• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.59-78
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• 2018

Objective : The purpose of this study was to investigate the effect of robot-assisted therapy on upper extremity function. Methods : This study used a single-subject experimental A-B-A' design. Three Parkinson's disease patients took part. Each subject received a robot-assisted therapy intervention (45 min/session, 5 sessions/week for 4 weeks). Upper extremity movement was evaluated with the Reo Assessment tool in Reogo. The Jebsen-Taylor hand motor function test, Fugle-Mayer Assessment score, Box and Block Test, and Nine-hole pegboard test were assessed pre- and post-intervention. Results : After intervention, all subjects underwent 3D motion analysis of reaching function. There was overall improvement in resistance, smoothness, direction accuracy, path efficiency, initiation time, and time to moving target with robot-assisted therapy. Robot-assisted therapy may have a positive effect on upper extremity movement in Parkinson's disease. Conclusion : Robot-assisted therapy is considered an alternative in clinical occupational therapy to improve upper extremity function in Parkinson's disease.

• Journal of the Korean Applied Science and Technology
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• v.37 no.4
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• pp.744-754
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• 2020

We investigated the whether endurance exercise and MitoQ intake mediated neuroprotection are associated with mitochondrial function in 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine(MPTP) -induced mice model of Parkinson's disease. C57BL/6 male mice were randomly assigned to five groups: Normal Conrol(NC, n=10), MPTP Control(MC, n=10), MPTP +MitoQ(MQ, n=10), MPTP + Exercise(ME, n=10) and MPTP + MitoQ + Exercise(MQE, n=10). Exercise intervention groups performed the treadmill exercise for 5days/week for 5 weeks with gradual increase of intensity. MitoQ intake groups consumed the MitoQ at a concentration of 250μmol by dissolving with water during experiment period. Our data demonstrated that ME and MQE group restored MPTP-induced motor dysfunction. In addition, treatment groups(MQ, ME and MQE) increased tyrosine hydroxylase levels, and suppressed the accumulation of α-synuclein levels. Futhermore, treatment groups modulated the mitochondrial function such as upregulated mitochondrial biogenesis, increased antioxidant enzyme, enhanced a anti-apoptotic protein(e.g., BCL2), and reduced a pro-apoptotic protein(e.g., BAX). Taken together, these results suggested that endurance exercise and MitoQ intake-mediated increase in mitochondrial function contributes to improvement of aggravated dopaminergic neuronal, resulting in attenuation of motor function of Parkinson's disease.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Journal of Sasang Constitutional Medicine
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• v.30 no.3
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• pp.62-73
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• 2018

Objectives The aim of this study was to make an analysis of clinical characteristics and status of Sasang constitutional medicine of patients with Parkinson's Disease who visited a Korean medicine hospital. Methods We studied 129 patients with Parkinson's Disease who visited a Korean medicine hospital from September 1, 2012 to June 30, 2018. We retrospectively collected medical history and characteristics of subjects using data of EMR (electronic medical record). Results The proportion of female was higher than male. The average age was 60s. The patients visited a hospital more than one year after the occurrence of symptoms. And they were mostly under western medicine treatment. Among the 129 patients, 56 persons(43.4%) were Taeeumin, 45 persons(34.9%) Soyangin and 28 persons Soeumin(21.7%). In the distribution of prescription according Sasang Constitutional Medicine symptomatology, there was no significant difference in the proportion of exterior cold disease(48.9%) and interior heat disease(51.1%) in Soyangin. Meanwhile the proportion of heat disease's prescription was higher than cold disease in Taeeumin(73.2%) and Soeumin(84.1%). The majority of disease were Dry-febrile symptom(73.2%) of heat disease in Taeeumin, Yang depletion-syndrome(64.3%) of heat disease in Soeumin, and Gyolhyung-symptom(33.3%) of exterior cold disease and Wasting thirst-syndrome(22.2%) of interior heat disease in Soyangin, Conclusions By Developing of guideline for treatment of Parkinson's Disease through analyzing on clinical characteristics and distribution of Sasang Constitutional Medicine symptomatology could contribute to the improvement of the cure rate and accuracy of constitution pattern.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.833-845
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• 2021

Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.

• 재활복지
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• v.18 no.4
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• pp.237-255
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• 2014

Idiopathic Parkinson disease(IPD) is an neurodegenerative disease caused by the loss of dopamine cells in the substantia nigra, a region of midbrain. Its major symptoms are muscular rigidity, bradykinesia, resting tremor, and postural instability. An estimated 70~90% of patients with IPD also have hypokinetic dysarthria. Subthalamic nucleus deep brain stimulation (STN-DBS) has been reported to be successful in relieving the core motor symptoms of IPD in the advanced stages of the disease. However, data on the effects of STN-DBS on speech performance are inconsistent. A medline literature search was done to retrieve articles published from 1987 to 2012. The results were narrowed down to focus on speech performance under STN-DBS based perceptual, acoustic, and/or aerodynamic analyses. Among the 32 publications which dealt with speech performance after STN-DBS indicated improvement(42%), deterioration(29%), mixed results(26%), or no change(3%). The most favorite method was found to be based upon acoustic analysis by using a vowel prolongation and Unified Parkinson's Disease Rating Scale(UPDRS). For the purpose of verifying the effect of the STN-DBS, speech evaluation should be undertaken on all speech components such as articulation, resonance, phonation, respiration, and prosody by using a contextual speech task.

