• Title/Summary/Keyword: Moderate impairment

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Comparison of the Relationship Between Impairment, Disability and Psychological Factors According to the Difference of Duration of Low Back Pain (요통기간에 따른 손상, 장애, 심리적 요인들의 상관성 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.76-84
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    • 2011
  • The purpose of this study was to investigate the correlations between pain intensity, physical impairments, disability, and psychological factors according to the difference in duration of low back pain. This study was a cross-sectional survey of 102 participants with low back pain, divided into two groups equal in number: The first group consisted of patients with acute and subacute low back pain, while the second group consisted of patients suffering from chronic low back pain. The results showed that gender, age, pain intensity, physical impairment, disability and Fear-Avoidance Beliefs (FABs) for work activities were not significantly different between two groups. FABs for physical activities of the first group were significantly more prevalent than in the second group. More than moderate correlations were found between pain intensity, physical impairment, and disability in the first group. Less than moderate correlations were found between pain intensity, physical impairment, disability, FABs, and depression in the second group. These findings suggest that we must consider psychological factors in the treatment of patients with chronic low back pain. Regression analyses revealed that pain intensity and FABs for work activities significantly contributed to the prediction of disability in the first group. Also, pain intensity and FABs for physical activities significantly contributed to the prediction of disability in the second group. Pain intensity was most important predictor of disability in two groups.

Action observation training enhances upper extremity function in subacute stroke survivor with moderate impairment: a double-blind, randomized controlled pilot trial

  • Kim, Chang-Heon;Bang, Dae-Hyouk
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.1
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    • pp.133-140
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    • 2016
  • PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

Prospective Memory Loss and Related White Matter Changes in Patients with Amnestic Mild Cognitive Impairment

  • Yoon, Bora;Ryu, Sun Young;Yoon, Soo Jin
    • Dementia and Neurocognitive Disorders
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    • v.17 no.3
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    • pp.120-129
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    • 2018
  • Background and Purpose: Prospective memory (PM) has a known relationship with frontal function, and PM decline has been observed in amnestic mild cognitive impairment (aMCI). Cerebral small vessel disease, as evidenced by white matter hyperintensities (WMHs), is linked to frontal dysfunction. This study was undertaken to evaluate the relationship between PM decline and WMHs in patients with aMCI. Methods: Of 74 enrollees with aMCI, 69 completed this prospective study. We compared total scores and sub-scores of the Prospective and Retrospective Memory Questionnaire (PRMQ) administered at baseline and 3 months later, stratifying patients by degree of WMHs. Results: A significant decline was seen in PRMQ total scores and PM scores at the 3-month mark in patients with moderate (vs. mild) degrees of WMHs ($-2.8{\pm}7.2$ vs. $0.2{\pm}7.1$; p=0.032). In addition, patients with moderate (vs. mild) degrees of deep WMHs (DWMHs) showed greater PM decline, whereas PM loss in patients with mild, moderate, or severe degrees of periventricular WMHs (PVWMHs) did not differ significantly. Conclusions: Findings of this study indicate that the burden of WMHs is consistently implicated in PM deterioration experienced by patients with aMCI, and signifies greater PM decline, especially in instances of extensive DWMHs. Greater attention to the change of PM is therefore needed in aMCI patients with WMHs.

Association between Intake of Food and Cognitive Impairment: A Systematic Review and Meta-analysis (식품 섭취와 인지기능장애와의 관계: 체계적 문헌고찰 및 메타분석)

