• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.159-165
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• 2022

Objective: This clinical study describes the effect of Korean medicine on a patient with Delayed Neuropsychiatric Sequelae after Carbon Monoxide Poisoning. Case presentation: A patient with the delayed neuropsychiatric effects of carbon monoxide exposure was treated with herbal medicine, acupuncture, moxibustion, and cupping. Clinical symptoms were measured with the Korean Mini Mental State Examination (K-MMSE), Functional Independence Measure (FIM), and the Modified Barthel Index (MBI). After 32 days of treatment, the patient's K-MMSE score increased from 11 to 21 points, the FIM score from 52 to 94 points, and the MBI score from 46 to 84 points. There were no side effects. Conclusion: According to this case study, Korean medicine may be considered an effective treatment for delayed neuropsychiatric sequelae, although more studies are needed to confirm its validity.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.2
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• pp.53-62
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• 2021

PURPOSE: Social participation is essential for stroke survivors. Although participation restrictions are affected by several factors, a few studies have focused on the effects of living in a particular residential area (urban versus rural) on the participation restrictions after a stroke. This study examined the factors affecting participation restrictions in stroke survivors according to the residential area. METHODS: One hundred sixty-six stroke patients (including 130 living in urban areas and 36 living in rural areas) were recruited for this study. The Korean Modified Barthel Index (K-MBI) was used to assess the activities of daily living (ADL). The Korean Mini-Mental Examination Status (MMSE-K) was used to assess cognition. The motor function was evaluated using the Fugl-Meyer function assessment (FMA). Path analysis was used to test the hypothesized model of participation restriction. RESULTS: The proposed path model showed good fit indices. In rural and urban areas, the direct effects were significant between the ADL and participation restrictions (β = -.673 and -.457, respectively). For urban areas, the direct effects were significant between cognition and participation restrictions (β = -.252). In both area types, motor function and cognition had a significant direct effect on the ADL. CONCLUSION: For urban community-dwelling stroke survivors, the ADL and cognition had direct effects on participation restrictions. For rural area stroke survivors, the ADL had direct effects on participation restrictions. Activity level exercise programs help reduce the participation restrictions. Moreover, it is essential to address cognition training to improve participation in urban community-dwelling stroke survivors.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.123-132
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of cognitive orientation to daily occupational performance (CO-OP) interventions on the upper extremity function and occupational performance in subacute stroke patients. METHODS: A total of 30 eligible stroke patients were randomly distributed into the CO-OP experimental group (n = 15) and the traditional occupational therapy (OT) control group (n = 15). The CO-OP approach was applied for twelve 60-minute sessions. The Jebson Taylor Hand Function Test (JTHFT), the Korean version of the Modified Barthel Index (K-MBI), and the Performance Quality Rating Scale (PQRS) were used for outcome evaluations. RESULTS: There was a statistically significant difference in the paralytic upper extremity function before and after treatment (p < .01) between the group treated with the CO-OP approach and the group treated with traditional OT. The occupational performance of the CO-OP approach group showed a significant improvement (p < .01), and this group also showed a statistically significant improvement in quality of performance compared to the traditional OT group (p < .01). CONCLUSION: The CO-OP approach may be useful in clinical practice as a therapeutic intervention for improving the functional recovery and performance of subacute stroke patients. Future research should be carried out to investigate the persistence of this effect involving more participants and follow-up studies should also be undertaken.

• Journal of Korean Physical Therapy Science
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• v.29 no.3
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• pp.1-11
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• 2022

