• Title/Summary/Keyword: Recovery Assessment Scale

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Risk and protective factors affecting sensory recovery after breast reconstruction

  • Bae, Jae Young;Shin, Ha Young;Song, Seung Yong;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.26-32
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    • 2021
  • Background Although loss of sensation in patients with breast cancer after mastectomy followed by breast reconstruction is an important factor affecting patients' quality of life, the mechanism of sensory recovery is still unclear. Our study aimed to identify variables that affect sensory recovery, especially pain, in reconstructed breasts. Methods All patients with breast cancer who underwent mastectomy followed by immediate breast reconstruction, including nipple reconstruction or areolar tattooing, were included in this study. Sensation was evaluated in the nipple as an endpoint of sensation recovery of the whole breast. Patients rated pain severity using a 3-point verbal rating scale (VRS): grade 0, no pain; grade 1, mild to moderate pain; and grade 2, severe pain. The VRS was assessed by a single experienced plastic surgeon. Results In the univariate analysis, the odds ratio (OR) for sensation recovery was 0.951 for age (P=0.014), 0.803 for body mass index (P=0.001), 0.996 for breast volume before surgery (P=0.001), 0.998 for specimen weight after mastectomy (P=0.040), and 1.066 for the period between mastectomy and sensory assessment (P=0.003). In the multivariate analysis, the variables that showed a significant effect were age (OR, 0.953; P=0.034), the period between mastectomy and sensory assessment (OR, 1.071; P=0.006), and reconstruction using abdominal tissue instead of prosthetic reconstruction (OR, 0.270; P=0.004). Conclusions Based on our results, it can be inferred that aging has a negative impact on the recovery of sensation, breast sensation improves with time after surgery, and the recovery of sensation is better in prosthetic reconstruction.

Targetting Balance and Gait Rehabilitation with Multichannel Transcranial Direct Current Stimulation in a Sub-Acute Stroke Survivor-A Case Report

  • Gakhar, Kazal;Arumugam, Narkeesh;Midha, Divya
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.8-15
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    • 2022
  • Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

Reliability and Validity of Gait Assessment Tools for Elderly Person (노인의 보행에 대한 평가 도구의 신뢰도와 타당도 조사 연구)

  • Kim, Jae-Hyun
    • The Journal of Korean Physical Therapy
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    • v.21 no.1
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    • pp.41-48
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    • 2009
  • Purpose: The examine the Reliability and Validity of the modified Emory Functional Ambulation Profile (mEFAP), Tinetti. Gait (TG), Timed Up & Go Tes t (TUG), Comfortable Gait Speed (CGS), Berg Balance Scale (BBS) in assessing gait function and balance in elderly person. Methods: The 45 community-dwelling subjects were participated in this study. Reliability was determined by intra-class correlation coefficient (ICC$_{3,1}$), Bland and Altman method (Standard Error of Measurement (SEM), Smallest Real Difference (SRD)). Results: Validity was examined by correlation the mEFAP, TG, TUG, CGS, BBS. The intra-rater reliability were High (ICC$_{3,1}$ : mEFAP=0.95, TG=0.96, TUG=0.94, CGS=0.96, BBS=0.92) and Absolute reliability were excellent (SEM: mEFAP=1.90, TG=0.21, TUG=0.28 CGS=0.25, BBS=0.52), (SRD: mEFAP=5.26, TG=0.58, TUG=0.77, CGS=0.69, BBS=1.44). There were significant correlations between assessment tool (r=.0.58$\sim$0.78, p<0.01) indicating good validity. Our results provide strong evidence that the assessment tool has good reliability, validity for assessing elderly person undergoing rehabilitation. Conclusion: The gait assessment tool is a useful scale for measuring walking function and recovery in elderly person.

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The Approach of Robot-assisted Gait Therapy for Locomotor Recovery of Chronic Stroke Patients: a Case Report

  • Shin, Hee-Joon;Lee, Ju-Hyeok;Seo, Dong-Kyu;Kim, Hong-Rae;Moon, Ok-Kon;Park, Si-Eun;Park, Joo-Hyun;Kim, Nyeon-Jun;Min, Kyung-Ok
    • Journal of International Academy of Physical Therapy Research
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    • v.2 no.1
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    • pp.207-213
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    • 2011
  • In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

The Relationship Between Postural Control, ADL Function, Muscle Tone, and Functional Improvement in Chronic Stroke Patients (만성 뇌졸중 환자의 자세 조절과 일상생활동작, 근긴장도, 그리고 기능증진과의 관계)

  • An, Seung-Heon;Seo, Young-Jong;Park, Chang-Sik
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.64-73
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    • 2007
  • The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance ($R^2$=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

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Effects of Forest Healing Program on Depression, Stress and Cortisol Changes of Cancer Patients

