• Title/Summary/Keyword: Motor impairment

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Evidence of Cortical Reorganization in a Monoparetic Patient with Cerebral Palsy Detected by Combined Functional MRI and TMS

  • Kwon, Yong-Hyun;Jang, Sung-Ho;Lee, Mi-Young;Byun, Woo-Mok;Cho, Yoon-Woo;Ahn, Sang-Ho
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.96-103
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    • 2005
  • The motor recovery mechanism of a 21-year-old male monoparetic patient with cerebral palsy, who had complained of a mild weakness on his right hand since infancy, was examined using functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). The patient showed mild motor impairment on the right hand. MRI located the main lesion on the left precentral knob of the brain. fMRI was performed on this patient as well as 8 control subjects using the Blood Oxygen Level Dependent technique at 1.5 T with a standard head coil. The motor activation task consisted of finger flexionextension exercises at 1 Hz cycles. TMS was carried out using a round coil. The anterior portion of the coil was applied tangentially to the scalp at a 1.0 cm separation. Magnetic stimulation was carried out with the maximal output. The Motor Evoked Potentials (MEPs) from both Abductor Pollicis Brevis muscles (APB) were obtained simultaneously. fMRI revealed that the unaffected (right) primary sensori-motor cortex (SM1), which was centered on precentral knob, was activated by the hand movements of the control subjects as well as by the unaffected (left) hand movements of the patient. However, the affected(right) hand movements of the patient activated the medial portion of the injured precentral knob of the left SM1. The optimal scalp site for the affected (right) APB was located at 1 cm medial to that of the unaffected (left) APB. When the optimal scalp site was stimulated, the MEP characteristics from the affected (right) APB showed a delayed latency, lower amplitude, and a distorted figure compared with that of the unaffected (left) APB. Therefore, the motor function of the affected (right) hand was shown to be reorganized in the medial portion of the injured precentral knob.

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PSYCHIATRIC CHARACTERISTICS OF CHILD PATIENTS WITH INVERSION OF CHROMOSOME 9 - A PRELIMINARY STUDY - (9번 염색체 전위를 지닌 환아들의 정신과적 특성 - 예비적 연구 -)

  • Lee, Jun-Young;Hwang, Jun-Won;Hong, Kang-E;Kim, Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.71-78
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    • 2001
  • Objectives:Few studies have examined the psychiatric properties or child developmental problems associated with inversion of chromosome 9. The purpose of this study is to examine the psychiatric properties of child patients who have inversion of chromosome 9, focused on behavioral problems and child developmental problems like motor or language developmental delay, intellectual impairment, and growth retardation. Methods:1) The authors examined the cases referred for cytogenetic examination from 1984 to 2000 at Seoul National University Hospital in Korea. The cases with the examination result of inversion of chromosome 9 were collected and informations about the departments which referred and the main reasons for referral were also checked. 2) 12 child subjects with inversion of chromosome 9 and their parents underwent psychiatric interview and parent questionnaire(child and adolescent past history questionnare, CBCL). 45 normal students whose sex and age were matched to patients were selected as a control group. Results:1) There were 165 cases of inversion of chromosome 9. The major departments which referred were Obstetrics and Gynecology(47.3%), Pediatrics(23.6%) and Child and Adolescent Psychiatry(17.0%). The major reasons for referral from the Pediatrics and the Child and Adolescent Psychiatry department (67 cases total) were intellectual impairment(35.8%), language or motor developmental delay(31.3%), suspected Fragile X syndrome(23.9%), and growth retardation(20.9%). 2) Compared to normal control group, the rate to be included in the clinical range with regard to the social problems profile was higher in patient group according to the CBCL results. The patient group had language and motor developmental delay. Conclusion:There is a possibility of inversion of chromosome 9 to be associated with child developmental problems or behavioral problems. This study is the first approach to evaluate the developmental aspects associated with inversion of chromosome 9.

