Yang, Min Ah;Won, Kyung-A;Park, Hae Yean;Park, Ji-Hyuk
Therapeutic Science for Rehabilitation
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v.10
no.2
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pp.7-22
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2021
Objective : This study aimed to analyze the effect of transcranial direct current stimulation (tDCS) on cognitive function recovery in patients with stroke. Methods : Data published in Korean and foreign academic journals from 2009 to 2019 were searched using the NDSL, RISS, PubMed, and CINAHL databases. A total of 11 experimental research articles were selected based on the inclusion and exclusion criteria. A qualitative assessment was conducted, and a meta-analysis of nine results from seven of the stuides was performed using the Comprehensive Meta-Analysis 3.0 program. Results : Based on the results of the meta-analysis, the attention and memory effect sizes were 0.725 and 0.796, respectively, which were both considered a "medium effect size". Statistically significant changes were observed in both the areas (p<0.05). Conclusion : The results of this study confirmed that tDCS can be useful in the rehabilitation of patients with stroke with limited cognitive function. In addition, the application methods differed, indicating that a formalized tDCS protocol is required.
Bae, Suyeong;Lee, Mi Jung;Nam, Sanghun;Hong, Ickpyo
Therapeutic Science for Rehabilitation
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v.11
no.4
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pp.23-39
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2022
Objective : To summarize clinical and demographic variables and machine learning uses for predicting functional outcomes of patients with stroke. Methods : We searched PubMed, CINAHL and Web of Science to identify published articles from 2010 to 2021. The search terms were "machine learning OR data mining AND stroke AND function OR prediction OR/AND rehabilitation". Articles exclusively using brain imaging techniques, deep learning method and articles without available full text were excluded in this study. Results : Nine articles were selected for this study. Support vector machines (19.05%) and random forests (19.05%) were two most frequently used machine learning models. Five articles (55.56%) demonstrated that the impact of patient initial and/or discharge assessment scores such as modified ranking scale (mRS) or functional independence measure (FIM) on stroke patients' functional outcomes was higher than their clinical characteristics. Conclusions : This study showed that patient initial and/or discharge assessment scores such as mRS or FIM could influence their functional outcomes more than their clinical characteristics. Evaluating and reviewing initial and or discharge functional outcomes of patients with stroke might be required to develop the optimal therapeutic interventions to enhance functional outcomes of patients with stroke.
Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.
Objective : This study was to apply a cognitive rehabilitation group program based on sensory activity in patients with dementia living in a facility and to check its effectiveness on cognitive function, depression, and quality of life (QOL). Methods : Sensory-based cognitive rehabilitation group programs (20 sessions) were conducted for eight elderly with dementia over the age of 65 living in a nursing facility located in H-gun, Gangwon-do. The participants' cognitive function, depression level, and QOL were evaluated before and after the program. Results : The mean of Mini-Mental State Examination-Dementia Screening increased; however, there was no statistically significant difference. In contrast, the mean post-test score of the Subjective Memory Complaints Questionnaire decreased, and there was a statistically significant difference (p < .05). The mean post-evaluation score of Short Geriatric Depression Scale measured to confirm the decrease in depression compared to the pre-evaluation score, but there was no statistically significant difference. Finally, the mean post-evaluation score of the World Health Organization QOL assessment instrument-Brief confirmed the change in the QOL, and there was a statistically significant difference (p < .001). Conclusion : This study will provide the basis for suggesting the usefulness of developing a sensory activity-based cognitive rehabilitation group program for dementia patients living in facilities.
Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.
Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.
Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p < 0.01), and there was a statistically significant decrease in their depression level (p < 0.05). Also, there was an increase in the rating score of the degree of balance from $46.83{\pm}9.11$ points before the intervention, to $48.08{\pm}7.00$ points after the intervention; however, it was not statistically significant (p > 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist's professional treatment, and experimental group-control research.
Physiotherapy may be defined as the use of physical techniques for the treatment of injuries and movement dysfunction. In the world of human medicine, physiotherapy has been proven as an indispensable aid in the recovery of many musculoskeletal conditions, as evidenced by the extensive physiotherapy departments within most hospitals. Nowadays, this important branch of medicine is also rapidly becoming a recognised tool in the prevention, cure, and rehabilitation of many equine, canine and feline injuries. In 1978, canine physical therapy techniques were described by Ann Downer, a physical therapist on faculty at Ohio State University. Animal physical therapy is a new and rapidly developing field of health care for animals. The benefits of physical therapy have long been recognized in humans. More recently, work in the veterinary field has shown the same benefits of physical therapy to be true for animal patients. Performing orthopaedic or neurological surgery, or fitting a human patient with a cast or splint, and then discharging the patient is an outdated approach. In such cases, physical therapy is clearly warranted. Similarly, recent research has shown that post-surgical rehabilitation and therapy after injuries significantly improves the functional outcomes for animals. The goals of physiotherapy are to relieve pain, restore range of motion/movement, improve function, prevent injuries and expand the physical potential of the patient. Once in the field, physical therapists actively continue their education to keep up to date on the latest treatments and technologies. Via continuing education courses, physiotherapists can learn how to apply their unique and specialized knowledge to other animal species.
Natural products have been used to treat many neurological illnesses such as Alzheimer's disease. In the present study, the effects of the water extract of smoke-dried skipjack tuna (WSST), which is used as a traditional seasoning in Japan, as well as its fractions on acetylcholinesterase (AChE) inhibition in vitro and on memory in scopolamine-induced amnesia mice in vivo were evaluated. Bio-Rad P-2 gel permeation chromatography revealed the presence of 7 peaks and AChE significantly inhibited peak 3 and 5. When in vivo behavioral studies were conducted, a passive avoidance test revealed that treatment with 50 and 100 mg/kg WSST as well as with fraction 3 and 5 improved the loss in memory retention induced by scopolamine. These results suggest that skipjack tuna extract and its fractions improve memory deficits and that these substances are suitable for use in healthy foods designed to improve memory deficits induced by aging and Alzheimer's disease.
Hypoxic ischemia injury is a common cause of functional brain damage, resulting from a decrease in cerebral blood flow and oxygen supply to the brain. The main problems associated with hypoxic ischemia to the brain are memory impairment and dopamine dysfunction. Hypothermia has been suggested to ameliorate the neurological impairment induced by various brain insults. In this study, we investigated the effects of hypothermia on memory function and dopamine synthesis following hypoxic ischemia to the brain in rats. For this purpose, a step-down avoidance task, a radial eight-arm maze task, and immunohistochemistry for tyrosine hydroxylase (TH) and 5-bromo-2'-deoxyuridine (BrdU) were performed. The present results indicated that the hypoxic ischemia-induced disturbance of the animal's performances and spatial working memory was associated with a decrement in TH expression in the substantia nigra and striatum, and an increase in cell proliferation in the hippocampal dentate gyrus. Hypothermia treatment improved the animals' performance and spatial working memory by suppressing the decrement in TH expression in the substantia nigra and striatum and the increase in cell proliferation in the dentate gyrus. We suggest that hypothermia can be an efficient therapeutic modality to facilitate recovery following hypoxic ischemia injury to the brain, presumably by modulating the dopaminergic cell loss.
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