OBJECTIVE: To evaluate the effect of a contralateral shoe-lift and ipsilateral leather outsole on the energy consumption in hemiplegic gait. METHOD: Ten hemiplegic patients who could walk independently were enrolled. Using portable ergospirometer (K4b2, Cosmed, Italy), quantitative evaluation of oxygen consumption under varying shoes conditions was done: 1) regular shoes 2) a half-inch shoe-lift on the sound side 3) a half-inch shoe-lift on the sound side and leather outsole on the plegic side. The evaluation distance was 20 meter on comfortable walking speed. RESULTS: The oxygen consumption was significantly decreased after the application of shoe-lift compared with regular shoes (p<0.01), and the oxygen consumption was least with the application of shoe-lift and leather outsole (p<0.05). This effect was prominent in subject with poor muscle power in hemiplegic lower extremity. The walking speed was also increased with shoe-lift and leather outsole (p<0.05). CONCLUSION: The results of this study demonstrate that proper shoes modification can reduce the energy consumption in hemiplegic gait and can lead to more efficient functional ambulation.
Evaluation Studies as Topic ; Gait Disorders, Neurologic* ; Humans ; Lower Extremity ; Oxygen Consumption ; Shoes* ; Walking

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVE: This research aimed to define the usefulness of the computerized neuropsychological test (CNT) for evaluation of cognitive deficit in the patients with brain injury. METHOD: Twenty five subjects with brain injury (16 males, 9 females) were enrolled. Their mean age was 39.2 years. All patient were assessed their cognitive function using CNT. The CNT consisted of digit span, verbal learning test, visual span test, visual learning test, auditory continuous performance test, auditory controlled continuous performance test, visual continuous performance test, visual controlled continuous performance test, word-color test, hypothesis formation test and trail making test. Scores of each subtest on CNT analysed according to the brain lesion and involved hemisphere of the patients. RESULTS: In patients with left hemisphere lesion, scores in digit span and verbal-learning test were lower than that of right side lesion (p<0.05). In contrast, patients with right hemisphere lesion showed significantly lower scores in visual span and visual-learning test (p<0.05). The patients with frontal lobe lesion marked lower scores in verbal-learning and word-color test than the patients without frontal lesion (p<0.01). Whereas the patients with parietal lobe lesion showed significantly lower scores in visual learning test (p<0.05) than the patients without parietal lesion. CONCLUSION: The cognitive deficit following the brain lesion could be characterized using CNT. CNT is considered to be used as a useful tool in the patients with brain injury for the assessment of their cognitive function.
Brain Injuries* ; Brain* ; Frontal Lobe ; Humans ; Learning ; Male ; Neuropsychological Tests* ; Parietal Lobe ; Rabeprazole ; Trail Making Test ; Verbal Learning

OBJECTIVES: To investigate the lower extremity blood flow in hemiplegic patients with a quantitative Doppler ultrasound examination of the common femoral artery(CFA). METHODS: Cross-sectional area(CSA), peak systolic velocity(PSV) and inflow volume(IV) of CFA of normal and paralyzed limbs in 24 hemiplegic patients were measured with a Doppler ultrasound. Patients were divided into three groups according to the ambulation levels: 1) nonambulator, 2) assisted ambulator, and 3) independent ambulator. The results from Doppler images of paralyzed lower extremity were compared with the normal side in each three different groups. RESULTS: In the nonambulator group, the three parameters were not significantly different between normal and paralyzed lower extremity. In the assisted ambulator group, the CSA of the paralyzed lower extremity was significantly smaller than the normal side (p<0.05). In the independent ambulator group, the CSA and IV of the paralyzed lower extremity were significantly smaller than the normal side (p<0.05). CONCLUSION: The results of this study proved that the blood flow of the paralyzed lower extremity was diminished than the normal side in hemiplegic patients especially for the independent ambulator group.
Extremities ; Hemiplegia ; Humans ; Lower Extremity* ; Ultrasonography* ; Walking

Significant illnesses or a major trauma including spinal cord injury can induce the changes of thyroid hormone metabolism, leading to the findings of "Euthyroid Sick Syndrome(ESS)". The physicians should be aware of these changes in order to interpret thyroid function test correctly after the spinal cord injury. We report three cases of ESS after the spinal cord injury. On a routine evaluation, they showed a low serum T3 level, and the T3 level returned to the normal range on a follow up study without any specific treatment.
Euthyroid Sick Syndromes* ; Follow-Up Studies ; Metabolism ; Reference Values ; Spinal Cord Injuries* ; Spinal Cord* ; Thyroid Function Tests ; Thyroid Gland

