Virtual reality (VR) therapy has many benefits to promote neurological and functional recovery in the field of neurorehabilitation after brain injury. VR-assisted neurorehabilitation can be applied in motor, sensori-motor, cognitive, activities of daily living (ADL), and telerehabilitation. Recent reports found that VR therapy appears to be a safe intervention that is effective at improving arm function and ADL function following stroke. Greater improvements were seen at a higher VR therapeutic dose. There has been insufficient evidence that VR therapy improved lower extremity gait speed, balance, and cognitive function after brain injury. As a result, the number of commercially available devices have increased and large-scale controlled trials have reported positive effects recently. Interface devices, various feedback methods, and the advancement of augmented reality technology are quickly developing, therefore, the potential value of VR therapy in neurorehabilitation will be high and its clinical application will be diversified.
Activities of Daily Living ; Arm ; Brain Injuries ; Cognition ; Gait ; Lower Extremity ; Neurological Rehabilitation* ; Rehabilitation ; Stroke ; Telerehabilitation

No abstract available.
Brain* ; Neurological Rehabilitation*

Although studies have demonstrated that several specific brain lesions are related to the recovery and functional prognosis in patients with stroke, it still remained to be illusive. Modern imaging techniques make us possible to identify regions that are commonly related to specific deficit. Superimposing individual lesions to identify an area related to a particular function is based on the assumption that these functional modules are in the same location in different individuals. It is traditional to overlay plots using ‘lesion subtraction.’ Additionally, voxel-based lesion-symptom mapping (VLSM) can be used to determine relationships between behavioral measures and its neural correlates in the brain. VLSM estimates statistical parameters on a voxel-by-voxel basis by calculating the correlations between t-scores for tasks and treating voxels as subjects, allowing fairly high spatial precision. Understanding their relative merits with regard to specific brain lesions should be useful in planning rehabilitation strategies and will become an important part of neurorehabilitation.
Brain ; Humans ; Neurological Rehabilitation ; Prognosis* ; Rehabilitation ; Stroke*

This study identified the explanatory power of the Korean rehabilitation patient group (KRPG) v1.1 for acquired brain injury (ABI) on medical expenses in the rehabilitation hospitals and the correlation of functional outcomes with the expenses. Here, the design is a retrospective analysis from the claim data of the designated rehabilitation hospitals. Data including KRPG information with functional status and medical expenses were collected from 1 January and 31 August 2018. Reduction of variance (R2) was statistically analyzed for the explanation power of the KRPG. Association between functional status and the medical expenses was carried out using the Spearman's rank order correlation (rho). From the claim data of 365 patients with ABI, the KRPG v1.1 explained 8.6% of variance for the total medical expenses and also explained 9.8% of variance for the rehabilitation therapy costs. Cognitive function and spasticity showed very weak correlation with the total medical expenses (rho = −0.17 and −0.14, respectively). Motor power and performance of activities of daily living were associated weakly (rho = −0.27 and −0.30, respectively). The KRPG and related functional status in ABI reflects the total medical expenses and rehabilitation therapy costs insufficiently in the designated rehabilitation hospitals. Thus, the current KRPG algorithm and variables for ABI may need to be ameliorated in the future.
Activities of Daily Living ; Brain Diseases ; Brain Injuries ; Brain ; Cognition ; Diagnosis-Related Groups ; Fee-for-Service Plans ; Humans ; Muscle Spasticity ; Neurological Rehabilitation ; Rehabilitation ; Retrospective Studies

OBJECTIVE: To evaluate the effectiveness of intensive rehabilitation to support recovery of neurological function after brain tumor surgery and assess long-term satisfaction. METHODS: This retrospective study included patients with neurological impairment after brain tumor surgery who underwent intensive rehabilitation therapy between December 2013 and May 2017. To assess effectiveness of rehabilitation, functional outcomes (motor, cognition, and activities of daily living [ADL]) were compared between brain tumor group and a control group enrolling stroke patients who received equivalent rehabilitation during the study period. Long-term satisfaction with rehabilitation was evaluated by surveying family caregivers. RESULTS: This study included 21 patients with benign brain tumor, 14 with malignant brain tumor, and 108 with stroke. Significant and similar improvement in motor, cognition, and ADL function were noted in both the brain tumor group and the stroke group. Malignancy status did not influence the extent of functional improvement. According to medical records and surveys, 9 (69.2%) patients with malignant tumor and 2 (11.8%) with benign tumor had expired by the time of the survey. Most family caregivers confirmed that rehabilitation was effective for functional improvement (>60%), expressing overall satisfaction and stating they would recommend such therapy to patients with similar conditions (approximately 70%). CONCLUSION: Intensive rehabilitation may help promote functional improvement following brain tumor surgery regardless of malignancy compared with stroke patients. Family caregivers expressed overall satisfaction with rehabilitation at long-term follow-up. These findings support the provision of intensive rehabilitation therapy for neurologic function recovery following brain tumor surgery.
Activities of Daily Living ; Brain Neoplasms ; Brain ; Caregivers ; Cognition ; Follow-Up Studies ; Humans ; Medical Records ; Neurological Rehabilitation ; Pilot Projects ; Recovery of Function ; Rehabilitation ; Retrospective Studies ; Stroke ; Treatment Outcome

OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.
Budgets ; Deinstitutionalization ; Electronic Mail ; Financial Support ; Government Programs ; Humans ; Korea ; Mental Disorders ; Mental Health ; Occupations ; Psychiatric Rehabilitation ; Public Health ; Rehabilitation ; Rehabilitation, Vocational ; Schizophrenia ; Telephone

