Purpose: New therapeutic approaches have emerged to improve gait ability in patients with brain damage, such as action observation learning (AOT), auditory cueing, motor imagery etc. We attempted to investigate the effects of AOT with auditory cueing (AOTAC) on gait function in patients with stroke. Methods: The eighteen stroke patients with a unilateral hemiparesis were randomly divided into three groups; the AOTAC, AOT, and control groups. The AOTAC group (n = 8) received training via observing a video that showed normal gait with sound of footsteps as an auditory cue; the AOT group (n = 6) receive action observation without auditory stimulation; the control group (n = 5) observed the landscape video image. Intervention time of three groups was 30 minutes per day, five times a week, for four weeks. Gait parameters, such as cadence, velocity, stride length, stance phase, and swing phase were collected in all patients before and after each training session. Results: Significant differences were observed among the three groups with respect to the parameters, such as cadence, velocity, stride length, and stance/swing phase. Post-hoc analysis indicated that the AOTAC group had a greater significant change in all of parameters, compared with the AOT and control groups. Conclusion Our findings suggest that AOTAC may be an effective therapeutic approach to improve gait symmetry and function in patients with stroke. We believe that this effect is attributable to the change of cortical excitability on motor related to cortical areas.

Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.
Benign Paroxysmal Positional Vertigo ; Cognition ; Curriculum ; Dizziness ; Education ; Humans ; Korea ; Pathology ; Physical Therapists ; Rehabilitation ; Specialization ; United States ; Vestibular Neuronitis

This study investigated the differences in the effect of repetitive transcranial magnetic stimulation (rTMS) between patients with and without the involvement of Broca's area (IBA).The medical records of 20 stroke patients treated with rTMS for non-fluent aphasia were reviewed. Patients completed the Korean version of the Western Aphasia Battery (K-WAB) pre- and post-rTMS. Magnetic resonance T1-weighted images of the brain were analyzed using SPM12 software. Montreal Neurological Institute templates and Talairach coordinates were used to determine Broca's area involvement and segregate patients into 2 groups: IBA and non-IBA (NBA) groups. All statistical analyses were performed using the SPSS software.Twenty subjects were included in the study. The K-WAB scores revealed improvements in the total subjects and IBA and NBA groups. There were no statistical differences between the IBA and NBA groups in the ΔK-WAB scores of aphasia quotient, fluency, comprehension, repetition, and naming. The rTMS was positive for non-fluent aphasia patients, but there was no significant difference in effectiveness depending on the IBA. Further research with a larger number of patients is needed to identify the differences in the effect of rTMS on the IBA.

PURPOSE: This study was conducted to investigate the effects of variations in arm swing during gait on movement of the trunk and pelvis. During the gait task, the angle of the trunk and pelvic rotation were analyzed according to arm swing conditions. METHODS: Seventeen healthy males participated in this study. All subjects were analyzed for gait on a treadmill three times each under three different types of arm swing conditions – natural arm swing, restricted arm swing using a phone, restricted swing in both arms. 3-D motion analysis systems were used to collect and analyze the kinematic data of trunk and pelvic movements, and repeated one-way ANOVA was used to compare the trunk and pelvic kinematic data and symmetry index. The level of significance was α=0.05. RESULTS: The results showed kinematic differences in trunk and pelvic during gait based on the arm swing conditions. Specifically, there were significant differences in trunk rotation, left and right trunk rotation and symmetry index of trunk rotation during gait among the three arm swing conditions. ROM was used to calculate a symmetry index (SI) based on the average left and right trunk rotation in which a value closer to zero indicated better balance. The SI obtained for arm swing restricted with the phone was closer to –1 than the other conditions. CONCLUSION: Restricted arm swing due to use of a phone had the possibility to induce instability of postural control while walking, which could be seen to suggest a risk of falling during gait.
Accidental Falls ; Arm* ; Cell Phones* ; Gait ; Humans ; Male ; Pelvis* ; Walking

Purpose: Myofascial syndrome is a chronic muscle pain caused by repetitive motions with stress-related muscle tension. This study aimed to investigate the validity and reliability of the evidence for diagnosing myofascial pain syndrome in trapezius muscle using a pressure algometer and surface electromyography. Methods: The experiments were performed using a total of 10 subjects, and the target locations were determined by means of a pressure algometer in the right upper trapezius muscle. The part with the lowest pain value as the trigger point and the part with the highest pain value as the non-pain trigger point were selected for measuring the locations. The median frequency and average frequency were measured in those locations with electromyography. To check the muscle fatigue, the upper trapezius muscle was moved up and down for 2 seconds at 5-second intervals in 30 seconds. The measured values were evaluated using the independent paired t-test and MannWhitney U-test. Results: The median frequency at the non-trigger point (13.7) was significantly higher than that at the trigger point (7.3). Furthermore, the mean frequency (14.7) at the non-trigger point was significantly higher than that at the trigger point (6.3). Conclusion The results showed the correlations between the trigger points of the muscle pain and frequency analysis of surface electromyography. Thus, this study may be possible to use as a diagnostic tool for myofascial pain syndrome.

