Objective: To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). Materials and Methods: Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31-56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. Results: Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839-0.943: inter-examination, ICC = 0.765-0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4-19.4%). Conclusion: Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.
Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.
Journal of the Korean Society of Physical Medicine
/
v.12
no.3
/
pp.119-130
/
2017
PURPOSE: The purpose of this study is to determine, by conducting a 10 week hippotherapy, the effects on the physical, cognitive and psychological factors of children with intellectual disabilities. METHODS: As an intervention method, intervention was based on a program from the American Hippotherapy Association and was modified and enhanced. 16 children with intellectual disabilities was conducted horse riding intervention program and Intervention was conducted once a week for a total of 10 weeks with each session lasting 30 minutes. A doctor of rehabilitation medical treatment of D rehabilitation center, physical therapist and occupational therapist evaluated the upper limbs test, balance, gait function, Korea-mini mental state examination (MMSE) before and after hippotherapy intervention. Self-esteem scale and aggression scale was evaluated by Psychology Counseling of C psychological clinic before and after hippotherapy intervention. RESULTS: The results of this study reveal that first, there was a positive effect. Second, statistically significant differences were found in BBS, TUG, K-MMSE, 10m walking test, 6 min walking test, self-esteem scale and aggression scale (p<.05). However no statistically significant differences were found in upper limbs function and good balance analysis before and after intervention. CONCLUSION: The hippotherapy is effective way to improve the physical, cognitive and psychological factors of children with intellectual disability.
Journal of The Korean Society of Integrative Medicine
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v.4
no.3
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pp.49-59
/
2016
Purpose : The study was aimed to evaluate the improvement of cognitive and hand functions after the application of a complex rehabilitation intervention program on patients with mild cognitive impairment (MCI) and dementia who were living a regional community from. Methods : Subjects who were living in a regional sanatorium or who were outpatients of a community health center were enrolled from 2012. 2 to 2013.2 All subjects were enforced 8 cycles of a complex rehabilitation intervention program including RON dance, physical activity using therabands, reality awareness training, space retrieval training and handicraft activities. Results : There were significant improvement in LOTCA-G cognitive function and JTHFT hand function test after the application of a complex rehabilitation intervention program. Conclusion : The result shows a significant improvement in cognitive and hand functions after the application of a complex rehabilitation intervention program in patients with MCI and dementia. Therefore the authors suggest the vast studies of the cognitive function program development and hand function vitalization by the application of a complex rehabilitation intervention program.
Journal of International Academy of Physical Therapy Research
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v.9
no.2
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pp.1498-1507
/
2018
The purpose of this study was to examine the immediate effect of neck stabilization exercise and Swiss ball exercise on the recovery from the fatigue of neck muscles induced. The turtleneck posture was set artificially by using Smartphone with healthy adults. Repetitively measured ANOVA was executed to examine the changes in the muscle fatigue of sternocleidomastoid, upper trapezius, and splenius capitis among three-time intervals (at the time of general resting, work and after intervention) in the three intervention groups (neck stabilization exercise group, Swiss ball exercise group, and ordinary rest group). There were no significant differences in the changes of fatigue of sternocleidomastoid muscle among all three intervention groups at the time of general resting, work and after intervention (p>.05). Although there was no significant difference in the changes in the fatigue of upper trapezius and splenius capitis muscles between the intervention groups at the time of general resting and work (p>.05), there was the significant difference between the three intervention groups at the time of work and after intervention (p>.05). This study suggest that Swiss ball exercise is more effective in reducing the muscular fatigue of the neck and shoulder at a turtleneck posture than neck stabilization exercise.
Objectives: Epidemiological evidence linking long working hours and shift work to metabolic syndrome remains inadequate. We sought to evaluate the impact of reducing working hours on metabolic syndrome. Methods: We compared the prevalence of metabolic syndrome among male manual workers in a manufacturing company (N = 371) before and after the introduction of policy to reduce daily work hours from 10 to 8 hours. Components of metabolic syndrome were measured in periodic health examinations before the intervention, 6-9 months after, and 1.5-2 years after the intervention. Generalized estimating equation models were used to estimate changes in the prevalence of metabolic syndrome. Analyses were stratified by day work versus shift work. Results: The results showed a significantly decreased prevalence of metabolic syndrome 6-9 months following the intervention in day workers (risk ratio = 0.68, 95% confidence interval 0.52-0.88), but the benefit disappeared after 1.5-2 years. Shift workers showed a decreased prevalence of metabolic syndrome for the whole follow-up duration after the intervention, although the change was not statistically significant. Conclusion: Reducing working hours was associated with short-term improvement in metabolic syndrome in male manual workers.
