OBJECTIVE: To investigate the usefulness of infrared thermal imaging for define the cause of shoulder pain on hemiplegic patients. METHOD: Subjects were 91 stroke patients who admitted to rehabilitation department from January 2002 to June 2003. Retrospective study was done by review of medical records. The subjects were divided into the control group (n=42) without shoulder pain and study group (n=49) who had the shoulder pain. The study group were also divided into subluxation, adhesive capsulitis, complex regional pain syndrome (CRPS) type I by main cause of pain. RESULTS: In the control group, the result revealed hypothermia on the involved upper extremity compared with the opposite intact side (p <0.05). In the study group, it revealed hyperthermia on the hand and forearm who diagnosed with CRPS type I. CONCLUSION: Distal infrared thermal imaging is considered to be useful diagnostic tool of CRPS type I in hemiplegic patient with shoulder pain.
Bursitis ; Fever ; Forearm ; Hand ; Humans ; Hypothermia ; Medical Records ; Rehabilitation ; Retrospective Studies ; Shoulder Pain ; Stroke* ; Upper Extremity*

OBJECTIVE: To examine the relationship of the Berg Balance Scale (BBS) and Functional Independence Measure (FIM) in stroke patients. METHOD: Ninety-two subjects with the first attack of stroke were enrolled to assess BBS, FIM at admission and discharge following rehabilitation programs. We divided subjects into three groups by severity of BBS at the first evaluation. Group I was low BBS (score< or =12), Group II was medium BBS (13< or =score< or =42), and group III was high BBS (score> or =43). The admission BBS and the admission FIM, and the admission BBS and the discharge FIM were compared, and also the relationship between them were assessed at the admission and/or discharge. RESULTS: Admission and discharge BBS of all three groups were significantly different, respectively (p <0.01). Admission and discharge FIM of all three groups were also significantly different (p <0.01). There was highly correlated with admission BBS and admission FIM (r=0.529, p <0.01), and moderately correlated between admission BBS and discharge FIM (r=0.43, p <0.05). Also there was high relationship between BBS gain and FIM gain (r=0.516, p <0.01). CONCLUSION: These results indicated that balance function could affect functional ability during rehabilitation programs and BBS was a useful tool to predict discharge functional status in hemiplegic subjects with stroke.
Humans ; Rehabilitation ; Stroke*

Golf has become an increasingly popular sport worldwide. In a survey done by the National Statistical Office of Korea in 2004, it is shown that 3.3% of Koreans who are 15 or older which is about 1.27 million people have played golf. Unfortunately, despite the rising popularity of golf, the research on the prevention and treatment of golf related injury was quite lacking in Korea. In terms of sports injuries, golf is considered to have a medium-class injury potential, with most injuries resulting from overuse but other causes such as lack of flexibility, unbalanced muscles, failures in condition management, inadequate stretching and warm-up/cool-down exercises are also possible. Furthermore, many golfers tend to force themselves in more exercises and rounds even when not fully recovered from the initial injury, risking secondary injuries. The prevalence of golf-related injuries varies much among researchers, but even with the average of 50%, it can be assumed that about six hundred thousand Korean golfers are suffering from various pain and discomfort. It was the purpose of this review to understand the causes of injury, treatment and prevention of golf-related injuries.
Athletic Injuries ; Exercise ; Golf* ; Korea ; Muscles ; Pliability ; Prevalence ; Sports

Pancoast tumor is a specific lung carcinoma that has symptoms according to the location. It often involves the extrathoracic structure more than parenchyme of lung, that cause shoulder pain. A 61-years old man had been complaining of shoulder pain and limitation of range of motions of shoulder joint. Conservative management of the shoulder pain was not effective with physical therapy and injection therapy and the symptom of right upper extremity radiating pain had been aggravated. We had examination of the eletro-diagnostic test in 17 months after shoulder pain was developed. The findngs of the electrodiagnostic test was suspected as the injury of lower trunk of brachial plexus, so we had checked MRI on brachial view. The pancoast tumor was found in the extrathoracic region that invaded the lower trunk of the brachial plexus. The shoulder pain related with tumor was rare and could cause brachial plexopathy.
Brachial Plexus ; Brachial Plexus Neuropathies* ; Humans ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Pancoast Syndrome* ; Shoulder Joint ; Shoulder Pain ; Upper Extremity

Syringomyelia may present with confusing, unilateral patterns of segmental muscle involvement and dissociated sensory loss. The objective of this study was to report a patient with syringomyelia and Chiari malformation type 1 (CM 1) who had an unusual presentation suggesting lower cervical radiculopathy. A 50-year-old woman presented with clinical evidence of left lower cervical radiculopathy. Nerve conduction studies revealed normal in both motor and sensory nerves of the left upper extremity. Electromyography showed abnormal spontaneous activities in the paracervical muscles at C7-T1 levels and in some examined muscles of the left upper extremity such as abductor pollicis brevis and abductor digiti minimi muscles. Magnetic resonance imaging of cervical spine demonstrated syringomyelia at C4- T4 levels. Syringomyelia may clinically mimic lower cervical radiculopathy.
Electromyography ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Neural Conduction ; Radiculopathy* ; Spine ; Syringomyelia* ; Upper Extremity

