BACKGROUND: After the group education program for the families of stroke patients, we found there were improvement in family members' mental health state and coping skills. However, we also found that family caregiver's burden varied depending on patient and family factors. The purpose of this study, therefore, were to explore which factors affected caregiver's burden on family members of stroke patients and to make a background for suggesting an effective intervention strategies for them. METHOD: The subjects of this study were 187 family members of stroke patients who received the treatment from Hospital located in Seoul and Kyunggi area and they completed the written questionnaire. RESULTS: While Family member's health state, share of care responsibility, patient's functional status and family and friends support were predictors of subjective care burden, patients age and left hemiparesis among patient's functional status were predictors of objective care burden. CONCLUSIONS: Family members play a critical role in the long-term rehabilitation of a stroke patient. Hence reducing family members' care burden is very important for a patient as well as their family members. Therefore if we make intervention strategies considering these influential factors, it could be more effective to reduce family caregiver's burden.
Adaptation, Psychological ; Caregivers* ; Education ; Friends ; Gyeonggi-do ; Humans ; Mental Health ; Paresis ; Surveys and Questionnaires ; Rehabilitation ; Seoul ; Stroke*

Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016–2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B 1 , vitamin B 2 , niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.

South Korea implemented interventions to curb the spread of the novel coronavirus disease 2019 (COVID-19) pandemic with discovery of the first case in early 2020. Mathematical modeling designed to reflect the dynamics of disease transmission has been shown to be an important tool for responding to COVID-19. This study aimed to review publications on the structure, method, and role of mathematical models focusing on COVID-19 transmission dynamics in Korea. In total, 42 papers published between August 7, 2020 and August 21, 2022 were studied and reviewed. This study highlights the construction and utilization of mathematical models to help craft strategies for predicting the course of an epidemic and evaluating the effectiveness of control strategies. Despite the limitations caused by a lack of available epidemiological and surveillance data, modeling studies could contribute to providing scientific evidence for policymaking by simulating various scenarios.

Purpose: This study examined the demographics, health status, dietary habits, energy, nutrient intake, and protein intake based on levels of inclusion of animal food among females in their 20s by using data from the 7th Korea National Health and Nutrition Examination Survey. Methods: The subjects (n = 912) were divided into 4 groups according to the frequency of animal foods consumed which were categorized as meat, seafood, eggs, and dairy products, or other animal-derived foods. Results: The subjects with a lower frequency of animal food intake ate out less frequently.As the frequency of animal food intake decreased, the total energy intake too decreased with higher carbohydrate and lower protein intake ratios. In the low frequency of animal food intake group, a higher proportion of subjects had energy intake below the estimated energy requirement and the intake of protein, vitamin B 1 , vitamin B 2 , niacin, calcium, phosphorus, and iron were below the estimated average requirements. The average protein intake was more than the recommended 45 g in all four groups. However, the lower the frequency of animal food intake, the higher the proportion of people having lower protein intake compared to the recommended intake of 0.91 g per kg body weight. It became apparent that people who do not consume animal foods at all did not meet the recommended levels of protein intake. Thus, people pursuing a vegan diet may be at risk of low protein intake. Conclusion This study suggests that economic characteristics, dietary habits, energy, and nutrient intake are affected by the frequency of animal food consumed, or in other words, by the degree of vegetable-centered diet. Thus, this study would help improve the perception of vegetarianism, develop individualized dietary guidance and nutrition education programs for people practicing vegan or vegetarian diets to ensure that they have a balanced diet.

Purpose: Adult Korean men belonging to the main economically active population are known to have long sedentary hours. This study was undertaken to determine the difference and relevance of sedentary hours on the nutrition, diet, and health status of adult men, and to suggest how to prevent health risk factors. Methods: Subjects (n = 1,068) were classified into 4 groups based on their sedentary hours, ranging from the first quartile (Q1) having the least hours spent sitting, to the fourth quartile (Q4) spending the longest hours. Results: Subjects belonging to Q4 had the lowest average age, the largest waist circumference, and the highest level of education. Among those engaged in economic activities, the ratio of white-collar workers was significantly higher in Q4. Accordingly, the rate of not doing high-intensity or moderate-intensity physical activity while working was also the highest in Q4. A significant difference was obtained in the drinking frequency between groups, but this was found to be associated with the average working hours rather than sedentary hours. The proportion of not doing aerobic exercise was higher with longer sitting hours. The highest diagnosis of diabetes (8.8%) was obtained in the Q4 group. Among the factors related to cardiovascular disease, only low density lipoprotein-cholesterol showed a significant difference, with Q4 being significantly higher than Q1. Considering energy and nutrient intake, vitamin B 1 and calcium intake were the lowest in the group with the longest sitting hours, as well as the least consumption of vitamin C than the recommended estimated average requirement. Conclusion The results of this study suggest that the health and nutritional status of Korean adult men are affected by sedentary hours. This should be recognized as a health risk factor and guidelines need to be developed for sedentary lifestyle management.

