• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.1-11
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• 2020

Background: The purpose of this study was to investigated the effects of threshold resistance inspiratory muscle training on respiratory function in chronic stroke patients. Design: Randomized Controlled Trial Methods: Eighteen patient with stroke were randomly assigned to the experimental group (n=9) and control group (n=9) all testing and training. The experimental group underwent threshold resistance inspiratory muscle training with resistance adjusted of maximal inspiratory pressure, 60 breathing a day and general physical therapy 30 minutes a day, 5 times a week for 4 weeks. The control group was taken general respiratory muscle training and general physical therapy for 4 weeks in the same way. Respiratory function, walking ability were evaluated before and after the intervention. Statistical significance of the results were evaluated by ANCOVA between control group and experimental group after intervention. Results: There was a significant increase in FVC and FEV1 in the experimental group in pulmonary function tests (p<0.05). There was a significant difference with the maximum inspiratory pressure and the maximum inspiratory flow rate between experimental and control group (p<0.05). There was no significant difference with the maximum inspiratory capacity between experimental and control group (p>0.05) but the maximum inspiratory capacity of experimental group some increased than that of control group. Conclusion: These finding gave some indications that the threshold resistance inspiratory training may benefit on pulmonary function in people with stroke, and it is feasible to be included in rehabilitation interventions with this population.

• PNF and Movement
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• v.18 no.3
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• pp.383-392
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• 2020

Purpose: Balance and gait dysfunction caused by aging affect elderly individuals' independent life, which, in turn, can reduce their overall quality of life. The purpose of this study is to compare the differences in the vestibular function of healthy elderly and young adults based on the subjective visual vertical (SVV) test as well as to compare and analyze the gait ability between these two groups to study the differences and association between vestibular, dizziness, and balance ability. Methods: The subjects were 18 young and 16 elderly adults with no neurological or musculoskeletal damage. To evaluate vestibular function, a subjective visual vertical test was performed. To evaluate the gait function, the step time, step length, stride length, stance phase ratio, and swing phase ratio were measured. Balance was evaluated using the Berg Balance Scale (BBS), and dizziness was evaluated using a dizziness handicap inventory (DHI). Results: There were significant differences in the SVV, BBS, and DHI between the young and elderly adults (p < 0.05). The gait variables of the older adults were all significantly different (except for the swing phase ratio) than those of the young adults (p < 0.05). As the result of correlation analysis, the SVV values of the young adults showed a significant negative correlation with step length and stride length (p < 0.05), while the SVV values of the elderly adults only showed a significant positive correlation with the DHI (p < 0.05). Conclusion: The elderly appeared to show a decrease in vestibular function when compared to the young adults, and it is thought that walking and balance function declined, while dizziness increased. Moreover, it is believed that these results can be used as basic data for vestibular rehabilitation in the future.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.107-115
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• 2020

Purpose: This study aims to systematically review the dual-task evaluation applied to the screening of mild cognitive impairment. It also aims to present various evaluation items and results analysis methods for dual tasks applied to patients with mild cognitive impairment. Methods: We conducted a systematic search of published studies in PubMed databases and KISS from January 2000 to August 2020 using the main keywords such as "Dual task," "Mild Cognitive impairment," "Elderly," and "Screening." We selected a total of 10 studies for the analysis from 1314 searched articles. Results: We analyzed the qualitative level of 10 studies that were nonrandomized two-group studies with evidence level II (100.0%). These results suggest that the evidence level of the studies was high. We analyzed 10 studies and identified 12 motor tasks and 19 cognitive tasks. Walking was the most commonly used evaluation motor task and counting backward by ones and naming animals were the most commonly used evaluation cognitive tasks. Moreover, the velocity speed was the most used result analysis method. The results indicate that there were significant differences in dual-task performance between patients with normal and mild cognitive impairment. Conclusion: The results of this study can be used as a basis for the selection of dual-task evaluation items and methods of analyzing the results for screening mild cognitive impairment. Furthermore, they are expected to be used for research on the development of dual-task evaluation tools. It is necessary to compare and analyze the usage trends of dual-task evaluation by cultural differences in future studies.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.1
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• pp.1-9
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• 2021

