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Back Extensor Strengthening Exercise and Backpack Wearing Treatment for Camptocormia in Parkinson's Disease: A Retrospective Pilot Study.

Kun Hee LEE ; Jong Moon KIM ; Hyoung Seop KIM

Annals of Rehabilitation Medicine.2017;41(4):677-685. doi:10.5535/arm.2017.41.4.677

OBJECTIVE: To investigate the effect of a conservative treatment regime in Parkinson's disease patients with camptocormia. METHODS: Nine patients with Parkinson's disease were included in a retrospective pilot study of the value of back extensor strengthening exercise. Six inpatients received a 30-minute treatment, twice daily for 5 weeks, being treated on average for 34 days; while three outpatients visited the clinic and were educated for home exercise and backpack wearing treatment. Outpatients should be scheduled to visit the outpatient department to check physical status every 2–4 weeks for an average of 3 months. RESULTS: All patients except one showed statistically significant improvements in activities of daily living (ADL) and motor symptoms, as measured by flexion angle at standing posture, Unified Parkinson's Disease Rating Scale (UPDRS) II and III, and modified Hoehn-Yahr staging. CONCLUSION: Conservative treatment is effective in postural correction of camptocormia in Parkinson's disease, as well as improvement in ADL and motor symptoms.
Activities of Daily Living ; Humans ; Inpatients ; Outpatients ; Parkinson Disease* ; Physical Therapy Modalities ; Pilot Projects* ; Posture ; Rehabilitation ; Retrospective Studies*

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Is WHODAS 2.0 Useful for Colorectal Cancer Survivors?.

Hyun Haeng LEE ; Eun Kyoung SHIN ; Hyung Ik SHIN ; Eun Joo YANG

Annals of Rehabilitation Medicine.2017;41(4):667-676. doi:10.5535/arm.2017.41.4.667

OBJECTIVE: To compare the disability level of colorectal cancer survivors with and without stoma by using the Korean version of the 12-item, interview-administered World Health Organization Disability Assessment Schedule 2.0 (Korean version of WHODAS 2.0). METHODS: This is a multicenter (five tertiary university hospitals and the Korea Ostomy Association) and cross-sectional survey. Colorectal cancer survivors with and without stoma were interviewed. Survey measured disability level using the Korean version of WHODAS 2.0 and health-related quality of life using the SF-36. RESULTS: A significant difference was observed between patients with and without a stoma in two subdomains: getting around (31.1 vs. 20.3; p=0.013) and participation in society (32.3 vs. 22.2; p=0.028). After adjusting for age, gender, and time since surgery, having a stoma was associated with severe to extreme disabilities in participation (OR=2.72, p=0.045). The Korean version of WHODAS 2.0 showed satisfactory internal consistency (r=0.96) and convergent validity. CONCLUSION: Patients with stoma participated less in society than those without stoma. The Korean version of WHODAS 2.0 is a reliable and valid instrument for measuring disability in Korean colorectal cancer patients.
Appointments and Schedules ; Colorectal Neoplasms* ; Cross-Sectional Studies ; Hospitals, University ; Humans ; Korea ; Ostomy ; Quality of Life ; Surgical Stomas ; Survivors* ; World Health Organization

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Respiratory Muscle Strength in Patients With Chronic Obstructive Pulmonary Disease.

Nam Sik KIM ; Jeong Hwan SEO ; Myoung Hwan KO ; Sung Hee PARK ; Seong Woong KANG ; Yu Hui WON

Annals of Rehabilitation Medicine.2017;41(4):659-666. doi:10.5535/arm.2017.41.4.659

OBJECTIVE: To compare the respiratory muscle strength between patients with stable and acutely exacerbated (AE) chronic obstructive pulmonary disease (COPD) at various stages. METHODS: A retrospective medical record review was conducted on patients with COPD from March 2014 to May 2016. Patients were subdivided into COPD stages 1–4 according to the Global Initiative for Chronic Obstructive Lung Disease guidelines: mild, moderate, severe, and very severe. A rehabilitation physician reviewed their medical records and initial assessment, including spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test, and modified Medical Research Council scale. We then compared the initial parameters in patients with a stable condition and those at AE status. RESULTS: The AE group (n=94) had significantly lower MIP (AE, 55.93±20.57; stable, 67.88±24.96; p=0.006) and MIP% (AE, 82.82±27.92; stable, 96.64±30.46; p=0.015) than the stable patient group (n=36). MIP, but not MEP, was proportional to disease severity in patients with AE and stable COPD. CONCLUSION: The strength of the inspiratory muscles may better reflect severity of disease when compared to that of expiratory muscles.
Dyspnea ; Humans ; Medical Records ; Muscle Strength ; Muscles ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Respiratory Muscles* ; Retrospective Studies ; Spirometry

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Cardiac Rehabilitation Exercise Training for High-Risk Cardiac Patients.

