• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.74-74
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• 2003

Purpose: To investigate whether there are significant changes in regional brain metabolism in patients with Parkinson's disease after thalamotomy using proton magnetic resonance spectroscopy (lH MRS). Methods: Fifteen patients with Parkinson's disease of mean age 56.5 years (7 males and 8 females; mean age, 56.5 years) that have treated with levodopa were included. All patients with tremor experienced amelioration of their symptoms on the side contralateral to the thalamotomy. As a single-voxel technique, 1H MR spectra were obtained from the volume of interested regions in thalamus and primary motor cortex. Spectral parameters were: 20 ms TE, 2000 ms TR, 128 averages, 2500 Hz spectral width, and 2048 data points. Results: We found that NAA/Cho ratios showed generally low levels in thalamus in Parkinson's disease patients with clinical improvement following thalamotomy. Conclusions: 1H MRS may be a useful utility for the aid in better understanding the pathophy-siologic process in Parkinson's disease patients on the basis of the variation of NAA/Cho ratio. Acknowledgement: This study was supported by a grant of the Center for Functional and Metabolic Imaging Technology, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV07-0002).

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.653-660
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• 2016

Objectives: The purpose of this study was to investigate the effects of Korean medicine on patients with idiopathic Parkinson’s disease.Methods: The charts of 47 patients diagnosed with idiopathic Parkinson’s disease in the Department of Internal Korean medicine, Stroke and Neurological Disorders Center, Kyung Hee University Hospital, Gangdong between August 2012 and July 2016 were reviewed. The Unified Parkinson’s disease rating scale (UPDRS) was administered before and after treatment with Korean medicine.Results: Thee average UPDRS Ⅱ+Ⅲ, UPDRS Ⅱ, and UPDRS Ⅲ of the 47 patients decreased significantly from 22.26±15.15, 10.19±7.53, and 12.06±8.35, respectively, pretreatment to 16.96±13.63, 7.47±6.44, and 9.49±7.73, respectively, post-treatment. The average postural instability and gait difficulty (PIGD), tremor, and bradykinesia also significantly improved post-treatment.Conclusions: These results provide evidence that Korean medicine can improve the activities of daily living and motor function of patients with idiopathic Parkinson’s disease. In particular, Korean medicine may be effective for the treatment of PIGD, tremor, and bradykinesia.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.96-102
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• 2013

Purpose: The purpose of the study was to investigate the effect of a training program using virtual reality on the balance and lower muscular strength of Parkinson's disease patients. Methods: The study included 22 patients with Parkinson's disease who were arbitrarily classified into 2 groups: 11 patients in the experimental group and 11 patients in the control group. Balance was measured with the Berg balance scale (BBS), the functional reach test (FRT), one-leg stance test (OLST), and the timed up and go test (TUG); whereas, lower muscular strength was measured with the sit-to-stand test (STS). Ping-Pong, bowling, and tennis were selected for virtual reality training for the experimental group, and were performed for 30 minutes 3 times a week for 8 weeks. The control group did not undergo any of the virtual reality training programs. Results: A significant difference was observed in the BBS, FRT, OLST, TUG, and STS results within the experimental group that underwent the virtual reality training program. On the other hand, no significant difference was observed in the BBS, FRT, OLST, TUG, and STS values within the control groups. Conclusion: In conclusion, the virtual reality training program positively affects the balance and lower muscular strength in Parkinson's disease patients. This result indicates the possibility of application of the virtual reality training program to the management for Parkinson's disease patients, and highlights the need for the development and application of more efficient virtual reality training programs in the future.

• Korean Journal of Adult Nursing
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• v.27 no.3
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• pp.283-293
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• 2015

Purpose: Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD). Methods: The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. Results: All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. Conclusion: Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.121-133
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• 2015

Objectives: This study aimed to examine factors that affect chronic illness anticipated stigma among patient living with Parkinson's disease. The attributes of stigma measured in this study were labeling, expectation of prejudice, negative stereotyping, and discrimination. Chronic illness anticipated stigma was correlated with measures of mental and physical health as well as certain health behaviors. Methods: The sample included 250 adults with idiopathic Parkinson's disease that attended D university hospital in B metropolitan city from June to August 2014. Results: The chronic illness anticipated stigma were significantly correlated to depression, anxiety, Schwab & England ADL, Hoehn & Yahr stage, and age. The significant predictors of chronic illness anticipated stigma were anxiety, depression, and age. These factors accounted for 47% of variance in chronic illness anticipated stigma. Conclusions: In order to reduce the chronic illness anticipated stigma, nurse involved in the treatment and care of patients with Parkinson's disease should encourage patients to attend programs of depression and anxiety management in Parkinson's disease and systemic education programs on stigma.

