• 한국전문물리치료학회지
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• 제13권1호
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• pp.38-46
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• 2006

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

• 한국운동역학회지
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• 제28권2호
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• pp.135-141
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• 2018

Objective: The purpose of this study was to investigate the effect of functional ankle instability (FAI) and surgical treatment (ST) on postural stability and leg stiffness during vertical-drop landing. Method: A total of 21 men participated in this study (normal [NOR]: 7, FAI: 7, ST: 7). We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force and the change in stance-phase leg length. Leg length was calculated as the distance from the center of the pelvis to the center of pressure under the foot. Furthermore, the analyzed variables included the loading rate and the dynamic postural stability index (DPSI; medial-lateral [ML], anterior-posterior [AP], and vertical [V]) in the initial contact phase. Results: The dimensionless leg stiffness in the FAI group was higher than that of the NOR group and the ST group (p = .018). This result may be due to a smaller change in stance-phase leg length (p = .001). DPSI (ML, AP, and V) and loading rate did not show differences according to the types of ankle instability during drop landing (p > .05). Conclusion: This study suggested that the dimensionless leg stiffness was within the normal range in the ST group, whereas it was increased by the stiffness of the legs rather than the peak vertical force during vertical-drop landing in the FAI group. Identifying these potential differences may enable clinicians to assess ankle instability and design rehabilitation protocols specific for the impairment.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.441-447
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• 2007

Purpose: Various kinds of local flap or free flap have been used for coverage for soft tissue defects with bone exposure over the ankle and dorsum of foot. Adipofascial flaps, nourished by vascular plexuses of the subcutaneous tissue and deep fascia originating from the local perforators of the major vessels, appear particularly to be indicated for the reconstruction of these areas. Our experience with this flap on the dorsum of foot and ankle has also been quite encouraging. Methods: The design of the flap is determined by the size and the location of the defect. The base of the flap is chosen depending on the availability of the soft tissue around the defect. The ratio of the area of the flap to the area of the base wound be more reliable to predict the survival of the turnover flap by the conventional length-to-width ratio. Nineteen patients with defect over the dorsum of the foot and ankle were resurfaced with adipofascial turn-over flaps and skin graft. Results: The average age of the patients was 38.2 years(3 - 81 years). The flap size was from $2{\times}3cm$ to $8{\times}5cm$. The average follow-up time was 6 months. All flaps survived completely except one case who suffered distal necrosis of the flap. The additional skin graft was required for partial skin loss in the five cases. Other functional impairment was not noted. Conclusion: Dissection of the local adipofascial turnover flap is quite easy, quick, requires less time and sacrifice of surrounding muscle itself, and maintains major arteries. In most cases, donor-site morbidity is minimal with an acceptable scar, and both functional and esthetical results were satisfactory. Therefore, Adipofascial flap could be an option for the difficult wounds around the foot and ankle.

• 대한통합의학회지
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• 제7권3호
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• pp.1-9
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• 2019

Purpose : To find out how action observation training for chronic stroke patients affects their balance and body control abilities in the posture seated in the rehabilitation of stroke. Methods : This study was conducted on 30 subjects who were diagnosed with stroke. The group conducted motion observation training through video clips, while the control group only conducted physical training, and the general physical therapy was performed equally by both counties. The static balance was measured using Biorescue and the dynamic balance was measured using Modified Functional Reach Test (MFRT), Postural Assessment Scale for Stroke, and Trunk Impairment Scale. Results : Static balance showed statistically significant difference in foot pressure (p<.05) as a result of comparison between pre and post exercise training. Dynamic balance was statistically significant (p>.05) as a result of comparing pre and post differences using modified functional reach test. The trunk control ability was statistically significant (p>.001). Comparison between the results of before and after motion observation training showed a statistically significant difference. Conclusion: This study confirmed that exercise training in sitting position was effective for static, dynamic balance ability and trunk control ability of hemiplegic patients due to stroke. These results suggest that the use of motion monitoring in stroke patients may have a positive impact on the diversity and function of rehabilitation.

• PNF and Movement
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• 제10권3호
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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.

• Molecules and Cells
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• 제44권11호
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• pp.795-804
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• 2021

Memory T (T_M) cells play an important role in the long-term defense against pathogen reinvasion. However, it is still unclear how these cells receive the crucial signals necessary for their longevity and homeostatic turnover. To understand how T_M cells receive these signals, we infected mice with lymphocytic choriomeningitis virus (LCMV) and examined the expression sites of neural cadherin (N-cadherin) by immunofluorescence microscopy. We found that N-cadherin was expressed in the surroundings of the white pulps of the spleen and medulla of lymph nodes (LNs). Moreover, T_M cells expressing high levels of killer cell lectin-like receptor G1 (KLRG1), a ligand of N-cadherin, were co-localized with N-cadherin⁺ cells in the spleen but not in LNs. We then blocked N-cadherin in vivo to investigate whether it regulates the formation or function of T_M cells. The numbers of CD127^hiCD62L^hi T_M cells in the spleen of memory P14 chimeric mice declined when N-cadherin was blocked during the contraction phase, without functional impairment of these cells. In addition, when CD127^loKLRG1^hi T_M cells were adoptively transferred into anti-N-cadherin-treated mice compared with control mice, the number of these cells was reduced in the bone marrow and LNs, without functional loss. Taken together, our results suggest that N-cadherin participates in the development of CD127^hiCD62L^hi T_M cells and homing of CD127^loKLRG1^hi T_M cells to lymphoid organs.

