• PNF and Movement
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• 제17권2호
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• pp.189-197
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• 2019

Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson's disease (PD). Methods: Twenty-four participants with Stage 1 to 3 ($2.13{\pm}0.64$) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson's disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081-6.519), BBS (p = 0.042; 95% CI, 1.375-4.541), TUG (p = 0.034; 95% CI, -3.315--0.143), 10MWT (p = 0.011; 95% CI, -2.032--0.289), and 6MWT (p = 0.002; 95% CI, 24.39-91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

• 대한지역사회작업치료학회지
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• 제1권2호
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• pp.71-79
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• 2011

목적 : 감각통합에 기반을 둔 작업치료의 효과를 연구한 연구들의 체계적인 고찰을 통하여, 임상에서 치료계획 시 도움이 될 수 있는 정보를 제공하고, 앞으로 감각통합에 기반을 둔 작업치료의 연구 방향을 제시하고자 한다. 연구방법 : MEDLINE/PubMed와 AOTAPress에서 제공되는 연구논문들 중에서 1993년부터 2011년까지 발표된 아동과 청소년을 대상으로 감각통합에 기반을 둔 작업치료 효과를 살펴 본 10개의 논문을 분석하였다. 결과 : 연구대상은 감각조절장애와 자폐스펙트럼의 진단군이었으며, 중재 효과를 증명하기 위에 선택한 다른 중재유형은 여전히 과거의 체계적 고찰연구와 유사하였다. 중재기간은 대체로 감각통합에 기반을 둔 작업치료중재를 10주 이상, 20회기 이상, 적어도 주당 2~3회 정도 실시하였다. 감각통합에 기반을 둔 작업치료중재가 대체로 효과적인 편으로 특히 운동수행영역과 행동개선 영역, 학습과 관련한 교육영역이 효과적인 것으로 나타났고, 최근에는 감각처리 영역이나 작업수행영역에 감각통합중재의 효과가 있음을 GAS를 사용하여 규명하고자 하는 연구노력이 있었다. 결론 : 본 연구를 통하여 임상가들에게 감각통합에 기반을 둔 작업치료중재 효과를 증명할 수 있는 연구디자인의 최소 틀을 알고 연구계획을 실시할 수 있는 근거를 갖게 될 것이다.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.345-350
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• 2018

Background The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site. Methods We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively. Results A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss. Conclusions For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.303-309
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• 2021

Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

• The Korean Journal of Pain
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• 제36권4호
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• pp.408-424
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• 2023

Central post-stroke pain (CPSP) is an incapacitating disorder that impacts a substantial proportion of stroke survivors and can diminish their quality of life. Conventional therapies for CPSP, including tricyclic antidepressants, anticonvulsants, and opioids, are frequently ineffective, necessitating the investigation of alternative therapeutic strategies. Repetitive transcranial magnetic stimulation (rTMS) is now recognized as a promising noninvasive pain management method for CPSP. rTMS modulates neural activity through the administration of magnetic pulses to specific cortical regions. Trials analyzing the effects of rTMS on CPSP have generated various outcomes, but the evidence suggests possible analgesic benefits. In CPSP and other neuropathic pain conditions, high-frequency rTMS targeting the primary motor cortex (M1) with figure-eight coils has demonstrated significant pain alleviation. Due to its associaton with analgesic benefits, M1 is the most frequently targeted area. The duration and frequency of rTMS sessions, as well as the stimulation intensity, have been studied in an effort to optimize treatment outcomes. The short-term pain relief effects of rTMS have been observed, but the long-term effects (> 3 months) require further investigation. Aspects such as stimulation frequency, location, and treatment period can influence the efficacy of rTMS and ought to be considered while planning the procedure. Standardized guidelines for using rTMS in CPSP would optimize therapy protocols and improve patient outcomes. This review article provides an up-to-date overview of the incidence, clinical characteristics, outcome of rTMS in CPSP patients, and future perspective in the field.

