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Journal of the Korean Academy of Rehabilitation Medicine.2006;30(2):103-110.

Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and adaptive skills, which originates before the age of 18. The prevalence of mental retardation among elementary school children in Korea is estimated as 9~12/1,000. In most cases of mental retardation, the interplay of genetic and environmental influences remains poorly understood. However, recent advances in molecular genetic techniques have enabled us to understand more about the molecular basis of several genetic syndromes associated with mental retardation. This article presents a review of three common genetic conditions causing mental retardation-Down syndrome, fragile X syndrome, and Prader-Willi syndrome-with the summary of the effectiveness of early intervention for the children with mental retardation.
Adaptation, Psychological ; Child ; Down Syndrome ; Early Intervention (Education) ; Fragile X Syndrome ; Humans ; Intellectual Disability* ; Korea ; Molecular Biology ; Prader-Willi Syndrome ; Prevalence

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The Shoes Designed to Inhibit Excessive External Rotation of Hemiplegic Foot with Plastic Ankle Foot Orthosis: A case report.

Ju Kang LEE ; Oh Kyung LIM ; Yoon Myung YIM ; Seu Reon CHUNG ; Keun Hwan BAE ; Sung Hwan KIM ; Kwang Lae LEE

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):94-97.

Hemiplegic patients with an ankle foot orthosis (AFO) has a tendency to show external rotation of affected side foot. External rotation inhibiting shoes (ERIS) were designed to inhibit excessive rotation of hemiplegic foot. ERIS were applied to two hemiplegic patients who were able to walk independently with a plastic AFO. Both of them showed an excessive external rotation of hemiplegic foot after AFO apply. Each patient tried to walk with a pair of common shoes first and ERIS later. The external rotation angle, step length, stride length, cadence, speed were measured by footprint method. The external rotation angle of hemiplegic foot was significantly decreased with ERIS than with common shoes. However they did not show consistent improvement in the step length, stride length, cadence and speed. We reported that hemiplegic patients who walked with ERIS showed remarkable reduction in excessive external rotation of hemiplegic foot.
Ankle* ; Foot Orthoses* ; Foot* ; Humans ; Plastics* ; Shoes*

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Effect of Repetitive Transcranial Magnetic Stimulation in Patients with Intractable Neuropathic Pain: Cases report.

Eun Jin KIM ; Jae Eun SHIN ; Chul Pyo HONG ; Jung Il LEE ; Se Hun PARK ; Peter K W LEE ; Yun Hee KIM

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):89-93.

Drug resistant neuropathic pain can be relieved by non-invasive new therapy of repetitive transcranial magnetic stimulation (rTMS). Three patients who have been suffered from intractable neuropathic pain with diverse underlying causes were enrolled. The causes of their pain were the thalamic hemorrhage, the complex regional pain syndrome (CRPS) after resection of neurilemmoma, and the trigeminal schwanoma respectively. A thousand pulses of 10 Hz rTMS were delivered over the contralateral primary motor cortex at 80% of resting motor threshold for a period of 20 minutes per each treatment session. The intensity of pain was assessed using a visual analogue scale before and after rTMS session for 5 consecutive days. Immediate and dramatic analgesic effects were noticed as a result of rTMS in patients with thalamic hemorrhage and trigerminal schwanoma. Moderate analgesic effect was noticed in patient with CRPS. The duration of analgesic effect was variable.
Hemorrhage ; Humans ; Motor Cortex ; Neuralgia* ; Neurilemmoma ; Transcranial Magnetic Stimulation*

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Epidural Motor Cortex Stimulation for Intractable Thalamic Pain: A case report.

Jong Kyu KIM ; Soo Beom SHIN

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):86-88.

Motor cortex stimulation is a new technique for post-stroke central pain. The authors reported a case of epidural motor cortex stimulation for thalamic pain after right thalamic intracerebral hematoma. The patient was a 52 year old female who had presented with neuropathic pain on left upper and lower extremity. The authors performed epidural motor cortex stimulation via a small craniotomy site by use of navigation system. Good relief of the pain was achieved. Postoperative visual analogue scale pain score decreased from 9 to 3. The epidural trial of motor cortex stimulation was an effective method in treating refractory thalamic pain as our case.
Craniotomy ; Female ; Hematoma ; Humans ; Lower Extremity ; Middle Aged ; Motor Cortex* ; Neuralgia

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Change in Forced Vital Capacity with Postures according to Neuromuscular Disease.

Tae Won YOO ; Seong Woong KANG ; Jae Ho MOON ; Hyung Jung KIM ; Dong Hee CHO ; Jung Hyun PARK

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):80-85.

