• Therapeutic Science for Rehabilitation
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• v.4 no.1
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• pp.7-17
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• 2015

Objective : To investigate the current researches which identify the improvement of bilateral coordination skill of children with hemiplegic cerebral palsy after bimanual intensive training. Methods : We systematically examined papers published in journals from 2004 to 2014, using RISS, Pubmed. Total 6 studies were included in the analyses. Result : All of the selected 6 studies were foreign papers, and the Pedro score was 5 or more. Among various interventions, modified CIMT designs were the most. The primary outcome measure tools are AHA and JTTHF for evaluating bilateral coordination and hand functions, and QUEST, ABILHAND-Kids, COPM, GAS, PEDI, 3-D movement kinematics were used for evaluating various aspects of effectiveness of interventions. Conclusion : Through this systematic review, it is identified that bilateral intensive training provides positive effects to not only hand functions but also bilateral coordination. Furthermore, it also provided supports to participate in ADL requiring bilateral coordination. These results will provides evidence concerning the effectiveness of BIT for children with hemiplegic cerebral palsy.

• Therapeutic Science for Rehabilitation
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• v.9 no.4
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• pp.7-20
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• 2020

Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.757-760
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• 2007

Purpose : Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. Methods : All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. Results : This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median $34.2{\pm}11.6$ months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). Conclusion : We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.203-210
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• 2001

Objective : Paraclinoidal aneurysms termed that aneurysms arising from proximal internal carotid artery(ICA) between the site of emergence of the carotid artery from roof of the cavernous sinus and origin of the posterior communicating artery(PCoA). These aneurysms pose conceptual and technical surgical problems with regard to acquisition of proximal control and safe intracranial exposure. The efficiency of surgical technique according to the location of paraclinoidal aneurysm was studied for minimal exposure. Materials and Methods : Over the past four years, the authors treated surgically 171 cases of cerebral aneurysm, among them ten patients were paraclinoidal aneurysms with two patients unruptured aneurysms. Mean age was 47 years old, and all patients were female. Three patients were proximal posterior carotid artery wall aneurysms(one large, one giant), four patients carotid-ophthalmic artery aneurysms and three patients superior hypophyseal artery aneurysms. Results : There could be done clip in all cases, there were no deaths and no complication. And no patient developed sustained neurological deficits including visual function except hydrocephalus in one case. Four patients complained of visual disturbance but two patients had recovery after postoperation and two patient were not longer to bad. Conclusion : Our recent experience suggests that preoperative scrutiny of diagnostic angiography allows classification of all paraclinoidal aneurysms regardless of size and surgical technique which this classification has focused on operative approaches unique to each aneurysm projection was helpful to improve the operative outcome with good visual function and to shorten the operative time.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.439-447
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• 2018

Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using $0^{\circ}$ or $30^{\circ}$ endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of $0^{\circ}$ or $30^{\circ}$ endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). Results: The IVA significantly increased from $6.24^{\circ}{\pm}4.27^{\circ}$ to $6.96^{\circ}{\pm}3.58^{\circ}$ at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from $6.27^{\circ}{\pm}3.12^{\circ}$ to $6.04^{\circ}{\pm}2.41^{\circ}$, but the difference was not statistically significant (p = 0.375). The percentage of slip was $3.41%{\pm}5.24%$ preoperatively and $6.01%{\pm}1.43%$ at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was $2.90%{\pm}3.37%$; at 1 year postoperatively, it was $3.13%{\pm}4.11%$ (p = 0.720), showing no significant difference. The DHI changed from $34.78%{\pm}9.54%$ preoperatively to $35.05%{\pm}8.83%$ postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from $55.15%{\pm}9.45%$ preoperatively to $54.56%{\pm}9.86%$ postoperatively, but the results were not statistically significant (p = 0.705). Conclusions: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.176-183
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• 2018

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.568-577
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• 2018

Objective: Performing high quality cardiopulmonary resuscitation (CPR) is important for improving the survival rate with a good neurological outcome and fewer complications. The retention of accurate CPR knowledge is essential for providing high quality CPR. This study examined the effects of chest compression only CPR training on the retention of correct CPR knowledge. Methods: In December 2016, an interview survey to target the study population was conducted by trained interviewers, using a structured questionnaire. The respondents' general characteristics, status of CPR education, and knowledge and willingness regarding CPR were investigated. Pearson's chi-square tests and multivariate logistic regression analyses were used to determine which education-related factors affected the correct skill knowledge of performing CPR. Results: Among the respondents, there are 80 persons (17.4%) who answered correctly in the questions regarding the skills of performing CPR. The respondents who had a willingness to perform CPR to family and strangers were 90.2% and 44.9% respectively. Through multivariable analysis, the factors related to correct skill knowledge in performing CPR in the didactic with practice group were people who had undergone CPR training within 2 years (odds ratio [OR], 2.293; 95% confidence interval [CI], 1.311-4.009), and person who had undergone chest compression only CPR training (OR, 2.044; 95% CI, 1.033-4.042). Conclusion: Chest compression only type of CPR training and the experience of CPR education within 2 years were associated with accurate skill knowledge of performing CPR.

• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.60-67
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• 2018

Background Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors. Methods We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. There were 44 operations (27 tumor resections, 17 biopsies). DTI was employed in 17 cases, neuro-navigation in 23 cases and IOM in 14 cases. All diagnoses were revised according to the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Progression-free survival (PFS) and overall survival (OS) rates were calculated, and relevant prognostic factors were analyzed. The median follow-up duration was 19 months. Results Fifteen cases were gross total resections (GTR), 6 subtotal resections (STR), and 6 partial resections (PR). Neurological status did not worsen after 22 tumor resections. There were statistically significant differences in terms of the extent of resection between the groups with DTI, neuro-navigation and IOM (n=12, GTR or STR=12) and the group without at least one of the three techniques (n= 15, GTR or STR=9, p=0.020). The mean PFS was $87.2{\pm}38.0$ months, and the mean OS $90.7{\pm}36.1$ months. The 5-year PFS was 37%, and the 5-year OS 47%. The histological grade ($p{\leq}0.001$) and adjuvant therapy (done vs. not done, p=0.016) were significantly related to longer PFS. The histological grade (p=0.002) and the extent of removal (GTR/STR vs. PR/biopsy, p=0.047) were significantly related to longer OS. Conclusion Maximal surgical resection was achieved with acceptable morbidity in children with thalamic tumors by employing DTI, neuro-navigation and IOM. Maximal tumor resection was a relevant clinical factor affecting OS; therefore, it should be considered the initial therapeutic option for pediatric thalamic tumors.

• Therapeutic Science for Rehabilitation
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• v.10 no.3
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• pp.7-22
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• 2021

Objective : The purpose of this study was to verify the effect of virtual reality interventions (VRIs) on cognitive function in individuals with stroke through a systematic literature review and meta-analysis. Methods : We reviewed randomized controlled trials (RCTs) the last 10 years using academic databases. PubMed, MEDLINE, and CINAHL were used for international studies, and DBpia, KISS, Kyoboscholar, and e-article were used for Korean studies. For the quantitative meta-analysis, subgroups of outcomes were classified into general cognitive function (G-CF), attention and memory (A&M), and executive function (EF). Results : Nine RCTs were analyzed. The total number of participants was 271 (140 in the experimental group). The effect size (Cohen's d) was estimated using a random effects model. The effect sizes of the outcome subgroups of were as follows: small to medium for G-CF (d=0.422; 95% CI: 0.101~0.742; p=0.010), small for A&M (d=0.249; 95% CI: -0.107~0.605; p=0.170), and medium for EF (d=0.666; 95% CI: 0.136~1.195; p=0.014). Conclusion : Considering the various stimuli provided by the virtual environment and the results from available research, virtual reality should be applied to interventions for integrated cognitive functions. In addition, it would be appropriate to be used as an additional intervention to traditional cognitive rehabilitation for stroke.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.23-36
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• 2021

Objective : The purpose of this study was to analyze group programs for the elderly living in communities and to provide basic data for applying effective occupational therapy programs for the elderly in the community. Methods : From January 2009 to December 2019, articles on group programs for the elderly in the community were searched for in the NDSL, DBPia, Riss, and PubMed databases. Based on the inclusion and exclusion criteria, a total 16 out of the 147 identified studies were selected and analyzed. This review analyzed the characteristics of the participants, contents of the group program, session and duration of the intervention, outcome measures, and effect of the group program. Results : Single group pre-post test studies with evidence level III were most common (8, 50.0%), and five (31.3%) of the studies were conducted on the community-dwelling elderly. Across all the 16 studies, there were 10 types of group programs, and the most frequently used was an exercise group program (25.0%). According to the analysis of the group program period, sessions and time, the intervention period was most commonly 12 weeks (37.5%), with 8 sessions or 12 sessions (25.0%). The intervention time in the group program was most commonly 60 minutes (43.8%). Conclusion : This study can be used as a basis for the development of effective group programs for the elderly and patients with dementia in community-based long-term care services.