A customized vestibular rehabilitation (VRT) is an important treatment modality in patients with vestibular dysfunction with gaze instability, motion-provoked vertigo, disequilibrium and gait disturbance. We discuss in this paper the patient selection criteria for VRT, rehabilitation strategies for vestibular deficits, and the factors that affect the outcome.
Gait ; Humans ; Patient Selection ; Vertigo

OBJECTIVE: To understand the neural generator of double-peak potentials and the change of latency and amplitude of double peaks with aging. METHOD: In 50 healthy subjects made up of groups of 10 people per decade from the age of 20 to 60, orthodromic sensory nerve conduction studies were performed on the median nerves using submaximal stimulation. Various stimulus durations and interstimulation distances were used to obtain each double peak in the different age groups. The latency and amplitude of the second peak were measured. Statistical analyses included one-way ANOVA and correlation tests. p-values<0.05 were considered significant. RESULTS: When the cathode moved in a proximal direction, the interpeak intervals increased. Second peak amplitudes decreased, and second peak latencies were delayed with aging (p<0.05). In some older people, second peaks were not obtained. CONCLUSION: Our experiments indicate that the double-peak response represented the two stimulation sites under the cathode and anode. The delayed latency and decreased amplitude of the second peak that occurs with aging represented peripheral nerve degeneration in aging, which starts at the distal nerve.
Aging ; Electrodes ; Humans ; Median Nerve ; Nerve Degeneration ; Neural Conduction ; Peripheral Nerves

OBJECTIVE: To evaluate the effect of multiple sensory stimulation on cortical excitability by using transcranial magnetic stimulation (TMS). METHOD: Thirteen right handed young adults without neurological deficit were enrolled. Cortical excitability was tested by measuring recruitment of motor evoked potentials [recruitment curve (RC)], intracortical inhibition (ICI), and intracortical facilitation (ICF) at the abductor pollicis brevis of the dominant hand in two different conditions: (1) group A: active thumb and index finger pinch movement while observing the congruent finger movement in a screen with 0.2 Hz bell sound for 30 minutes, (2) group B: the same active finger movement in a dark screen with the same bell sound for 30 minutes. All of these procedures were done with a randomized crossover design. RESULTS: The amplitude of MEP and the slope of all RC (140%,160% of the resting motor threshold) of group A showed increment after visually-guided finger movement and the level of ICI showed decrement after visually guided finger movement (p<0.05), but there was no change in the level of ICF (p>0.05) in group A. In group B, the amplitude of MEP and the levels of ICI, ICF showed no significant changes following finger movement with no visual guidance (p>0.05), but the slope of RC with 140% showed increment (p<0.05). CONCLUSION: These findings suggest that cortical excitability can be enhanced by simple repetitive motor practice. The congruent sensori-motor stimulations lead to corresponding additional effect on cortical excitability, presumably by recruitment of remote motor neurons.

To evaluate the effectiveness of the human umbilical cord blood (HUCB) transplantation for the treatment of intrinsic sphincter deficiency (ISD), we analyzed the short term effects of HUCB mononuclear cell transplantation in rats with induced-ISD. ISD was induced in rats by electro-cauterization of periurethral soft tissue with HUCB mononuclear cell injection after 1 week. The sphincter function measured by mean leak point pressure was significantly improved in the experimental group compared to the control group at 4 weeks. (91.75+/-18.99 mmHg vs. 65.02+/-22.09 mmHg, P=0.001). Histologically, the sphincter muscle was restored without damage while in the control group it appeared markedly disrupted with atrophic muscle layers and collagen deposit. We identified injected HUCB cells in the tissue sections by Di-I signal and Prussian blue staining. HUCB mononuclear cell injection significantly improved urethral sphincter function, suggesting its potential efficacy in the treatment of ISD.
Animals ; Cells, Cultured ; Cord Blood Stem Cell Transplantation/*methods ; Humans ; Leukocytes, Mononuclear/*transplantation ; Rats ; Rats, Sprague-Dawley ; Treatment Outcome ; Urinary Incontinence, Stress/diagnosis/*physiopathology/*surgery ; Urologic Surgical Procedures/*methods

OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.
Aphasia ; Coat Protein Complex I ; Electronic Mail ; Hand ; Hand Strength ; Korea ; Language Tests ; Outcome Assessment (Health Care) ; Treatment Outcome ; Upper Extremity ; Surveys and Questionnaires

OBJECTIVE: The objective of present study was to identify the rehabilitation outcome measures currently used in Korea. METHOD: The survey was conducted by e-mail questionnaire to 165 department of rehabilitation medicine in hospitals of Korea. Non-responders were sent a second copy of the questionnaire if they did not answer within 1 week. Data from the returned questionnaires were entered into a Microsoft Excel and subjected to descriptive and simple quantitative analysis. RESULTS: A total of 99 (60%) responses were received. Of these, 95% units collected some outcome assessment measure as part of routine clinical practice. Korean version of Modified Barthel Index (K-MBI) (80%) was the most popular global outcome measures. The Korean version of Berg Balance Scale (K-BBS) (53%) was used most frequently for balance assessment. Upper extremity function was checked with hand grip strength test (70%) and Box and block test (67%) most commonly. Korean version of Mini Mental State Examination (K-MMSE) was the most popular cognitive function test (75%). PARADISE Korean version-Western Aphasia Battery (PARADISE K-WAB) was the most popular language test (67%). Sixty-three (67%) units used outcome results for discussion and goal setting. Seventy-eight (78%) units responded that they would use a standardized outcome measures if there is an agreed standardized outcome measures lists (80%) and support of money and time (43%). CONCLUSION: The survey demonstrated that quite widespread use of outcome assessments in routine clinical rehabilitation within Korea. There is also an agreement for need of common 'basket' of recommended instruments for rehabilitation.
Aphasia ; Coat Protein Complex I ; Electronic Mail ; Hand ; Hand Strength ; Korea ; Language Tests ; Outcome Assessment (Health Care) ; Treatment Outcome ; Upper Extremity ; Surveys and Questionnaires

The thalamus, located between the cerebrum and midbrain, is a nuclear complex connected to the cerebral cortex that influences motor skills, cognition, and mood. The thalamus is composed of 50-60 nuclei and can be divided into four areas according to vascular supply. In addition, it can be divided into five areas according to function. Many studies have reported on a thalamic infarction causing motor or sensory changes, but few have reported on behavioral and executive aspects of the ophthalmoplegia of the thalamus. This study reports a rare case of a paramedian thalamus infarction affecting the dorsomedial area of the thalamus, manifesting as oculomotor nerve palsy, an abnormal behavioral change, and executive dysfunction. This special case is presented with a review of the anatomical basis and function of the thalamus.
Cerebral Cortex ; Cerebrum ; Cognition ; Executive Function ; Infarction* ; Mesencephalon ; Motor Skills ; Oculomotor Nerve Diseases ; Ophthalmoplegia ; Thalamus

OBJECTIVE: To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification. METHODS: This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions. RESULTS: Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p < 0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p < 0.005). CONCLUSION: This study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.
Anxiety ; Depression ; Fatigue ; Humans ; Metabolic Equivalent ; Myocardial Infarction ; Outcome Assessment (Health Care) ; Oxygen ; Prospective Studies ; Walking