OBJECTIVE: To evaluate the difference in forced vital capacity (FVC) between sitting and supine position in patients with amyotrophic lateral sclerosis (ALS), cervical spinal cord injury (SCI) and Duchenne muscular dystrophy (DMD). METHOD: FVC was measured in sitting and supine position for 32 patients with DMD, 32 patients with cervical SCI and for 28 patients with ALS. The highest value in three or more attempts in each position was chosen. RESULTS: FVCs measured in cervical SCI and ALS patients in the sitting and supine position were 1612.8+/-291.0 ml, 1393.2+/-286.7 ml and 2054.7+/-545.8 ml, 1104.3+/-425.4 ml respectively. Cervical SCI patients showed significantly higher value in the supine position (p<0.05). And ALS patients showed significantly higher value in the sitting position (p<0.05). FVCs measured in DMD patients were 1311.6+/-260.7 ml and 1213.8+/-378.9 ml respectively. There was no statistically significant difference between the measurements in both positions. CONCLUSION: Difference in postural change of FVC was observed in patients with different types of neuromuscular disorders. Such difference in FVC suggest that postural change of FVC should be considered in management of neuromuscular disease with respiratory muscle weakness.
Amyotrophic Lateral Sclerosis ; Humans ; Muscular Dystrophy, Duchenne ; Neuromuscular Diseases* ; Posture* ; Respiratory Muscles ; Spinal Cord Injuries ; Supine Position ; Vital Capacity*

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Effectiveness of the Cardiac Rehabilitation on Exercise Capacity and Risk Factor in Coronary Artery Obstructive Disease.

Chul KIM ; Jae Ki AHN ; In Keol BANG ; Kun Joo RHEE ; Byung Ok KIM ; Mu Cheol SO ; Young Joo KIM ; In Tak JUNG

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):74-79.

OBJECTIVE: To evaluate the effectiveness of cardiac rehabilitation (CR) program on the exercise capacity and secondary prevention in coronary artery obstructive disease (CAOD). METHOD: CR group of 48 CAOD patients had underwent regularly supervised exercise training for 6~8 weeks as well as home exercise continued for 1 year. CR group was advised to control their risk factors by nutrition counsel, abstaining from smoking and reducing their weight. Control group of 16 CAOD patients did not participate in the CR program. Two groups were evaluated for their exercise capacity and risk factors at baseline and after 1 year. RESULTS: CR group showed significantly higher maximal oxygen consumption, maximal rate pressure product and ratings of perceived exertion at stage 3 compared with control group (p<0.05). The number of risk factors per person after 1 year in both groups was significantly lower than baseline (p<0.05), but there was no significant difference between the two groups. CONCLUSION: CR program can improve the exercise capacity and level of risk factor in CAOD patients. Therefore, CR program is recommended for helping CAOD patients improve their functional capacity and reduce the possibility of recurrence.
Coronary Vessels* ; Humans ; Oxygen Consumption ; Recurrence ; Rehabilitation* ; Risk Factors* ; Secondary Prevention ; Smoke ; Smoking

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Gait Analysis of Unilateral Transfemoral Amputees with Prosthetics on an Inclined Surface.

Hasuk BAE ; Ji Cheol SHIN ; Chang Il PARK ; Yong Wook KIM ; Young Hoon KO ; Ji Hoon JANG ; Don Sin LEE

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):69-73.

OBJECTIVE: The aim of this study was to investigate the characteristics of prosthetic gait of unilateral transfemoral amputees on an inclined surface compared with those of normal persons. METHOD: Five male unilateral transfemoral amputees and ten normal persons were recruited. Uphill and downhill walking of inclined surface on slopes of 10 and 20 degrees and level walking were investigated. Kinematic data were obtained with VICON 370 system (Oxford Metrics Ltd., UK). RESULTS: The kinematic data of the transfemoral amputees showed significantly decreased peak hip extension at all situation and peak hip flexion at 20 degrees uphill walking, significant increased knee extension at 20 degrees downhill and all uphill walking, and significant decreased knee flexion at all situation, and significant decreased ankle dorsiflexion at all situation and plantarflexion at all situation except 20 degrees downhill walking compared with those of normal persons. Also they showed significant decreased cadence, speed and increased step time, double support at all situation compared with normal persons. CONCLUSION: Analysis of prosthetic gait of unilateral transfemoral amputees on an inclined surface support the basic data for induction of normal gait pattern.
Amputees* ; Ankle ; Gait* ; Hip ; Humans ; Knee ; Male ; Walking

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The Usefulness of Trunk Accelerometry in Evaluating Walking Ability of Hemiparetic Patients.

Yu Nam CHOI ; Si Woon PARK ; Soon Ja JANG ; Jae Young LEE ; Young Ho KIM ; Kyoung Joung LEE

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):62-68.