Hee Eun CHOI ; Chul KIM ; Yukyung SOHN

Annals of Rehabilitation Medicine.2017;41(4):650-658. doi:10.5535/arm.2017.41.4.650

OBJECTIVE: To examine the effect and safety of cardiac rehabilitation (CR) program in high-risk cardiac patients and compare these results to those of control CR participants without high-risk criteria. METHODS: A total of 12 high-risk cardiac patients were recruited as subjects. The high-risk criteria were: advanced heart failure with left ventricular ejection fraction (LVEF) of less than 30%, a recent history of cardiac arrest or dangerous arrhythmia, and cardiac device insertion. Another 12 CR participants without any high-risk criteria mentioned above were recruited as controls. Both groups underwent 6 to 8 weeks of CR exercise training. Exercise tolerance tests were performed before and after completion of the CR program. After CR completion, both groups were evaluated and their results were compared. RESULTS: After completion of the CR exercise program, both groups showed significant increases in peak oxygen uptake (VO(2peak)) and LVEF. In the control group (n=12), VO(2peak) increased from 25.9 to 31.8 mL/kg/min (changing rate, +21.4%±22.1%) and LVEF increased from 56.1% to 59.1% (changing rate, +5.3%±8.4%). In the high-risk group (n=12), VO(2peak) increased from 16.8 to 21.0 mL/kg/min (changing rate, +28.6%±21.4%) and LVEF increased from 26.1% to 29.4% (changing rate, +16.1%±12.9%). There was no serious cardiovascular event during all exercise hours. CONCLUSION: High-risk cardiac patients who completed a supervised CR program demonstrated significant improvements in VO(2peak) and LVEF without any serious cardiovascular event. The improvement rate was similar to that of control group.
Arrhythmias, Cardiac ; Defibrillators ; Exercise Tolerance ; Heart Arrest ; Heart Failure ; Humans ; Oxygen ; Rehabilitation* ; Stroke Volume

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Korean Database of Cerebral Palsy: A Report on Characteristics of Cerebral Palsy in South Korea.

Shin Young YIM ; Chung Yong YANG ; Joo Hyun PARK ; Min Young KIM ; Yong Beom SHIN ; Eun Young KANG ; Zee Ihn LEE ; Bum Sun KWON ; Ji Chan CHANG ; Seong Woo KIM ; Myeong Ok KIM ; Jeong Yi KWON ; Han Young JUNG ; In Young SUNG

Annals of Rehabilitation Medicine.2017;41(4):638-649. doi:10.5535/arm.2017.41.4.638

OBJECTIVE: To introduce the Korean Database of Cerebral Palsy (KDCP) and to provide the first report on characteristics of subjects with cerebral palsy (CP). METHODS: The KDCP is a nationwide database of subjects with CP, which includes a total of 773 subjects. Characteristics such as demography, birth history, onset and type of CP, brain magnetic resonance imaging (MRI) findings, functional ability and accompanying impairments, were extracted and analyzed. RESULTS: Preterm delivery and low birth weight were found in 59.51% and 60.28% of subjects, respectively. Postnatally acquired CP was 15.3%. The distribution of CP was 87.32%, 5.17%, and 1.81% for spastic, dyskinetic, and ataxic types, respectively. Functional ability was the worst in dyskinetic CP, as compared to other types of CP. Speech-language disorder (43.9%), ophthalmologic impairment (32.9%), and intellectual disability (30.3%) were the three most common accompanying impairments. The number of accompanying impairments was elevated in subjects with preterm birth and low birth weight. Brain MRI showed normal findings, malformations, and non-malformations in 10.62%, 9.56%, and 77.35% of subjects, respectively. Subjects with normal MRI findings had better functional ability than subjects with other MRI findings. MRI findings of a non-malformation origin, such as periventricular leukomalacia, were more common in subjects with preterm birth and low birth weight. CONCLUSION: The KDCP and its first report are introduced in this report, wherein the KDCP established agreement on terminologies of CP. This study added information on the characteristics of subjects with CP in South Korea, which can now be compared to those of other countries and ethnicities.
Brain ; Cerebral Palsy* ; Classification ; Demography ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intellectual Disability ; Korea* ; Leukomalacia, Periventricular ; Magnetic Resonance Imaging ; Muscle Spasticity ; Premature Birth ; Reproductive History

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Verification of Reliability and Validity of the Feeding and Swallowing Scale for Premature Infants (FSSPI).

