1.Retrograde Changes of Median-Nerve Fibers in Carpal Tunnel Syndrome.
Journal of the Korean Academy of Rehabilitation Medicine 1997;21(1):121-127
Slowing in forearm median nerve conduction in patients with carpal tunnel syndrome(CTS) has been described. But the cause of slowing is still unclear whether it is related to a technical artifact on electrodiagnostic appr oach or pathophysiologic changes in the proximal segment of median nerve. To investigate the possible retrograde degeneration of median nerve in the forearm segment(wrist to elbow) in patients with known carpal tunnel syndrome, the median nerve conduction studies were performed in 23 normal persons as control and 25 patients with carpal tunnel syndrome. To evaluate the median nerve conductions in the forearm, the recording bar-electrode were placed at the volar aspect of the wrist and stimulating electrodes were applied at the elbow area. The mixed nerve action potentials and conduction velocities were measured. The median mixed nerve action potential(FNAP) amplitudes recorded at the wrist and motor nerve conduction velocity(MMCV) in patients with carpal tunnel syndrome patients were significantly reduced compared to those of control group(p<0.05). However, the median mixed nerve conduction velocity(FNCV) was not reduced significantly. The median mixed nerve action potential amplitudes demonstrated positive correlation with the decrease of motor and sensory action potential amplitudes and velocities. This result suggests that the retrograde degeneration progresses as the carpal tunnel syndrome progresses and the retrograde degeneration may play a major role in reduced motor nerve conduction velocity of the median nerve in the forearm. We propose that FNAP amplitude and MMCV might be used to evaluate the severity of retrograde degeneration in patients with carpal tunnel syndrome.
Action Potentials
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Artifacts
;
Carpal Tunnel Syndrome*
;
Elbow
;
Electrodes
;
Forearm
;
Humans
;
Median Nerve
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Neural Conduction
;
Retrograde Degeneration
;
Wrist
2.How to Deal with the Latency of Unobtainable Responses in the Statistical Analysis.
Seong Bom PYUN ; Hee Kyu KWON ; Hang Jae LEE
Journal of the Korean Academy of Rehabilitation Medicine 1998;22(5):1056-1059
OBJECTIVE: To evaluate the usability of near-nerve needle recording techniques in cases of unrecordable sensory nerve action potentials (SNAPs) with a surface electrode and to determine a proper alternative value of the missing latencies. METHOD: Twenty six hands of 23 patients with a carpal tunnel syndrome (CTS) and an unobtainable median SNAP by surface electrode were evaluated by the near-nerve needle recording of median SNAPs. Using the nerve conduction data of 113 patients with CTS, we have established 3 alternative values: maximal, 95 percentile and predictive latencies. The alternative values were compared with the mean onset latencies by the near-nerve needle recordings of median SNAPs. RESULTS: Median SNAPs were obtainable in the 22 out of 26 hands by the near-nerve recording technique. The mean onset latency was 5.51+/-0.36 ms. The alternative values from 113 patients with CTS were as follows: maximum latency, 6.9 ms; 95 percentile latency, 5.6 ms; and predictive latency, 5.52 ms (Y = 0.123x X 5.52491; Y, onset latency; X, amplitude; r2=0.564; p=0.00). The Predictive latency was nearest to the mean onset latency. CONCLUSION: To minimize the selection bias and statistical errors, the near nerve recording techniques proved to be a valuable method in cases of unrecordable SNAPs with surface electrode. For compensation of missing data, a proper alternative value can be obtained by the predictive latency calculated from a linear regression.
Action Potentials
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Carpal Tunnel Syndrome
;
Compensation and Redress
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Electrodes
;
Hand
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Humans
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Linear Models
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Needles
;
Neural Conduction
;
Selection Bias
3.Quality of Life after Stroke.
Seong Bom PYUN ; Sang Han KIM ; Myung Su HAHN ; Hee Kyu KWON ; Hang Jae LEE
Journal of the Korean Academy of Rehabilitation Medicine 1999;23(2):233-239
OBJECTIVE: The purposes of this study were to examine overall quality of life (QOL) in long term stroke survivals and to identify variables that predict QOL after stroke. METHOD: Subjects were 51 stroke patients (male; 28, female; 23) with stroke onset at least 6 months previously. Interview, measurement of depression and QOL were performed at outpatient clinic after discharge. Review of medical records included characteristics of stroke and communication disorders. Interview questionnare included caregiver, religion, education level, occupation and income. Depression and functional status was measured by the Beck depression inventory (BDI) and modified Barthel index (MBI), respectively. QOL was measured with the use of 5-item (activity, daily living, health, support, outlook) version of the Quality of Life Index (QLI) and its range of scores is 0~10. We compared QLI scores according to various factors obtained from medical records and questionnaire. RESULTS: Mean duration after onset of stroke was 33.6 months (range, 6~216 months). The mean score of QLI were 7.0+/-2.1. Low MBI score, communication disorder and depression had a negative effect on QOL (p<0.05). Sex, age, occupation, caregivers, religion, education level, income, duration after stroke onset and side of hemiplegia had no effect on QOL (p>0.05). CONCLUSION: Low MBI score, depression and communication disorders would be negative predictors of QOL and identification of these factor may assist stroke patients in coping their personal and social life.
