• 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.

• Journal of Acupuncture Research
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• v.37 no.3
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• pp.193-201
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• 2020

This case report describes a 60-year-old female patient diagnosed with intercostal neuropathy and vertebral compression fractures which occurred following an electric shock injury. The patient received acupuncture, pharmacopuncture, and herbal medicine administration between February 10^th, 2020 and April 25^th, 2020. The pain level in the thoracic and left intercostal areas was assessed using the Numerical Rating Scale. The Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used to diagnose neuropathic pain. The Neuropathic-Pain -Scale was used to evaluate the degree of neuropathic symptoms. The Oswestry Disability Index and the European Quality of Life-5 Dimensions were used to assess quality of life scales and functional disorder. Following combined Korean medicine treatment, the patient exhibited reduced levels of pain and significant improvement in functional disorder symptoms and quality of life.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.33-42
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• 2017

PURPOSE: To compare postural vertical training with and without visual feedback for improving functional recovery in post-stroke hemiparesis patients with pusher syndrome. METHODS: This study used a single-subject research with alternating design with multiple baselines. Three patients with hemiparetic post-stroke diagnosed with pusher syndrome were selected from the inpatients at the department of physical therapy of a local rehabilitation hospital. For subjective postural vertical (SPV) training with and without visual feedback, an alternating treatment was used. The subjects were randomly selected using the sequence of the two training methods upon starting the intervention, and then the training was alternated. SPV training was performed twice a day, once in the morning and again in the afternoon. Scale for contraversive pushing (SCP), postural assessment scale for stroke, and Barthel index score were used to determine the intervention-related changes. RESULTS: Compared to the average score at baseline, the average SCP score for the SPV training without visual feedback decreased from 5.3 to 2.8, from 4.6 to 3, and from 3.5 to 2.7 for subjects 1, 2, and 3, respectively. However, the average score for the SPV training with visual feedback decreased from 5.3 to 3.1, from 4.6 to 3.5, and from 3.5 to 3.3 for subjects 1, 2, and 3, respectively. CONCLUSION: Postural vertical training without visual feedback may be more beneficial than postural vertical training with visual feedback for improving pushing behavior and functional activity in stroke patients with pusher syndrome.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.351-357
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• 2014

Purpose: The purpose of this study was to investigate level of functioning in patients with stroke using Modified Bathel Index (MBI), World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and ICF core-set for stroke. Methods: Sixty-four patients with stroke were recruited for this study from nine medical institutes. The ICF core-set for stroke, WHODAS 2.0, and MBI were used to collect subjects' functional levels. ICF core-set was employed here as a standard frame to observe multi-dimension of functioning, that is physiological bodily function, activity and participation (AP) in daily life, and current environmental factors (EF) in patients with stroke. WHODAS 2.0 and MBI were also used in order to have a specific functioning level for subjects. The linkage of each item in WHODAS 2.0 and MBI into the ICF core-set for stroke was examined. Pearson correlation coefficient was used for analysis of their relationships. Results: Functioning level of participants showed moderate resulting from MBI and WHODAS 2.0 ($73.48{\pm}22.27$ and $35.55{\pm}12.53$, respectively). Strong relationship was observed between ICF core-set and WHODAS 2.0, and with MBI. Each item of disability scales was obtained its linkage into ICF in the domain of AP. However, lack of correlation between MBI and ICF in the domain of EF was found due to absence of related factors. Conclusion: MBI was found to be linked mainly into ICF in the domain of AP and to have limited linkage into EF. Therefore, it should be suggested that the ICF concept frame should be used as a multi-dimensional approach to patients with stroke.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• PNF and Movement
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• v.19 no.1
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• pp.19-29
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• 2021

Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.

• PNF and Movement
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• v.10 no.3
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• pp.7-18
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• 2012

Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.103-114
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• 2023

PURPOSE: This study compared the effects of computer-based and virtual reality-based cognitive rehabilitation programs on the cognitive function, upper limb function, activities of daily living, and their impact on the prefrontal cortex in convalescent stroke patients. METHODS: Ten recovering stroke patients were assessed for their cognitive function, upper limb function, and daily living activities using the Neurobehavioral Cognitive Status Examination, the Korean version of the Fugl-Meyer Assessment, and the Korean version of the Modified Barthel Index. The prefrontal cortex activity was measured with functional Near Infrared Spectroscopy. The virtual reality-based cognitive rehabilitation group utilized a program of daily living activities delivered via a laptop and Oculus Rift. The computer-based cognitive rehabilitation group performed various cognitive tasks on an all-in-one PC. Both groups underwent cognitive rehabilitation training for 30 minutes per day, three times a week, for six weeks, with identical conventional rehabilitation therapies in the hospital. RESULTS: Both programs positively impacted the cognitive and physical functions. On the other hand, the virtual reality-based cognitive rehabilitation program had a larger influence on improving the cognitive and physical functions of convalescing stroke patients. CONCLUSION: The virtual reality program suggests its potential to enhance cognitive and physical functions in convalescent stroke patients through increased engagement, focus, real-time feedback, and game elements, making it a promising rehabilitation approach.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.126-137
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• 2023

Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MMGT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.