• Journal of muscle and joint health
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• v.26 no.2
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• pp.102-110
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• 2019

Purpose: The purpose of this study was to investigate the factors affecting the quality of life of family caregivers of patients with Parkinson disease in Korea. Methods: A total of 162 family caregivers of patients with Parkinson disease who were visiting the D hospital in B city completed questionnaires, including general and disease-specific characteristics, family burden, patient-caregiver relationship satisfaction, family support and quality of life. Data were analyzed with t-test, ANOVA with $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression analysis using SPSS 23.0. Results: The average score of the quality of life was $85.54{\pm}17.74$ (range: 26~130) among family caregivers of patients with Parkinson disease. Stepwise multiple regression analysis revealed that fifty percent of the quality of life was explained by family support, family burden, and patient-caregiver relationship satisfaction. Conclusion: Family support, family burden, and patient-caregiver relationship satisfaction were identified as factors affecting the quality of life of family caregivers of patients with Parkinson disease. Therefore, it is necessary to develop a program to enhance family support and reduce family burden to improve the quality of life of family members caring for patients with Parkinson disease.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.48-55
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• 2014

Purpose: The purpose of this study was to examine correlations among UPDRS, respiratory function, and senior fitness and to investigate the effects of restrictive respiratory function on these factors in Parkinson's disease patients. Methods: Subjects (n=25, Hoehn & Yahr (H&Y) stage: 2-3, $69.3{\pm}5.9$ yrs) from D Hospital Parkinson's Disease Center at Busan metropolitan area in the Republic of Korea volunteered for this study. They performed the pulmonary function test, UPDRS, and the senior fitness test. SPSS 18.0 was used for analysis of data, and the collected data were analyzed using Pearson's correlation coefficient (n=25). In addition, Independent t-test was used for determination of differences between two groups (between the normal pulmonary function group (n=10) and the restrictive pulmonary function group (n=10)). Results: Forced vital capacity (FVC (L)) showed significant negative correlation (r=-0.44, p<0.05) with H&Y stage in Parkinson's disease patients, and chair stand showed significant negative correlations (r=0.41, 0.43, 0.42, p<0.05) with FVC (L), FVC (%), and FEV1 (L). FVC (%) showed significant positive correlations (r=0.44, r=0.44, p<0.05) with right and left back scratch. In addition, the restrictive respiratory function group showed significantly lower FVC (%) (p<0.01) and was significantly slower (p<0.05) in the 8-foot up-and-go test than the normal respiratory function group. Conclusion: In conclusion, these results suggest that restrictive respiratory function in PD was related to H&Y stage. In addition, agility of PD patients was lower in the restrictive respiratory function group than in the normal function group.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.441-451
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• 2015

Objective : The purpose of the study was to investigate and compare the differences between Parkinson's disease rating, balance, fall and gait scales. Results : Parkinson's disease rating scales include the Hoehn-Yahr Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). The Hoehn-Yahr Scale can measure disease rates easily; however it is not sensitive enough to evaluate the disease's process and management. UPDRS's advantage is in it's higher inter-reliability score; however it is more complicated to use. Parkinson's balance scales are comprised of the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence Scale (ABC). BBS has the advantage in that it is cheaper to measure and simple in use. ABC's advantage is especially in it's ability to measure higher functional levels; however it is more difficult measure responses due to scores appearing in both extremes. The Fall Efficacy Scale (FES) and The Survey of Activities and Fear of Falling in the Elderly (SAFE) are Parkinson's fall scales. FES's leverage over SAFE is that it is simpler to measure; however it does not coincide with responses which proves disadvantageous in measuring balance loss in high-level Parkinson's patients. SAFE's advantage is in it's simpler use and ability to be utilized without encountering the fear of fall; however it's at a disadvantage in regards to its use with multilateral aspects providing insufficient inspection. Lastly, the Dynamic Gait Index (DGI) and the Functional Gait Assessment (FGA) are Parkinson's gait scales. DGI is advantageous in its ability to test gait ability when exposed to a variety of external environments; however it is disadvantageous in that it registers higher scores with activities. FGA's advantage is in it's dynamic balance test; however it at a disadvantage with those unable to walk. Conclusion : A researcher of Parkinson's patients must choose each scale while considering their positive and negative characteristics.

• PNF and Movement
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• v.14 no.3
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• pp.219-229
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• 2016

Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.