Objective: This study examines the prevalence of osteoporosis, and compares with activity of daily living(ADL), instrumental activity of daily living(IADL) and health-related quality of life(QoL) among the elderly people with disabilities. Methods: This study analyzed the data of 3,113 persons with disabilities over 65 years of age who responded to the questionnaire using data from the National Survey of People with Disabilities in 2017 on the people with disabilities (PWD). Descriptive statistics, X2-test, and independent sample t-test were conducted using the SPSS win 21.0 program. Results: The prevalence of osteoporosis in the elderly PWD was 18.7%. There were significant differences in sex, age, type of disability, and disability severity according to the presence or absence of osteoporosis (p<0.05). Walking and Transfer of ADL were related to osteoporosis in elderly PWD. Financial management and Transportation use of IADL were related to osteoporosis (p<0.05). The PWD with osteoporosis were analyzed to have lower health-related quality of life compared to the disabled elderly without osteoporosis (p<0.05). Conclusion: Based on the results of this study, a strategy for developing a program for managing osteoporosis. Strengthening health management in the elderly PWD is required.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.65-73
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• 2022

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

• Journal of Korean Medicine for Obesity Research
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• v.22 no.1
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• pp.86-92
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• 2022

The purpose of this study was to investigate the effects of dietary therapy with Korean herbal medicine and cultivated wild ginseng pharmacopuncture on change of body composition retrospectively. We analyzed the medical records of 26 patients, who carried out dietary therapy with Korean herbal medicine and cultivated wild ginseng pharmacopuncture at Moemfit Clinic, Charmjin Oriental Medicine for 8-12 weeks. And exercise and nutrition were recommended self-developed food, Moemfit Shake, Moemfit Hankki and walking exercise for one hour a day. The body composition values (body weight, body mass index, body fat mass, skeletal muscle mass, waist-hip ratio, visceral fat area, percent body fat) decreased after dietary therapy with Korean herbal medicine and cultivated wild ginseng pharmacopuncture significantly. But, percent skeletal muscle increased significantly. Results from this investigation showed that dietary therapy Korean with herbal medicine and cultivated wild ginseng pharmacopuncture has positive effects on changes of body compositions.

• Journal of Korean Academy of Nursing
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• v.52 no.3
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• pp.261-277
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• 2022

Purpose: This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support. Methods: A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann-Whitney U test, ANCOVA, and Ranked ANCOVA. Results: The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, η_p² = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group. Conclusion: The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.57-65
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• 2022

Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

• Journal of Korean Biological Nursing Science
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• v.25 no.3
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• pp.172-182
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• 2023

Purpose: This study investigated the differences in physical function, self-efficacy (SE), and health-related quality of life (HRQoL) categorized by disease severity in community-dwelling patients with chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional study included 182 patients with COPD selected from the pulmonology outpatient department of a tertiary hospital. Disease severity was measured using forced expiratory volume in 1 second (FEV1). Physical function, SE, and HRQoL were measured with the six-minute walking distance, Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE), and St. George's Respiratory Questionnaire (SGRQ). Disease duration, FEV1, and 12-month history of exacerbations were obtained from medical records. Patients were categorized by Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Data were analyzed using the χ² test, and one-way ANOVA. Results: Most of the participants were male and nonsmokers. The disease duration was 10.76 ± 10.03 years, the mean FEV1% was 62.13 ± 22.80, and 70.3% of the participants were in GOLD category 2 (moderate) or milder. Half of the participants reported modified Medical Research Council scores ≥ 2. Patients in GOLD categories 1 and 3 (mild and severe) exhibited significantly higher PRAISE scores than those in the other groups (F = 8.23, p < .001). The total SGRQ scores were highest in GOLD 4 (very severe), indicating the lowest HRQoL. Significant differences were identified among GOLD 1, GOLD 2 and 3, and GOLD 4 (F = 9.92, p < .001). Conclusion: We identified potentially useful variables to comprehensively assess disease severity and tailor management strategies, including airflow limitation, and to determine the consequences of COPD from patients' perspectives.