 respectively). BDI was negatively related to domains of emotion, ADL, mobility, and participation (r=-0.43, -0.49, -0.52 and -0.33 respectively). Specific daily activity (MBI) and general functioning (WHODAS 2.0) were also found to be closely related to the domains of ADL, mobility, and participation (ranging from r=-0.41 to r=-0.59). No ceiling and floor effect was observed. Conclusion: Excellent reliability and validity of K-SIS were obtained in the study and it could be suggested that K-SIS may be used for patients with stroke for collection of information on functioning in the clinical context.
Objectives: This is a case report regarding the effect of Korean traditional medicine on vision disorder and quadriplegia in a patient with neuromyelitis optica. Methods: We treated a patient who was diagnosed with neuromyelitis optica with Korean traditional medicine, including acupuncture, moxibustion, and herbal medicine (Gigugyanghyeol-tang gamibang) for 106 days. We evaluated the patient with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Modified Barthel Index (MBI), Modified Ashworth Scale (MAS) Grade, and Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient's symptoms were improved. The ISNCSCI scores increased from 42 to 66 in motor score, from 152 to 196 in sensory score, and from A to D in the ASIA impairment scale; the MBI score increased from 9 to 33, while the score of the MAS Grade decreased from I+ to I, and the NRS-11 scores of vision disorder, spasticity, and tingling decreased from 10 to 7, 3, and 2-3, respectively. Conclusions: Korean traditional medicine may be effective for treatment of vision disorder and quadriplegia in patients with neuromyelitis optica.
Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia. Methods: The patient was treated with herbal medicine (Gamicheongsim-tang, Hwangryunhaedok-tang-tablet), acupuncture, moxibustion, and rehabilitative therapy. The effects of these treatments were evaluated using the manual muscle test (MMT), sensory scale, Korean version of the modified Barthel index (K-MBI), and the National Institutes of Health Stroke Scale (NIHSS). Results: After treatment, the MMT grade improved from 3+/3+ to 4+/4+, and the sensory scale increased from 40%/40%/40% to 80%/80%/80%. In addition, the K-MBI score improved from 56 to 100, and the NIHSS score decreased from 7 to 1. Conclusion: The results suggest that traditional Korean medicine can be effective in the treatment of patients with ICH.
Journal of the Korean Society of Physical Medicine
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v.8
no.2
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pp.245-252
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2013
PURPOSE: The aim of this study is to verify the effectiveness of modified constraint-induced movement therapy(mCIMT) on upper function and activities of daily living in people with subacute stroke patients. METHODS: Eighteen participants, with subacute stroke that were randomly assigned to either the experimental group(n=9) or the control group(n=9). For subjects from the experimental group modified Constraint-Induced Movement Therapy was performed. exercise program, the patient trained in affected side upper extremity with restricted non-affected side for 1 hour and using in activity daily living for 4 hours for five times per week, during 4 weeks. For subjects from the control group, conventional upper extremity training was performed. Outcomes such as the box and block test(BBT), Fugl-Meyer motor function assessment(FMA), and modified Barthel index(MBI) were measured before and after training. Between-group and within-group comparisons were analyzed by using Independent t-test and Paired t-test respectively. RESULTS: These finding suggest that experimental group was significant increase in BBT, FMA, MBI(p<.05). In comparison of two group, experimental group was high upper function and activity daily living than control group. CONCLUSION: This study showed experimental group can be used to improve upper function and activity daily living than control group. Thus it indicates that mCIMT will be more improved through the continued upper extremity exercise program.
Objective : The purpose of this study is to assess affects of pilates exercise program on balance ability and ADL performance ability of patient with chronic cerebellum infarction. Methods : The object of this study K-hospital located in daegu, 62-year-old woman who have receiving inpatient treatment with cerebellum infraction. Before and after the intervention in order to compare balance ability was assessed using berg balance scale(BBS) and ADL performance ability was assessed by modified barthel index(MBI). Results : Balance ability of the object score improved from 19 to 29, the ADL performance ability score increased from 74 to 87. Conclusion : The result of this study pilates exercise program in patients with chronic cerebellum infarction balance ability and ADL performance ability to promote was found that the effect. this pilates exercise program in the occupational therapy, if appropriately utilized more on the functional recovery of patients is expected to be helpful.
Objectives : The purpose of this study was to investigate the association between quality of life and Mibyeong index of abnormal symptoms by the Mibyeong state. Methods : A total of 1,100 people were recruited into this study and were collected by specialized research company. The data were collected by personal information using MBI(Mibyeong Index) and SF-12 (Short form-12) and were analyzed with SPSS (version 21.0) computer program, and included Pearson's chi-square test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. Results : The Mibyeong Index which represents abnormal symptom type showed significant difference for Mibyeong state (p<.001). In Total subject, fatigue, pain, low sleep quality and indigestion were found to be significant predictors of PCS(Physical Component Summary). In Healthy group, pain was found to be significant predictor of PCS. In MI 1 group, fatigue, pain, indigestion and anxiety were found to be significant predictors of PCS. In MI 2 group, fatigue, pain and low sleep quality were found to be significant predictors of PCS. In Total subject, fatigue, depression, anger and anxiety were found to be significant predictors of MCS (Mental Component Summary). In Healthy group, indigestion and anxiety were found to be significant predictors of MCS. In MI 1 group, depression and anger were found to be significant predictors of MCS. In MI 2 group, fatigue and depression were found to be significant predictors of MCS. Conclusions : The relationship between Quality of life and MBI changes according to Mibyeong state. We expect that this result could be contribute to health management of people in Mibyeong state.
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