Introduction : This study reviews the main areas of cognitive rehabilitation including executive dysfunction, memory dysfunction, perceptual dysfunction, attention deficit, and dysfunctions in activities of daily living in order to apply to the adaptation of occupational therapy. Body : Cognition programs based on the virtual reality are being used not only to evaluate but to train the overall components of human's cognition. Because the cognitive program is concentrating on the real environment, it is known to bring a remarkable transitional effect to the actual environment, compared to the basic computer-based evaluation and training. Applying virtual reality to the rehabilitation program can develop and advance the high technology and can result in a major effect on the innovative treatment technology. Conclusions : In this process, virtual reality is expected to be researched more in the near future. Particularly in the cognitive realm, it is imperative for researchers to pay attention to the improved transitional effect of the virtual reality toward the actual environment, rather than the already existing method of evaluations. Therefore, application of the virtual reality for the cognitive training should be researched for various types of subjects in the diverse aspects of congnitive function. Application of the virtual reality in the cognitive function has its unlimited potential, thus the rehabilitation program integrated with not only evaluation but training and education is expected extensively in the future.
Objectives: This study aimed to evaluate the effect of purgation therapy with Natrii sulfas, an oriental medical therapy for stroke patients with constipation, on physiological indexes and the brain edema of rats. Methods: Brain edema was induced by the middle cerebral artery occlusion (MCAO); Natrii sulfas was administered once after the MCAO. At 3, 6, 15, 24, 48 hours after reperfusion, physiological indexes such as fecal weight, urine volume and water content in stool were assessed, and at 48 hours after reperfusion the edema index was measured. Results: 1. Purgation therapy with Natrii sulfas significantly improved the reduction of fecal weight caused by ischemic insult (P<0.05). 2. Purgation therapy with Natrii sulfas significantly improved the reduction of urine volume caused by ischemic insult (P<0.05). 3. Purgation therapy with Natrii sulfas significantly improved the reduction of water content in stool caused by ischemic insult (P<0.05). 4. Purgation therapy with Natrii sulfas did not improve the neurological symptom caused by ischemic insult. 5. Purgation therapy with Natrii sulfas did not attenuate the total infarct volume caused by ischemic insult. 6. Purgation therapy with Natrii sulfas attenuated the brain edema caused by ischemic insult (P<0.05). Conclusions: These results suggest that purgation therapy with Natrii sulfas improves some important symptoms and has a protective effect on the brain edema caused by ischemic insult.
Objective : The purpose of this study was to investigate the effectiveness and basis of rehabilitation intervention in patients with spinal cord injury by systematic review and meta-analysis of randomized controlled studies. Methods : Two researchers independently searched and selected a study published in an academic journal using a search term in an international thesis database. A total of 21 studies met the selection criteria, and qualitative evaluation of the study was conducted using the PEDro Scale. Meta-analysis was performed using Comprehensive Meta-Analysis 3.0 program. Results : A total of 713 subjects were included. The results of the meta-analysis showed a score of 0.406 (95.0% confidence interval: 0.221 ~ 0.591) for intervention using physical activity and 0.505 (95.0% confidence interval: 0.449 ~ 1.528) for electronic stimulation therapy, which showed medium effect; educational intervention had a 0.248 (95.0% confidence interval: 0.033 ~ 0.464), and mixed intervention 0.280 (95.0% confidence interval: 0.122 ~ 0.438). It was shown that the effect of small (small). There was a significant heterogeneity in the statistical heterogeneity test, and thus the random effects model was selected and analyzed. Conclusion : The results showed that rehabilitation interventions were effective for patients with spinal cord injury. During the rehabilitation of spinal cord injury patients, clinicians are expected to contribute to the development of programs to improve their lifestyles.
Lead (Pb) exposure during development can produce neurological deficits. In this study, the effect of Pb exposure during neonatal development via lactation on anxiety of brain function was investigated. Long-Evans strain rats were raised through two generations. At the birth of the second generation, the dams were subdivided into two groups and supplied drinking water containing either $0.2\%$ Pb (Pb-treated group) or sodium (Na, Control group) acetate until weaning. Rats were sacrificed at 3 (weaning) and 11 weeks (maturity) for brain Pb and fatty acid analysis. Motor activity and elevated plus maze tests were initiated at 9 weeks. The brains in the Pb-treated group at weaning and maturity contained 1486$\pm$98 and $270{\pm}46$ ng Pb/g, respectively The control group showed the background level of Pb ($3.7{\pm}1.0_{ng}$ Pb/g) in both ages. The alterations in brain fatty acid composition induced by Pb exposure were more evident in 3 wks old than 11 wks old. For example, in 3 wks old, the percentages of $18:2_{n-6}$, $20:2_{n-6}$ and $18:2_{n-6}$ were decreased in the Pb-treated group with an increase in $20:4_{n-6}$ In motor activity test, there was a tendency of hyperactivity in the Pb-treated group compared with the control group but the difference was not significant. In elevated plus maze test, the Pb-treated group showed fewer numbers of visits to the open arms (P < 0.05), indicating that Pb exposure may lead to anxiogenic effect.