  • Lee, Mi-Mi;Park, Bong-Ju
    • Journal of People, Plants, and Environment
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    • v.23 no.2
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    • pp.245-254
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    • 2020
  • Patients diagnosed with cancer face mental problems such as alienation, isolation, anxiety about death and fear, recovering from psychological difficulties. In this study, a forest healing program was provided for cancer patients to recover from psychological stress, depression, social isolation and self-esteem caused by cancer and changes in salivary cortisol through psychological and emotional recovery were measured. From September 19 to November 28, 2017, a forest healing program composed of a total of 10 sessions, two hours per session was provided for 12 cancer patients in the Forest of Taegyo located in Yongin. Psychological tests were performed with Social Adaptation Self-evaluation Scale (SASS), Korean-version Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) and the collected data were analyzed with the SPSS 18.0. The salivary cortisol level was measured along with the psychological tests and were analyzed by a specialized testing agency. The results of the analysis showed that the pre- and post-assessment score of SASS was 29.17 and 25.92, respectively, and that the pre- and post-assessment score of PSS was 30.50 and 23.92, respectively. The pre- and post-assessment score of BDI was 41.00 and 34.83, respectively, which showed significant differences. In addition, the pre- and post-assessment level of saliva cortisol was 3.13 and 1.68, respectively, showing a significant decrease. In short, the forest healing program was found to be effective in reducing physiological changes caused by social isolation and stress due to the emotional and psychological difficulties that the subjects who were diagnosed with cancer and were recovering from it have. In the future, it will be necessary to develop and implement a forest healing program by conducting a forest healing requirement survey on cancer patients.

A Case Study on the Establishment of Assessment Standards for the Site Selection of Waste Treatment Facility (폐기물 처리시설 입지선정 평가기준 설정에 관한 사례연구)

  • Jung, Jong-Gwan;Jang, Won
    • Journal of Environmental Impact Assessment
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    • v.6 no.2
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    • pp.137-152
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    • 1997
  • The siting process of municipal solid waste treatment facility consists of a structured set of policies that guide the implementation of waste management goals. The main problems of siting process are the social and political context or the community opposition. During the past, the traditional siting process has been obsolete in most pans of the country, so public officials and researchers have tried to experiment with new policies and procedures. A number of controversial issues offer insight into the factors that are related to the local residents opposition to new waste treatment facilities. The purpose of this case study focused on the establishment of criteria in the site selection of waste treatment facilities which can carry out resources recovery. incineration and landfill simultaneously. That is to say. the main points are to make concrete the quantification standards of assignment and take an objective allotment scale according to the assessment factors. The summarized results are as follows; 1. To promote the site selection based on the guideline such as rational. objective and due process of law, it is desirable to inform the local residents the methods of assessment in advance. 2. Totally 20 factors for the site selection are divided into 3 categories such as living environment characteristics, technological location characteristics and socio-economic factors. And the supposed magnitude of weight in all items are equally applied. 3. In regard to 20 assessment factors, the allotment of point is distributed by the specific location characteristics. Namely to make the assessment easily, each factors are set the scale from 1 to 5 points en masse along the data which are acquired in the region.

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The Effect of Premorbid Demographic Factors on the Recovery of Neurocognitive Function in Traumatic Brain Injury Patients

  • Jeon, Ik-Chan;Kim, Oh-Lyong;Kim, Min-Su;Kim, Seong-Ho;Chang, Chul-Hoon;Bai, Dai-Seg
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.295-302
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    • 2008
  • Objective: Premorbid demographic backgrounds of injured individuals are likely to reflect more accurately the status of patients with traumatic brian injury (TBI) than clinical factors. However, the concrete study about the relationship between the demographic factors and neurocognitive function in TBI patients has not been reported. The object of this study was to evaluate the effect of premorbid demographic factors on the recovery of neurocognitive function following TBI. Methods: From July 1998 to February 2007, 293 patients (male: 228, female: 65) with a history of head injury, who had recovered from the acute phase, were selected from our hospital to include in this study. We analyzed the effect of premorbid demographic factors including age, sex, educational level and occupation on the recovery of neurocognitive function in each TBI subgroup as defined by Glasgow Coma Scale (GCS) score. Intelligence and memory are components of neurocognitive function, and the Korean Wechsler Intelligence Scale (K-WAIS) and the Korean memory assessment scale (K-MAS) were used in this study. The results were considered significant at p<0.05. Results: The higher level of education was a good prognostic factor for intelligence regardless of GCS score and younger age group showed a better result for memory with an exception of severe TBI group. In the severe TBI group, the meaningful effect of demographic factors was not noted by the cause of influence of severe brain injury. Conclusion: The demographic factors used in this study may be helpful for predicting the precise prognosis and developing an appropriate rehabilitation program for TBI patients.

The Effects of Complex Exercise Program for Upper Extremity Function and Balance Proficiency in Person With Stroke: A Case-Study (복합운동프로그램이 뇌졸중 환자의 상지 기능 및 균형 능력에 미치는 영향 : 사례연구)

  • Choi, Yoo-Im;Lee, Sang-Heon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4374-4381
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    • 2010
  • The purpose of this research was to investigate the effects of complex exercise program for upper extremity function and balance proficiency in person with stroke. The subject in this study was a 68 year old woman with left hemiplegia after stroke, and the study period was from April 16th, 2005 to August 30, 2007. Complex exercise program was compromised of range of motion exercises, strengthening exercises, and repetitive task-oriented activities and so on, and the subject performed exercises three times a week, one hour a day. The upper extremity function of the subject was evaluated by the Brunnstrom Hand Recovery Stage, the Brunnstrom Upper Extremity Recovery Stage, the Fugl-Meyer Assessment of Motor Function, and the Manual Function Test, and the balance proficiency was measured by the Tinetti Gait & Balance Scale, and the One Leg Standing Test. The results indicated that the upper extremity test scores were all improved, the balance proficiency test marks were maintained and improved, therefore complex exercise program was effective method to forward upper extremity and balance proficiency in person with stroke.

Correlation among Motor Function and Gait Velocity, and Explanatory Variable of Gait Velocity in Chronic Stroke Survivors

  • Lee, Dong Geon;Lee, Gyu Chang
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.181-188
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    • 2022
  • Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.