Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.
Communication Aids for Disabled ; Cranial Nerves ; Eye ; Eyelids ; Humans ; Mutism ; Paralysis ; Quadriplegia ; Stroke

OBJECTIVE: To investigate the effect of treadmill aerobic exercise for eight weeks on cardiopulmonary fitness and functional mobility in stroke patients METHOD: Twenty one stroke patients who could walk independently and had MMSE score of 24 or higher were included. We used maximal exercise test by means of modified Harbor protocol before and after eight weeks' treadmill aerobic exercise. We monitored patients' status with EKG, heart rate, blood pressure and Borg rating of perceived exertion, and measured maximal O2 consumption, maximal heart rate, blood pressure, minute ventilation, rate pressure product and respiratory exchange ratio during maximal exercise test. We also assessed functional mobility by Fugl-Meyer assessment of lower extremity, Berg balance scale, five times sit to stand test, timed up & go test, dynamic gait index scale, activities-specific balance confidence scale and Korean-modified Barthel index before and after 8 weeks' training. RESULTS: Twenty one patients completed treadmill aerobic exercise training. After eight weeks' treadmill aerobic exercise, the cardiopulmonary fitness, measured by maximal O2 consumption, maximal heart rate, minute ventilation, systolic blood pressure, functional mobility measured by Fugl-Meyer assessment of lower extremity, Berg balance scale, five times sit to stand test, timed up & go test, dynamic gait index scale, activities-specific balance confidence scale and Korean-modified Barthel index showed statistically significant improvement (p<0.05). CONCLUSION: Eight weeks' treadmill aerobic exercise improved the cardiopulmonary fitness and functional mobility in ambulatory stroke patients.
Blood Pressure ; Electrocardiography ; Exercise ; Exercise Test ; Gait ; Heart Rate ; Humans ; Lower Extremity ; Stroke ; Ventilation

In order to determine the most suitable computer interfaces for patients with high cervical cord injury, we report three cases of applications of special input devices. The first was a 49-year-old patient with neurological level of injury (NLI) C4, American Spinal Injury Association Impairment Scale (ASIA)-A. He could move the cursor by using a webcam-based Camera Mouse. Moreover, clicking the mouse could only be performed by pronation of the forearm on the modified Micro Light Switch. The second case was a 41-year-old patient with NLI C3, ASIA-A. The SmartNav 4AT which responds according to head movements could provide stable performance in clicking and dragging. The third was a 13-year-old patient with NLI C1, ASIA-B. The IntegraMouse enabling clicking and dragging with fine movements of the lips. Selecting the appropriate interface device for patients with high cervical cord injury could be considered an important part of rehabilitation. We expect the standard proposed in this study will be helpful.
Animals ; Forearm ; Head Movements ; Humans ; Light ; Lip ; Mice ; Pronation ; Spinal Injuries ; User-Computer Interface