• Journal of Nutrition and Health
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• 제56권6호
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• pp.655-666
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• 2023

Purpose: Gestational nutrition has an impact on the growth and development of the fetus. Choline (C) and docosahexaenoic acid (DHA) are important and essential nutrients for humans that play a role in the structural integrity of the membranes as well as signalling. C is used in the synthesis of phosphatidylcholine, and cell membranes are highly enriched with DHA. The dietary intake of C or DHA during pregnancy directly influences fetal development. Currently, there is no evidence to prove the effectiveness of the combined dietary supplementation of both C and DHA during gestation on developmental outcomes in the offspring. Methods: The current study was designed to assess the physical, sensory, and motor development of rat pups born to mothers supplemented with C and/or DHA during the entire gestational period. Pregnant rat dams were divided into the following five groups: Normal control (NC), Saline control (SC), Choline (C), DHA, and Choline+DHA (C+DHA). The NC dams did not receive any supplementation during the entire gestation period. The experimental groups were supplemented with Saline, C, and/or DHA, respectively, during the entire gestation (E0 to delivery). Results: Rat pups (n = 6/group) exposed to combined C and DHA showed significant improvement in birth weight, fur development, eye-opening as well as weight gain on the 7th, 14th, and 21st postnatal day and pinnae detachment (assessed from birth to postnatal day 21) when compared with age-matched NC, SC or C or DHA pups. Further, significant reflex responses were observed in visual placing and bar holding of pups exposed to both C and DHA, whereas the differences in surface righting, negative geotaxis, and grasping reflexes were not significant between the groups. Conclusion: Gestational supplementation of both C and DHA rather than either of them alone is better in enhancing developmental outcomes in rat pups.

• 대한감각통합치료학회지
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• 제1권1호
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• pp.25-37
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• 2003

Objective : To explore the effectiveness of sensory integration program of home-based outcomes in child with sensory modulation disorder. Methods : This study used the simple case study. The subjects were three children diagnosed as developmentally delayed who 14 month and 26 month males and a 15 month female. After initial evaluation, parents were educated on sensory diet and Wilbarger protocol method for 30 minutes twice for home-based treatment and asked to make out daily treatment planning. To measure improvement of children, we used for the Denver Developmental Screening Test II(DDST II), Wee Functional Independence Measure(WeeFIM), hand function, functional ability, oral motor function, Sensory Profile(Dunn, 1999). Results : After the home-based program, the scored of the Denver Developmental Screening Test II(DDST II), Wee Functional Independence Measure(WeeFIM), hand function, functional ability, oral motor function, Sensory Profile(Dunn, 1999) were higher rather than initial evaluation after the home-based program. Conclusion : The home-based program is effective for children with sensory modulation disorder but parents had to be educated by therapist specific evaluation and treatment in sensory integration.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.463-471
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• 2001

Objective : The authors reviewed 51 patients of spinal cord tumor located at the craniovertebral junction and high cervical area to determine which factors influenced resectability, complications, and postoperative outcomes. Methods : Radiological examinations, clinical data, and operation notes were evaluated, and additional follow-up information was obtained from outpatient examinations. The mean follow-up period was 3.5 years Results : The most common neurological findings were motor deficit(72.5%) and sensory change(47.1%). There was no clinical finding that is considered as pathognomic. Meningioma(18 cases, 35.3%) was the most common tumor in this region. Total removal was achieved in 45 patients. There was no surgical mortality. Immediate postoperative motor weakness were encounted in 11 cases(21.6%) which improved in long term followup except two patients. Conclusions : The location and relationship of the tumor to surrounding struncture determine its resectability. Postoperative results were related to the preoperative neurological status and pathological findings.

• 동의생리병리학회지
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• 제30권5호
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• pp.355-359
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• 2016

This study is to investigate the effect of the level of Korean medical intervention (KMI) on the recovery of activity of daily living (ADL) and the motor function in patients with stroke. A total of 43 stroke patients were recruited. The participants were divided into two groups, the basic Korean medical intervention (BKM) and the comprehensive Korean medical intervention (CKM) group. The patients in BKM group were treated with the basic acupuncture and the consultation of Korean medicine doctors. The treatments of CKM group patients included the comprehensive herbal medical therapies in addition to the treatments of BKM group. The western rehabilitation therapies were performed in all participants with KMI. The functional outcomes using modified Barthel Index of Korean version (K-MBI) and Fugl-Meyer assessment (FMA) were analyzed before and after the treatment between two groups. Significant differences between the BKM and the CKM group were demonstrated in both K-MBI and FMA (p<0.05). There were significant relationships between the level of the KMI and K-MBI/FMA (p<0.05). In conclusion, the comprehensive KMI was more effective to improve the ADL and motor function in patients with the stroke east-west integrative medical care.