• Physical Therapy Rehabilitation Science
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• 제1권1호
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• pp.1-5
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• 2012

Objective: Dual-task walking deficits impact functional daily life, which often requires walking while performing simultaneous tasks such as talking, thinking or carrying an object. This study is to find out the latest trend of dual-task training's influence on ambulatory abilities of a stroke patient. Design: Systematic review of randomized controlled trials. Methods: This literature review was conducted in Pubmed and Sciencedirect with the follwing key words:stroke, cerebro-vascular accident, hemiplegia, gait, rehabilitation, exercise. 7 studies were chosen in findings by search tool. 3 studies were case study, 3 studies were cross sectional observational study and 1 study was randomized controlled trial. Results: It was found that stroke patients have difficulties in doing 2 motor tasks simultaneously and when they do 2 tasks, one is done in a naturally preferred activity areas. Moreover, when simply applying dual-tasks, the walking speed decreased. Meanwhile, when applying them through training, the speed increased. This showed the improvement of effective task-implementation abilities after dual-task training using task-integration models. Conclusions: In the beginning of the 2000s, dual-tasks were implemented by simply combining walking and cognition or exercise task, and the results of this study suggest that subjects with stroke have difficulty performing dual task. However, the latest trend is to let patients do the dual-task training by combining it with virtual reality. Therefore, dual task training could be performed in a safe in the environment such as virtual reality or augment reality.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.218-222
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• 2017

Purpose: Driving is an important activity that is affected by various motor and cognitive deficits after stroke. On the other hand, there is no standard screening tool to evaluate the sitting asymmetry during driving, which is the stereotyped postural characteristic observed in patients with stroke. Therefore, this study compared the buttock pressure during simulated driving between healthy adults and patients with stroke. Methods: Ten post-stroke patients and ten healthy subjects participated in the experiment. The participants experienced simulated driving of 6.1 km during approximately 5 minutes for adaptation. The driving scenario consisted of 3.5 km urban traffic conditions, 10 km straight highway, and 7 km curved or hilly rural roads. Force sensitive application (FSA) was used to analyze the distribution of the buttock pressure on the driver's seat. The symmetry index (SI) was determined using the average buttock pressure of each side of the buttock. The closer SI is to zero, the higher the symmetry of buttock pressure. Results: These studies showed that the SI of healthy subjects was significantly closer to zero than that of the stroke patients. Conclusion: The buttock pressure of the stroke patients showed more asymmetry than that of the healthy subjects during simulated driving. Therefore, a therapeutic approach is needed for symmetrical sitting to improve the driving performance.

• 동의생리병리학회지
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• 제19권1호
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• pp.246-253
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• 2005

This study was designed to investigate the neuroprotective effects of Guh-Poong-Chung-Sim-Hwan(GCH) on ischemia induced by middle cerebral artery occlusion(MCAO) in Sprague-Dawley rats. The effects of GCH administration on the size of the brain infarct and the functional status of the rats after ischemia were examined, as well as the expression of COX-2 in acute phase. The recovery of motor functions for 7 days and the brain infarct were examined to find out the delayed effects of daily GCH-administration as well. In conclusion, we found that GCH reduced both functional deficits and brain damage in the MCAO rat model of stroke. In addition, high doses of GCH reduced COX-2 expression in the penumbra. It is well known that herbal medication including GCH is very safe for humans. Accordingly, our results support the clinical use of this GKM for the treatment of stroke and offer the possibility that a potent neuroprotective agent could be developed from Korean herbal medicines.

• 대한한의학회지
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• 제30권3호
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• pp.28-38
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• 2009

Background : Peripheral nerve injuries are a commonly encountered clinical problem and often result in a chronic pain and severe functional deficits. Objective : The aim of this study was to evaluate the effects of Gentianae Macrophyllae Radix (G. M. Radix) on the pain control and the recovery of the locomotor function that results from the sciatic crushed nerve injury in rats. Method : Using rats, we crushed their sciatic nerve, and then orally administered the aqueous extract of G. M. Radix. The effects of G. M. Radix on the recovery locomotor function were investigated by walking track analysis. The effects of G. M. Radix on pain control were investigated by brain-derived neurotrophic factor (BDNF) expression in the sciatic nerve, and c-Fos expression in the paraventricular nucleus (PVN) of the hypothalamus and in the ventrolateral periaqueductal gray (vlPAG). Result : G. M. RADIX facilitates motor function from the locomotor deficit, and thereby increased BDNF expression and suppressed painful stimuli in the PVN and vlPAG after sciatic crushed nerve injury. Conclusion : It is suggested that G. M. Radix might aid recovery locomotor function and control pain after sciatic crushed nerve injury. Further studies on identifying specific the component in G.M. Radix associated with enhanced neural activity in the peripheral nerve injury may be helpful to develop therapeutic strategies for the treatment of peripheral nerve injury.