Ambulatory Care Facilities
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Caregivers
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Communication Disorders
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Depression
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Education
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Female
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Hemiplegia
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Humans
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Medical Records
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Occupations
;
Quality of Life*
;
Surveys and Questionnaires
;
Stroke*
4.Development of a Short Version of ICF Core Set for Stroke Adapted for Rehabilitation in Korea: a Preliminary Study
Chan hyuk PARK ; Sung-Bom PYUN ; Seung Don YOO ; Seong Hoon LIM ; Han Young JUNG
Brain & Neurorehabilitation 2021;14(1):e8-
This study aimed to develop a short version of the International Classification of Functioning, Disability, and Health (ICF) core set and verify functioning levels of patients for stroke rehabilitation in Korea. Using the Delphi technique, a 3-round consensus process was conducted. Thirty multidisciplinary rehabilitation experts from different hospitals completed the consensus study. The questionnaire for this study adopted the comprehensive ICF core set for stroke developed by the Geyh group. A 7-point Likert-type scale was used by participants to weigh the impact of each category on activities of daily living or rehabilitation after a stroke. The consensus of ratings was assessed with Spearman's rho and inter-quartile range indices. A core set to assess functioning levels of patients with stroke was developed from those categories. A short version of ICF core set to assess and verify functioning levels of patients with stroke was developed for 12 categories, including 3 categories (consciousness, muscle power, and attention) from body functions, 1 (structure of brain) from body structures, 5 (eating, walking, moving around, changing basic body position, and carrying out daily routine) from activities and participation, and 3 (individual attitudes of immediate family members, immediate family, and personal care providers/personal assistants) from environmental factors. This preliminary study developed a Delphi consensus process, gathering statistical evidence and expert commands based on the short version of ICF core set for rehabilitation of stroke patients in Korea.
5.Erratum: Inpatient Stroke Rehabilitation Outcomes in Korea Derived from the Korean Brain Rehabilitation Centers' Online Database System for the Years 2007 to 2011.
Kyung Lim JOA ; Tai Ryoon HAN ; Sung Bom PYUN ; Ueon Woo RAH ; Joo Hyun PARK ; Yun Hee KIM ; Min Ho CHUN ; Nam Jong PAIK ; Seung Don YOO ; Sam Gyu LEE ; Si Woon PARK ; Seong Hoon LIM ; Han Young JUNG
Journal of Korean Medical Science 2015;30(7):995-995
In this article (J Korean Med Sci 2015; 30: 644-50), one author's name is misspelled. Correct Sung-Hun Im into Seong Hoon Lim.
6.Survey on Clinical Application of 'Neurodevelopmental Treatment'.
Minyoung KIM ; Ju Seok RYU ; Myeong Ok KIM ; Dong Hwan YUN ; Seong Eun KOH ; Geun Young PARK ; Sung Bom PYUN ; Eun Joo KIM ; Han Young JUNG
Brain & Neurorehabilitation 2012;5(2):68-74
OBJECTIVE: To investigate the recognition about clinical application of "neurodevelopmental treatment (NDT)". METHOD: We surveyed on the recognition for Bobath and NDT concepts and its training programs provided by Korean Academy of Rehabilitation Medicine from Jan 2009 to Feb 2009. The survey was made for physiatrists and physical therapists (PTs), separately. One hundred twelve physiatrists and 322 PTs have participated. RESULTS: In physiatrist, interest in NDT was very high (98%), and the need for further knowledge of NDT was also high (95%). Though the NDT was mainly used techniques in neuro-rehabilitation setting, the expectation about effectiveness of it was moderate (56%) and the requirement of changing concepts of the NDT was very high (93%). PTs have carried out NDT most frequently with Bobath's concepts, but they also did not regard NDT as the best procedure. PTs emphasized the importance of their handling technique in NDT practices and also had high interest in the other maneuvers beside Bobath's. CONCLUSION: Physiatrists and PTs regard NDT as one of the most important treating method for patients with brain lesions, but it is not approved as the most effective method yet. Nowadays NDT is changing or adapting, with discarding some of the old Bobath's concepts and adding new modern scientific knowledge. Therefore we suggest that physiatrists to give PTs the revised NDT concepts and evidence based the other therapeutic methods. And the NDT needs to be verified its therapeutic efficacy with evidence based view points through proper studies.
Brain
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Handling (Psychology)
;
Humans
;
Physical Therapists
7.Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012.