Chang Won MOON ; Han geul JUNG ; Hee Jung CHEON ; Su Mi OH ; Young Ok KI ; Jeong Yi KWON

Annals of Rehabilitation Medicine.2017;41(4):631-637. doi:10.5535/arm.2017.41.4.631

OBJECTIVE: To propose a new scale, the Feeding and Swallowing Scale for Premature Infants (FSSPI), based on videofluoroscopic swallowing study (VFSS) findings and to verify the reliability and validity of the FSSPI. METHODS: One hundred thirty preterm infants who had undergone VFSS were enrolled in this retrospective study. The FSSPI was developed by referring to the Baby Regulated Organization of Subsystems and Sucking approach. The FSSPI score for each VFSS video was evaluated by a physiatrist as well as by three experienced speech-language pathologists. To verify the reliability of the FSSPI, the inter-evaluator and intra-evaluator associations for the FSSPI scores were analyzed. To verify the validity of the FSSPI, the association between FSSPI scores and clinical characteristics including prognosis-related factors was analyzed. RESULTS: The mean gestational age was 27.3±2.8 weeks. The FSSPI showed a high degree of both intra-rater reliability and inter-rater reliability. Also, there was a significant negative correlation between the FSSPI score and corrected age (CA) at the time of performing VFSS. Further, a significant positive correlation was observed between the FSSPI score and CA at the time of achieving full oral feeding. A significant negative correlation was observed between the FSSPI score and weight gain, between the 1st and 2nd month after birth, and between the 2nd and 3rd month after birth, respectively. CONCLUSION: In this study, we proposed a new clinical scale using VFSS to reflect the development of feeding and swallowing skills in preterm infants. Further, we verified the reliability and validity of the scale.
Deglutition Disorders ; Deglutition* ; Fluoroscopy ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature* ; Parturition ; Reproducibility of Results* ; Retrospective Studies ; Weight Gain ; Weights and Measures

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Effect of Patient Education on Reducing Medication in Spinal Cord Injury Patients With Neuropathic Pain.

Ji Cheol SHIN ; Na Young KIM ; Shin Hye CHANG ; Jae Joong LEE ; Han Kyul PARK

Annals of Rehabilitation Medicine.2017;41(4):621-630. doi:10.5535/arm.2017.41.4.621

OBJECTIVE: To determine whether providing education about the disease pathophysiology and drug mechanisms and side effects, would be effective for reducing the use of pain medication while appropriately managing neurogenic pain in spinal cord injury (SCI) patients. METHODS: In this prospective study, 109 patients with an SCI and neuropathic pain, participated in an educational pain management program. This comprehensive program was specifically created, for patients with an SCI and neuropathic pain. It consisted of 6 sessions, including educational training, over a 6-week period. RESULTS: Of 109 patients, 79 (72.5%) initially took more than two types of pain medication, and this decreased to 36 (33.0%) after the educational pain management program was completed. The mean pain scale score and the number of pain medications decreased, compared to the baseline values. Compared to the non-response group, the response group had a shorter duration of pain onset (p=0.004), and a higher initial number of different medications (p<0.001) and certain types of medications. CONCLUSION: This study results imply that an educational pain management program, can be a valuable complement to the treatment of spinal cord injured patients with neuropathic pain. Early intervention is important, to prevent patients from developing chronic SCI-related pain.
Complement System Proteins ; Early Intervention (Education) ; Education ; Humans ; Neuralgia* ; Pain Management ; Patient Education as Topic* ; Prospective Studies ; Spinal Cord Injuries* ; Spinal Cord*

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Intraoperative Neurophysiological Monitoring for Spinal Cord Tumor Surgery: Comparison of Motor and Somatosensory Evoked Potentials According to Tumor Types.

