In a 27-month period, 47 selected patients with cerebrovascular accidents were studied utilizing computerized tomography or magnetic resonance image of brain, Modified Barthel Index, PULSES Profile, Brynnstrom stage and trunk control scale in an attempt to correlate radiological findings with final rehabilitation outcome and to evaluate the influences of the size and location of the lesion, which one has more effect on predicting the final outcome.

Parameters that were studied included the size, nature and location of the lesion, neurological and functional status at 3 months after the onset. Nonparametric statistical analysis assessed the impact of three independent variables of radiological findings on neurological and functional outcome at 3 months.

Small sized (less than 2 cm) lesion resulted in significantly better neurological recovery state. Infarction resulted in significantly better locomotion function than hemorrhage. Central brain damage (internal capsule, basal ganglia, thalamus) resulted in significantly higher degree of functional impairment than cortical damage. But there was no significant difference between the patients with basal ganglia lesion and the patients with thalamus lesion. Patients with small lesion and poorer outcome had significantly lower degree of functional and neurological impairment than patients with medium lesion and better outcome.

The study suggested that the size of the lesion had more impact on final outcome than location but two factors should be considered together in predicting the functional outcomes of stroke patients.

Early urinary incontinence is an important complication of stroke because it causes personal distress and lowering of functional outcome.

The aim of this study is to demonstrate the correlation of early urinary incontinence and rehabilitation outcome of stroke patients.

The subjects of this study were 91 stroke patients who were admitted to the Department of Rehabilitation Medicine, Yonsei University College of Medicine, and managed with comprehensive rehabilitative treatment between January 1, 1987 and January 31, 1990. Medical records were reviewed and data such as age, sex, hospital days, effect of operation, Barthel score, ambulation status at admission and discharge and duration of Foley insertion were suveyed. The study group consisted of 59 stroke patients who had urinary incontinence of early onset, and a control group of 32 stroke patients without urinary incontinence. The incidence of early urinary incontinence and correlation between early urinary incontinence and activities of daily living, ambulation status and hospital days after rehabilitation was determined statistically.

1. An incidence of early urinary incontinence was 64.8%.

2. There were no differences in age, sex, properties of brain lesion, effect of operation and duration of foley insertion between the two groups.

3. In the urinary incontinence group, post rehabilitation Barthel score of activities of daily living and ambulation status were poor and hospital days were prolonged.

4. Comparison of pre and post rehabilitation status in activities of daily living and ambulation showed little improvement in the urinary incontinence group.

5. The overall severity was greater, the activities of daily living and ambulation status was lower and the length of hospital days was longer in stoke patients with early urinary incontinence. This knowledge could be helpful in planning stroke rehabilitation programs.

Idiopathic facial palsy (Bell's palsy) is the most common mononeuropathy, but one from which 70∼80 percents of patient recover completely without treatment.

The prospective study of 84 facial nerve paralysis was carried out to observe the course of the disease and to correlate the physical findings, electrodiagnostic findings with the prognosis. The suspected lesion site was determined and comparision of compound muscle action potential amplitude, needle EMG, and blink reflex were performed as electrodiagnostic test. The result of 84 subjects was as follows.

1) The class Ⅴ was in 45 cases (52.4%) and the class Ⅳ, Ⅲ, Ⅱ, Ⅰwas in 15 cases (17.8%), 14 cases (16.7%), 2 cases (2.7%), 8 cases (9.5%), respectively.

2) According to the facial nerve pathway, the more distal the lesion, the better the prognosis.

3) There was higher recovery rate in the cases which reveal less than 90% of axonal degeneration.

4) The more the number of muscles which show motor unit action potentials in the lesion side, the higher the recovery rate.

5) There was higher recovery rate in the cases which preserve blink reflex in the lesion side.

The H reflex is the expression of a monosynaptic reflex, and then the H/M ratio contribute to the excitability of motorneuron in reflex arc.

The spasticity is major problem of the rehabilitation management, but the mechanism of the spasticity is still unknown and suggest intrinsic hyperexcitability response of the a motorneuron.

So, we provide the measure of motorneuron excitability under normal, spastic and rigid subjects using H/M ratio in H-reflex of EMG.

1) The H/M ratio of 14 normal persons are range 8.3-37.8% mean 20.46±8.4%

2) The H/M ratio of spastic 18 limbs of 14 persons are range 18.2-7.8%, mean 45.6 ± 17.85%. The P-value is highly significantly than Normal (P<0.05)

3) The H/M ratio of spastic affected 10 limbs are, mean 48.72±19.83%, highly significant than unaffected limbs, mean 21.28±10.59% (P<0.05).