• 한방재활의학과학회지
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• 제34권3호
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• pp.107-117
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• 2024

The objective of this study is to report the clinical effects of applying an integrated rehabilitation protocol to four patients with traumatic cervical spinal cord injuries. The treatments applied included acupuncture, cupping and moxibustion, chuna manual therapy, functional electrical stimulation, and other physical therapies. The evaluation methods included American Spinal Injury Association Impairment Scale, functional independence measure (FIM), modified Barthel index (MBI), numeric rating scale (NRS) and other scales. All patients presented marked improvements in FIM, MBI, NRS and other scales, along with increased muscle strength in the manual muscle test. The application of our protocol resulted in clear clinical benefits and enhanced the recovery and quality of life for the patients in this study.

• 대한치매학회지
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• 제21권2호
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• pp.59-70
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• 2022

Background and Purpose: Neurofilament light chain (NfL) has been considered as a biomarker for neurodegenerative diseases including Alzheimer's disease (AD). We measured plasma NfL levels in older adults with cognitive complaints and evaluated their clinical usefulness in AD. Methods: Plasma levels of NfL, measured by using the single molecule array method, were acquired in a total of 113 subjects consisting of subjective cognitive decline (SCD; n=14), mild cognitive impairment (MCI; n=37), or dementia of Alzheimer type (DAT; n=62). Plasma NfL level was compared among three groups, and its association with cognitive and functional status was also analyzed. Results: After adjusting for age, plasma NfL level was higher in subjects with DAT (65.98±84.96 pg/mL), compared to in subjects with SCD (16.90±2.54 pg/mL) or MCI (25.53±10.42 pg/mL, p=0.004). NfL levels were correlated with scores of the mini-mental state examination (r=-0.242, p=0.021), clinical dementia rating (CDR) (r=0.291, p=0.005), or CDR-sum of boxes (r=0.276, p=0.008). Just for participants who performed amyloid positron emission tomography (PET), the levels were different between subjects with PET (-) (n=17, 25.95±13.25 pg/mL) and PET (+) (n=16, 63.65±81.90 pg/mL, p=0.010). Additionally, plasma NfL levels were different between vascular dementia and vascular MCI, and between Parkinson's disease- dementia and no dementia. Conclusions: This pilot study shows that in subjects with DAT, plasma NfL levels increase. Plasma NfL level correlated with cognitive and functional status. Further longitudinal studies may help to apply the plasma NfL levels to AD, as a potential biomarker for the diagnosis and predicting progression.

• 대한물리의학회지
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• 제19권3호
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• pp.55-63
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• 2024

PURPOSE: This study examined the test-retest reliability and clinical utility of the Modified Trunk Impairment Scale (mTIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke - Trunk Control (PASS-TC) in patients with chronic stroke. METHODS: Thirty-eight stroke patients were reassessed using the mTIS, TCT, and PASS-TC with a seven-day interval between assessments. The test-retest reliability was evaluated using the intraclass correlation coefficient (ICC_2,1), the standard error of measurement (SEM), the minimal detectable change (MDC), and MDC%, as well as Bland-Altman analysis. The relationship between the mTIS, TCT, PASS-TC scores, and the Barthel Index (BI) was also investigated. RESULTS: The test-retest reliability for the mTIS, TCT, and PASS-TC was high, with ICC values ranging from .91 to .94 (95% confidence interval: .83-.97). The MDCs for the mTIS and TCT were 2.35 and 13.9, respectively, while the MDC for the P ASS-TC was 2.54, all below 20% of the maximum possible score, indicating reliable measurement. The optimal mTIS cut-off score for distinguishing between mild (75-95 points) and severe (50-74 points) dependence on the BI was ≥ 9.5, with an accuracy of 79%. Patients with an mTIS score ≥ 9.5 (out of 15) showed an 18-fold higher likelihood of achieving a mild level of functional independence than those with a score < 9.5. CONCLUSION: The mTIS, TCT, and PASS-TC showed high test-retest reliability and no systematic errors in chronic stroke patients. The MDC values were reliable, indicating meaningful change. Among these, the mTIS is a sensitive and a useful tool for predicting functional independence in clinical practice and is straightforward to apply.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.46-57
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder that can affect individuals across their lifespan. It is characterized by the core symptoms of inattention, impulsivity and hyperactivity. ADHD develops as a result of the complex interplay between genetic and environmental factors. Children and adults with ADHD usually suffer concomitantly from other psychiatric comorbidities, including both externalizing and internalizing disorders. It is associated with functional impairment and poor long-term outcomes. This review aims to summarize the key findings from recent research into ADHD and its prevalence, core symptoms, cause and comorbidities from childhood to adulthood.