Ueon Woo RAH ; Yun Hee KIM ; Suk Hoon OHN ; Min Ho CHUN ; Min Wook KIM ; Woo Kyoung YOO ; Sung Bom PYUN ; Young Hee LEE ; Joo Hyun PARK ; Min Kyun SOHN ; Seong Jae LEE ; Yang Soo LEE ; Jongmin LEE ; Sam Gyu LEE ; Yoon Ghil PARK ; Si Woon PARK ; Ju Kang LEE ; Seong Eun KOH ; Don Kyu KIM ; Myoung Hwan KO ; Yong Wook KIM ; Seung Don YOO ; Eun Joo KIM ; Seong Hoon LIM ; Byung Mo OH ; Ki Deok PARK ; Won Hyuk CHANG ; Hyoung Seop KIM ; Se Hee JUNG ; Myung Jun SHIN
Brain & Neurorehabilitation 2014;7(Suppl 1):S1-S75
"Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012" is a 2nd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 1st edition published in 2009. After 1st stroke rehabilitation CPG, many studies concerning stroke rehabilitation have been published and the necessity for update has been raised. The Korea Centers for Disease Control and Prevention supported the project "Development of Clinical Practice Guideline for Stroke Rehabilitation" in 2012. Thirty-two specialists in stroke rehabilitation from 18 universities and 3 rehabilitation hospitals and 10 consultants participated in this project. The scope of this CPG included both ischemic and hemorrhagic stroke from the acute to chronic stages. The purpose of this CPG is to provide guidelines for doctors and therapists to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. "Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012" consists of 'Chapter 1; Introduction of Stroke Rehabilitation', 'Chapter 2; Rehabilitation for Stroke Syndrome, 'Chapter 3; Rehabilitation for Return to the Society', and 'Chapter 4; Advanced Technique for Stroke Rehabilitation'. Both the adaptation and de novo development methods were used to develop this 2nd edition of CPG. The appraisal of foreign CPGs was performed using 'Korean appraisal of guidelines for research and evaluation II' (K-AGREE II); moreover, four CPGs from Scotland (2010), Austrailia (2010), USA (2010), Canada (2010) were chosen for adaptation. For de novo development, articles that were published following the latest foreign CPGs were searched from the database system, PubMed, Embase, and Cochrane library. Literatures were assessed in the aspect of subjects, study design, study results' consistency, language and application possibility in the Korean society. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. GPP (Good Practice Point) was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised.
Canada
;
Centers for Disease Control and Prevention (U.S.)
;
Consensus
;
Consultants
;
Humans
;
Korea*
;
Practice Guidelines as Topic
;
Rehabilitation*
;
Scotland
;
Specialization
;
Stroke*
8.Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016.
Deog Young KIM ; Yun Hee KIM ; Jongmin LEE ; Won Hyuk CHANG ; Min Wook KIM ; Sung Bom PYUN ; Woo Kyoung YOO ; Suk Hoon OHN ; Ki Deok PARK ; Byung Mo OH ; Seong Hoon LIM ; Kang Jae JUNG ; Byung Ju RYU ; Sun IM ; Sung Ju JEE ; Han Gil SEO ; Ueon Woo RAH ; Joo Hyun PARK ; Min Kyun SOHN ; Min Ho CHUN ; Hee Suk SHIN ; Seong Jae LEE ; Yang Soo LEE ; Si Woon PARK ; Yoon Ghil PARK ; Nam Jong PAIK ; Sam Gyu LEE ; Ju Kang LEE ; Seong Eun KOH ; Don Kyu KIM ; Geun Young PARK ; Yong Il SHIN ; Myoung Hwan KO ; Yong Wook KIM ; Seung Don YOO ; Eun Joo KIM ; Min Kyun OH ; Jae Hyeok CHANG ; Se Hee JUNG ; Tae Woo KIM ; Won Seok KIM ; Dae Hyun KIM ; Tai Hwan PARK ; Kwan Sung LEE ; Byong Yong HWANG ; Young Jin SONG
Brain & Neurorehabilitation 2017;10(Suppl 1):e11-
“Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” is the 3rd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 2nd edition published in 2014. Forty-two specialists in stroke rehabilitation from 21 universities and 4 rehabilitation hospitals and 4 consultants participated in this update. The purpose of this CPG is to provide optimum practical guidelines for stroke rehabilitation teams to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. The recent two CPGs from Canada (2015) and USA (2016) and articles that were published following the 2nd edition were used to develop this 3rd edition of CPG for stroke rehabilitation in Korea. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. Good Practice Point was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” consists of ‘Chapter 1; Introduction of Stroke Rehabilitation’, ‘Chapter 2; Rehabilitation for Stroke Syndrome, ‘Chapter 3; Rehabilitation for Returning to the Society’, and ‘Chapter 4; Advanced Technique for Stroke Rehabilitation’. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” will provide direction and standardization for acute, subacute and chronic stroke rehabilitation in Korea.
Canada
;
Consensus
;
Consultants
;
Humans
;
Korea*
;
Practice Guidelines as Topic
;
Rehabilitation*
;
Scotland
;
Specialization
;
Stroke*