4) The H/M ratio of rigid 4 limbs of 2 persons are range 12.5-29.1%, mean 22.68±4.4%. The P-value is not highly significant than normal (P>0.05).

Dysphagia is a common and serious problem after strokes involving both cerebral hemispheres or brainstem, Swallowing problems could have serious consequences, with dehydration leading to haemoconcentration and renal failure and aspiration leading to pneumonai.

Data from 80 conscious stroke patients, taking part in acute intervention trial and assesed within 48 hours of onset of symptoms, were used to investigate the prevalence and natural history of swallowing problems.

Nearly 49% of patients with single-hemisphere strokes were initially found to have difficulty swallowing a mouthful of water, but in 60% of those the deficit had resolved by the 6 months. Strong correlation were found between dysphagia and speech inteligibity and with urinary incontinence, muscle power on affected side, But there was no association with the side and cause of the stroke.

Swallowing impairment was associated with functional outcome at 6 months. These results indicate the dysphagia may hamper functional recovery and influence on rehabilitation of patients with strokes.

Hereditary Motor and Sensory Neuropathy involves anterior horn cell, spinal roots, posterior root ganglion, and peroneal nerves.

By this time, there were a few studies about the anterior horn cell involvement which were autopsy findings and EMG findings which showed large motor units.

We stimulated motor cortex and recorded from abductor digiti quinti muscle individually and found prolonged latency and decreased amplitude of motor evoked potentials, We concluded these finding were due to anterior horn cell involvement.

The range of motion of the lumbar spine was mesured in 108 healthy Korean subjects by plurimeter techniques of standardization of the meaurement of range of motion of the lumbar spine.

The results were as follows;

1) The average ranges of motion of the lumbar spine in healthy Korean adults are 23.0±5.9⁗ in extension, 52.5±8.9⁗ in flexion, 36.1±5.7⁗ left bending, 36.6±5.9⁗ in right bending, 34.1±4.8⁗ in left rotation and 33.5±4.6⁗ in right rotation.

2) The range of motion of the lumbar spine was significantly correlated with increasing age (P<0.001).

3) The interobserver reliability was substantial for the six measurements taken; coefficients ranged form+0.69 to +0.81 (P<0.001).

4) The plurimeter technique may prove useful to the clinician as an improved method for assessing the lumbar spine.

The objectives of this study were to demonstrate the diagnostic value and the clinical usefulness in low back pain patients with suspicious unilateral radiculopathy over lumbosacral area, The subjects of this study were 94 cases with low back pain who underwent electrodiagnostic examination including H reflex study at Chungnam National University Hospital during the period from March 1,1989 to June 30, 1990. Thirty normal subjects aged from 18 to 49 years served as controls for this study. The meas difference in the H reflex latency of both legs of 30 normal subjects was little as 0.01±0.54 msec and it was statistically nonsignificant (P>0.05).

Ninety-six cases with low back pain were divided into 3 groups which consisted of lumbar radiculopathy, including S1 radiculopathy and normal EMG groups. These groups consisted of 5.33 and 56 patients respectively. H reflex latency was measured in both legs.

The mean was 0.28±0.51 msec in lumbar radiculopathy and 1.75±1.22 msec in including S1 radiculopathy group, So the mean difference of S1 radiculopathy group was significantly prolonged. Therefore, in patients with S1 radiculopathy, a mean difference of more than 1.0 msec would indicate an abnormality.

The H reflex was present but prolonged in latency as compared to the unaffected side in 19 cases. it was absent in the affected side in 11 cases and the sum was 30 cases among 33 cases with S1 radiculopathy confirmd by EMG examination.

So the H reflex study was a diagnostic aid in unilateral S1 radiculopathy in addition traditional EMG study, Especially, side to side difference of H reflex was highly correlated than predicted value of Johnson or the actual value of Lee. In conclusion. the H reflex study can be easily done all EMG laboratories and so it will increase the chance for accuracy in the diagnosis of radiculopathy or in the determination of the level of the lesion.

To evaluate angulations of facet joints related, transverse interfacet angle(TIFA), transverse interlaminar angle(TILA) and facet angle(F4), by computed tomography in lower lumbar spines, one hundred thirty-six cases taken CT scan because of low back pain were studied. The patients studies were composed of 68 normal group and 68 abnormal group revealed disc herniation at lower lumbar spine. And relationship between disc herniation and facet joint asymmetry was evaluated.

There are gradual increase in TIFA and TILA from L3/L4 downward and gradual decrease in FA for L3/L4 downward. At the level of L3/L4, the facet joints and laminae are more sagittally oriented, while at L5/S1 they are more frontally oriented. The angles at L4/L5 were intermediate in theirorientations. Facet joints with lumbar disc herniation were more sagittally oriented at L3/L4 and L4/L5, significantly.

