• Title/Summary/Keyword: Patient with disabilities

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Validation Study of Behavior Problems Inventory-01 among Korean Children and Adolescents (한국판 문제행동 평가도구(Behavior Problems Inventory-01) 표준화 연구)

  • Choi, Miji;Kim, Yeni;Ban, Ji-Jeong;Hwang, Samuel Suk-Hyun;Kim, Bung-Nyun;Yang, Young-Hui
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.220-227
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    • 2017
  • Objectives: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. Methods: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. Results: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67-0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. Conclusion: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.

Anatomic coracoclavicular ligament reconstruction with triple flip-buttons leads to good functional outcomes and low reduction loss: a case series

  • Raul Aguila;Gonzalo Gana;J Tomas Munoz;Diego Garcia de la Pastora;Andres Oyarzun;Gabriel Mansilla;Sebastian Coda;J Tomas Rojas
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.140-147
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    • 2023
  • Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

Clinical outcome in patients with hand lesions associated with complex regional pain syndrome after arthroscopic rotator cuff repair

  • Imai, Takaki;Gotoh, Masafumi;Fukuda, Keiji;Ogino, Misa;Nakamura, Hidehiro;Ohzono, Hiroki;Shiba, Naoto;Okawa, Takahiro
    • Clinics in Shoulder and Elbow
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    • v.24 no.2
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    • pp.80-87
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    • 2021
  • Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

A modified method of augmented distal clavicle fracture osteosynthesis with a Fibertape coracoclavicular cerclage

  • Wu, ChengHan;Teo, Timothy Wei Wen;Wee, Andy Teck Huat;Toon, Dong Hao
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.230-235
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    • 2022
  • Background: Unstable distal clavicles experience high non-union rates, prompting surgeons to recommend surgery for more predictable outcomes. There is a lack of consensus on the optimal method of surgical fixation, with an array of techniques described in the literature. We describe an alternative method of fixation involving the use of a distal clavicular anatomical locking plate with Fibertape cerclage augmentation in our series of patients. Methods: Nine patients (8 males and 1 female), with a mean age of 36 years, who sustained unstable fracture of the distal clavicle in our institution were treated with our described technique. Postoperative range of motion, functional and pain scores, and time to radiographic union were measured over a mean follow-up period of 10 months. Incidences of postoperative complications were also recorded. Results: At the last patient consult, the mean visual analog scale score was 0.88±0.35, with a mean Disabilities of the Arm, Shoulder, and Hand (DASH) score of 1.46±0.87 and American Shoulder and Elbow Surgeons (ASES) score of 94.1±3.57. The mean range of motion achieved was forward flexion at 173°±10.6°, abduction at 173°±10.6°, and external rotation at 74.4°±10.5°. All patients achieved internal rotation at a vertebral height of at least L2 with radiographical union at a mean of 10 weeks. No removal of implants was required. Conclusions: Our described technique of augmented fixation of the distal clavicle is effective, produces good clinical outcomes, and has minimal complications.

Effect of Home-based Rehabilitation on Balance and Gait Function in Patient With Stroke: A Systematic Review and Meta-analysis

  • Yong-gu Han;Chung-hwi Yi
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.91-103
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    • 2024
  • Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger's regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger's regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.

TREATMENT OF LINGUAL ULCERS CAUSED BY TONGUE THRUST WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHY (저산소성 허혈성 뇌병변 환아에서 혀내밀기에 의해 발생된 혀 궤양의 치료: 증례 보고)

  • Oh, Mee-Hee;Kim, So-Jung;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.22-25
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    • 2012
  • Hypoxic ischemic encephalopathy(HIE) is a condition that occurs when the entire brain is deprived of an adequate oxygen supply and associated in most cases with oxygen deprivation in the neonate due to birth asphyxia. Children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other disabilities. We hereby report the case of treating a child patient with HIE whose chief complaint of severe lingual ulceration. A 12-month-old boy referred to our hospital to treat ulcers of ventral surface of tongue. He has been suffering from lingual ulceration due to persistent tongue thrusting. He has bitten his own tongue involuntary. The ulceration was apparently seemed to be not healed because of the constant irritation by lower incisors. So we designed tongue protector to prevent lingual ulcers. The appliance was proved to be effective to reduce tongue trauma by lower incisors and periodic follow-up is needed.

Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

  • Lee, Hak-Jae;Sun, Hyun-Woo;Lee, Jae-Seok;Choi, Nak-Joon;Jung, Yoon-Joong;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.51-57
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    • 2018
  • Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

Early Diagnosis of KBG Syndrome Using Diagnostic Exome Sequencing (Diagnostic exome sequencing을 통한 KBG 증후군의 조기 진단)

  • Hong, Jun Ho;Kim, Se Hee;Lee, Seung Tae;Choi, Jong Rak;Kang, Hoon Chul;Lee, Joon Soo;Kim, Heung Dong
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.272-275
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    • 2018
  • KBG syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, skeletal anomalies, short stature, craniofacial dysmorphism, and macrodontia. ANKRD11 gene mutation and 16q24.3 microdeletion have been reported to cause KBG syndrome. Here, we report two patients with ANKRD11 mutations who initially presented with neurologic symptoms such as developmental delay and seizures. Patient 1 was a 23-month-old boy who presented with a global developmental delay. Language delay was the most dominant feature. He had hypertelorism, hearing impairment, and behavior problems characterized as hyperactivity. A c.1903_1907delAAACA (p.Lys635GInfsTer26) mutation in ANKRD11 was identified with diagnostic exome sequencing. Patient 2 was a 14-month-old boy with developmental delay and seizure. He also had atrial septum defect, and ventricular septal defect. Generalized tonic seizures began at the age of 8 months. Electroencephalography showed generalized sharp and slow wave pattern. Seizures did not respond to antiepileptic drugs. A loss of function mutation c.5350_5351delTC (p.ser1784HisfsTer12) in ANKRD11 was identified with diagnostic exome sequencing. In both cases, characteristic features of KBG syndrome such as short stature or macrodontia, were absent, and they visited the hospital due to neurological symptoms. These findings suggest that more patients with mild phenotypes of KBG syndrome are being recognized with advances in diagnostic exome sequencing genetic technologies.

Pulp Vitality Evaluation and Comparison with Old Methods Using Pulse Oximetry (맥박산소측정기(pulse oximetry)를 이용한 치수 생활력 측정과 기존 방법과의 비교)

  • Kwon, Ik-Jae;Seo, Kwang-Suk;Kim, Jung-Wook;Chang, Ju-Hea;Kong, Hyoun-Joong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.17-23
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    • 2012
  • Background: This study evaluated pulp vitality of anterior permanent teeth using pulse oximetry (PO), which is already used for monitoring of patient's $SpO_2$ and pulse rates (PR). Also we compared with ice tests and electric pulp test (EPT). Methods: 9 teeth, endodontic treated, were selected as non-vital teeth group. 17 vital teeth were selected as control group. Our aim is to compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ice test, electric pulp test and pulse oximetry, respectively. Pulse oximetry has two test results, $SpO_2$ and pulse rates. Also we calculated correlation and statistical significances by Pearson's test between EPT and pulse oximetry. Results: Sensitivity, specificity, PPV, NPV were calculated on each tests. Ice test has results of 1.00, 0.89, 0.94 and 1.00, respectively. EPT has results of 0.94, 0.78, 0.89 and 0.88 respectively. $SpO_2$ has results of 0.94, 1.00, 1.00 and 0.90, respectively. PR has results of all 1.00. Conclusions: PO showed relatively accurate, stable and objective results on both $SpO_2$ and PR. Percentage of ability of accurate diagnosis for vital teeth is 94% for ice test, 89% for EPT, 100% for $SpO_2$ and PR. Percentage of ability of accurate diagnosis for non-vital teeth is 100% for ice test, 88% for EPT, 90% for $SpO_2$ and 100% for PR. In additions, PR could be more accurate and significant tests than $SpO_2$.

A Case of Conversion Disorder Treated with Gaegyeolseogyeong-tang (전환장애 환자에 개결서경탕(開結舒經湯)을 투여한 치험례)

  • Yoon, Ji-Won;Kim, Hong-Joon;Kim, Woo-Sung;Sim, Kuk-Jin;Shim, Ha-Na;Lee, Sang-Kwan;Kang, Sei-Young
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.590-595
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    • 2004
  • Conversion Disorder is a disorder whose predominant feature is a loss or alteration in physical functioning that suggests a physical disorder but that is actually a direct expression of a psychological conflict or need. The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) guidelines for Conversion Disorder include these definitions: A psychosocial stressor produces a psychological conflict that is believed to help initiate or exacerbate the illness The symptoms are not under conscious control, etc. While functional disabilities are common with conversion disorders, physical and laboratory abnormalities are absent or minor in comparison with the patient's subjective complaints. Symptoms of Conversion Disorder are similar to those of stroke. But the mechanism of Conversion Disorder is similar as that of Stagnation Syndrome of Ki (氣鬱證) in Oriental medicine. Gaegyeolseogyeong-tang has been used to treat women who suffer from Conversion Disorder induced by the Stagnation Syndrome of Ki (氣鬱證). After application of the Gaegyeolseogyeong-tang for 7 days, symptoms and signs improved dramatically.

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