• Journal of Biomedical Engineering Research
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• v.29 no.3
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• pp.179-186
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• 2008

This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.3
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• pp.105-114
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• 2021

A 38-year-old Korean man without any other history was diagnosed with myelopathy due to a spinal dural arteriovenous fistula. Following embolization and high-dose steroid therapy, the patient was treated with complex Korean medical therapies including acupuncture, pharmacopuncture, electro-acupuncture, Chuna manual therapy, herbal medicine, and cupping therapy in addition to conventional treatment. To assess the patient's improvement, international standard for neurological classification of spinal cord injury, Korean version of modified Barthel index, functional independence measure, spinal cord independence measure III, walking index for spinal cord injury II, modified Ashworth scale were used. After treatment, the muscle strength and sensory function of the lower extremities were improved, and the spasticity was reduced, resulting in a rapid improvement in performance of daily activities. These results suggest that complex Korean medical therapies may be effective for myelopathy, and further clinical studies are needed to clarify their effects.

• Journal of Genetic Medicine
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• v.18 no.2
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• pp.105-109
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• 2021

Tetrasomy 18p is a genetic syndrome caused by an isochromosome consisting of two copies of the short arm of chromosome 18. Clinically, pediatric cases of tetrasomy 18p manifest with global developmental delay, similar to most cases of chromosomal abnormality. In addition, it causes various symptoms including abnormal muscle tone. We report a case of an infant with global developmental delay and remarkable spasticity, the typical phenotype of bilateral spastic cerebral palsy. However, she had a subtle anomaly in her face, and brain magnetic resonance imaging (MRI) findings were inconsistent with her strong upper motor neuron signs. Upon genetic testing, she was determined to have an 18p isochromosome, confirming de novo non-mosaic tetrasomy 18p. Cerebral palsy is a neurological disorder that includes developmental delay caused by a non-progressive lesion in the developing brain. During diagnostic workup in patients with cerebral palsy, genetic testing should be considered when there are minor physical anomalies or equivocal MRI findings.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.91-99
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• 2020

Objective : The purpose of this study was to investigate the effects of the IOPI articulator strength training program on articulator(tongue and lip) muscle strength, numbers of /l, s, ʨ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates, and sequential motion rate changes in patients with spastic dysarthria. Methods : Three cases of patients with spastic dysarthria living in Jeju, Korea, were included in this study. A single subject design was selected to study changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy in the alternate motion rates and sequential motion rates. Results : After the articulator strength training program was conducted on patients with spastic dysarthria, there were positive changes in articulator(tongue and lip) muscle strength, numbers of /ㄹ, ㅅ, ㅈ/ articulation accuracy, articulatory numbers, articulation regularity and accuracy on the alternate motion rates and sequential motion rates. Conclusion : Our findings suggest that IOPI articulator strength training program could be very useful for the most representative childeren with cerebral palsy if conducted in various subtypes of dysarthric patients and linked with articulatory function training with IOPI at home.

• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.13-24
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• 2020

Background: This study evaluates physical function, balance, and cognition rehabilitation motivation. Design: Cross-sectional study. Methods: The subjects include 67 stroke patients to measure physical function, balance, and cognition rehabilitation motivation. For evaluation of physical function, Manual Muscle Test, Range of Motion, Modified Ashworth Scale for spasticity, grasping power, and balance was measured using Functional reach test (FRT), Berg Balance Scale (BBS). For evaluating Cognition, Korean-Mini Mental State Examination, motivation for rehabilitation scale was used to measure for motivation. Results: The results of this study that the moderating effect of rehabilitation motivation was significant in the effect of physical function on BBS (p<0.01), The moderating effect of rehabilitation motivation was significant in the effect of FRT on physical function (p<0.01), The moderating effect of external motivation was also significant in the effect of FRT on physical function (p<0.01). However, the results of the rehabilitation motivations generally divided into three groups (Lower, Average, Upper) and all three results were statistically significant only in groups of average and lower. Conclusion: This study confirms that the rehabilitation motive has demonstrated significant adjustment effects between the body function and balance. In this study, physical function, balance and cognition were significantly correlated with each other, and rehabilitation motivation proved a significant moderating effect between physical function and balance.

• Health Policy and Management
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• v.26 no.4
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• pp.289-304
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• 2016

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

• International Journal of Advanced Culture Technology
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• v.7 no.1
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• pp.231-236
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• 2019

Background/Objectives: This paper proposes a dual mode feedback-controlled cycling system for children with spastic cerebral palsy to rehabilitate upper extremities. Repetitive upper limb exercise in this therapy aims to both reduce and analyze the abnormal torque patterns of arm movements in three- dimensional space. Methods/Statistical analysis: We designed an exercycle robot which consists of a BLDC motor, a torque sensor, a bevel gear and bearings. Mechanical structures are customized for children of age between 7~13 years old and induces reaching and pulling task in a symmetric circulation. The shafts and external frames were designed and printed using 3D printer. While the child performs active/passive exercise, angular position, angular velocity, and relative torque of the pedal shaft are measured and displayed in real time. Findings: Experiment was designed to observe the features of a cerebral palsy child's exercise. Two children with bilateral spastic cerebral palsy participated in the experiment and conducted an active exercise at normal speed for 3 sets, 15 seconds for each. As the pedal reached 90 degrees and 270 degrees, the subject showed minimum torque, in which the child showed difficulty in the pulling task of the cycle. The passive exercise assisted the child to maintain a relatively constant torque while visually observing the movement patterns. Using two types of exercise enabled the child to overcome the abnormal torque measured in the active data by performing the passive exercise. Thus, this system has advantage not only in allowing the child to perform the difficult task, which may contribute in improving the muscle strength and endurance and reducing the spasticity but also provide customizable system according to the child's motion characteristic. Improvements/Applications: Further study is needed to observe how passive exercise influences the movement characteristics of an active motion and how customized experiment settings can optimize the effect of pediatric rehabilitation for spastic cerebral palsy.