OBJECTIVE: To categorize the spinal cord injury level and American Spinal Injury Association (ASIA) impairment scale into functional classification of shooting and to give information about shooting sport for the disabled to medical staffs, and to remind importance of sports activities for rehabilitation. METHOD: Seventy nine spinal cord injured players were classified into each functional classes by two international classifier. During the classification process, demographic data such as age, sex, duration, injury type and questions including attitude toward disabled shooting or benefits or difficulties from shooting were collected by interview. RESULTS: Functional classes of players were closely related to injury level and ASIA impairment scale. Average duration of shooting experience of men (8.01 years) was significantly different from that of women (5.29 years)(p<0.05). Self-motivated (39.3%) and disabled friends (21.5%) were leading motive providers followed by medical staff (20.2%), other shooting player or coach (12.7%), family (6.3%). Promoting self confidence (32.5%) was number one benefit from shooting and followed by making friends (22.1%), increasing independence (18.3%), and increasing in social participation (12.7%). CONCLUSION: We report the functional classification result of spinal cord inured player and we found that sports activities promote social activities and help to develop self confidence.
Asia ; Classification* ; Female ; Friends ; Humans ; Male ; Medical Staff ; Rehabilitation ; Social Participation ; Spinal Cord Injuries ; Spinal Cord* ; Spinal Injuries ; Sports

OBJECTIVE: To assess cough reflex sensitivity using the simplified cough test (SCT) and to evaluate the usefulness of SCT to screen for silent aspiration. METHODS: The healthy control group was divided into two subgroups: the young (n=29, 33.44+/-9.99 years) and the elderly (n=30, 63.66+/-4.37 years). The dysphagic elderly group (n=101, 72.95+/-9.19 years) consisted of patients with dysphagia, who suffered from a disease involving central nervous system (ischemic stroke 47, intracerebral hemorrhage 27, traumatic brain injury 11, encephalitis 5, hypoxic brain damage 3, and Parkinson disease 8). The SCT was performed using the mist of a 1% citric acid from a portable nebulizer. The time from the start of the inhalation to the first cough was measured as the cough latency. All the dysphagic patients underwent the videofluoroscopic swallowing study. RESULTS: The cough latency was more significantly prolonged in the healthy elderly group than in the healthy young group (p<0.001), and in the dysphagic elderly group than in the healthy elderly group (p<0.001). The sensitivity and specificity of SCT were 73.8% and 72.5% for detecting aspiration in the dysphagic patients, and 87.1% and 66.7% for detecting silent aspiration in the aspirated patients. CONCLUSION: Cough latency measured with the SCT reflects the impairment of cough reflex in healthy elderly and dysphasic subjects. The results of this study show that the SCT test can be a valuable method of screening aspiration with or without cough in dysphasic patients.
Aged ; Brain Injuries ; Central Nervous System ; Cerebral Hemorrhage ; Citric Acid ; Cough* ; Deglutition ; Deglutition Disorders ; Diagnosis ; Encephalitis ; Humans ; Hypoxia, Brain ; Inhalation ; Mass Screening* ; Nebulizers and Vaporizers ; Parkinson Disease ; Reflex* ; Respiratory Aspiration of Gastric Contents ; Sensitivity and Specificity ; Stroke

OBJECTIVE: To investigate if walking is independently associated with low back pain (LBP) in the general population. METHODS: This cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 5,982 community-dwelling adults aged ≥50 years. Presence of current LBP was defined as LBP for 1 month or more in the past 3 months. Walking was measured as total walking duration for the past week and subjects were divided into four quartiles. Independent effect of walking on LBP was determined using odds ratios (OR) adjusted for age, sex, osteoporosis, depression or anxiety, and radiographic lumbar spondylosis. RESULTS: Prevalence of LBP was 26.4% in this population. Older people and women had higher prevalence of current LBP. Prevalence of obesity and osteoporosis was higher in subjects with current LBP and quality of life was poorer in subjects with current LBP. Adjusted logistic regression model revealed that older age (OR, 1.655; p=0.018), female sex (OR, 2.578; p<0.001), radiographic lumbar spondylosis (OR, 2.728; p<0.001), depression or anxiety (OR, 5.409; p<0.001), and presence of osteoporosis (OR, 1.467; p=0.002) were positively associated with current LBP. Walking decreased prevalence of current LBP proportionally (2nd quartile OR, 0.795; 3rd quartile OR, 0.770; and 4th quartile OR, 0.686 compared with the 1st quartile of walking). CONCLUSION: Walking was negatively associated with LBP. Further studies are needed to reveal causal relationship of this phenomenon.
Adult ; Anxiety ; Cross-Sectional Studies* ; Depression ; Female ; Humans ; Logistic Models ; Low Back Pain* ; Nutrition Surveys ; Obesity ; Odds Ratio ; Osteoporosis ; Prevalence ; Quality of Life ; Spondylosis ; Walking*