OBJECTIVE: Accelerometer is a convenient device that can easily measure human movement. The purpose of this study was to evaluate its usefulness in the assessment of hemiparetic gait after stroke. METHOD: Twenty hemiparetic stroke patients were enrolled in the study. A portable accelerometer was attached between L3,4 intervertebral area. Vertical and medio-lateral acceleration was measured while walking 10 m. Walking ability of each subject was classified by Functional Walking Category (FWC). RESULTS: Accelerometric parameters, such as walking speed, a mean amount of peak vertical acceleration in one gait cycle, mean peak value of unaffected side, peak vertical acceleration ratio, step time ratio were significantly higher in groups of FWC 4, 5, 6 than in groups of FWC 2, 3. In subjects using cane there was an extra peak other than peaks observed in non-users. Mean peak value, step length of unaffected side and cadence were significantly higher in non-users than in users. CONCLUSION: Trunk accelerometer can be used as an objective method to evaluate walking ability in hemiparetic patients after stroke.
Acceleration ; Accelerometry* ; Canes ; Gait ; Humans ; Stroke ; Walking*

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Dynamic Changes of Pelvis and Lower Extremities after Operation in Lumbar Degenerative Kyphosis.

Su Seop LEE ; Jong Yoon YOO ; Seung Chul RHIM ; Jung Woo LEE ; Jae Hyun BYUN

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):57-61.

OBJECTIVE: Gait pattern in patients with lumbar degenerative kyphosis (LDK) is disturbed because trunk bends forward due to decreased lumbar lordosis. Surgical therapy in LDK is required when conservative management fails. We investigated kinematic and kinetic changes of the pelvis, hip, and knee joints on the sagittal plane in patients with LDK before and after operation. METHOD: Fifteen patients underwent operations between March 1999 and September 2003. Gait analysis was performed for all patients. RESULTS: Total lumbar lordotic angle increased from 10.50 degrees +/-11.22 degrees to 26.71 degrees +/-8.80 degrees postoperation. In gait analysis, anterior pelvic tilting angle increased from maximum 7.86 degrees +/-9.69 degrees, minimum 4.40 degrees +/-9.82 degrees to maximum 12.61 degrees +/-5.36 degrees, minimum 9.68 degrees +/-5.63 degrees (p<0.05). Maximum hip flexion angle changed from 31.39 degrees +/-11.71 degrees to 35.83 degrees +/-5.84 degrees (p<0.05). Maximum knee flexion angle in terminal stance phase decreased from 13.32 degrees +/-7.34 degrees to 8.30 degrees +/-6.38 degrees (p<0.05). CONCLUSION: After corrective operation, an increase of lumbar spine lordosis and anterior pelvic tilt with decrease of knee flexion were observed. However, an increase of maximum hip flexion secondary to increased anterior pelvic tilting influenced ambulation negatively. Therefore, stretching of the hip flexor and strengthening of the hip extensor are required before and after operation.
Animals ; Decompression Sickness ; Gait ; Hip ; Humans ; Knee ; Knee Joint ; Kyphosis* ; Lordosis ; Lower Extremity* ; Pelvis* ; Spine ; Walking

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Histological Changes after Intradiscal Steroid Injection to the Intervertebral Disc in Disc Injury Rabbit Model.

Jae Heung PARK ; Hyun Yoon KO ; Young Hyun AHN ; Chang Hoon LEE

Journal of the Korean Academy of Rehabilitation Medicine.2006;30(1):51-56.

OBJECTIVE: To evaluate the degeneration changes of disc injury rabbit model produced by needle puncture to intervertebral disc and to observe the histological changes of the degenerated disc treated with intradiscal steroid. METHOD: The subjects were composed of 10 L4-5 intervertebral discs (study group) and 10 L3-4 intervertebral discs (control group) of Newzealand white rabbits. The rabbits' discs were exposed by anterior approach and degeneration was elicited by 21 G needle puncture. After 4 weeks, the study group was injected with 0.2 ml triamcinolone acetonide (Tamcetone 40 mg/ml) and the control group was injected with 0.2 ml normal saline, intradiscally. The discs were extracted on 4 weeks after degeneration and stained with Hematoxylin-Eosin and investigated by light microscopy. RESULTS: Degenerative changes, including fissuring and focal fibrosis, were elicited in the all groups, but there were no significant histological differences between the two groups. CONCLUSION: We concluded that the degenerative changes are well observed in disc injury rabbit model. The mollification of discogenic pain following intradiscal steroid injection in practice may not be explained from light microscopic histological changes of the disc. Further biochemical or electromicroscopic study will be necessary to clarify the mechanism of alleviation of discogenic pain by intradiscal steroid.
Fibrosis ; Intervertebral Disc Degeneration ; Intervertebral Disc* ; Microscopy ; Needles ; Punctures ; Rabbits ; Triamcinolone Acetonide

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