• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.143-150
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• 2021

Spinal dysraphism often causes neurological impairment from direct involvement of lesions or from cord tethering. The conus medullaris and lumbosacral roots are most vulnerable. Surgical intervention such as untethering surgery is indicated to minimize or prevent further neurological deficits. Because untethering surgery itself imposes risk of neural injury, intraoperative neurophysiological monitoring (IONM) is indicated to help surgeons to be guided during surgery and to improve functional outcome. Monitoring of electromyography (EMG), motor evoked potential, and bulbocavernosus reflex (BCR) is essential modalities in IONM for untethering. Sensory evoked potential can be also employed to further interpretation. In specific, free-running EMG and triggered EMG is of most utility to identify lumbosacral roots within the field of surgery and filum terminale or non-functioning cord can be also confirmed by absence of responses at higher intensity of stimulation. The sacral nervous system should be vigilantly monitored as pathophysiology of tethered cord syndrome affects the sacral function most and earliest. BCR monitoring can be readily applicable for sacral monitoring and has been shown to be useful for prediction of postoperative sacral dysfunction. Further research is guaranteed because current IONM methodology in spinal dysraphism is still deficient of quantitative and objective evaluation and fails to directly measure the sacral autonomic nervous system.

• PNF and Movement
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• v.12 no.3
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• pp.189-199
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• 2014

Purpose: The objective of this case report is to examine the impact of physical therapy using the proprioceptive neuromuscular facilitation (PNF) concept for a patient with shoulder impingement syndrome. Methods: The patient is a 35-year-old female who has felt pain in the right shoulder for one month. The physical examination evaluated sensory integration, pain, joint integration and mobility, posture, reflex integration, range of motion, muscular strength, analysis of movement, and shoulder function. Comprehensive physical therapy was given to the patient, including stretching, mobilization, strengthening, posture correction, coordination improvement, daily activities, and sports exercises. The therapy was given 5 times a week for the first 5 weeks, then 3 times a week for the next 5 weeks. In all, the intervention lasted for 10 weeks. Results: The patient's senses, posture, and muscular strength all improved to a normal level. The degree of pain fell from 3/10 to 0/10 for activities taking place below shoulder height, and from 8/10 to 1/10 for activities above the head. Additionally, joint integration, motility, range of motion, and movements also improved. The disabilities of the arm, shoulder and hand (DASH) for functional evaluation improved from 27.5 to 10.3. Conclusion: Physical therapy using the PNF concept is effective in improving the body structure, function, activity, and participation of patients with motor disorders of the shoulder impingement syndrome.

• PNF and Movement
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• v.10 no.1
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• pp.25-33
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• 2012

Purpose : The purpose of this study was to compare the effect of treadmill training and cognitive task with in the course of treadmill training at the same time with chronic stroke patients. Methods : Fourteen chronic stroke patients participated. Participants were randomly assigned to the control and experimental group(7 experimental, 7 control). All of participants were in-patients at local hospital and had been receiving a traditional rehabilitation program, five days a week. The both groups have undergone 4weeks. The experimental group trained in treadmill and cognitive task at the same time, but control group trained only treadmill. 10m walking test, Timed Up & Go (TUG) test and 6 Minutes walking(6M walking) test to measure the walking speed, dynamic balance and waling endurance ability were carried out before and after the training. Results : The result of the study were as follow:10m walking test were significantly increased both groups(p<.01), but not significant between groups(p>.05). TUG test were significantly increased both groups(p<.001) and between groups(p<.01). 6M walking test were significantly increased both groups(p<.001), but not significant between groups(p>.05). Conclusion : Ahead of return to the community to patients with stroke, cognitive task with in the course of treadmill training at the same time was effective in improving the dynamic balance ability.

• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.91-96
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• 2021

Purpose: This study investigated the effects of cryotherapy on the ankle joint muscle strength and balance ability in stroke patients with ankle joint muscles. Methods: In this study, 20 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a cryotherapy group (10 patients) and a control group (10 patients). The cryotherapy group performed sit-to-stand training for 15 minutes and then cryotherapy for the minutes. In the control group, after sit-to-stand training for 15 minutes, blocked cryotherapy was provided for three minutes. In both groups, the interventions were provided five times a week for three weeks. The strength of the ankle joint muscles was measured before and after the training using the Biodex systems 3. The static balance ability was measured using balancia software, and the dynamic balance ability was measured by performing the sit-to-stand test (FTSST) five times. Results: After the training periods, the cryotherapy group showed significant improvement in the ankle dorsiflexor strength, ankle plantarflexor strength, weight distribution of the affected side, and FTSST compared to the control group (p<0.05). Conclusion: Based on these results, cryotherapy could be considered an effective method to improve the strength of ankle joint muscles. Cryotherapy improves muscle strength as it increases the motor neuron excitability. Therefore, cryotherapy may be considered to improve the strength of the ankle joint muscles of stroke patients.

• Korean Journal of Applied Biomechanics
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• v.32 no.4
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• pp.121-127
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• 2022

Objective: The purpose of this study was to investigate potential effects of transcranial direct current stimulation (tDCS) on bimanual force control capabilities in healthy young adults. Method: Eighteen right-handed healthy young adults (10 females and 8 males; age: 23.55 ± 3.56 yrs) participated in this crossover design study. All participants were randomly allocated to both active-tDCS and sham-tDCS conditions, respectively. While receiving 20 min of active- or sham-tDCS interventions, all participants performed bimanual isometric force control tasks at four submaximal targeted force levels (i.e., 5%, 10%, 15, and 20% of maximal voluntary contraction: MVC). To compare bimanual force control capabilities including force accuracy, variability, and regularity between active-tDCS and sham-tDCS conditions, we conducted two-way repeated measures ANOVAs (2 × 4; tDCS condition × Force levels). Results: We found no significant difference in baseline MVC between active-tDCS and sham-tDCS conditions. Moreover, our findings revealed that providing bilateral tDCS including anodal tDCS on left primary motor cortex (M1) and cathodal on right M1 while conducting bimanual force control trials significantly decreased force variability and regularity at 5%MVC. Conclusion: These findings suggest that providing bilateral tDCS on M1 areas may improve bimanual force control capabilities at a relatively low targeted force level.