  • Kim, Yoo-Gyeong;Kim, Kyung-Hee
    • Journal of the Korean Society of Food Culture
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    • v.35 no.6
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    • pp.553-568
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    • 2020
  • This systematic review and meta-analysis aimed to determine whether food intake is effective in preventing diseases related to cognitive impairment. We searched English databases namely MEDLINE, PubMed and ScienceDirect from 2000 to May 2020, and Korean databases namely RISS, KISS, and DBPIA from 1990 to May 2020. We divided the data into 15 groups using the food group classification of the Korean Nutrition Society (KNS). The effect size (Cohen's d) was estimated using a random-effect model, and a 95% confidence interval was calculated for each study. We included 17 cross-sectional studies and 7 cohort studies which involved 45,115 participants. As a result of analyzing the subgroups in the Asian population of both sexes, it was observed that grain intake has a protective effect against cognitive impairment. For females, pulses and fish also have a protective role against cognitive impairment. In the case of seaweed, a negative relationship was found with a moderate protective effect against cognitive impairment (Cohen's d:-0.533, 95% CI: -0.939, -0.126; p=0.010) in Korean studies. Dairy products are associated with an increased risk of cognitive impairment in the American and European population but drinking alcohol is associated with a lower impairment risk. These results provide a basis for formulating the dietary guidelines for preventing dementia for each country.

Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

Meta-Analysis of Constraint-Induced Movement Therapy in Hemiplegic Stroke Patient in Korea (국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석)

  • Park, So-Yeon;Shin, In-Soo
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.59-68
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    • 2012
  • This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

Neuropsychiatric Symptoms in Patients with Mild Cognitive Impairment and Dementia of Alzheimer's Type (경도인지장애 및 알쯔하이머형 치매 환자에서의 신경정신증상)

  • HwangBo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.105-111
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    • 2012
  • Objectives : We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. Methods : A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuro-psychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. Results : The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. Conclusions : Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.

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A Reliability the Montreal Cognitive Assessment on Cognitive impairment Following Stroke (뇌졸중 환자의 인지손상을 위한 몬트리올인지평가의 신뢰도)

  • Song, Chiang-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1228-1233
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    • 2013
  • The purposes of this study were to assess the reliability of the Korean version of Montreal Cognitive Assessment (MoCA-K) and Korean version of Mini-Mental State Examination (MMSE-K) and correlation between MoCA-K and MMSE-K to detect cognitive impairment following stroke determined by a neuropsychological battery. Fifty-two chronic stroke patients participated in this study. They divided two group, normal cognitive group (20 patients) with stroke and cognitive impairment group with stroke (32 patients), and research period was from October 2th. to November 30th., 2013. The subjects were measured K-MoCA and K-MMSE. Normal cognitive group showed the moderate reliability in K-MoCA and K-MMSE. Cognitive group showed the more moderate relaibility in K-MoCA and K-MMSE. There was positive correlation as the more score of K-MoCA gain, the more score of K-MMSE showed in both group. The results suggest that both clinical measures are moderately sensitive and proper feasibility to chronic post-stroke cognitive impairment. The both clinical tools suggest to use in research and clinical settings by a neuropshchological battery.

Prevalence and Risk Factors of Unmet Healthcare Needs among Korean Adults with Hypertension (한국인 고혈압 환자의 의료접근성 및 미 충족 의료실태와 위험요인 분석)

  • Oh, Heeyoung;Gil, Eunha
    • Korean Journal of Adult Nursing
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    • v.29 no.1
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    • pp.22-31
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    • 2017
  • Purpose: The purposes of this secondary analysis study was to examine prevalence, risk factors and unmet healthcare needs among adults with hypertension. Methods: A sample of 3,386 adults over the age of 40 with hypertension were drawn from the Korea Health Panel Study (2013). Using SPSS 22.0 version, descriptive statistics including frequency, percentage, chi-square and logistic regression were performed. Results: Results showed that 18.9% of the sample reported unmet healthcare needs with the most frequently cited one was financial burdens (43.2%). The reported experiences of unmet healthcare needs differed by gender, marital status, vision or hearing impairment, memory problem, impaired mobility, subjective health status, total family income, depressive episode and the difficulty in making decisions. The sample participants were more likely to report unmet healthcare if they had vision impairment, low income and perception that their health status as moderate to poor. Those without vision impairment were less likely to report unmet healthcare needs. Conclusion: The identified risk factors of unmet healthcare needs should be addressed which would enhance access both to health care and to resolution of unmet healthcare needs. Since visual ability seems to impact perception of unmet healthcare needs, it may be useful to find ways to address this factor.