The experimental evidences suggest that the roles of basal ganglia are cognition and emotion through the corticostriatothalamocortical relationship. The patients with lesions in the caudate nucleus have high incidences of cognitive and behavioral abnormalities accompanied with the motor paralysis. In these patients, the accurate assessment of neuropsychologic dysfunctions and the prompt application of cognitive rehabilitation programs are important for the functional restoration. We evaluated the patients with stroke of basal ganglia for the clinical and neuropsychological characteristics in relation to the involved substructures of basal ganglia. Fourteen patients were evaluated for the clinical neurologic examinations, functional assessment by functional independence measure(FIM), speech assessment, and various neuropsychological tests for the assessment of attention and memory functions. The results were analysed a ccording to their lesion sites. Of the nine patients with stroke at the right basal ganglia, five patients had neglect of the contralateral hemispace and one had dysarthria. On the other hand, of the five patients with stroke at the left basal ganglia, none had hemispatial neglect and three had aphasia or dysarthria. Of the six patients with caudate lesions, three had aphasia or dysarthria, whereas of the eight patients without caudate lesion, one had dysarthria. The scores of Wechsler memory test were significantly lower in the patients with caudate lesions(P<0.05). Among the FIM subscales, the scores of communication and social cognition were significantly lower in the patients with caudate lesions(P<0.05). The Motor Score was significantly lower in the patients with putamen lesions(P<0.05). Among the FIM subscales, the scores of self care and locomotion were significantly lower in the patients with putamen lesions(P<0.05).
Aphasia ; Basal Ganglia* ; Caudate Nucleus ; Cognition ; Dysarthria ; Hand ; Humans ; Incidence ; Locomotion ; Memory ; Neurologic Examination ; Neuropsychological Tests ; Paralysis ; Perceptual Disorders ; Putamen ; Rehabilitation ; Self Care ; Stroke*

The purpose of this study is to delineate the pattern of reorganization of cortical language areas using functional magnetic resonance imaging (fMRI) after rehabilitation therapy in patients with aphasia. Six right-handed aphasic patients were investigated. Causes of aphasia were intracerebral hemorrhages of the left basal ganglia in 3 patients, cerebral infarction of the left MCA in 2, and surgical resection of the frontotemporal lobes to control intractable epilepsy in 1. An auditory sentence completion task was used to activate brain language areas during the fMRI. Three patients with left frontal lesions showed activation in the right inferior frontal lobes while performing language tasks, whereas the other 3, whose lesions located at subcortical areas, showed activation in the bilateral frontal and temporal lobes. Our results demonstrated the differences in interhemispheric reorganization of the language network depending on the location of the lesion in aphasic patients. While the patients with subcortical lesion showed tendency of bilateral frontal activation, those with cortical lesion showed activation of the right frontal lobe.
Adult ; Aphasia/*pathology/physiopathology ; Cerebral Cortex/*pathology ; Female ; Human ; *Language ; Magnetic Resonance Imaging ; Male ; Middle Age

Idiopathic restrictive cardiomyopathy is characterized by clinical and hemodynamic findings of restrictive cardiomyopathy in the absence of morphologic cause. The differential diagnosis between idiopathic restrictive cardiomyopathy and noncalcified constrictive pericarditis is difficult but the distinction is crucial because of the therapeutic implication. The diagnosis of idiopathic restrictive cardiomyopathy is aided by echocardiography and cardiac catheterization, cardiac magnetic resonance imaging. The patients should be approached systemically to differentiate from noncalcified constritive pericarditis.
Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Pericarditis ; Pericarditis, Constrictive

OBJECTIVE: This study was conducted to assess the effect of intramuscular electrical stimulation (IMES) and compared it with that of transcutaneous electrical nerve stimulation (TENS) and dry needling in the patients with myofascial pain syndrome (MPS). METHOD: Forty five patients with MPS was assigned randomly to TENS group (n=15), dry needling group (n=15) and IMES group (n=15). In TENS group, TENS was applied to the trigger point. In dry needling group, dry needling was applied to the trigger point. In IMES group, IMES was applied to the trigger point. Duration of treatment was 2 weeks. Effects were assessed before treatment, 1 day, 3 days, 7 days and 14 days after treatment by visual analogue scale (VAS) and McGill pain questionnaire (MPQ). Thermography was performed before treatment, 7 days and 14 days after treatment. RESULTS: Significant change of VAS improvement ratio was noticed in IMES group from the 1 day after treatment compared with other groups. Significant change of MPQ improvement ratio was noticed in IMES group from the 3 days after treatment compared with other groups. The skin temperature difference was significantly improved in IMES group at 14 days after treatment. CONCLUSION: These results showed that IMES is effective treatment method for pain control in patients with MPS.
Electric Stimulation* ; Humans ; Myofascial Pain Syndromes* ; Pain Measurement ; Skin Temperature ; Thermography ; Transcutaneous Electric Nerve Stimulation ; Trigger Points

OBJECTIVE: To see whether anodal direct current (DC) polarization of the inferior parietal cortex (IPC) and the primary sensorimotor area (SM1) in corticobasal degeneration (CBD) patients leads to improvement of praxia and finger motion. METHOD: Twelve patients with CBD were enrolled. This single blind crossover study had three arms, anodal DC to IPC, anodal DC to SM1, and shame polarization on occipital area. DC was delivered for 40 minute at 2 mA with 25 cm2 sponge electrodes. Before and 20 min after the start of polarization, we performed the test of oral and limb apraxia (TOLA), finger tapping frequency, and grooved pegboard test. RESULTS: The total score of TOLA was increased 5.4+/-2.3% after anodal DC to IPC. The scores of limb apraxia and picture gesture subtests of TOLA, not of oral apraxia subtest, increased significantly after anodal DC to IPC compared to sham DC polarization (p<0.05). In anodal DC to SM1 group, the finger tapping frequency increased 15.5+/-14.1%, which was significantly greater than in sham group (p<0.05). CONCLUSION: These results showed beneficial effects of anodal DC polarization on apraxia and hand function in CBD patients. In addition, these effects for apraxia and hand movement were dependent on their stimulation sites of brain.
Apraxias* ; Arm ; Brain* ; Cross-Over Studies ; Electrodes ; Extremities ; Fingers ; Gestures ; Hand* ; Humans ; Porifera ; Rabeprazole ; Shame