Objective: To investigate the impact of self-efficacy in using one’s upper limbs on the overall wellbeing of stroke patients, we developed the Korean version of the Confidence of Arm and Hand Movement (K-CAHM) scale by modifying the original CAHM to suit Korean cultural conditions. Methods: This study was conducted from May 2022 to June 2023 at a rehabilitation hospital with 54 stroke patients. Participants with sufficient cognitive and verbal abilities were included, while those with severe comorbidities were excluded. For the translation and cultural adaptation of CAHM into Korean, permission was obtained from the original author. Two translators independently translated the questionnaire, followed by a consensus discussion and expert review to create K-CAHM version 1.0. After back-translation and further review, the final Korean version was completed. Reliability and validity were assessed using Cronbach’s alpha, intraclass correlation coefficient (ICC), exploratory factor analysis, Bland–Altman analysis, and Pearson correlation. Results: The K-CAHM showed good reliability (Cronbach’s alpha=0.97; ICC=0.895). Bland–Altman plot analysis showed good agreement, indicating test-retest reliability. Moreover, K-CAHM showed good concurrent validity, demonstrated by its correlation with three domains of the International Classification of Functioning, Disability and Health: Fugl-Meyer assessment, the Jebsen-Taylor Hand Function Test, personal hygiene and bathing in the modified Barthel Index, and hand and stroke recovery domain in the Stroke Impact Scale. Conclusion The newly developed K-CAHM could complement other outcome measures, facilitating patient-centered rehabilitation in the Korean context.

Objective: To assess mobility in prosthetic limb users, the Prosthetic Limb Users Survey of Mobility (PLUS-M) was developed as a brief item bank. The PLUS-M exhibits good reliability and has been translated into more than 15 languages; however, a Korean translation is not yet available. Therefore, this study translated the 44 items of PLUS-M into the Korean language and analysed the psychometric properties of the PLUS-M/Short Form 12 (PLUS-M/SF- 12) instrument through official procedures. Methods: The process of Korean translation began with a consultation with the developer of the PLUS-M and included the first and second compatibility verification, back-translation, back-translation verification by the developer, and the final approval of the Korean version. This study tested validity using different instruments such as Activities-specific Balance Confidence scale, 2-Minute Walk Test, Timed Up and Go Test to assess various characteristics related to mobility. The translated version PLUS-M was then sent to two physical therapists working at Incheon Hospital and one prosthetist working at a Rehabilitation Engineering Center for them to assess the appropriateness of term use and understanding of the instrument. Results: The study found excellent internal consistency and test-retest reliability of the PLUS-M/SF-12 Korean version questionnaire, indicating its reliability and predictability across repeated measurements. Conclusion This study provided a tool to assess the mobility of individuals with lower limb amputations.

Objective: To investigate the effectiveness of radial extracorporeal shock wave therapy (rESWT) on pain, lumbar range of motion (ROM) and F-wave minimal latency and F-chronodispersion in patients with post laminectomy epidural fibrosis. Methods: Sixty patients complaining of low back pain and sciatica secondary to lumbar post laminectomy epidural fibrosis were allocated to one of the two equal groups (study and control groups). Pain intensity, lumbar ROM, and F-wave latency and F-chronodispersion were assessed pre- and posttreatment using visual analogue scale (VAS), Back ROM II device, and Neuro-MEP-Micro electromyography device, respectively. Results: Posttreatment mean values showed statistically significant decrease in VAS mean scores in both groups, with more significant decrease posttreatment in favor of the study group. There was statistically significant increase in all lumbar ROM mean scores and statistically significant decrease in F-minimal latency and F-chronodispersion for both peroneal and tibial nerves in the study group only posttreatment. Also, the results showed that significant positive moderate correlation between VAS scores and F-chronodispersion for peroneal nerve, strong negative correlation between right side bending scores and F-wave minimal latency for peroneal nerve and moderate negative correlation between left side bending scores and F-wave minimal latency for peroneal nerve after treatment. Conclusion It was concluded that rESWT is a new and convenient modality, that would be beneficial if added to the conventional physical therapy protocols in managing patients with lumbar post-laminectomy epidural fibrosis.

