• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.40-44
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• 2011

We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT) showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) of white matter tract, visualization was possible.

• Journal of the Korean Society of Manufacturing Technology Engineers
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• v.22 no.3_1spc
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• pp.587-592
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• 2013

Until recently, the primary users of wheelchairs were people with lower body disabilities. However, the number of patients recovering from accidents or surgery, as well as the number of elderly people using wheelchairs, is constantly increasing. This study examined the design and manufacture of standing and gait assist wheelchairs that assist temporary gait disturbed patients to take rehabilitation training and elderly people to engage in walking exercise. A kinematic analysis was used to select a drive motor and design a four-bar linkage mechanism for lifting the backrest vertically. Using a multibody dynamic simulation, detailed design was performed taking into consideration the spatial motion and partial interference, and the necessary push force and stroke of the linear actuator were also calculated. To ensure structural safety, the von-Mises equivalent stresses of the upper and lower brackets of the linear actuator were verified through a finite element analysis. The manufactured wheelchair was shown to operate successfully as intended, using the developed controller for the drive motors and linear actuator.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.43-46
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• 2014

Cerebral Palsy is a genetic term referring to abnormalities of motor control caused by damage to a child's brain early in the course of development. Due to the impairment of balanced perioral muscle development, the prevalence of malocclusions in patients with cerebral palsy such as maxillary protrusion is high. But most clinicians may feel uncomfortable to treatment of these problems. Here a case report about mitigation of maxillary anterior teeth protruded in patient with cerebral palsy. 8y 4m old boy who have cerebral palsy visited our dental hospital. He showed severely protrusive maxillary anterior teeth with mouth breathing and could not close his mouth. He and his mother wanted to improve dental and facial esthetic problem. Specially designed or modified intraoral fixed appliance and rubber elastic chain was used in the therapy. Treatment carried out for 8 months and we could observe maxillary incisor angle was improved and mouth breathing habit was stopped. In conclusion, modified fixed appliance therapy for the patients with cerebral palsy might be useful. Continuous rehabilitation training of lips should be followed after treatment to correct imbalance of muscle tone.

• Physical Therapy Korea
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• v.27 no.3
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.43-55
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• 2019

Objective: The purpose of this study is to conduct a preliminary research for the development of a Performance-Based Cognitive Function Test (PCFT) to screen the elderly for cognitive function impairment, and examine the reliability and validity of the test. Methods: A draft version of the Performance-Based Cognitive Function Test (PCFT) was developed and utilized in nine healthy elderly individuals. In order to verify its reliability, we analyzed the internal consistency of the PCFT. In order to verify the concurrent validity of the PCFT, this study analyzed the correlation between motor-cognitive dual task assessments and the Korean version of the Mini-Mental State Examination (MMSE-K). Results: The internal consistency of the PCFT for motor and cognitive tasks was 0.871 and 0.959 (Cronbach's ${\alpha}$), respectively. Concurrent validity of the PCFT, which was performed through motor-cognitive dual task assessments, ranged from 0.755 to 0.964 (Spearman's rho statistic, p < 0.05). In addition, correlation between the cognitive assessment tool and the MMSE-K ranged from 0.849 to 0.943 (p < 0.01). Conclusion: This study verified, and established the reliability and validity of the PCFT. Further studies are required to examine other psychometric properties in a modified PCFT, for screening cognitive function impairments in the elderly.