• Journal of Acupuncture Research
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• v.40 no.1
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• pp.78-89
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• 2023

This paper presents the clinical outcome of an 82-year-old female who experienced sudden back pain combined with lower limb paresthesia and weakness after epidural steroid injection. The magnetic resonance imaging of the thoracolumbar spine showed a spinal epidural hematoma (SEH) extending from T8 to L4. She was treated non-operatively in the traditional Korean medicine (TKM) hospital. The patient's progress was assessed using the Numerical Rating Scale (NRS), American Spinal Injury Association (ASIS), Spinal Cord Independence Measure version III (SCIM III), and self-reported symptoms. During the 22-day hospitalization period,the NRS score decreased from 7 to 2 points, the motor score on the ASIS scale increased from 65 to 95 points. The subjective sense of lower extremities was felt by 1 increased to 8. The SCIM III score increased from 32 to 69 points. These results suggest that TKM could effectively reduce pain and aid the rehabilitation of patients with SEH.

• Journal of the Semiconductor & Display Technology
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• v.22 no.4
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• pp.87-92
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• 2023

As the elderly population increases, the number of patients with various joint diseases, including degenerative arthritis, is steadily increasing. CPM medical devices are needed to effectively treat degenerative arthritis that is common in the elderly population. Domestic CPM medical devices have limited functions and are highly dependent on imports for expensive imported medical devices. To solve this problem, we designed a ROM measurement function using a current sensor that is not present in existing composite joint CPM medical devices. The algorithm was designed using the fact that the force caused by joint stiffness greatly increases the current flowing through the DC motor. In addition, the need for digital healthcare in the medical field is gradually expanding as the proportion of chronically ill patients increases due to the spread of the non-face-to-face economy due to COVID-19 and the aging population. Therefore, this paper aims to improve the performance of CPM medical devices by allowing real-time confirmation of rehabilitation exercise information and operation range measurement results in accordance with digital healthcare trends through a Bluetooth application developed as an Android studio.

• Physical Therapy Korea
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• v.12 no.3
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• pp.11-21
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• 2005

The present study was aimed at investigating the effect of swimming training on brain function after focal cerebral ischemia in rats. Therefore, this study was examined on neurogenesis in dentate gyrus of hippocampus using 5-bromo-2'-deoxyuridine (BrdU) to label proliferating cells and assessed the neurological response following focal cerebral ischemia in rats using neurological motor behavioral test. In an observer-blinded fashion, twenty male Sprague-Dawley (280~310 g, 7 weeks old) rats were divided into four groups: MCAO plus swimming group (ME, $n_1$=5), MCAO plus control group (MC, $n_2$=5), SHAM plus swimming group (SE, $n_3$=5), SHAM plus control group (SC, $n_4$=5). The results of this study were as follows: 1) The limb placing time before and after swimming in the ME group were significantly longer than the MC group (p<.05), the SE group were significantly longer than the SC group (p<.01). 2) The balance beam scores before and after swimming in the ME group was higher than the SE group, the MC group was higher than the SC group but was not significantly different (p>.001). 3) The foot fault index before and after swimming training in ME group was significantly lower (i.e., improved) than the MC group (p<.001) and the SE group (p<.001), the SE group was significantly lower (i.e., improved) than the SC group (p<.001). 4) The mean number of BrdU-positive cells in the dentate gyrus in the ME group was significantly higher than the MC group (p<.001) and the SE group (p<.01). The MC group and the SE group was significantly higher than the SC group (p<.001). 5) There was significantly correlation between limb placing time and number of BrdU-positive cells on swimming training, there was positive correlation (r=.807, p<.0001) and between foot fault index and BrdU-positive cells number, there was negative correlation (r=-.503, p<.05). However, between balance beam scores and BrdU-positive cells number, there was no correlation. In conclusion, the present study demonstrates that the role of swimming training improves behavioral motor function probably by enhancing cell proliferation in that hippocampus. This study provides a model for investigating the stroke rehabilitation that underlies neurogenesis and functional ability.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.7-25
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• 2020

Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

• Therapeutic Science for Rehabilitation
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• v.5 no.1
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• pp.77-87
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• 2016

Objective : The purpose of this study is to investigate the impact of task-oriented approach based on upper limb coordinated movement on the ability of the Korean handwriting in children with developmental coordination disorder(DCD). Methods/Design : This randomized controlled trial designed as a pre-/post- test will compare the effectiveness of task-oriented approach and process-oriented approach on handwriting performance for children with DCD aged 5 to 10. These interventions consist of 10 training sessions and 4 assessment sessions over 7weeks. Children will be measured regard to handwriting legibility, speed and pre-handwriting skills including upper limb movement skills, visual perception and visual motor coordination. Conclusion : This is the first attempt to investigate effects of a task-oriented approach in children with DCD. The significance of this study is to provide the clinical evidences to apply the task-oriented approach improves the children's handwriting performance. Furthermore it will also present a more effective intervention for handwriting by figuring out each approach's impact on the improvement of pre-handwriting skills.