Background: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group ($n_1=10$), a placebo group ($n_2=10$), and a control group ($n_3=10$). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton(R)PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.24
no.2
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pp.75-81
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2018
Background: The purpose of this study was to investigate the effect of various relaxation techniques on various dysfunction problems caused by shortening of the sagittal muscles. Method: The subjects were 44(18 males, 26 females). The subjects were composed of 3 groups. The experimental group consisted of 14 patients with proprioceptive neuromuscular facilitation stretching (PNF) technique, control group A 15 patients with self myofacial release (SMR) ball exercise, and control group B with 15 patients with Sling exercise. After 3 weeks of relaxation on the hamstring muscle, the length of the hamstring muscle before and after the intervention was compared. Results: The results of relaxation exercise of the snake muscles applied to passive PNF group, SMR ball group, and Sling relaxation group are as follows. 1. In the passive PNF group, the muscle length of the hamstring muscle was significantly increased after the intervention. 2. The muscle length of the hamstring muscle was significantly increased after the intervention in the SMR ball group. 3. Sling relaxation group significantly increased the muscle length of the hamstring muscle after sling exercise intervention. 4. Passive PNF group showed the greatest change in muscle length before and after intervention than SMR ball group and Sling relaxation group. Conclusion: Passive PNF relaxation therapy, SMR ball relaxation therapy, and Sling relaxation therapy applied to the hamstring muscle were effective in increasing muscle length of the hamstring muscle. PNF relaxation therapy showed the most significant effect after 3 weeks intervention.
Purpose: This study attempted to identify the effectiveness and substantiality of a dementia education program for family caregivers of the demented elderly. Methods: This quasi-experimental study using a nonequivalent control pretest-posttest design was carried out from April 15 to July 29 in 2012 with 137 subjects divided into an experimental group (n=70) and a control group (n=67). This study examined the subjects' general characteristics, and evaluated their nursing method four times, respectively, before the intervention, right after the intervention, and 2 and 4 weeks after the intervention, and then analyzed collected data through t-test and $x^2$-test. Results: In the experimental group that had received the dementia education, the nursing method score was significantly higher right after the intervention (t=8.33, p<.001) and 2 weeks after the intervention (t=8.01, p<.001) than before the intervention, but their score 4 weeks after the intervention was not significantly different from that of the control group (t=1.08, p=.28). Conclusion: The dementia education was found to be effective in improving the nursing method of family caregivers of the demented elderly. This study implies that further follow-up dementia education is necessary between 2 and 4 weeks to maintain the effectiveness.
Purpose: The purpose of this study was to investigate the effects of whole-body vibration stimulation on proprioception and tactile in patients with spastic cerebral palsy. Methods: This study was conducted on 9 children diagnosed with spastic cerebral palsy. Of the single case study methods, the ABAB design was employed in this study. Out of a 12-week study period, three weeks were allocated to each of two baseline periods and two intervention periods. The exercise was performed twice a week for 30 minutes. A general trunk stabilization exercise was performed during the baseline period and a trunk stabilization exercise accompanied with whole-body vibration was performed during the intervention period. Evaluation was performed five times in total: before the experiment, after baseline 1, after intervention 1, after baseline 2, and after intervention 2. To determine the effect of the exercise method, a skin sensory evaluation tool (monofilament kit) and a trunk proprioception sensor (digital dual inclinometer) were used. To compare the effects of the exercises at baseline and after intervention, an analysis of variance on repeated measures (repeated ANOVA) was performed to analyze the data. Results: The results showed that there were statistically significant increases from baseline in the means of proprioception and tactile during the intervention period with whole-body vibration (p <.05). Conclusion: Whole-body vibration can be proposed as an effective intervention method for improving the proprioception and tactile in children with spastic cerebral palsy, and this exercise method is expected to be actively used in clinical practice.
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