• The Korean Journal of Pain
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• 제19권1호
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• pp.63-67
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• 2006

Background: Pain due to spinal stenosis is one of the major causes of low back pain, and it sometimes does not respond to conservative treatment. We postulated that anterior epidural irrigation could be a good choice for treating lumbar spinal stenosis patients. However, the effects and theoretical basis of anterior epidural irrigation have not been investigated for spinal stenosis. So, this study was designed to identify the clinical efficacy of anterior epidural irrigation for treating lumbar spinal stenosis. Methods: 71 patients with lumbar spinal stenosis underwent anterior epidural irrigation. Anterior epidural irrigation was performed with normal saline and a mixture of local anesthetic with steroid through a catheter under fluoroscopic guidance. The findings were evaluated with using visual analogue scales for low back pain and leg symptoms. Results: Relief from low back pain and leg pain was observed for up to 12 months after anterior epidural irrigation. None of the patients showed any deterioration of their motor or sensory deficits during follow up. Conclusions: Anterior epidural irrigation is effective for the relief of back and leg pain in spinal stenosis patients.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.178-181
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• 2011

Congenital anomalies in arches of the atlas are rare, and are usually discovered incidentally. However, a very rare subgroup of patients with unique radiographic features is predisposed to transient quadriparesis after minor cervical or head trauma, A 46-year-old male presented with a 2-month history of tremor and hyperesthesia of the lower extremities after experiencing a minor head trauma. He said that he had been quadriplegic for about 2 weeks after that trauma. Radiographs of his cervical spine revealed bilateral bony defects of the lateral aspects of the posterior arch of C1 and a midline cleft within the anterior arch of the atlas. A magnetic resonance imaging revealed an increased cord signal at the C2 level on the T2-weighted sagittal image. A posterior, suboccipital midline approach for excision of the remnant posterior tubercle was performed. The patient showed significant improvement of his motor and sensory functions. Since major neurologic deficits can be produced by a minor trauma, it is crucial to recognize this anomaly.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.70-80
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• 2015

The spinal cord is highly complex, consisting of a specialized neural network that comprised both neuronal and non-neuronal cells. Any kind of injury and/or insult to the spinal cord leads to a series of damaging events resulting in motor and/or sensory deficits below the level of injury. As a result, muscle paralysis (or paresis) leading to muscle atrophy or shrinking of the muscle along with changes in muscle fiber type, and contractile properties have been observed. Traditionally, histology had been used as a gold standard to characterize spinal cord injury (SCI)-induced adaptation in spinal cord and skeletal muscle. However, histology measurements is invasive and cannot be used for longitudinal analysis. Therefore, the use of conventional magnetic resonance imaging (MRI) is promoted to be used as an alternative non-invasive method, which allows the repeated measurements over time and secures the safety against radiation by using radiofrequency pulse. Currently, many of pathological changes and adaptations occurring after SCI can be measured by MRI methods, specifically 3-dimensional MRI with the advanced diffusion tensor imaging technique. Both techniques have shown to be sensitive in measuring morphological and structural changes in skeletal muscle and the spinal cord.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.52-58
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• 2015

Balance control deficits have been indicated to be a primary problem among cerebral palsy (CP) patients. Fabric ankle foot orthosis (AFO) can allow more efficient balance control by facilitating proprioception. The purpose of this study was to investigate the immediate effect of fabric AFO on balance, compared to a barefoot condition in children with unilateral CP. Twelve children with unilateral CP participated in this study. Their balance ability was evaluated using pediatric balance scale and bubble test. Both pediatric balance scale and bubble test showed significant improvement with the use of the fabirc AFO (p<.05). The fabric AFO could improve functional balance ability, and promote better balance among children with unilateral CP. We demonstrated that fabric AFO contributed to improving balance among children with unilateral CP, classified as Gross Motor Function Classification System level I and II. Consequently, fabric AFO might be an assistive device leading to the improvement of balance instead of the typical AFOs.

• Journal of Preventive Medicine and Public Health
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• 제46권sup1호
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• pp.50-54
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• 2013

Out-of-home mobility is necessary for accessing commodities, making use of neighborhood facilities, and participation in meaningful social, cultural, and physical activities. Mobility also promotes healthy aging as it relates to the basic human need of physical movement. Mobility is typically assessed either with standardized performance-based tests or with self-reports of perceived difficulty in carrying out specific mobility tasks. Mobility declines with increasing age, and the most complex and demanding tasks are affected first. Sometimes people cope with declining functional capacity by making changes in their way or frequency of doing these tasks, thus avoiding facing manifest difficulties. From the physiological point of view, walking is an integrated result of the functioning of the musculoskeletal, cardio-respiratory, sensory and neural systems. Studies have shown that interventions aiming to increase muscle strength will also improve mobility. Physical activity counseling, an educational intervention aiming to increase physical activity, may also prevent mobility decline among older people. Sensory deficits, such as poor vision and hearing may increase the risk of mobility decline. Consequently, rehabilitation of sensory functions may prevent falls and decline in mobility. To promote mobility, it is not enough to target only individuals because environmental barriers to mobility may also accelerate mobility decline among older people. Communities need to promote the accessibility of physical environments while also trying to minimize negative or stereotypic attitudes toward the physical activity of older people.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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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.