Background: The aim of this randomized controlled pilot study was to determine the effect of trunk training in wheelchair on fall efficacy, fall risk and activities of daily living in acute stroke patients. Design: Randomized controlled pilot trial. Methods: The study included 18 patients with acute stroke who were randomly allocated to an experimental group (EG) (n=9) and a control group (CG) (n=9). Patients in the EG group received general rehabilitation therapy combined with trunk training in wheelchair for 20min, whereas CG group received general rehabilitation therapy combined with bicycle training for 20min. Both groups performed the exercise 5 times a week for 3 weeks. Outcomes were assessed using Korean-Fall Efficacy Scale (K-FES), Fullerton Advanced Balance Scale (FAB) and Korean-Modified Barthel Index (K-MBI). Results: After 3 weeks of training, both groups showed significantly improved K-FES, FAB and K-MBI (p<.05 in both groups). However, the K-FES, FAB and K-MBI in the experimental group was significantly improving than in the control group (p<.05). Conclusion: These findings indicate that trunk training in wheelchair may be effective at decreasing fall risk and improving activities of daily living in acute stroke patients. Therefore, trunk training in wheelchair may be recommended as an intervention in reducing the incidence of fall risk in acute stroke patient.

• The Journal of Internal Korean Medicine
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• v.44 no.1
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• pp.77-85
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• 2023

Objective: This clinical study describes the effect of Korean medicine on a post-traumatic hydrocephalus patient complaining of gait disturbance and dementia. Case presentation: A post-traumatic hydrocephalus patient complaining of gait disturbance and dementia was treated with herbal medicine, acupuncture, moxibustion, and cupping. Clinical symptoms were measured with the Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After treatment, the patient showed improved K-MMSE, FIM, and MBI scores. Conclusion: This clinical case study provides evidence of the effect of Korean medicine on a post-traumatic hydrocephalus patient complaining of gait disturbance and dementia.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.103-114
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• 2023

PURPOSE: This study compared the effects of computer-based and virtual reality-based cognitive rehabilitation programs on the cognitive function, upper limb function, activities of daily living, and their impact on the prefrontal cortex in convalescent stroke patients. METHODS: Ten recovering stroke patients were assessed for their cognitive function, upper limb function, and daily living activities using the Neurobehavioral Cognitive Status Examination, the Korean version of the Fugl-Meyer Assessment, and the Korean version of the Modified Barthel Index. The prefrontal cortex activity was measured with functional Near Infrared Spectroscopy. The virtual reality-based cognitive rehabilitation group utilized a program of daily living activities delivered via a laptop and Oculus Rift. The computer-based cognitive rehabilitation group performed various cognitive tasks on an all-in-one PC. Both groups underwent cognitive rehabilitation training for 30 minutes per day, three times a week, for six weeks, with identical conventional rehabilitation therapies in the hospital. RESULTS: Both programs positively impacted the cognitive and physical functions. On the other hand, the virtual reality-based cognitive rehabilitation program had a larger influence on improving the cognitive and physical functions of convalescing stroke patients. CONCLUSION: The virtual reality program suggests its potential to enhance cognitive and physical functions in convalescent stroke patients through increased engagement, focus, real-time feedback, and game elements, making it a promising rehabilitation approach.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.207-213
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• 2023

Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.167-175
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• 2023

Purpose : The study aim was to apply high-frequency repetitive transcranial magnetic stimulation to and investigate the effects on upper extremity function and activities of daily living. Methods : This study was conducted at Hospital D in U City from April to June 2018. Thirty-two patients diagnosed with stroke according to prior research criteria were selected and divided into two groups. Sixteen people in the experimental group received high-frequency repetitive transcranial magnetic stimulation and traditional occupational therapy, and sixteen people in the received sham stimulation and traditional occupational therapy. Both groups received 20 minutes of transcranial magnetic stimulation and 30 minutes of traditional occupational therapy per session, five times per week, for a total of 10 sessions over two weeks. Upper extremity functional evaluation, MFT and activities of daily living (Korean Version of the Modified Barthel Index, K-MBI) were conducted before and after the intervention, and an independent t test was used to confirm the effects of the intervention. Results : No statistically significant difference between the aforementioned groups' MFT and K-MBI scores was noted before the intervention. After the intervention, however, a statistically significant difference was found in K-MBI scores (p<.001). Additionally, after the intervention, a significant difference between the groups' MFT scores was found (p<.05). Conclusion : The results of this study showed that the combination of high-frequency repetitive transcranial magnetic stimulation and occupational therapy was effective in recovering upper extremity function and activities of daily living in patients diagnosed with acute stroke.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.133-144
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• 2023

PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.