• Journal of Music and Human Behavior
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• v.3 no.1
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• pp.29-62
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• 2006

The early development of an infant is crucial due to the enormous impact it has throughout an infant's life. Therefore, it is important to understand the development process of an infant and provide a high-quality educational environment so that an infant can progress at an innate pace to learn how to exercise, understand, speak, socialize, and empathize as well as having a balanced growth. When educating an infant, joy is a substantial factor in the formation of trust and development of relationship that makes education efficient. Music can be an effective means to offer a fun atmosphere vto the infant in which it stimulates active participation of the infant and development of a variety of dimensions to the infant's development. Also, the purpose of music therapy education is utilizes to plan for the different age groups' level of understanding of music and allow the infant to have a positive experience and develop properly. The purposes of this study are as following: to examine characteristics according to an infant' developmental steps thoroughly, to suggest interventions using music therapy education to stimulate development of an infant, to prove that infants age 3 to 6 obtain the necessary ability and skill through the effective educational therapy through music, and finally to create a music program for educating infants or music therapy. This study has examined theories of the music approach targeting infants age 3 to 6 and made character observations of infant' Motor, Cognition, Communication, Socialization, and Emotions. With the basis of the above theory, the different levels of development has been divided, specific goals has been set up according to the levels, and various music therapy education for infants have been created. The music therapy education activity has been approved by five professionals who are renown in their specific field. They made comments that the development levels were properly divided in the paper. They also commented that the music program is adequate for achieving the goal of each developmental level and it stimulates the different levels of an infant's development. In conclusion, the study reflects that the approach of music therapy education stimulates the different levels of infant development. Music therapists can utilize this music program to help handicapped children identify characteristics of progress and develop at their own ability.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.1-6
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• 2017

Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.8-13
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• 2016

Purpose: The purpose of the present current study was to examine control of upper limb multi-joint movements with differential coordination stability. To achieve the goals of the study, torque analyses were utilized to answer questions about how torque components were differed among various elbow-wrist coordination patterns. Methods: Eight self-reported right-handed college students (3 males and 5 females, mean age=20.6 yr) were volunteered. The task required participants to rhythmically coordinate the flexion-extension motions of their elbow and wrist with coordination relationship of $0^{\circ}$, $90^{\circ}$, and $180^{\circ}$relative phases between the two joints. Mean relative phase and phase stability (standard deviation of relative phase) were computed to for analysisze of overall coordination performance. To determine the figure out characteristics of torque components in elbow and wrist joints, impulse values of muscle torque (MT) and interactive torque (IT) and MT as a percentage of cycle duration (MT-PCD) were analyzed. Results: Torque results showed that the proximal elbow joint generated motions with mainly muscle efforts regardless of coordination patterns, while the distal wrist joint adjusted the coordination patterns by changing amount of MT. Impulse analyses showed that the least stable $90^{\circ}$ pattern was performed by utilizing a similar coordination strategy of the most stable $0^{\circ}$ pattern. Conclusion: The present current study suggests that the roles of distal and proximal joints differ in order to achieve various multi-joint coordination movements. This study provides information for use in gives an idea to development of rehabilitation or training programs for to persons with an impaired upper limb motor ability.

• PNF and Movement
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• v.13 no.2
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• pp.89-93
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• 2015

Purpose: This study aimed to verify the effect of integrated patterns (IPs) of PNF on individuals with malalignment using upper extremity and lower extremity patterns simultaneously. This information was then compared to the effect of bowling exercises on malalignment. The study population included individuals in their twenties with malalignment in their posture. Methods: Individuals with malalignment (40 participants in total) were divided into 2 groups based on trunk inclination and side deviation. In one group, IPs of PNF were used as interventions, while the other group used bowling exercises. This process was completed over the course of four weeks. The IP group used two patterns simultaneously: flexion-adduction-external rotation and extension-abduction-internal rotation. These patterns were used in the upper and lower extremities and were crossed diagonally. Results: The trunk inclination decreased in the IP and the bowling group. In the IP group, the degree of inclination decreased from 0.94 to 0.33. The side deviation also decreased to 1.53 (p < 0.05). In the bowling group, the two measured values decreased significantly (p < 0.05). Conclusion: Compared to the bowling exercises used in the bowling group, the results of this study indicate that the use of IPs had a significant effect on trunk inclination and side deviation for malalignment posture patients. Individuals can easily improve malalignment using IPs of PNF (for example, at home or at their office), which suggests that they are not required to seek assistance from a fitness or bowling center, which may save them time.