• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.360-368
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• 2009

Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.43-52
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• 2021

Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords "Chuna OR Tuina" AND "Obesity." We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

• Journal of radiological science and technology
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• v.44 no.6
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• pp.663-669
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• 2021

The purpose of this study was to evaluate the usefulness of the rice bolus for upper-lower extremity radiation therapy by Tomotherapy. The computed tomography images were obtained for air, water, and rice bolus. The average and standard deviation of the Hounsfield unit (HU) were measured for image evaluation. The conformity index (CI) and homogeneity index (HI) were calculated for dose distribution of the planning target volume (PTV) which was treated by direct mode with gantry angle (90 and 270 angle). The point dose of a total of ten axial planes was measured to confirm the different regions. The mean of HU was -999.72 ± 0.72 at the air. The water and rice bolus were -0.13 ± 1.65 and -170 ± 27.2, respectively. The CI (HI) of PTV was 0.96 (1.36) at the air. 0.95 (1.04) at the water bolus, and 0.95 (1.04) at the rice bolus. The maximum dose for air was 136 cGy which is about 32% higher than 103 cGy for water and 104 cGy for rice bolus. There was a statistical difference for point dose between air and water including rice bolus (p=0.04), however, no statistical difference between water and rice bolus (p=0.579).The rice bolus phantom for extremities radiation therapy could be not only the optimized dose distribution but also the convenience and equipment safety at Tomotherapy. However, additional research will be necessary to more accurately verify the clinical usefulness of rice bolus phantom due to not enough examination.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.23-33
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• 2021

Purpose : This study aimed to investigate the effects of dual-task training according to the variability of the walking environment on balance, gait, and function in patients with stroke. Methods : Twenty-five patients with stroke were randomly assigned to experimental group I (n=12) and experimental group II (n=13). Experimental group I and II performed obstacle and non-obstacle walking training, respectively, along with cognitive tasks for 21 minutes per session, 3 times a week for 6 weeks. Both groups received additional general physical therapy for 30 minutes per session. The functional reach test (FRT), gait analyzer (G-Walk), and functional independence measure (FIM) were used to evaluate balance, gait and function of pre- and post-interventions, respectively, while gait cadence, gait velocity, and stride length were evaluated using a gait analyzer. Results : In the within-group comparison of FRT, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait cadence, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of gait velocity, all the two groups showed significant post-intervention improvements (p<.05). In within-group comparison of stride length, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). In within-group comparison of FIM scores, experimental group I showed significant post-intervention improvements (p<.05), while experimental group II did not show significant post-intervention improvements (p>.05). There was a significant difference in the change of FIM scores pre- and post-intervention (p<.05) in the between-group comparison. Conclusion : The results of this study show that dual-task training with cognitive tasks and walking training can improve the balance, gait and function of patients with stroke, and obstacle walking training is effective for improving functions including activities of daily living compared to non-obstacle walking training.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.81-89
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• 2022

Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.57-69
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• 2022

Purpose : The purpose of this study was to investigate the effect of ankle strengthening exercise combined with sling-assisted gluteus medius strengthening on ankle instability score, and static and dynamic balance ability, muscle strength in adults in their 20s with chronic ankle instability. Methods : Twenty-eight adults in their 20s with chronic ankle instability were recruited. After screening test, they were randomized through R studio program as an experimental group (n=14) to apply an ankle strengthening exercise combined with sling-assisted gluteus medius strengthening and a control group (n=14) to apply ankle strengthening exercise. The intervention lasted two times a week for 6 weeks. To compare the intervention effects, the Cumberland ankle instability tool (CAIT) score, static and dynamic balance ability, and muscle strength of lower extremities were measured. Results : The experimental group showed a significant increase in pre and post-intervention Cumberland ankle instability tool (CAIT) score, static and dynamic balance ability, and muscle strengt (p<.05). The control group showed a significant increase in pre and post-intervention CAIT score, dynamic balance ability, and muscle strength (p<.05). The experimental group showed a significant increase in CAIT score, dynamic balance ability, and muscle strength compared to the control group (p<.05), and showed a high effect size. Conclusions : The results of this study confirmed that ankle strengthening exercise combined with sling-assisted gluteus medius strengthening on people with chronic ankle instability the possibility that it could be effective in improving ankle instability and improving dynamic balance ability, and strength by movement. Although additional research is needed to increase the number of participants due to the small sample size, it is hoped that this study will be an optimistic clinical protocol for people with chronic ankle instability.