Purpose: To evaluate the efficacy of intervention policies on coronavirus disease-19 (COVID-19) dissemination. Materials and Methods: An age-structured compartmental model for the COVID-19 outbreak was proposed to predict the impact of control measures in the Seoul/Gyeonggi region. The model was calibrated based on actual data and realistic situations, including daily vaccine doses, proportion of delta variant cases, and confirmed cases by age. We simulated different scenarios for non-pharmaceutical interventions by varying social distancing and school attendance strategies. Results: Two-step mitigation of social distancing without in-person classes would result in a rapid increase in confirmed cases up to 10000 but would keep severe cases within the manageable range of the health care system. The overall impact of taking down the distancing level by one step with twice the increase in contacts at school was comparable to the above scenario. Implementation of two-step mitigation of social distancing along with a two-fold increase in contacts among the school-age group would dramatically increase confirmed and severe cases by over 80000 and 100, respectively, as early as the beginning of December. This policy would cause the situation to spiral out of control, considering the scale of the response and time to prepare. On the other hand, the burden on the current healthcare system caused by two-step mitigation of social distancing and 40% increased contacts in the school-age group was manageable if prepared. Conclusion A compromise between social distancing and school attendance policy and timely preparations for the spread of COVID-19 are required.

Objective: To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital. Methods: This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed. Results: Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%). Conclusion The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

Cardiac arrhythmia is a rare manifestation of the Wallenberg syndrome; lesions are located in the brainstem, especially the lower medulla, which regulates sympathetic and parasympathetic activity. A 55-year-old man was admitted to the university hospital with symptoms including ataxia, left ptosis, decreased sensation of pain and temperature on the right side, left facial numbness, and dizziness. Brain magnetic resonance imaging revealed an infarction in the left dorsolateral medulla. Therefore, he was diagnosed with Wallenberg syndrome. While he underwent conservative treatment for Wallenberg syndrome, he experienced several events of self-limiting heart pounding, which required an evaluation of cardiac function. The 24-hour Holter monitor showed an increased RR interval with bradycardia and prolonged sinus pause. As a result, the diagnosis of sick sinus syndrome combined with Wallenberg syndrome was made. Sick sinus syndrome is a rare cardiac complication of the Wallenberg syndrome, and clinicians could overlook it when the initial electrocardiography shows a normal sinus rhythm. Sick sinus syndrome can cause sudden death without appropriate medical intervention. Therefore, clinicians should consider further evaluation, including a 24-hour Holter monitor, to check for the potential presence of sick sinus syndrome in the acute phase of Wallenberg syndrome.

OBJECTIVE: To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. METHODS: The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. RESULTS: The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. CONCLUSION: In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.
Activities of Daily Living ; Appointments and Schedules ; Humans ; Stroke ; Upper Extremity

OBJECTIVE: To evaluate the cardiovascular response during head-out water immersion, underwater treadmill gait, and land treadmill gait in stroke patients. METHODS: Ten stroke patients were recruited for underwater and land treadmill gait sessions. Each session was 40 minutes long; 5 minutes for standing rest on land, 5 minutes for standing rest in water or on treadmill, 20 minutes for treadmill walking in water or on land, 5 minutes for standing rest in water or on treadmill, and 5 minutes for standing rest on land. Blood pressure (BP) and heart rate (HR) were measured during each session. In order to estimate the cardiovascular workload and myocardial oxygen demand, the rate pressure product (RPP) value was calculated by multiplying systolic BP (SBP) by HR. RESULTS: SBP, DBP, mean BP (mBP), and RPP decreased significantly after water immersion, but HR was unchanged. During underwater and land treadmill gait, SBP, mBP, DBP, RPP, and HR increased. However, the mean maximum increases in BP, HR and RPP of underwater treadmill walking were significantly lower than that of land treadmill walking. CONCLUSION: Stroke patients showed different cardiovascular responses during water immersion and underwater gait as opposed to standing and treadmill-walking on land. Water immersion and aquatic treadmill gait may reduce the workload of the cardiovascular system. This study suggested that underwater treadmill may be a safe and useful option for cardiovascular fitness and early ambulation in stroke rehabilitation.
Blood Pressure ; Cardiovascular System ; Early Ambulation ; Gait ; Heart Rate ; Humans ; Immersion ; Oxygen ; Rehabilitation ; Stroke* ; Walking ; Water