Objective : The purpose of this study was to analyze the effects of simultaneous dual-task training to assess executive function in older adults. Methods : We searched the PubMed, EMBASE, Cochrane, Web of Science, and RISS databases of publicated studies in the past decade. Seven studies were selected based on the inclusion and exclusion criteria. Qualitative assessment and meta-analysis were performed for the seven studies. Results : A randomized controlled trial design was used in the selected studies, and PEDro Scores above seven were obtained. The Trial Making Test (TMT) evaluated the effects of dual-task training on executive function in four studies. The Color Trail Test (CTT) was used in two studies, and Stroop test was used in three studies. The effect size for total executive function was 0.38, which was small. The effect sizes for TMT and CTT were 0.37. Stroop Test was 0.34, demonstrating that their effect sizes were also small. Only significant effects in total executive function, TMT, and CTT showed significant effects (all p<0.05). Conclusion : This study confirmed that dual-task training was effective in improving executive function in older adults. To improve the effectiveness of dual-task training, the difficulty of the dual-task training should be considered. It is also necessary to implement assessments that can evaluate performance under dual-task conditions as well as conventional test tools for executive function. In the future, dual-task training could be used as an appropriate intervention for executive function in older adults to delay the onset of dementia.
Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.
Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.
Bak, Koang Hum;Ferrara, Lisa;Kim, Kwang Jin;Kim, Jae Min;Kim, Choong Hyun;Benzel, Edward C.
Journal of Korean Neurosurgical Society
/
v.30
no.2
/
pp.131-136
/
2001
Object : The clinical uses of screws are increasing with broader applications in spinal disorders. When screws are inserted repeatedly to achieve optimal position, tips of screw pitch may become damaged during insertion even though there are significant differences in the moduli of elasticity between bone and titanium. The effect of repeated screw insertion on pullout resistance was investigated. Methods : Three different titanium screws(cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw) were inserted into the synthetic cancellous material and then extracted axially at a rate of 2.4mm/min using Instron(Model TT-D, Canton, MA). Each set of screws was inserted and pulled out three times. There were six screws in each group. The insertional torque was measured with a torque wrench during insertion. Pullout strength was recorded with a digital oscilloscope. Results : The mean pullout force measurements for the cortical lateral mass screws($185.66N{\pm}42.60$, $167.10N{\pm}27.01$ and $162.52 N{\pm}23.83$ for first, second and third pullout respectively : p=0.03) and the cervical vertebral body screws($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024) showed consecutive decrease in pullout resistance after each pullout, whereas the cancellous lateral mass screws did not($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and 199.49N(36.63 : p=0.24). The SEM after insertion and pullout three times showed a blunting in the tip of the screw pitch and a smearing of the screw surface. Conclusions : Repetitive screw insertion and pullout resulted in the decrease of pullout resistance in certain screws possibly caused by blunting the screw tip. This means screw tips suffer deformations during either repeated insertion or pullout. Thus, the screws that have been inserted should not be used for the final construct.
Cerebral palsy is a collection of motor disorders resulting from damage to the central nervous system that arise in multiple handicaps including cognitive disorders, speech disorders, epilepsy, perception disorders, and emotion disorders. Today spastic cerebral palsy has become more prevalent because intensive care for newborns has resulted in higher survival rates for very small premature babies. Since the children grow the fastest in order for a development during one year after birth, the therapeutic intervention is provided as early as possible to the children with cerebral palsy. After seven year old, there is no effect of intervention. So, the necessity of early intervention to spastic cerebral palsied infants is increasing. The purpose of this study is to develop the music therapy activity program using the techniques of neurological music therapy(NMT), the therapeutic application of music to dysfunctions due to neurologic disease of the human nervous system, for rudimentary movement phase of spastic cerebral palsied infant. This music therapy activity program was developed on the basis of the major developmental tasks of the rudimentary movement phase, the period that children can acquire the most basic movement function at the 0 to 2. Then the developmental characteristics of spastic cerebral palsy were applied to this music therapy activity program. This music therapy activity program was classified to three domains, those are stability, locomotion, and manipulation. This study has been consisted of three steps, those are the development of the activities, the evaluation of the activities by th panels, and the adjustment and complement of the activities. Reviewing literatures and interviews were done for the development of the activities, and the evaluation the activities was done by seven music therapists. In the evaluation steps, the questionnaire was used for estimating the content validity and application efficiency. The adjustment and complement of the activities were evaluated by the panels who were participating in the music therapy for cerebral palsied children in the clinical setting, and the results of the adjustment and complement were confirmed by the panels. The evaluation was presented in a mean value with the comment of the panels. In conclusion, the music therapy activity program for the spastic cerebral palsied infants using the techniques of NMT was developed on the basis of the major developmental tasks of the rudimentary movement phase. The program is comprised of 38 activities, those are 14 activities for developing the stability, 10 activities for developing the locomotion, and 14 activities for developing the manipulation. The programed activities would bring out the answers in the affirmative for the conformance with infants' development phase, the harmony between the objective and the activity, the conformance with the cerebral palsied infants, the properness of the music and the instruments, and the utility in the clinic field. This results mean that this developed music activity program is appropriate to help spastic cerebral palsied infants progress their movement development by stages.
The Journal of Korean society of community based occupational therapy
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v.6
no.1
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pp.41-48
/
2016
Objective : We tried to know the improvement and neurological effect of diabetes when the complex exercise training was applied on diabetes that delayed the recovery of the ischemic brain injury. Methods : We performed this study in a animal lab which located in Gyengsangbukdo. We used 10 diabetes rats with ischemic brain injury, which is induced by STZ. We applied the complex exercise training on the rats for 4 weeks. We executed the maze test to confirm the recovery of the brain function and checked the blood sugar to know the improvement. Results : As a result of applying the complex exercise on diabetes rats with ischemic brain injury, there was a significant reduce of error and escape time in 3 weeks and 1 weeks, respectively. There was no difference of the blood sugar in control but there was a significant improvement in experiment group after applying the exercise training in 4 weeks. Conclusion : The senile disease like stroke and diabetes was increased currently. It is important for rehabilitation to improve the quality of life during the remainder of their life. In the study, we've known the improvement of diabetes and the recovery of the brain function when the complex exercise training was applied the rats with both diabetes and the ischemic brain injury.
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