• The Journal of Korean Academy of Sensory Integration
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• v.14 no.1
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• pp.41-49
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• 2016

Objective : The purpose of this study was to investigate how undressing skill training based on Neuro-developmental treatment (NDT) approach effected on the midline orientation and protective reaction of children with cerebral palsy (CP). Methods : Two participants of this study were 3 years 5 months old boy and 4 years 5 months old girl, living in B city. They were medically diagnosed as cerebral palsy. Research design used in this study is AB design for a single subject research. There was no intervention on the baseline A phases, and functional activity based NDT was used undressing skill training during the B phases. Midline orientation was tested by Stepping subtest in MAP. Protective reaction was measured by Protective reaction subtest in QUEST. Results : In comparison with the baseline (A), midline orientation was improved above 2 standard deviations at intervention phase (B). and protective reaction was improved above averages in both hands. Conclusion : The study showed undressing skill training based on NDT approach that were effective for midline orientation of children with CP. Undressing skill training was one of the major functional activities. Thus, large studies are required to ensure the training effects.

• Journal of the Ergonomics Society of Korea
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• v.29 no.3
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• pp.279-286
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• 2010

The purpose of this study was to compare the electromyographic(EMG) activities of trunk and hip muscles between right and left sides while subjects performed prolonged manual task in asymmetric and symmetric weight-bearing posture. Fifteen healthy male college students were recruited for this study. The subjects were asked to perform bimanual upper extremity task for 6 minutes in two different standing postures. In the symmetric weight-bearing posture, the subjects were standing with evenly distributed body weights to both legs. In the asymmetric weight-bearing posture, the subjects distributed about 90% of their body weight onto their preferred(supporting) leg and 10% of their body weight onto the opposite leg while they were standing. EMG activities of the right and left internal oblique, erector spinae, gluteus maximus, and gluteus medius were measured and normalized as % MVIC. Then the EMG data were statistically analyzed using paired t-tests. The EMG activities of all measured muscles were not significantly different between the right and left side in the symmetrical weight-bearing posture(p>0.05). However, the EMG of the supporting side internal oblique was significantly lower than the opposite side(p<0.05), and the EMG of the erector spinae, gluteus maximus, and gluteus medius were significantly greater on the supporting side(p<0.05). The results of this study support that unbalanced use of right and left muscle possibly causes the changes in muscle length which results in asymmetry of trunk and hip muscles. Furthermore, the uneven weight support onto right and left legs will cause a distortion of viscoelastic ligaments around hip and sacroiliac joints in the long run. Further studies to determine the effect of various manual tasks on the trunk and hip muscles as well as the effect of asymmetrical weight-bearing standing posture on hip and back muscle fatigue may be required.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.353-356
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• 2006

Acute transverse myelitis (TM) is a neurological syndrome caused by inflammation of the spinal cord. TM is rare but is frequently caused by viral or bacterial infections. TM caused by tuberculosis (TB) is extremely rare and there are no reports of TM caused by multidrug-resistant TB (MDR-TB). We report a case of acute TM due to MDR-TB in a 40-year-old man. The patient had been diagnosed with pulmonary TB and was started on the first-line anti-TB treatment. However, the chest radiographic findings were aggravated and neurological symptoms such as weakness in both lower extremities, sensory changes, and voiding difficulty were newly developed. The T2-weighted magnetic resonance image of the spine showed diffusely increased signal intensity in the spinal cord, particularly at the lower cervical and upper thoracic levels, without any definite evidence of myeloradicular compression, which is consistent with a diagnosis of TM. A drug susceptibility test revealed MDR and second-line anti-TB drugs were prescribed. The chest radiographic findings showed improvement after treatment, the mycobacterial culture converted to negative, the MRI findings improved, and there was partial improvement in the low extremity weakness. The patient has been prescribing second-line anti-TB medications for 14 months.

• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.117-126
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• 2004

Objects:It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. Methods:Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance- related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. Results:There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. Conclusion:In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of $HbA_1C$, waist, and weight are recommended for schizophrenics.

• Therapeutic Science for Rehabilitation
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• v.1 no.1
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• pp.57-70
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• 2012

Objective : This study was to evaluate the effects of a Neurofeedback(NFB) and Computer Assisted Cognitive Rehabilitation(CACR) training to improve on cognition and affected arm function in stroke subjects. Methods : Participants were randomly allocated to three groups: NFB(n=14), CACR(n=14) and control(n=16). All groups received occupational therapy and physical therapy for 5 session 30 minutes per week during 6 weeks. Also NFB and CACR group practiced additional NeuroComp training and RehaCom training for 30 sessions 30 minutes during 6 weeks. Results were evaluated by cognition, affected arm function. Results : There were significantly increased by CACR training that outcomes of MMSE-K(p<.05). And there weren't significantly difference by NFB and CACR training that outcomes of the affected arm function. And a difference between three groups wasn't found. Conclusion : The NFB and CACR training improves cognitive function. These results suggest that NFB and CACR training is feasible and suitable for individuals with stroke.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.208-211
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• 1998

Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.

