• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.3
• /
• pp.19-27
• /
• 2015

PURPOSE: This study aimed to investigate the effects of pressure sense perception training (PSPT) on various surfaces on the somatosensory system, balance, and walking ability in chronic stroke patients. METHODS: Thirty patients with stroke participated in this study and were randomly assigned to one of three groups; group 1 received the general physical therapy and the PSPT on a stable surface, group 2 received the general physical therapy and the PSPT on an unstable surface, and group 3 received the general physical therapy alone. Participants in group 1 and group 2 underwent 30 min/session, 3 days per week, for 4 weeks. Pressure error (PE) was used to evaluate changes of proprioception. The Balancia, Functional reach test (FRT), and Timed Up and Go (TUG) were used to assess the balance ability, and the 10m Walking Test (10-MWT) was used to assess walking ability. RESULTS: Experimental groups (group 1 and group 2) showed significant differences in PE, FRT, TUG, and 10-MWT compared to the control group (p <0.05). Group 2 (PSPT on an unstable surface) was significantly different in PE, FRT, and 10-MWT from group 1 (p <0.05). No significant differences were observed for other measures. CONCLUSION: Pressure sense perception training on an unstable surface might be a significantly more effective method for improving somatosensory function, balance, and walking ability, than PSPT on a stable surface.

• The Journal of Korean Physical Therapy
• /
• v.23 no.3
• /
• pp.7-12
• /
• 2011

Purpose: The cane is one of the most popular assistive devices for stroke patients. Clinical complaints of sensorimotor functions on the ipsilateral upper limb were appealed in stroke patients who had used a cane for a long period. Therefore, we investigated whether cane usage for a long-term period affected sensoriomotor dysfunctions on the non-affected upper limb, in terms of pain presence, shoulder joint sense, a nine-hole pegboard test, and a tracking task. Methods: We recruited 12 stroke patients, who were divided into the cane-using (CU) group or the non-cane using (NCU) group, according to cane usage experience. We evaluated joint position sense for the integrity of proprioceptive reposition sense in the shoulder joint, used a nine-hole pegboard test for upper limb dexterity evaluation, and a tracking task for visuomotor coordination. Results: Four patients in the CU group had complained of shoulder pain none did in the NCU group. In addition, the CU group showed more reposition errors on the shoulder joint than the NCU group did. In addition, the CU group had more difficulty in proprioceptive sense perception and in performance of the nine-hole pegboard teat and tracking task, compared with the NCU group. Conclusion: Our findings suggest that cane usage for a long period in stroke patients could give rise to trigger joint pain and decrease proprioceptive sense. In addition, complex motor performance in the ipsilateral upper limb could deteriorate. In stroke patients who had used acane for long period, careful observation and proper intervention will be necessary.

• Journal of The Korean Society of Integrative Medicine
• /
• v.8 no.3
• /
• pp.21-31
• /
• 2020

Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

• Safety and Health at Work
• /
• v.3 no.4
• /
• pp.257-267
• /
• 2012

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.

• Journal of the Korea Society for Simulation
• /
• v.22 no.1
• /
• pp.53-61
• /
• 2013

The purpose of this paper is to examine how the humans learn and perceive the weight of objects corresponding to visual information in virtual environment. We conducted two kinds of load-on-tasks with two virtual objects that have same weight but different visual cues; have same visual cues but changed weight by trails. We found that the subject could not generate appropriate force for the smaller and changed weight objects in the beginning of the trials. the discrepancy between the expected weight and actual force consequences sue to visually invoked size and previous experience made subjects perceive the small object were heavier. one the other hand, after the tasks were repeated, the subject responded the weights were the same or very similar when the mismatch between the expected weight and the actual weight became vanished. this means that the sensorimotor feedback influences the anticipatory control scheme and weight perception aggressively in virtual environment.

• Annals of Clinical Neurophysiology
• /
• v.5 no.2
• /
• pp.181-186
• /
• 2003

Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

• Journal of Korean Physical Therapy Science
• /
• v.9 no.4
• /
• pp.119-130
• /
• 2002

Objective: The purpose of this research was to use data for furnish quality physical therapy service. The research subjects were admitted shoulder pain patients treated with physical therapy that was to grasp physical therapy method as distinguishing application time. Subject: Total number of distributed questionnaire was 563 persons that was to utilized physical therapy room of 56th medical institution and distributed it to each physical therapist in charge. Method: The research used questionnaire in order to research itemized treatment application time that is according to physical therapy method to applicated with shoulder pain patient. The research contents is to received shoulder pain diagnosis period, total duration of utilizing physical therapy room, the number of times per week to used physical therapy room, etc. And we had physical therapist recording the time of application physical therapy method come under the items. Result: The average treatment time was 59.2 minutes at all patients. During this time, 39.7 min was modality treatment. Active movement treatment was only 7.1 min. Total treatment time was longest in general hospital at 64.9 min, it was shortest in clinical hospital at 53.3 min. Treatment time was difference as hospital scale(p<0.001). Active movement treatment time was longest in general hospital at 11.5 min. The average treatment time was 4.5 min in clinical hospital. Therefore, it was related to hospital scale(p<0.05). The average of manual therapy time by physical therapist was 7.5 min. General hospital was linger at 8.6 min than clinical hospital at 6.7 min(p<0.05). Patient of 90.2 % were treated to hot pack, ultra-sound treatment was next as 50.1%. Active strengthening exercise was most carrying out of the active treatment as 25.4 %. Active sensorimotor exercise was practiced only 28 persons of 5.0 %. Most joint mobilization (38.4 %) was used of the passive manual therapy items, next to soft tissue mobilization (33.0 %), and next to manual distraction therapy(14.0 %).

• Archives of Plastic Surgery
• /
• v.46 no.4
• /
• pp.365-370
• /
• 2019

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed-correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.

• Investigative Magnetic Resonance Imaging
• /
• v.23 no.1
• /
• pp.55-64
• /
• 2019

Purpose: One of the suggested potential mechanisms of tinnitus is an alteration in perception in the neural auditory pathway. The aim of this study was to investigate the difference in laterality in functional connectivity between tinnitus patients and healthy controls using resting state functional MRI (rs-fMRI). Materials and Methods: Thirty-eight chronic tinnitus subjects and 45 age-matched healthy controls were enrolled in this study. Connectivity was investigated using independent component analysis, and the laterality index map was calculated based on auditory (AN) and dorsal attention (DAN), default mode (DMN), sensorimotor, salience (SalN), and visual networks (VNs). The laterality index (LI) of tinnitus subjects was compared with that of normal controls using region-of-interest (ROI) and voxel-based methods and a two-sample unpaired t-test. Pearson correlation was conducted to assess the associations between the LI in each network and clinical variables. Results: The AN and VN showed significant differences in LI between the two groups in ROI analysis (P < 0.05), and the tinnitus group had clusters with significantly decreased laterality of AN, SalN, and VN in voxel-based comparisons. The AN was positively correlated with tinnitus distress (tinnitus handicap inventory), and the SalN was negatively correlated with symptom duration (P < 0.05). Conclusion: The results of this study suggest that various functional networks related to psychological distress can be modified by tinnitus, and that this interrelation can present differently on the right and left sides, according to the dominance of the network.

• The Korean Journal of Pain
• /
• v.32 no.1
• /
• pp.30-38
• /
• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.