Objective: To investigate the effects of modified stepping exercises over six weeks on functional mobility and individual lower extremity muscle strength in community-dwelling older individuals. Methods: This prospective randomized controlled trial design was conducted in thirty-two older adults who completed a modified stepping exercises program (n=16 for soft-surface stepping exercise; n=16 for firm-surface stepping exercise). These exercises were practiced for 50 minutes/day, three days/week, over six weeks. They were assessed for their functional mobility relating to levels of independence at baseline, after 4 weeks, after 6 weeks of intervention, and at 1 month after the last intervention sessions. Results: Both groups showed significant improvements in functional mobility, lower extremity muscle strength, and walking speed after 4 and 6 weeks of intervention, as well as at the one-month follow-up. However, the soft-surface stepping exercise group exhibited significantly greater improvements in dynamic balance (p=0.035) and lower extremity muscle strength (p=0.015) compared to the firm-surface stepping exercise group after 6 weeks of intervention. Additionally, the soft-surface group demonstrated superior gains in hip flexor (p=0.041), hip extensor (p=0.047), hip adductor (p=0.026), and hip abductor strength (p=0.046), with these enhancements maintained at the one-month follow-up. Conclusion Soft-surface stepping exercise that involves whole-body movements offers a promising alternative to promote independence and safety among community-dwelling older adults. This study underscores the need for future research to evaluate the sustained impact of these benefits post-intervention, particularly during a retention period following the intervention.

Objective: To evaluate the effectiveness of a squatting posture grading system established to screen for limited ankle dorsiflexion. Methods: The squat posture grading system categorizes subjects’ squat posture into three grades. Grade 1 is defined as being able to maintain a squatting posture with heels on the ground in full ankle dorsiflexion without effort. Grade 2 is defined as being able to perform the same position, but unable to maintain the position for more than 5 seconds or requiring trunk and leg muscle efforts to maintain the position. Grade 3 is defined as being unable to maintain the same position and falling backwards immediately if attempted to touch the ground with heels. Next, subjects’ ankle dorsiflexion angles were directly measured in knee flexed and extended position by goniometer. Results: Out of the 92 total subjects, 35 were in grade 1, 18 were in grade 2, and 39 were in grade 3. The average ankle dorsiflexion angle with knee flexed position were 23.13° for grade 1, 16.03° for grade 2, and 9.31° for grade 3. The average ankle dorsiflexion angle with knee extended position were 15.16° for grade 1, 7.92° for grade 2, and 3.40° for grade 3. Ankle dorsiflexion angles showed a significant decrease from grade 1 to 3 (p<0.05). Conclusion The squatting posture grading system defined in this study effectively graded the subjects based on the difference in their average ankle dorsiflexion angle. This system could be used as a quick screening method for limited ankle dorsiflexion.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective: To determine the effectiveness of adding inspiratory muscle training (IMT) alongside a pulmonary rehabilitation protocol in terms of inspiratory muscle strength, lung function, and exercise capacity in burned adults. Methods: A randomized, double-blinded, sham-controlled study. Fifty-two adult patients with burn injuries, more than 20 years old and at least 20% total body surface area, were assigned randomly either to the experimental or the conventional group. The participants in the experimental group were given IMT plus a pulmonary rehabilitation program; the conventional group received only a pulmonary rehabilitation program. The interventions were performed for 8 weeks. At the beginning and after 8 weeks of training, the respiratory muscles’ strength, lung function and exercise capacity were all examined. Results: After 2 months of training, the experimental group demonstrated statistically significant improvements than conventional group in maximum inspiratory pressure, maximum expiratory pressure, 6-minute walk test, forced vital capacity, and forced expiratory volume in 1 second (p<0.05). Conclusion An 8-week IMT program coupled with pulmonary rehabilitation increases respiratory muscle strength, pulmonary functions, and functional capacity in burn patients. IMT is a beneficial and efficient therapy that can be easily implemented for burn patients.

Objective: To evaluate the association between outcomes, including affected extremity functions and activities of daily living (ADL), and fractional anisotropy (FA) derived from automated tractography incorporating age among patients after stroke. Methods: This study enrolled stroke patients, and diffusion-tensor imaging was conducted during the second week. Standardized automated tractography was utilized to compute FA values in the corticospinal tract (CST), the inferior fronto-occipital fasciculus (IFOF), and the superior longitudinal fasciculus (SLF). Outcome evaluations were performed at discharge from our affiliated rehabilitation facility. Extremity functions were assessed using the total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor). Independence levels in ADL were appraised through the motor and cognition components of the Functional Independence Measure (FIM). For each outcome measure, multivariate regression analysis incorporated the FA values of the CST, the IFOF, and the SLF, along with age. Results: Forty-two patients were enrolled in the final analytical database. Among the four explanatory variables, the CST emerged as the most influential factor for SIAS-motor scores. Conversely, age proved to be the primary determinant for both the motor and cognition components of FIM, surpassing the impact of FA metrics, including the CST and the IFOF. Conclusion The key influencing factors exhibited significant variations based on the targeted outcome assessments. Clinicians should be aware of these differences when utilizing neuroimaging techniques to predict stroke outcomes.

Objective: To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction. Methods: A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT). Results: A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001). Conclusion The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.