OBJECTIVES: The aims of this study were to determine the total fluoride concentration and bioavailable fluoride concentration in different toothpastes, based on a newly suggested method by the International Organization for Standardization (ISO), and to compare the measured concentrations with the concentrations written on the packaging. METHODS: The concentrations of total fluoride (TF) and bioavailable fluoride (BF) were measured in six toothpastes. For the TF measurement, 1 g of each toothpaste was mixed with dipotassium hydrogen phosphate (K2HPO4), and hydrogen chloride (HCl) was placed. After 24 hours, the samples were centrifuged and total ionic strength adjustment buffer (TISAB) solution was added. For the BF measurement, the toothpaste was mixed with K2HPO4 for only 1 minute. The samples were centrifuged, and then HCl was placed and allowed to stand for 24 hours. The TISAB solution was added subsequently. The concentration of fluoride ions was measured using a fluoride ion-selective electrode and calculated against a standard curve. RESULTS: The six toothpastes were composed of different fluoride compounds and abrasives. The measured TF concentration ranged from 624.99 ppm to 1,353.00 ppm, and the similarity to the declared fluoride concentration ranged from 53.48% to 93.31%. The measured BF concentration ranged from 587.61 ppm to 1,360.05 ppm, and the similarity to the expected fluoride concentration ranged from 41.97% to 93.80%. Two samples were clearly separated when the samples were centrifuged, whereas the remaining four samples had unclear supernatants. The clearly separated toothpastes (i.e., toothpastes 5 and 6) had BF concentrations that were similar to or lower than the declared fluoride concentrations and the measured TF concentrations. However, the unclearly separated toothpastes showed inconsistent relationships between the measured TF and BF concentrations. CONCLUSIONS: The measured TF and BF concentrations of the six toothpastes did not reach the expected fluoride concentration. This finding resulted from the different compositions and forms of the toothpastes. Therefore, the properties of toothpastes need to be considered when measuring their fluoride concentrations.
Biological Availability* ; Fluorides* ; Hydrochloric Acid ; Hydrogen ; Ion-Selective Electrodes ; Ions ; Osmolar Concentration ; Product Packaging ; Toothpastes*

This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries.
Brain Injuries/*physiopathology/radiography ; *Deglutition ; Deglutition Disorders/*physiopathology/radiography ; *Eating ; Fluoroscopy/*methods ; Food ; Humans ; Mastication ; Stroke/*physiopathology/radiography ; Video Recording

PURPOSE: Dental implants present several advantages over other tooth replacement options. However, there has been little research on masticatory function in relation to implant treatment. Therefore, the aim of the present study was to evaluate the improvement of masticatory function two weeks after implant restoration. METHODS: Masticatory ability was evaluated with the subjective food intake ability (FIA) and objective mixing ability index (MAI) methods. Fifty-four subjects with first and second missing molars completed the study. The subjects were asked to complete a self-reported questionnaire about 30 different food items, and to chew wax samples 10 times both before and two weeks after implant restoration. A total of 108 waxes were analyzed with an image analysis program. RESULTS: Dental implant restoration for lost molar teeth on one side increased the FIA score by 9.0% (P<0.0001). The MAI score also increased, by 14.3% after implant restoration (P<0.0001). Comparison between the good and poor mastication groups, which were subdivided based on the median MAI score before implant restoration, showed that the FIA score of the poor group was enhanced 1.1-fold while its MAI score was enhanced 2.0-fold two weeks after an implant surgery. CONCLUSIONS: Using the FIA and MAI assessment methods, this study showed that masticatory function was improved two weeks after implant restoration. In particular, the enhancement of masticatory function by implant restoration was greater in patients with relatively poor initial mastication than in those with good initial mastication.
Dental Implants ; Diagnosis ; Eating ; Humans ; Mastication ; Molar ; Tooth ; Waxes

We report a rare case of a 10-year-old girl with anomalous course of extensor pollicis longus (EPL) muscle, which exists with absence of thenar muscles and muscles in the 1st extensor compartment. Her chief complaint was severe atrophy on the right thenar eminence. On physical examination, there was no obvious functional abnormality on her right thumb. On magnetic resonance imaging, we found that the abductor pollicis brevis, opponens pollicis, abductor pollicis longus, and extensor pollicis brevis muscles were absent. The tendon of the EPL muscle was found, but it had abnormal insertion on the radial side of the proximal phalanx, not on the distal phalanx. This variation was thought to have played a major role in compensating for impaired abduction of the thumb, which is usually accompanied by agenesis of major abductors of the thumb.
Atrophy ; Congenital Abnormalities ; Magnetic Resonance Imaging ; Muscles ; Physical Examination ; Tendons ; Thumb