PURPOSE: This study examined the effects of trunk side shift exercise on the Cobb's angle. METHODS: Fifty-eight subjects (control group=30, scoliosis group=28) were enrolled in this study. The idiopathic scoliosis groups were divided randomly into two groups, a side shift exercise (SSE) group, and a trunk stabilization exercise (TSE) group. The SSE group performed side shift exercise on the developed chair training for eight weeks. The TSE group performed trunk stabilization exercise. A one-way ANOVA test was carried out to compare the results within the idiopathic scoliosis patient group before and after the exercises based on the different exercise methods. RESULTS: The Cobb's angles were compared among control group and SSE group and TSE group. As a result, there was a significant difference from SSE group and TSE group(p=0.000), but there were no significant differences between the SSE and TSE groups (p=0.085). CONCLUSION: Side shift exercises are effective in improving the Cobb's angle. Therefore, the use of the side shift exercise chair designed in this study can replace general exercise either at work or during studies. Therefore, this method is easily accessible for busy modern students who are exposed to scoliosis or spinal disorders due to a pattern of inactivity.
Exercise ; Humans ; Methods ; Scoliosis*

No abstract available.
Endometriosis* ; Exons* ; Female ; Humans ; Polycystic Ovary Syndrome*

Objective: This study examined the correlation between dysarthria and aspiration to determine if dysarthria can predict aspiration in stroke patients. Methods: The medical records of 176 patients with first stroke, who underwent a videofluoroscopic swallowing study (VFSS) and Urimal test of articulation and phonology (U-TAP) at the same time between January 2012 and December 2015 in the authors’ hospital, were reviewed retrospectively. The correlation between the penetration aspiration scale (PAS) score and U-TAP score was analyzed in all patients. The mean PAS score and frequency of each PAS score in the dysarthria group and non-dysarthria group were compared. In addition, the aspiration was analyzed based on the severity of dysarthria in the dysphagia group. All statistical analyses were performed using SPSS software. Results: The correlation between the PAS score and U-TAP score was not statistically significant in all the subjects.The mean PAS score was 3.46±5.52 and 3.07±5.49 in the dysphagia and non-dysphagia group, respectively. The mean PAS score of the dysphagia group was higher than that of the non-dysphagia group. On the other hand, it was not statistically significant. In addition, there was no significant difference in the frequency of the PAS scores between the two groups. The aspiration was compared with the severity of dysarthria according to the U-TAP score; there was no statistically significant difference. Conclusion No correlation was observed between dysarthria and aspiration in stroke patients. In addition, there was no difference in the frequency of aspiration with or without dysarthria. According to the results of this study, aspiration cannot be predicted by dysarthria in stroke patients. Therefore, each diagnostic test and assessment should be performed for each symptom.

OBJECTIVE: Low heart rate variability (HRV) has been confirmed in heroin users, but the effects of heart-rate-variability-biofeedback in heroin users remain unknown. This study examined (1) correlations between depression and HRV indices; (2) group differences in HRV indices among a heroin-user group, a group with major depressive disorder but no heroin use, and healthy controls; and (3) the effects of heart-rate-variability-biofeedback on depressive symptoms, HRV indices, and respiratory rates within the heroin group. METHODS: All participants completed a depression questionnaire and underwent electrocardiogram measurements, and group differences in baseline HRV indices were examined. The heroin group underwent electrocardiogram and respiration rate measurements at baseline, during a depressive condition, and during a happiness condition, before and after which they took part in the heart-rate-variability-biofeedback program. The effects of heart-rate-variability-biofeedback on depressive symptoms, HRV indices, and respiration rates were examined. RESULTS: There was a negative correlation between depression and high frequency of HRV, and a positive correlation between depression and low frequency to high frequency ratio of HRV. The heroin group had a lower overall and high frequency of HRV, and a higher low frequency/high frequency ratio than healthy controls. The heart-rate-variability-biofeedback intervention increased HRV indices and decreased respiratory rates from pre-intervention to post-intervention. CONCLUSION: Reduced parasympathetic and increased sympathetic activations were found in heroin users. Heart-rate-variability-biofeedback was an effective non-pharmacological intervention to restore autonomic balance.
Autonomic Nervous System ; Biofeedback, Psychology* ; Depression* ; Depressive Disorder, Major ; Electrocardiography ; Happiness ; Heart Rate* ; Heart* ; Heroin* ; Respiratory Rate

BACKGROUND/AIMS: Nucleos(t)ide analogues (NAs) help reduce the recurrence rate after the curative treatment of hepatitis B related hepatocellular carcinoma (HCC). Sorafenib has been shown to improve survival of advanced HCC patients. Whether antiviral therapy with NAs could help such patients is unknown. Our aim is to investigate the usefulness of antiviral therapy for advanced-stage HCC treated with sorafenib. METHODS: We performed a retrospective cohort study in advanced-stage HCC patients treated with sorafenib between June 2007 and December 2013. Patients in group A (the non-antiviral therapy group) were treated with sorafenib alone. Those in group B (the antiviral therapy group) were treated with sorafenib and NAs. Progression-free survival (PS) and overall survival (OS) were compared between these two groups. RESULTS: Finally, 23 patients in group A and 40 patients in group B were enrolled in the study. The mean number of days of treatment with sorafenib was 79 (34-231) days and 96 (33-449) days for group A and B, respectively (P=0.286). The mean PS of group A and B was 97 (14-449) days and 51 (0-461) days, respectively (P=0.068). The OS was 154 (44-741) days in group A and 138 (30-1,025) days in group B (P=0.665). PS and OS showed no significant difference between the two groups. CONCLUSIONS: This study shows that there was no significant survival gain of using antiviral therapy in patients with advanced-stage HCC treated with sorafenib. In consideration of cost-effectiveness, antiviral therapy may be not mandatory.
Antiviral Agents* ; Carcinoma, Hepatocellular* ; Cohort Studies ; Disease-Free Survival ; Hepatitis B ; Humans ; Recurrence ; Retrospective Studies