• Therapeutic Science for Rehabilitation
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• v.8 no.4
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• pp.7-18
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• 2019

Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.

• 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.3
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• pp.97-110
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• 2021

Objective : This study aimed to develop evaluation items based on Parten's social play developmental stages to measure social play in preschool children. Methods : Through a literature review, the investigation items according to Parten's social play developmental stages were collected. Two Delphi surveys were conducted using 22 expert panels. An understanding of the contents of the preliminary items was determined via parents of preschool children. The evaluation method was established through an expert advisory meeting. Results : Through data collection and the Delphi survey, a total of 89 items were drawn, including 12 unoccupied behaviors, 7 onlooker behaviors, 14 solitary play, 16 parallel play, 17 associative play, and 23 cooperative play items. The average content validity ratio of the Delphi survey was 0.85. The stability was 0.15. The consensus was 0.78. The final preliminary evaluation items comprised a total of 40 items, including 17 for associative play and 23 for cooperative play. Conclusion : An evaluation items that can measure social play in preschool children was developed, and its content validity was verified. It is expected to be used as an evaluation tool in clinical practice.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.41-53
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• 2022

Objective : The purpose of this study is to identify and analyze the vocational rehabilitation evaluation tool for the mentally disabled. Methods : For literature search, the Pubmed database was used, and for the analysis, the development year, evaluation method, number of items, scale, and evaluation items were analyzed. In the analysis method, each evaluation item was divided into four categories: function, internal factor, environment, and mental symptom, and the evaluation elements of each evaluation tool were identified. Results : When searching Pubmed through search terms, 161 documents were retrieved. According to the selection method, Griffiths Work Behavior Scale (GWBS), Occupational Functioning Scale (OFS), Social and Occupational Functioning Assessment Scale (SOFAS), Work Ability Index (WAI), Work Behavior Inventory (WBI), Work Environment Impact Scale (WEIS), and Work and Social Adjustment Scale (WSAS) were screened. The evaluation items of all evaluation tools included job-related functional evaluation. According to the purpose of each evaluation tool, internal factors, environment, and mental symptoms were measured. Conclusion : Occupational skills are skills in which various functions such as physical, cognitive, social skills, and coping skills act in a complex way. Therefore, it is necessary to include the four factors analyzed in this study: function, internal factors, environment, and psychiatric symptoms.

• Therapeutic Science for Rehabilitation
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• v.11 no.3
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• pp.7-22
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• 2022

Objectives : This study was a systematic review of tongue movements in stroke patients with dysphagia. This study aimed to provide a basis for verifying the effects of tongue movement and identifying the tendency of tongue movement. Methods : A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and flow chart. PubMed, MEDLINE, CINAHL, RISS, and e-articles databases were searched. A total of six documents were investigated, and the PEDro scale was used to evaluate the quality of the papers. Results : Three intervention methods were included in the six papers analyzed. Regarding the type of tongue exercise, three TPRT (Tongue to Palate Resistance Trainings) and two TSAT (Tongue Strength and Accuracy Training) were mediated through the IOPI (Iowa Oral Performance Instrument), and only one study applied TSE (Tongue Stretching Exercise). The treatment effects for each intervention implemented in the literature were confirmed to be effective. However, generalizability of findings is difficult because of the small sample size. Further, no significant difference was found between the experimental and control groups. Conclusions : This study can help occupational therapists provide efficient swallowing rehabilitation treatment by applying tongue exercises to stroke patients with dysphagia. More research should be conducted to determine the effects of tongue exercise.

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.9-23
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• 2023

Objective : Among the studies using neglect interventions in the field of occupational therapy, this study was conducted to confirm the contents and characteristics of literature applying single-subject studies, and to analyze the intervention effect and quality level. Methods : This study is a systematic review, and the single subject study published in academic journals for the last 10 years. Results : As a result of the thesis analysis, it was conducted on stroke, and the removal design with seven studies, and two studies were multiple baseline designs. As a result of analyzing the size of the intervention effect applied to neglect, 'highly effective' was found seven times, 'fairly effective' 18 times, 'questionable effective' five times, and 'unreliable effective' six times. As a result of the quality level, there were no studies with low level, with six high level and three medium level. Conclusion : As a result of the study, various methods were applied to neglect interventions. It is thought that this study will provide basic data for evidence-based interventions.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.21-33
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• 2022