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ORTHODONTIC APPROACH TO THE CEREBRAL PALSY PATIENT WITH MAXILLARY PROTRUSION IN THE MIXED DENTITION : A CASE (혼합치열기 뇌성마비환자의 상악전돌에 대한 교정치료 : 치험례)

  • Kim, Jongsoo;Jo, Anna;Kim, Jiyeon;Jeong, Taesung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.43-46
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    • 2014
  • Cerebral Palsy is a genetic term referring to abnormalities of motor control caused by damage to a child's brain early in the course of development. Due to the impairment of balanced perioral muscle development, the prevalence of malocclusions in patients with cerebral palsy such as maxillary protrusion is high. But most clinicians may feel uncomfortable to treatment of these problems. Here a case report about mitigation of maxillary anterior teeth protruded in patient with cerebral palsy. 8y 4m old boy who have cerebral palsy visited our dental hospital. He showed severely protrusive maxillary anterior teeth with mouth breathing and could not close his mouth. He and his mother wanted to improve dental and facial esthetic problem. Specially designed or modified intraoral fixed appliance and rubber elastic chain was used in the therapy. Treatment carried out for 8 months and we could observe maxillary incisor angle was improved and mouth breathing habit was stopped. In conclusion, modified fixed appliance therapy for the patients with cerebral palsy might be useful. Continuous rehabilitation training of lips should be followed after treatment to correct imbalance of muscle tone.

Four-Week Comparative Effects of Abdominal Drawing-In and Diaphragmatic Breathing Maneuvers on Abdominal Muscle Thickness, Trunk Control, and Balance in Patients With Chronic Stroke

  • Kim, Su-kyung;Kang, Tae-woo;Park, Dong-hwan;Lee, Ji-hyun;Cynn, Heon-seock
    • Physical Therapy Korea
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    • v.24 no.3
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    • pp.10-20
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    • 2017
  • Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.

Osteosarcopenic Obesity in Elderly: The Cascade of Bone, Muscle, and Fat in Inflammatory Process

  • Du, Yang;Oh, Chorong;No, Jae-kyung
    • Culinary science and hospitality research
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    • v.23 no.6
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    • pp.173-183
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    • 2017
  • Conditions related to body composition and aging, such as osteopenic obesity, sarcopenia/ sarcopenic obesity, and the newly termed osteosarcopenic obesity(triad of bone, muscle and adipose tissue impairment), are beginning to gain recognition. Currently, it has begun to attract the attention of scholars from all over the world, however, for this disease, it still needs a more clear understanding and perception. Therefore, this article considered the osteoporosis, muscle depression, and obesity, these diseases as a gate to study the relationship among muscle, bone, and fat. In addition, in the aging process, the formation of IGF-cortisol, testosterone, and estrogen is sensitive. These hormones can not only absorb muscle protein metabolism, but also affect alienation. The decrease in IGF-cortisol in the elderly resulted in increased visceral fat, decreased muscle mass and bone mineral density, and then affected decreased skeletal muscle atrophy and decreased quality. The reduction of skeletal muscle quality and strength and increase body fat affected the adipose tissue to produce inflammatory cytokines, thereby reduced skeletal muscle, promoted cardiovascular disease, metabolic syndrome and insulin resistance in chronic diseases. Almost all chronic inflammatory diseases were associated with bone, muscle and fat. These mechanisms were complex and interrelated. Inflammation reduces bone formation, increases fat and reduces muscle mass. And thus not only had a significant impact on the motor system, but also made the incidence increase of fracture, osteoporosis, fragile syndrome, fall, osteomalacia and other bone disease. This article aimed to start from the interaction between the muscles and bones of the elderly, extended to obesity, muscle deficiency, osteoporosis and other diseases, finally, from a nutritional point of view, to discuss how to treat osteoporosis obesity.

Characteristics of Magnetic Resonance Arthrography Findings in Traumatic Posterosuperior Rotator Cuff Tears

  • Cho, Yung-Min;Kim, Sung-Jae;Oh, Jin-Cheol;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.211-216
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    • 2015
  • Background: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. Methods: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. Results: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. Conclusions: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.