OBJECTIVES: The purpose of this study was to examine the effect of the vocational rehabilitation program on the quality of life of the chronic schizophrenics, and to evaluate how chronic schizophrenics felt about their lives. METHOD: The subjects were 39 chronic schizophrenics who had participated in the vocational rehabilitation program(participant group) and now lived in the community. The control group were 43 chronic schizophrenics who were outpatients without vocational rehabilitation(non-participant group). The scale for quality of life was divided into two subscales, i.e., the objective and the subjective areas. The subscales are composed of living situation, family situations, interpersonal relations, work, health, finances, leisure activities, autonomy, and self-esteem. RESULTS: 1) In the demographic characteristics such as age, sex, duration of illness, and duration of education, two groups were not different significantly. However, dosage of antipsychotics were lower in participant group than non-participant group. 2) In the objective quality of life subscale, the scores of living situation, interpersonal relations, work, health, economic state, and leisures were higher in participant group than non-participant group. But, family relations score were lower in participant group than in non-participant group. autonomy were not different between two groups. 3) In the subjective quality of life subscale, the score of living situation, family relations, interpersonal relations, work, health, economic states, leisure activities, and autonomy were all higher in participant group than in non-partcipant group. 4)Self-esteem was significantly higher in participant group than in non-participant group. CONCLUSION: The results from this study suggest that the objective and subjective quality of life of participant group in the vocational rehabilitation program were higher than those of non-participant group. The vocational rehabilitation program of Yong-In Mental Hospital seems to have been effective for the chronic schizophrenics. And the psychosocial rehabilitation program, vocational rehabilitation program, and family education program should be developed more and implemented in the community.
Antipsychotic Agents ; Education ; Family Relations ; Gyeonggi-do ; Hospitals, Psychiatric ; Humans ; Interpersonal Relations ; Leisure Activities ; Outpatients ; Quality of Life* ; Rehabilitation ; Rehabilitation, Vocational*

OBJECTIVE: To observe the effect of staged acupuncture on serum irisin level, neurological deficit, balance ability and spasticity in patients with ischemic stroke. METHODS: Sixty patients with ischemic stroke were randomly divided into a staged acupuncture group and a routine acupuncture group, 30 cases in each group; another 30 healthy subjects were selected as a normal group. The patients with ischemic stroke were treated with aspirin (100 mg each time, once a day, changing to 50 mg for prophylactic dose after 4 weeks). The patients in the staged acupuncture group were treated with staged acupuncture (acupoints were selected according to the soft paralysis period, spasticity period and recovery period, sequelae period) and rehabilitation treatment, while the patients in the routine acupuncture group were treated with acupuncture of soft paralysis-period as the staged acupuncture group and rehabilitation treatment. All the treatment was given once a day, 5 times a week, 2 weeks as a course of treatment, and 4 consecutive courses of treatment were provided. Before treatment and at 2 weeks, 4 weeks, 6 weeks and 8 weeks into treatment, the serum irisin level was measured, and the scores of National Institutes of Health stroke scale (NIHSS), Fugl-Meyer assessment scale-balance (FM-B) and comprehensive spasticity scale (CSS) were compared, and the correlation between the serum irisin level and NIHSS and FM-B scores in the two groups was analyzed. RESULTS: Before treatment, the serum irisin levels in the two groups were lower than those in the normal group (P<0.01). Compared before treatment, the serum irisin levels and FM-B scores were increased (P<0.01), and the NIHSS scores were decreased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, in the staged acupuncture group, the serum irisin levels and FM-B scores were higher than those in the routine acupuncture group (P<0.01, P<0.05), and the NIHSS scores were lower than those in the routine acupuncture group (P<0.01). After treatment, the CSS scores in the two groups were increased first and then decreased. Compared before treatment, the CSS scores were increased at 2, 4, 6 and 8 weeks into treatment in the two groups (P<0.01). At 4, 6 and 8 weeks into treatment, the CSS scores in the staged acupuncture group were lower than those in the routine acupuncture group (P<0.01). The serum irisin level was negatively correlated with NIHSS score (r =-0.772, P =0.000), and positively correlated with FM-B score (r =0.675, P =0.000). CONCLUSION The severity of neurological deficit and balance ability are related to serum irisin level in patients with ischemic stroke. The staged acupuncture could increase the serum irisin level, improve the neurological function, balance ability and spasticity in patients with ischemic stroke.
Acupuncture Therapy ; Fibronectins ; Humans ; Ischemic Stroke ; Muscle Spasticity ; Neurological Rehabilitation ; Paralysis/complications* ; Stroke/therapy* ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVES: Despite growing interest in the area of vocational rehabilitation for persons with psychiatric disabilities, there exist few specialized vocational training facilities nor programs for schizophrenic patients in Korea. This study was intended to develop and evaluate a vocational rehabilitation program geared to improving personal factors identified to be the most significant barriers to schizophrenics' vocational rehabilitation. METHODS: The effects of program were evaluated using experimental/control pretest-posttest design. An experimental group received the vocational training two sessions a week for three months and a control group received same day treatment except the vocational training. RESULTS: The results indicated that the score of a training group was significantly increased compared to those of a control group on 'The assertive job hunting survey' and 'The job related problemsolving skill assessment'. The score of a training group on the PANSS was not significantly changed compared to those of a control group. CONCLUSION: The data provide useful information about the potential role of the program on assertiveness in job hunting activity and job related problem-solving skill. Although the impact of training on symptom reduction was not significant, the program seemed to suggest an important intervention method for schizophrenic patients' rehabilitation.
Assertiveness ; Humans ; Korea ; Rehabilitation ; Rehabilitation, Vocational* ; Schizophrenia*

No abstract available.
Rehabilitation*