We reported three types of newly designed arm slings (the "V" strap pouch arm sling, the Modified hemisling, the Tripod arm sling). The three slings and the conventional hemisling were all tested by a single stroke patient for the correction of shoulder subluxation. Sling effectiveness was evaluated by simple shoulder AP X-rays, quantitative electromyography (root mean square; RMS), strap tension, and preference of the patient. Of the four types, the "V" strap pouch arm sling reduced the vertical displacement the most. RMS values of the supraspinatus muscle tended decrease and strap tension was also lower after using the "V" strap pouch arm sling compared with others. The patient also preferred the "V" strap pouch arm sling to the other slings. We suggested that "V" strap pouch arm sling was the most effective among four types of arm slings (including conventional hemisling) for the correction of shoulder subluxation, and patient's preference.
Arm* ; Electromyography ; Humans ; Shoulder* ; Stroke*

OBJECTIVE: To identify the factors which can delay home discharges or transfers to other hospitals of rehabilitation inpatients in a tertiary hospital and the change of discharge destination during past 6 years. METHOD: This was a retrospective study of patients with a diagnosis of stroke, traumatic brain injury or spinal cord injury who were admitted to our hospital in 1996, 1999, 2001 and 2003. Demographic data, length of stay, discharge destination and functional status by the FIM(TM) instrument were studied by a medical record review. RESULT: Patients who were transferred to other hospitals or discharged with delay showed significantly lower admission and discharge FIM scores, lower FIM efficiencies, longer length of stays and longer intervals between the onset and admission to a rehabilitation ward. CONCLUSION: Lower functional outcome was associated with a longer length of stay and discharge to another hospital. It would be necessary to establish the long term rehabilitation care facilities with extended rehabilitation program for the patients with lower functional gains in a rehabilitation unit of the tertiary hospitals.
Brain Injuries ; Diagnosis ; Humans ; Inpatients* ; Length of Stay ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Spinal Cord Injuries ; Stroke ; Tertiary Care Centers*

OBJECTIVE: To evaluate the effect of Vacuum-Assisted Closure (V.A.C.) therapy in stage 3 or 4 pressure ulcers refractory to traditional saline wet gauze dressing. METHOD: Ten patients who had stage 3 or 4 pressure ulcers which were failed to heal with saline wet gauze dressing over 4 weeks were investigated. We treated these subjects with V.A.C. therapy. The length, width and depth of pressure ulcers were evaluated every week for 3 weeks. Soft tissue biopsy from pressure ulcer was taken before starting V.A.C. therapy and after the scheduled therapy was done. RESULTS: The sizes of length, width and depth in pressure ulcer were significantly decreased after one week of V.A.C. application. And then healthy granulation tissue was formed. The length, width and depth of the pressure ulcer were decreased of 40.2%, 42.7% and 79.8% of their original size. Soft tissue biopsy in pressure ulcers was taken in 4 cases, the number and size of capillaries were more increased and inflammatory cells were decreased. CONCLUSION: V.A.C. therapy promoted wound healing and revealed favorable histological changes in pressure ulcers refractory to traditional dressing. We suggest that V.A.C. therapy can be used for the effective management of pressure ulcer.
Bandages ; Biopsy ; Capillaries ; Granulation Tissue ; Humans ; Negative-Pressure Wound Therapy* ; Pressure Ulcer* ; Wound Healing

OBJECTIVE: To investigate the characteristics, predictors, and consequences of pressure ulcers and to provide prospective epidemiologic data. METHOD: The prospective data of 100 patients with pressure ulcers were collected who were admitted to the department of rehabilitation medicine of 4 hospitals from 2002 June to 2003 September. We have collected the informations on clinical features of pressure ulcer prospectively. RESULTS: Quadriplegia/Tetraplegia was the most commonly involved type of injury, followed by hemiplegia, paraplegia. Most patients developed pressure ulcer before they were transferred to the rehabilitation unit. The average Braden scale scores was 13.06+/-3.46 and were 16 point or below in 80% of patients, and this point was considered as the cut-off score of the patients with high risk. Sacrum was the most common site of the ulcers and most ulcers were 2nd and 3rd stage. The ulcers were treated with conservative (82%) or surgical management (18%). The more severe and larger ulcers required the surgical management. CONCLUSION: The results of this prospective study on clinical features would be helpful for the understandings, prevention and management of pressure ulcers.
Epidemiologic Studies* ; Epidemiology ; Hemiplegia ; Humans ; Paraplegia ; Pressure Ulcer* ; Prospective Studies* ; Rehabilitation ; Sacrum ; Ulcer

OBJECTIVE: The purpose of this study was to analysis the medial longitudinal arch of the foot with simple radiography METHOD: We reviewed 387 feet of 219 patients with no deformity who took weight-bearing foot simple radiography. Foot length, length from talonavicular joint to posterior heel (TN), length from cuneonavicular joint to posterior heel (CN), length from cuneiform-metatarsal joint to posterior heel (CM) were measured with the digital imaging and communication in medicine (DICOM) files of the picture archiving communication system (PACS) (PiViewSTAR(r), INFINITT, Korea). RESULTS: There was significant correlation of foot length and relative location of joints of medial longitudinal arch. In males, relative value to foot length of TN, CN, CM was 39.86+/-0.97%, 45.97+/-1.20%, and 57.12+/-1.15% respectively. In females, relative value to foot length of TN, CN, CM was 39.41+/-1.19%, 47.12+/-1.44%, and 56.51+/-1.37% respectively. There were significant differences between men and women for location of joints of medial longitudinal arch. CONCLUSION: Location of joints of the medial longitudinal arch of the foot can be given a numerical value.
Congenital Abnormalities ; Female ; Foot* ; Heel ; Humans ; Joints ; Male ; Radiography ; Weight-Bearing