Taeha PARK ; Jinyoung PARK ; Yoon Ghil PARK ; Joowon LEE

Annals of Rehabilitation Medicine.2017;41(4):610-620. doi:10.5535/arm.2017.41.4.610

OBJECTIVE: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. METHODS: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later. We analyzed sensitivity, specificity, positive and negative predictive values of each significant change in SEPs and MEPs. RESULTS: The overall sensitivity and specificity of SEPs or MEPs were 100% and 61.3%, respectively. The intraoperative MEP monitoring alone showed both higher sensitivity (67.9%) and specificity (83.2%) than SEP monitoring alone for postoperative motor deterioration. Two patients with persistent motor deterioration had significant changes only in SEPs. There are no significant differences in reliabilities between anatomical types, except with hemangioma, where SEPs were more specific than MEPs for postoperative motor deterioration. Both overall positive and negative predictive values of MEPs were higher than the predictive values of SEPs. However, the positive predictive value was higher by the dual monitoring of MEPs and SEPs, compared to MEPs alone. CONCLUSION: For spinal cord tumor surgery, combined MEP and SEP monitoring showed the highest sensitivity for the postoperative motor deterioration. Although MEPs are more specific than SEPs in most types of spinal cord tumor surgery, SEPs should still be monitored, especially in hemangioma surgery.
Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Hemangioma ; Humans ; Intraoperative Neurophysiological Monitoring* ; Muscle Strength ; Postoperative Complications ; Sensitivity and Specificity ; Spinal Cord Neoplasms* ; Spinal Cord*

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Determination of Electrophysiologically Moderate and Severe Carpal Tunnel Syndrome: Ultrasonographic Measurement of Median Nerve at the Wrist.

Chanwit PHONGAMWONG ; Narathorn SOPONPRAPAKORN ; Wipoo KUMNERDDEE

Annals of Rehabilitation Medicine.2017;41(4):604-609. doi:10.5535/arm.2017.41.4.604

OBJECTIVE: To establish the cutoff value of cross-sectional area (CSA) of the median nerve at the wrist, for determination of electrophysiologically moderate and severe carpal tunnel syndrome (CTS). METHODS: The prospective study was conducted among patients suspected of having CTS. A total of 106 patients (185 symptomatic wrists) received nerve conduction study (NCS) and ultrasonography. To establish a cutoff value, various diagnostic properties were calculated across a range of the CSA. RESULTS: A mean±standard deviation of CSA of the median nerve of normal and mild, moderate and severe CTS was 9.4±2.1, 12.0±2.7, 13.8±4.7, and 15.4±4.1 mm², respectively. The positive relationship between CTS severities and CSA was observed (rs=0.56). A 14 mm² CSA had sufficient power to rule in moderate and severe CTS, with a specificity of 91.4% and sensitivity of 42.3%. In addition, it showed a post-test probability (positive predictive value) of 86.3% as against a pre-test probability of 56.2%. CONCLUSION: Patients who had ≥14 mm² of median nerve CSA had very high probability of moderate to severe CTS.
Carpal Tunnel Syndrome* ; Electrophysiology ; Humans ; Median Nerve* ; Neural Conduction ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Wrist*

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The Correlation Between Electrodiagnostic Results and Ultrasonographic Findings in the Severity of Carpal Tunnel Syndrome in Females.

Da Sol HA ; Hyoung Seop KIM ; Jong Moon KIM ; Kun Hee LEE

Annals of Rehabilitation Medicine.2017;41(4):595-603. doi:10.5535/arm.2017.41.4.595

OBJECTIVE: To determine which ultrasonographic measurement can be used as an indicator reflecting the severity of carpal tunnel syndrome (CTS), by comparing electrodiagnostic results with ultrasonographic measurements in females. Many previous studies have tried to reveal that the ultrasonography (US) can possibility be used for diagnosis and severity of CTS. However, the criteria are different by gender. Thus far, there have been many efforts towards providing patients with a CTS diagnosis and severity prediction using US, but studies' results are still unclear due to lack of data on gender differences. METHODS: We collected data from 54 female patients. We classified the severity of CTS according to electrodiagnostic results. Ultrasonographic measurements included proximal and distal cross-sectional areas of the median nerve and carpal tunnel. RESULTS: The severity by electrodiagnostic results statistically correlated to the proximal cross-sectional area (CSA) of the median nerve and carpal tunnel. However, there was no relationship between the proximal and distal nerve/tunnel indexes and the severity by electrodiagnostic results. CONCLUSION: In female patients with CTS, the proximal CSAs of the median nerve and carpal tunnel increase. They correlate with the severity by electrodiagnostic findings. The CSA of the proximal median nerve could be particularly used as a predictor of the severity of CTS in female patients. However, the nerve/tunnel index is constant, irrespective of the severity of CTS.
Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Female* ; Humans ; Median Nerve ; Ultrasonography

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