Purpose : The purpose of this study was to establish scientific evidence though a systematic review, of the existing interventional methods and their respective effects, for swallowing disorders among dementia patients. The interventional methods were based on patient characteristics. Methods : An electronic literature search was performed using five electronic databases from 2010 to 2020. The keywords were 'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'. Five articles met the inclusion criteria. Results : One study with moderate-to-severe and four studies with severe dementia patients were included. The interventions consisted of one remedial intervention, three compensatory interventions, and one comprehensive intervention. Compensatory intervention, including behavioral and psychological management, were used in moderate-to-severe patients. For the severe patients, remedial, compensatory, and comprehensive intervention were used to address the feeding tube problem. The interventions used in each study had a positive effect on the outcome variables associated with swallowing ability. Conclusion : The purpose of the intervention and the intervention factors changed depending on the patient's dementia stage. The intervention was effective when considering the progressive stage of the patient. These results may serve as a guide in designing effective interventions for swallowing disorders in dementia patients.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.49-68
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• 2022

Objective : This study aimed to conduct a Delphi survey of occupational therapists with experience in elderly occupational therapy to derive items about the 'Elder Leisure Value Assessment Tool'. Methods : This study was conducted in two stages. The first stage was the collection of preliminary questions, and the second stage was the Delphi survey. In the first stage, a literature review and analysis of the 2019 National Leisure Activity Survey were conducted. The modified Delphi technique of the Delphi investigation was implemented in two rounds. Results : In the preliminary item collection phase, 39 items were selected for leisure value assessment and 45 were listed for the participating leisure activities. Subsequently, a Delphi survey of 25 professional groups resulted in 38 leisure value assessment items and 45 participating leisure activities. Conclusion : The questions drawn from this study are meaningful because they can identify specific leisure activities that the elderly participate in, as well as the various values that the elderly consider important when participating in such activities

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.64-67
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• 2014

Esophageal cancer has a poor prognosis, because the progression rate is faster compared to that of other cancers, Up to 30-40% of cases are inoperable at diagnosis, and most cases occur in the elderly. By this time, surgery has been regarded as the treatment of choice in patients suffering esophageal cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. And Although the combination of chemotherapy and radiation therapy has been reported to be an effective treatment for esophageal cancer, most cases show only partial remission. Moreover, radiation therapy alone or chemotherapy alone has limited efficacy. We report a rare case of an 80-year-old man who presented with a chief complaint of dysphasia and was diagnosed with advanced esophageal cancer, with a review of the literature. Considering his advanced age, generally poor performance status, and the risk of fistula development after radiation therapy due to indentation of esophageal cancer into the main bronchus, palliative, rather than therapeutic, chemotherapy was performed, and complete remission was obtained.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.584-595
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• 2021

Objective: Immune checkpoint inhibitor (ICI) therapy has shown activity against melanoma brain metastases. Recently, promising results have also been reported for ICI combination therapy and ICI combined with radiotherapy. We aimed to evaluate radiologic response and adverse event rates of these therapeutic options by a systematic review and meta-analysis. Materials and Methods: A systematic literature search of Ovid-MEDLINE and EMBASE was performed up to October 12, 2019 and included studies evaluating the intracranial objective response rates (ORRs) and/or disease control rates (DCRs) of ICI with or without radiotherapy for treating melanoma brain metastases. We also evaluated safety-associated outcomes. Results: Eleven studies with 14 cohorts (3 with ICI combination therapy; 5 with ICI combined with radiotherapy; 6 with ICI monotherapy) were included. ICI combination therapy {pooled ORR, 53% (95% confidence interval [CI], 44-61%); DCR, 57% (95% CI, 49-66%)} and ICI combined with radiotherapy (pooled ORR, 42% [95% CI, 31-54%]; DCR, 85% [95% CI, 63-95%]) showed higher local efficacy compared to ICI monotherapy (pooled ORR, 15% [95% CI, 11-20%]; DCR, 26% [95% CI, 21-32%]). The grade 3 or 4 adverse event rate was significantly higher with ICI combination therapy (60%; 95% CI, 52-67%) compared to ICI monotherapy (11%; 95% CI, 8-17%) and ICI combined with radiotherapy (4%; 95% CI, 1-19%). Grade 3 or 4 central nervous system (CNS)-related adverse event rates were not different (9% in ICI combination therapy; 8% in ICI combined with radiotherapy; 5% in ICI monotherapy). Conclusion: ICI combination therapy or ICI combined with radiotherapy showed better local efficacy than ICI monotherapy for treating melanoma brain metastasis. The grade 3 or 4 adverse event rate was highest with ICI combination therapy, and the CNS-related grade 3 or 4 event rate was similar. Prospective trials will be necessary to compare the efficacy of ICI combination therapy and ICI combined with radiotherapy.