The Analysis on the Reliability and Validity of Korean-Version Balance Assessment Tools (한글화된 균형 평가도구들의 신뢰도와 타당도 분석)

  • Jang, Ho-Young;Lee, Jeong-Hoon;Lee, Suk-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.4
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    • pp.139-146
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    • 2017
  • PURPOSE: The purpose of this study was to systematically analyze the reliability and validity of the Korean-version of the balance assessment tools. METHODS: Two reviewers of this study independently evaluated the titles of articles and abstracts of studies published until December 2016 through electronic databases (RISS, NDSL, KISS, DBpia) using the keywords "Balance or posture or postural control or postural stability", "Test or assessment or measurement or outcome measure or assessment tool or measurement tool", "Korean version", "Reliability" and "Validity". Regarding the questions considered suitable for the purpose of this study, consensus was reached after reading the full text. Selecting journals suitable for the purpose of the study, they were analyzed as data. RESULTS: The reviewers selected nine papers suitable for the purpose of this study, and Korean-version of the balance assessment tools, included the Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC) scale, Postural Assessment Scale for Stroke (PASS), Motor Assessment Scale (MAS), Trunk Impairment Scale (TIS), Falls Efficacy Scale (FES), Tinetti-Balance scale, Fullerton Advanced Balance (FAB) scale, and Function In Sitting Test (FIST). Our study showed that the reliability and validity of the Korean-version of the balance assessment tools were high. CONCLUSION: The Korean-version of the balance assessment tools with high reliability and validity would enable physical therapists to make a more accurate evaluation of balance.

Kinetic Feedback Frequency Effects on Learning Weight Shifting Skills in Nondisabled Subjects (체중이동 과제 학습시 효과적인 운동학적 되먹임 유형과 상대적 빈도)

  • Cha, Seung-Kyu;Park, So-Yeon;Chung, Jin-Ho;Kim, Young-Ho
    • Physical Therapy Korea
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    • v.7 no.1
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    • pp.55-63
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    • 2000
  • Physical therapists have been using balance and weight shifting training to induce improvements in standing and walking. This study compared the effects of kinetic feedback frequency and concurrent kinetic feedback on the performance and learning of a weight shifting skill in young, nondisabled adults. Sixteen young adults without known impairment of the neuromusculoskeletal system volunteered for the study. Subjects in each of three kinetic feedback groups performed a weight shifting task in an attempt to minimize error between their effort and a center of pressure (COP) template for a 12 second period. Feedback was provided: 1) concurrently (concurrent feedback), 2) after each trial (100% feedback), 3) after every other trial (50% feedback). Immediate and delayed (24 hour) retention tests were performed without feedback. During acquisition phase, the concurrent feedback group exhibited less error than either of the post response feedback group. For the immediate retention test, the 50% feedback group exhibited less error than did the 100% feedback and concurrent feedback. During the delayed retention, 50% feedback group displayed less error than did the other groups. But no significant differences were found between groups. These results suggest that practice with concurrent feedback is beneficial for the immediate performance, but not for the learning of this weight shifting skill. Lower frequency of feedback resulted in more permanent changes in the subject's ability to complete the task.

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Examination of trunk muscle co-activation during prolonged sitting in healthy adults and adults with non-specific chronic low back pain based on the O'Sullivan Classification System

  • Alameri, Mansoor;Lohman, Everett III;Daher, Noha;Jaber, Hatem
    • Physical Therapy Rehabilitation Science
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    • v.8 no.4
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    • pp.175-186
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    • 2019
  • Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.

SEVERE-EARLY CHILDHOOD CARIES IN CHILDREN WITH GRADE 1 NEUROLOGICAL DISORDER (뇌병변장애 1급 아동에서 발생한 중증유아기우식증)

  • Lee, Hyo-Seol;Baek, Seung-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.15-20
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    • 2011
  • A person with neurological disorder is defined as a person with limitation of ambulation or basic life activity due to the cerebral palsy or traumatic brain damage, stroke. Recently, the DMFT of the children with neurological disorders is similar or lower than the DMFT of the children with no disability. But, this article is about the severe-early childhood caries in children with grade 1 neurological disorder. It is supposed that the primary motor impairment and secondary physical weakness, frequent hospitalization, sugar- rich food and drugs, lack of oral care, delayed dental visit made high caries susceptibility. In case of treatment of the children with severe neurological disorders, dentists should make a thorough caries preventive plan based on individualized caries risk assessment. Also parents and medical doctors should recognize the importance of oral care and do the early dental visit and home care.