• PNF and Movement
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• v.20 no.2
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• pp.147-156
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• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.1
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• pp.9-14
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• 2023

PURPOSE: This study examined the effect of vibration stimulation of a vibration foam roller on the change in the range of motion of the ankle joint and proprioception in patients with chronic ankle instability. An additional aim was to provide basic data for rehabilitation programs for chronic ankle instability patients. METHODS: This study was a randomized crossover design of 22 patients with chronic ankle instability. All subjects were divided into a vibrating group, a non-vibrating group, and a control group. The vibration and non-vibration groups performed the interventions, but the control group did not. For the measurement, the range of motion and proprioception of the ankle joint was measured using an electronic protractor (Electrogoniometer, BPM Pathway, UK). RESULTS: The vibration group showed significant differences in the dorsiflexion angle, dorsiflexion proprioception, and plantar flexion proprioception (p < .05). The non- vibration group showed significant differences in the dorsiflexion angle and dorsiflexion proprioceptive sensation (p < .05). The vibration group and the control group showed significant differences in dorsiflexion proprioception and plantar flexion proprioception (p < .05). CONCLUSION: The range of motion and proprioception of the ankle joint were improved in the group that received vibration stimulation after the intervention than before the intervention. Future research will be needed on patients with various diseases.

• Biomolecules & Therapeutics
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• v.31 no.3
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• pp.264-275
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• 2023

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by tremors, bradykinesia, and rigidity. PD is caused by loss of dopaminergic (DA) neurons in the midbrain substantia nigra (SN) and therefore, replenishment of DA neurons via stem cell-based therapy is a potential treatment option. Astrocytes are the most abundant non-neuronal cells in the central nervous system and are promising candidates for reprogramming into neuronal cells because they share a common origin with neurons. The ability of neural progenitor cells (NPCs) to proliferate and differentiate may overcome the limitations of the reduced viability and function of transplanted cells after cell replacement therapy. Achaete-scute complex homolog-like 1 (Ascl1) is a well-known neuronal-specific factor that induces various cell types such as human and mouse astrocytes and fibroblasts to differentiate into neurons. Nurr1 is involved in the differentiation and maintenance of DA neurons, and decreased Nurr1 expression is known to be a major risk factor for PD. Previous studies have shown that direct conversion of astrocytes into DA neurons and NPCs can be induced by overexpression of Ascl1 and Nurr1 and additional transcription factors genes such as superoxide dismutase 1 and SRY-box 2. Here, we demonstrate that astrocytes isolated from the ventral midbrain, the origin of SN DA neurons, can be effectively converted into DA neurons and NPCs with enhanced viability. In addition, when these NPCs are inducted to differentiate, they exhibit key characteristics of DA neurons. Thus, direct conversion of midbrain astrocytes is a possible cell therapy strategy to treat neurodegenerative diseases.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.1-10
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• 2023

Purpose : This study was conducted to determine the effect of intervention using a smartphone application on abdominal muscle thickness and maximum voluntary ventilation when conducting pelvic floor muscle exercise (PFME). Methods : This study was performed on 14 subjects. They were divided into two groups; PFME using smartphone application (n=7), common PFME (n=7). Both of group executed the exercise 5 times a week for 1 weeks. Abdominal muscle thickness was measured using ultrasound. Maximum voluntary ventilation was measured using a spirometer. The smartphone application used the paid version of Kegel trainer. This material was analyzed by the paired t-test to compare differences on each group and the independent t-test to compare between the two groups. Results : The PFME group using the smartphone application showed a significant increase in the transverse abdominis and internal oblique muscles (p<.05). The common PFME group showed a significant increase in the internal oblique muscle (p<.05). There was no significant difference in variation of the muscle thickness between the two groups (p>.05). The PFME group using the smartphone application showed a significant increase in the maximal voluntary ventilation (p<.05). There was no significant difference in variation of the maximal voluntary ventilation between the two groups (p>.05). Conclusion : As a results of this study, PFME using a smartphone application seems to induce voluntary participation of subjects and maintain continuity against time constraints. As a result, it is thought that using a smartphone application when performing PFME is efficient and convenient in terms of research method. However, this study is difficult to generalize due to the small number of subjects and short intervention period. Therefore, additional research should be conducted by modifying and supplementing these limitations.