Incidence of asymmerty of facet joins (tropism) was 36.8%, but no significant difference of the incidence of tropism between groups with disc herniation and not was noted.

The accurate diagnosis of lumbar radiculopathy in intervertebral disc herniation remains a significant problem In an attempt to aid the diagnosis of the proper roots which responsible for the clinical symptoms, somatosensory evoked potential has been used in conjunction with standard diagnostic technique in 21 patients with herniated nucleus pulposus. And the results were compared with the surgical findings of the patients and with the results of control group of 25 normal adults.

1) Latencies of P1 in normal adults were 38.6 msec in L4, 38 msec in L5, and 39.7 msec in S1 nerve root in average.

2) Latencies of P1 in the 23 compressed roots were 39.2 msce in L4 42.3 msec in L5, and 41.4 msec in S1 roots in average. But the delay of latency was significant in L5 only (P<0.01). 3) Latency of P1 in 23 compressed roots were delayed significantly to 41.9 msec than 39.8 msec in unaffected side of same patients(P<0.05)

4) The diagnostic accuracy for the compressed nerve roots, compared with surgical findings was 78%

From the above results, the author concludes that the P1 latency of the affected side should be compared with that of the unaffected side of same patient than that of normal persons, for the diagnosis of compressed nerve roots in herniated nucleus pulposus.

Upper extremity amputees who reside in the rural areas were followed up via questionnaires about their status of rehabilitation using prostheses.

The results were as follows;

1) The mean age at the time of amputation was 34.9 years. Above elbow and below elbow amputees accounted for 80% of all cases.

2) Prostheses were made by 80% and cosmetic hands were 62.5% of them.

3) Prostheses were worn by 81.3% all or part time of the day and 93.7% used their prostheses only for cosmetic purposes.

4) 60% were unemployed and 55% lost their jobs after amputation. Needs and request for employment were relatively low, but 5 cases who needed a job all wanted vocational training.

The influence of unilateral visual neglect on functional status after stroke was investigated in 40 patients. The 11 subjects with visual neglect were of similar age and pre-stroke dependency as the 22 subjects without unilateral visual neglect. but had a more severe current stroke deficits a evidenced by a higher incidence of incontinence, homonymous hemianopsia. lower minimental state score.

Subjects with unilateral neglect had poorer functional outcome than those without neglect as measured by Modified Barthel Index. PULSES profile and the incidence of returning to social role. Poor functional outcome was observed in both ADL and transfer activity, the difference of functional outcome between the two groups was more distinct at 3 month after onset than at 1 month after onset.

We can suggest that unilateral visual neglect appear in more severe stroke patients and in patients with unilateral visual neglect, the prognosis should be poor.

103 patients with pain & stiff shoulder were followed up closely for 3 months to assess the effect of conservative treatment with intraarticular steroids, thermal therapy and therapeutic exercises, Patients with other recognized causes of stroke, Parkinsonism, diabetes mellitus, hyperthyroidism, myocardial infarction were exclued.

The subjects were 46 males and 57 females, the age range was 21 to 71 years (mean 54.3 years), and duration for condition at presentation was 1 to 50 months (mean 7 months).

The painful stiff shoulder involved the dominant arm in 51.5%, and 9.7% patients became bilateral. The onset was spontaneous in 73 cases and followed by minor trauma in 30 cases. The housewives were 37 cases in female and 29 cases were desk worker in male.

Clinical assessment was performed before and after treatment with pain score on 10 cm visual analogue scales and the range of shoulder movement was measured according to the method of Norkin & White in passive movement only.

The results were as follows;

1) In patients who took more than 10 days of treatment, the pain was reduced from 10 to 2.9 in self pain assessment scale and the range of motion increased by 36.4 in flexion, 40 in abduction, 16.4 in internal rotation and 20.6 in external rotation.

2) In patients, who's duration of symptom was less than 10 weeks, the pain was reduced form 10 to 4.1 in self pain assessment scale and the range of motion was increased by 26.4 in flexion. 29.6 in abduction, 14.3 in internal rotation and 12.5 in external rotation.

3) Subjective pain decrement was earlier effect and predominant finding than the changes in range of motion.

Isokinetic evaluation of bilateral quadriceps and hamstrings at 60⁗/sec, 120⁗/sec, and 180⁗/sec was performed using the Isokinetic Rehabilitation and Testing System (Model No. Cybex 340) on 30 male students comprising 15 soccer players (Group 1) and 15 general students (Group 2) with no significant difference in age, weight, and height between the two groups. All subjects used their right foot to kick the ball.