• Journal of Naturopathy
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• v.9 no.2
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• pp.37-45
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• 2020

Purpose: Symptoms of idiopathic Parkinson's disease (PD) include tremors, bradykinesia, and rigidity. The purpose was to explore the effects of breathing, meditation and qigong on the improving of insight, behavior, mood discomfort, depression, anxiety, and olfactory dysfunction, which are PD non-motor symptoms. Methods: Three stages of An's-4444 healing breathing, An's Gwanjeong healing meditation, and healing qigong performed 12 times for 80 minutes at a time in subjects with PD (11 patients), and pre- and post-measurements compared and evaluated. Results: The Integrated Parkinson's Rating Scale (UPDRSI) for mood discomfort after 12 healings was 69%. The Depression Scale (61%) for HAMD, and 64% for Anxiety (HAMA)), and the smell identification test (TSI) for a trial for olfactory dysfunction, improved to 82%, respectively. However, the numerical values after one month after 12 healing were almost same in all four scales. This means that the healing effect maintained until after one month. Conclusions: An's healing breathing, meditation and qigong therapy significantly improved insight, behavior, and mood discomfort, and non-motor symptoms such as depression, anxiety, and olfactory dysfunction. These results suggest that An's breathing, meditation and qigong therapy are valuable as a primary therapy to improve and heal non-motor symptoms in Parkinson's disease patients. Further research in biomedical science is needed.

• Journal of the Korean Society of Radiology
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• v.16 no.6
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• pp.787-797
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• 2022

The purpose of this study was to confirm the reduction of pain and symptom relief of Parkinson's disease by vertically stimulating the spine through the application of a mechanical bed capable of thermal and massage stimulation. For this purpose, after confirming the segmental motion of the spine due to the use of a medical combination stimulation bed for Parkinson's disease patients, VAS, ODI, gait ability, and spiral drawing tests were performed, and the relationship between the variables was identified. In the 10-day visual analog scale and evaluation of low back pain dysfunction, the average trend of decreasing after bed use was confirmed. For walking ability, a decrease in the moving time and an increase in the moving distance were observed. In the spiral drawing test, the mean test time after using bed was significantly lower than before. As a result, it suggested the possibility of using it as an auxiliary method for recovery and pain relief of Parkinson's disease patients due to spinal segmental movement with mechanical heating and massage. However, this study is a preliminary study, and there is a small number of subjects, so additional research is needed that considers the number and condition of future subjects in detail.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.774-790
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• 2023

Objective: This study examined the effectiveness of Korean medicine treatments in two patients with Parkinson's disease complaining of discomfort stemming from postural instability and gait disturbance (PIGD). Methods: Two patients were treated for 3 months. They visited the clinic once a week for the first month and thereafter once every 2 weeks. The Unified Parkinson's Disease Rating Scale (UPDRS) and a three-dimensional gait analysis were performed at the first visit and at 1, 2, and 3 months thereafter. Results: In Case 1, gait speed, stride length, and swing phase increased. Double support decreased until 2 months after treatment but increased slightly after 3 months. Among the kinematic parameters, tilt and rotation increased. The total UPDRS Part III score decreased from 51 points to 29 points after 3 months of treatment. In Case 2, gait speed, stride length, and swing phase increased, but double support decreased. Among the kinematic parameters, tilt, rotation, and obliquity decreased. The total UPDRS Part III score decreased from 11 points to 7 points after 3 months of treatment. Conclusions: This study suggests that Korean medicine can be an effective treatment for patients with Parkinson's disease who experience discomfort due to PIGD.

• Korean Journal of Radiology
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• v.24 no.7
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• pp.690-697
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• 2023

Objective: ¹⁸F-FP-CIT positron emission tomography (PET) is known for its high sensitivity and specificity for evaluating striatal dopamine transporter (DAT) binding. Recently, for the early diagnose of Parkinson's disease, many researchers focused on the diagnosis of synucleinopathy in organs involved in non-motor symptoms of Parkinson's disease. We investigated the feasibility of salivary gland uptake on ¹⁸F-FP-CIT PET as a new biomarker in patients with parkinsonism. Materials and Methods: A total of 219 participants with confirmed or presumed parkinsonism, including 54 clinically diagnosed idiopathic Parkinson's disease (IPD), 59 suspected and yet undiagnosed, and 106 with secondary parkinsonism, were enrolled. The standardized uptake value ratio (SUVR) of the salivary glands was measured on both early and delayed ¹⁸F-FP-CIT PET scans using the cerebellum as the reference region. Additionally, the delayed-to-early ratio (DE_ratio) of salivary gland was obtained. The results were compared between patients with different PET patterns. Results: The SUVR in early ¹⁸F-FP-CIT PET scan was significantly higher in patients with IPD pattern compared that in the non-dopaminergic degradation group (0.5 ± 0.19 vs. 0.6 ± 0.21, P < 0.001). Compared with the non-dopaminergic degradation group, the DE_ratio was significantly lower in patients with IPD (5.05 ± 1.7 vs. 4.0 ± 1.31, P < 0.001) or atypical parkinsonism patterns (5.05 ± 1.7 vs. 3.76 ± 0.96, P < 0.05). The DE_ratio was moderately and positively correlated with striatal DAT availability in both the whole striatum (r = 0.37, P < 0.001) and posterior putamen (r = 0.36, P < 0.001). Conclusion: Parkinsonism patients with an IPD pattern exhibited a significant increase in uptake on early ¹⁸F-FP-CIT PET and a decrease in the DE_ratio in the salivary gland. Our findings suggest that salivary gland uptake of dual-phase ¹⁸F-FP-CIT PET can provide diagnostic information on DAT availability in patients with Parkinson's disease.