• Journal of Biomedical Engineering Research
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• v.25 no.2
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• pp.151-156
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• 2004

The purpose of this study was to develop EMG triggered FES system for restoration of upper extremity function in chronic hemiplegic patients and to identify the optimal location of electrode application for the EMG triggered FES system which produces effective muscle contraction and detects EMG activity for extension in the wrist and finger joints. The stimulus system was composed of EMG measuring component, constant current component and the program for muscle contraction by EMG triggered FES and passive FES. Parameter of electrical stimulation was 35 ㎐ in frequency, 150 ${\mu}\textrm{s}$ in pulse width and symmetric bi-phasic wave. In 15 hemiplegic patients, EMG triggered FES was applied to the proximal half of forearm which was divided into 12 areas. The most sensitive area for measuring EMG activities during extension of the wrist and fingers was area 4, 5 and the optimal location of electrical stimulation for producing extension of the wrist and fingers was area 4, 5, 7, 8. These results suggest that the area 4 and 5 was considered as the most optimal location of electrode application for measuring EMG activities as well as producing extension of the wrist and fingers by EMG triggered FES system.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.20-27
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• 1988

Continuous cervical epidural anesthesia with two different concentrations of bupivacaine had been performed in 43 cases for surgery of upper extremity and cervical spine. After the initial dose of 0.33% bupivacaine 15ml to Group I(n=22) and 0.5% bupivacaine 15ml to Group II(n=21) was injected respectively, we observed the circulatory and pulmonary functions to be changed, and evaluated the duration of those analgesic action. The number of spinal segment to be affected and the complications were checked. Statistical significance of changes after the initial dose in both groups was determined by student's t-test. All values are impresed as mean$\pm$1S.D.. The results were as follows: 1) Circulatory functions; Systolic B.P. and Pulse rate were decreased by 10~15torr and 5~6 beats per minute respectively between 10~30 minutes following the initial dose, which were statistically significant in both groups. 2) Pulmonary functions; The diminution of minute volume showed to 20% and a rise of $PaCO_2$ level to 5~6 torr respectively between 30~60 minutes following the initial dose, which were statistically significant in both groups. There were no significant changes in self respiration and respiratory rate in both groups. 3) The duration of analgesic action was $72.3{\pm}25.7$(min) in Group I and $83.5{\pm}28.5$(min) in Group II which was not statistically significant between two groups, and the number of affected spinal segment at ore hour following the Anesthusia was $8.7{\pm}2.0$ in Group I and $10.5{\pm}2.4$ in Group II which was statistically significant between two groups. 4) Complications; a. Hypotension(below 80torr in systolic pressure) was appeared in 5% of all patients. b. Bradycardia(below 60 beats per minutes) was appeared in 25% of all patients. c. Inadvertent dural puncture was developed in only one patient, In conclusion, the 0.33% bupivacaine as well as 0.5% bupivacaine were enough for those analgesic effect in the above mentioned surgery even though the duration of analgesic action was about 10 minutes shorter in Group I than that of Group II. The cardiopulmonary function was clinically rather stable in Group I than that of Group II. Therefore we thought 0.33% bupivacaine was satisfactory for the clinical practicality in the cervical epidural anesthesia.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• Physical Therapy Korea
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• v.24 no.2
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• pp.48-57
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• 2017

Background: Rounded shoulder posture (RSP), a postural abnormality, might cause shoulder pain and pathologic conditions. Although most previous research has investigated RSP focusing on the proximal structures of the shoulder, such as the scapula and pectoralis muscles, the relationship between RSP and anterior distal structures of the upper extremity, such as the biceps brachii muscle and elbow joint, is not clearly understood. Objects: This study aimed to investigate the correlations between RSP and the biceps brachii length, elbow joint angle (EJA), pectoralis minor length, general pectoralis major length, humeral head anterior translation (HHAT), glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HAD). Methods: Twelve subjects with RSP (6 male, 6 female) were recruited. All subjects fulfilled the RSP criteria indicated by a distance ${\geq}2.5cm$ from the posterior aspect of the acromion to the table in the supine position. The examiner measured each of the following parameters twice: RSP, biceps brachii length, EJA, pectoralis minor length, pectoralis major length, HHAT, glenohumeral IR, ER, and HAD. Pearson's correlation coefficient(r) was used to assess the correlation between RSP and all the variables. Results: There was a significant moderate positive correlation between RSP and biceps brachii length (r=.55, p=.032), moderate negative correlation between RSP and pectoralis minor length (r=-.62, p=.015), and moderate positive correlation between RSP and HHAT (r=.53, p=.038). Conclusion: The biceps brachii length, pectoralis minor length, and HHAT could be used to evaluate patients with RSP. Better understanding of the correlation between these factors and RSP could help in the development of effective methods to treat patients with this condition in clinical management.