OBJECTIVE: To confirm the relationship between initial trunk performance and functional outcomes according to gait ability, and whether initial trunk performance is of predictive value in terms of functional prognosis in patients with stroke. METHODS: We reviewed 135 patients who suffered from stroke. Trunk performance of the patients was evaluated using the Trunk Impairment Scale (TIS). The patients were divided into 2 groups according to gait ability at initial stage of stroke. Correlation analyses were performed to assess relationship between initial TIS and functional outcomes. We also evaluated the relationship between initial TIS and the Korean version of Modified Barthel Index (K-MBI) subitems. Finally, stepwise multiple regression analyses were performed to examine the predictive validity of initial TIS and its subscales with functional outcomes. RESULTS: For both groups, initial TIS was correlated with K-MBI and Functional Ambulation Categories at 4 weeks after stroke; however, the relationship did not remain stable at 6 months in ambulatory patients. All K-MBI subitems, which were associated with trunk movement, as well as others about basic skills was correlated with initial TIS. Finally, when of subscales TIS, dynamic sitting balance (TIS-D) was included in by stepwise multiple regression analyses, high proportion of the explained variance was represented. CONCLUSION: The strong relationship between trunk performance and functional outcomes in patients with stroke emphasizes the importance of trunk rehabilitation. Indeed, an evaluation of a patient's initial TIS after stroke, especially TIS-D, could be helpful in predicting patient's functional prognosis.
Activities of Daily Living ; Gait ; Humans ; Postural Balance ; Prognosis* ; Rehabilitation ; Stroke* ; Walking

OBJECTIVE: To determine the reliability and validity of hand-held dynamometer (HHD) depending on its fixation in measuring isometric knee extensor strength by comparing the results with an isokinetic dynamometer. METHODS: Twenty-seven healthy female volunteers participated in this study. The subjects were tested in seated and supine position using three measurement methods: isometric knee extension by isokinetic dynamometer, non-fixed HHD, and fixed HHD. During the measurement, the knee joints of subjects were fixed at a 35degrees angle from the extended position. The fixed HHD measurement was conducted with the HHD fixed to distal tibia with a Velcro strap; non-fixed HHD was performed with a hand-held method without Velcro fixation. All the measurements were repeated three times and among them, the maximum values of peak torque were used for the analysis. RESULTS: The data from the fixed HHD method showed higher validity than the non-fixed method compared with the results of the isokinetic dynamometer. Pearson correlation coefficients (r) between fixed HHD and isokinetic dynamometer method were statistically significant (supine-right: r=0.806, p<0.05; seating-right: r=0.473, p<0.05; supine-left: r=0.524, p<0.05), whereas Pearson correlation coefficients between non-fixed dynamometer and isokinetic dynamometer methods were not statistically significant, except for the result of the supine position of the left leg (r=0.384, p<0.05). Both fixed and non-fixed HHD methods showed excellent inter-rater reliability. However, the fixed HHD method showed a higher reliability than the non-fixed HHD method by considering the intraclass correlation coefficient (fixed HHD, 0.952-0.984; non-fixed HHD, 0.940-0.963). CONCLUSION: Fixation of HHD during measurement in the supine position increases the reliability and validity in measuring the quadriceps strength.
Dimensional Measurement Accuracy ; Female ; Humans ; Isometric Contraction ; Knee Joint ; Knee* ; Leg ; Methods ; Muscle Strength Dynamometer ; Pilot Projects* ; Reproducibility of Results* ; Restraint, Physical ; Supine Position ; Tibia ; Torque ; Volunteers

Methods: We developed a questionnaire related to VFSS protocols and test diet. It was sent to the expert physicians who directly implementing VFSS in 35 training hospitals, which were sent out and collected by e-mail from December 7, 2017 to February 19, 2018. Among them, 12 out of 28 hospitals selected randomly and we conducted field survey including observing the process of the VFSS. Results: The most common protocol was to provide a test sample with 7 stages (28.1%). In the order of provided test samples, ‘the small amount of liquid’ was the most provided in the 1st stage (53.1%). Among the used samples of thin liquid level, the mixing ratio of the liquid samples and barium was not uniform among each institution. ‘Yogurt (semi-solid type)’ was the most commonly used sample for ‘nectar thick’ and ‘honey thick’ diet. Various samples were used on ‘pudding thick’ diet. Conclusion These results indicate that, in the 32 Korean general hospitals, each hospital uses samples depending on experience or according to its own standards rather than unified standard among the institutions. Thus, the protocols for each hospital are not standardized, which make them difficult to the accurate sharing of information about the test results. Therefore, it will be necessary to make a consensus for the protocol and establish nationwide standard of VFSS through future research