• Journal of Trauma and Injury
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• v.26 no.3
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.34-45
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• 2003

A 'pusher syndrome' encompassing postural imbalance and hemi-neglect is believed to aggravate the prognosis of stroke patients. The patients with pusher syndrome show a particular posture that pushing away from the unaffected side of the body. The objective of this study was to investigate associated proprioception, associated neuro-psychological symptoms and characteristics of functional outcome with and without pusher syndrome. The subjects of this study were 58 acute stroke patients who been rehabilitated at two university hospitals in Seoul and Buchun. Data were collected using proprioception test and line bisection test. The ability of ADL was assessed by the Modified Barthel Index, transfer by the Functional Independence Measure, and balance by the Modified Motor Assessment Scale. The results were that significant difference was found in the presence of proprioception, in the incidence of hemineglect and anosognosia, and in the score of ADL, transfer and balance between patients with and without pusher syndrome. Patients without pusher syndrome gained more motor score than patients with pusher syndrome. From improvement of view, patients with pusher syndrome gained the lowest score in ability of transfer. The finding suggest that the patients with pusher syndrome is a poorer functional outcome, be related to proprioception, hemineglect and anosognosia.

• Journal of Korean Academy of Medicine & Therapy Science
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• v.10 no.2
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• pp.21-30
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• 2018

Objective: The purpose of this study was to investigate questions and instructions for internal feedback effects on functional recovery and task performance while chronic stroke patients practised task-specific training. Method: Twenty-four chronic stroke patients were randomly divided into two groups; when patients performed same tasks, one was treated using questions and the other using instructions for internal feedback Both lasted 30 minutes, 5 times a week for 8 weeks. Outcome measures included Erasmus MC Modifications to the Nottingham Sensory Assessment (EmNSA), Measurement Properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), Chedoke Arm and Hand Activity Inventory (CAHAI), Korean version of Modified Barthel Index (K-MBI). Results: There were no significant differences between the two groups in EmNSA and K-MBI(p>.05). But, in MESUPES and CAHAI, there was significant difference between the two groups(p<.05). Conclusion: In this study, questions for internal feedback during task-specific training are more effective in improving upper extremity motor function and task performance than instructions for internal feedback.

• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.9-18
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• 2008

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.291-299
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• 2012

Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.201-201
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• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.25-35
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• 2020

Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.71-83
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• 2019

Purpose: This meta-analysis aimed to analyze to the effects of aquatic exercise programs in children with cerebral palsy and identify directions for future research. Methods: A systematic search based on the PRISMA guidelines was undertaken for studies conducted between 2006 and 2018 on aquatic exercise programs in children with cerebral palsy. A total of 10 studies were selected according to the inclusion criteria. The methodological quality was assessed using the Risk of Bias Tool for Randomized Controlled Trials (RoB) and Risk-of-Bias Assessment Tool for Non-randomized Studies (RoBANS). A meta-analysis software (CMA 3.0) was used to calculate the mean effect size, effect size by intervention (Halliwick and Watsu Aquatic methods), and effect size by outcome. Results: The mean effect size was 0.457. The effect size by intervention was largest for the Halliwick method, followed by the Watsu method. The effect size by outcome was largest for range of motion, followed by the gross motor function measure, the Pediatric Berg Balance Scale, and the Modified Ashworth Scale. Meta-regression analysis showed effect size increased when sample size, number of sessions, and length of sessions increased. Conclusion: The results show that aquatic exercise programs have a positive effect on children with cerebral palsy. Therefore, it is necessary to develop a guideline that recommends the appropriate intervention and the identifies the direction of future studies on aquatic exercise programs.

• Child Health Nursing Research
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• v.12 no.2
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• pp.260-267
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• 2006

Purpose: This pilot study was to develop Korean version of CDI(The Child Development Inventory) and assess the validation and reliability on K-CDI. Method: The K-CDI is assessed by parent-report method that has designed to screen children developmental functioning on 12 months to 6.5 years of age /or older children who are judged to be functioning in the one to six-year range. The inventory assesses areas of child development in the social, self-help, motor, language, letter and number skills. also, it includes various symptoms and behavior problems that young children may have. Participants were 130 children and their mothers who has lived in Seoul or Gyounggi-Do. Data was analyzed on the ratio of item response, Pearson's correlation, and Cronbach alpha. Results: 270 items with 8 sub-developmental realms were confirmed the reliabilities and validity on Korean children. Total 300 items were selected for restandardization. There was a significant correlation between the score of Social Maturity Scale and K-CDI. The corrlation coefficient alpha was .98. Conclusion: This study indicated that CDI is applicable in the clinical and early childhood educational setting for developmental assessment in Korea.