Introduction : Oral motor function is basic function of sensory exploration, feeding, and communication, that develops from the fetal stage to childhood. Problems with oral motor function result in difficulty within handling food in the oral cavity, decreased swallowing and feeding skills, difficulty with communication, and problems with oral hygiene. To treat these symptoms, oral motor therapy is provided for normalizing sensory adaptation in the oral cavity, and increasing postural control, oral movement and oral motor function. Discussion : The oral motor facilitation technique (OMFT) was developed for increasing general and integrated oral motor function based on the following: 1) understanding orofacial muscular physiology; 2) a comprehensive approach to sensory·adaptation·behavior·cognition; 3) sensorimotor stimulation by a manual approach; 4) motor control and motor learning theory. The OMFT is a new evidence-based treatment protocol, for children and adults with neuromuscular and oral motor problems. Conclusion : The goal of this article is to provide a theoretical background for OMFT development and the basic concept for the clinical application of OMFT. We hope that this article will help oral motor therapy experts to provide effective therapy in a more professional way.
Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.
Background: Throughtout the last three decades, the therapy of leukemias and lymphoma has set the stage for curative cancer therapy in systemic malignant disease. This was the result of an integrated work of basic reaserch and clinical investigators leading to more aggressive albeit tolerable protocol of chemotherapy and radiotherapy. High dose therapy marks the most elaborated strategies in this field today. However, intensification of conventional therapeutic modalities as mentioned has to be based on new approaches and the exploration of new antineoplastic mechanisms. This insight has resulted in immune therapy of cancer. Among the cells of the immune system, natural killer (NK) cells and T cells are of major interest for the development of therapeutic strategies. Methods: Cytotoxicity to target cells was measured by LDH release method, Characterization of activated lymphocyte was measured by Flow cytometry analysis. Anti-CD3, 16, 56 monoclonal antibody and IL-2 were used for the activation of NK and T cell. The analysis of effect of activated lymphocyte, in vivo, were used by Balb/c nude mouse. Results and Conclusion: Cytotoxicity to K562 cells was significantly higher in the mixture group of NK and T cells than that of a group of activating T cells. The survivors and the rate of reduction of size of tumor craft of nude mouse group treatment with activated lymphocyte was higher than that of the group without treatment with activated lymphocyte. Therefore, this results are suggested that the activated lymphocytes by anti-CD3, CD16 and CD56 can reduce the malignancy effect of lymphoma.
Purpose: The purpose of this study was to investigate the effect of strengthening exercises of hip abductors on muscle strength and ambulation for patients with ACL reconstruction. Methods: The subjects were randomly assigned to the intervention group (general exercise plus strengthening of hip abductors) or the control group (general exercise without the strengthening of hip abductors). Both groups participated in a six-week exercise protocol after the surgery for ACL reconstruction. The knee strength test (quadriceps, hamstring, hip abductor) and gait analysis were performed in pretest and post-test. Results: Muscle strength was measured using the Biodex system III model (Biodex Medical System, Inc, NY, US). The results showed no significant difference in knee strength (quadriceps, hamstring) between the two groups (p>0.05), however, there was a significant difference in hip abductors (p<0.05). The gait analysis was measured with Gaitrite system (CIR System Inc, US). Results of comparison between groups showed a significant increase in the step length of both groups. (p<0.05), and there was a significant difference in the affected leg of the intervention group(p<0.05). Conclusion: Exercise of hip abductors for patients with ACL reconstruction provides significant benefits with respect to improvement of muscle strength in hip abductors, increasing the stride. This result indicates that a training program designed for ACL reconstruction patients should include strengthening of the hip abductor. We think that further study is needed to determine the relationship of hip muscles and knee joint for patients with ACL reconstruction.
Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.
Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.
Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.
Purpose: The purpose of this study was to investigate changes in muscle activation associated with foot position during a sit-to-stand exercise among normally healthy elderly subjects. Methods: Eight subjects (male=3; female=5; mean age=$70.13{\pm}{\pm}2.53$years) were recruited.The activation of six muscles (neck extensor; lumbar extensor; hamstring; rectus femoris; gastrocnemius; tibialis anterior) was measured by surface EMG (TeleMyo 2400T G2, Noraxon Inc., USA) during a sit-to-stand protocol under three different foot positions (ankle dorsiflexion of 0, 15, or 30 degrees). Results: Muscle activation of the neck extensor and hamstring was decreased according to the change in foot position (p<0.05), but activation of the rectus femoris was increased (p<0.05). Muscle activation of the neck extensor was significantly different between 0 and 15 degrees (p<0.05). Muscle activation of the hamstring was significantly different between 0 and 15 degrees and between 0 and 30 degrees (p<0.05). Muscle activation of the rectus femoris was significantly different between 0 and 30 degrees and between 15 and 30 degrees (p<0.05). However, activation of lumbar extensor, gastrocnemius and tibialis anterior muscles did not significantly differ between foot positions. Conclusion: These findings suggest that muscle activation during a sit-to-stand movement differs depending on foot position. We believe that these differences should be considered when educating the elderly regarding proper body movements.
Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed $2.1{\pm}0.3$ times and $2.9{\pm}0.4$ times, respectively. After disimpaction, the frequency of defecation increased from $2.2{\pm}0.3$ per week to once a day ($1.1{\pm}0.1$ per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.
Since non-cardiac chest discomfort (NCCD) can result in substantial healthcare burden and lower quality of life, interventions such as cognitive behavioral therapy (CBT) have been investigated for the relief of NCCD. In this review, we aimed to summarize the evidence on the efficacy of the CBT for the treatment of NCCD while introducing a newly-developed computerized CBT program for NCCD. Studies applying CBT to individuals with NCCD were searched for from both English and Korean electronic databases. Among 37 studies, 11 randomized controlled trials, 4 case-control studies, 1 case series, and 2 review articles were eligible for this review. Efficacy of conventional CBT for NCCD was shown in a series of studies as most of them reported improved symptom severity of NCCD or NCCD-related anxiety. However, a substantial variability existed among these studies in participants, treatment procedures and durations. High attrition rates were also reported in these studies on conventional CBT. Computerized CBT could be an alternative to the conventional CBT as it can be standardized and more easily accessible, but it was only reported in one previous study. In addition to the literature review, we presented a newly-developed computerized CBT program for NCCD which may overcome some of the limitations of conventional CBT. A computerized CBT could be an alternative treatment of NCCD, however, need further studies on its usefulness.
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