In both groups, there were no significant differences in the mean peak torque of both muscles between dominant (right) and nondominant (left) limbs. There were no significant differences between Group 1 and Group 2 were found in the angle of peak torque output for the quadriceps. No significant differences between the two groups were found for average power, torque acceleration energy, or total work of both muscles. There were significant differences between Group 1 and Group 2 in the hamstrings to quadriceps(H/Q) ratio at 180⁗/sec and also in the endurance ratios for both muscles at 180⁗/sec. As the angular velocity increased. the H/Q ratio for Group 1 was significantly increased(P<0.01), but there were no significant changes in the H/Q ratio for Group 2.

To obtain the isokinetic normative data of isokinetic laboratory of department of Rehabilitation Medicine in the Chungnam National University Hospital, isokinetic evaluation of knee extensors and flexors at speed of 60⁗/sec, 180⁗/sec with the Cybex Ⅱ⁺ Isokinetic Dynamometer was performed in 30 males and 10 females volunteered among medical students of Chungnam National University.

The results were as follows;

1) The mean peak torque of knee extensors at speed of 60⁗/sec were 124 ft-lbs both limbs, and the mean ratio of peak torque to body weight of knee extensors at speed of 60⁗/sec, 180⁗/sec were 85%, 55%, respectively in both limbs.

2) The mean peak touque of knee flexors at speed of 60⁗/sec in dominant and non-dominant limb were 70 ft-lbs, 69 ft-lbs, respectively, and the peak torque to body weight of knee flexors at speed of 60⁗/sec in dominant and non-dominant limb were 48%, 47%, respectively, and at speed of 180⁗/sec those were 36% in both limbs.

3) The mean endurance ratio of knee extensors at speed of 180⁗/sec in domanant and non-dominant limb were 54%, 50%, respectively, and the mean peak torque acceleration energy of knee extensors at speed of 180⁗/sec in dominant and non-dominant limb were 19.5 ft-lbs, 19.3 ft-lbs, respectively.

4) The mean endurance ratio of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 59%, 58%, respectively, and the mean peak torque acceleration energy of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 11.4 ft-lbs, 11.7 ft-lbs, respectively.

5) The mean H/Q ratio at speed of 60⁗/sec in both limbs were 57%, and the mean H/Q ratio at speed of 180⁗/sec in both limbs were 67%

6) The mean total work of knee extensors at speed 180⁗/sec in dominant and non-dominant limb were 1.590 ft-lbs, 1.509 ft-lbs, respectively, and the mean average power of knee extensors at speed of 180⁗/sec in dominant and non-dominant limb were 179 watts, 170 watts, respectively.

7) The mean total work of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 1.143 ft-lbs, 1.095 ft-lbs, respectively, and the mean average power of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 127 watts, 121 watts, respectively.

8) The mean work ratio of flexors to extensors at the speed of 180⁗/sec in dominant and non-dominant limb were 73%, 74%, respectively.

9) The mean average of motion of knee extension at speed of 180⁗/sec in dominant and non-dominant limb were 86⁗, 87⁗, respectively, and the mean average range of motion of knee flexion at speed 180⁗/sec in dominant and non-dominant limb were 87⁗, 88⁗, respectively.

In female subjects;

1) The mean peak torque of knee extensors at speed of 60⁗/sec in dominant and non-dominant limb were 73 ft-lbs, 71 ft-lbs, respectively, and mean ratio of peak torque to body weigth of knee extensors at speed of 60⁗/sec in dominant and non-dominant limb were 65%, 63%, respectively, and at speed of 180⁗/sec those were 38% in both limbs.

2) The mean peak torque of knee flexors at speed of 60⁗/sec in dominant and non-dominant limb were 39 ft-lbs, 38 ft-lbs, respectively, and the mean ratio of peak torque to body weight of knee flexors at speed 60⁗/sec in dominant and non-dominant limb were 25⁗, 24⁗, respectively.

3) The mean endurance ratio of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 53%, 46%, respectively. the mean peak torque acceleration energy of knee extensors at speed of 180⁗/sec in dominant and non-dominant limb were 11.2 ft-lbs, 10.5 ft-lbs, respectively.

4) The mean endurance ratio of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 65%, 66%, respectively. the mean peak torque acceleration energy of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 6.8 ft-lbs, 6.4 ft-lbs respectively.

5) The mean H/Q ratio at speed of 60⁗/sec in dominant and non-dominant limb were 55%, 54% respectively, and the mean H/Q ratio at speed of 180⁗/sec in dominant and non-dominant limb were 64%, 63% respectively.

6) The mean total work of knee extensors at speed of 180⁗/sec in dominant and non-dominant limb were 710 ft-lbs, 697 ft-lbs, respectively, and the mean average power of knee extensors at speed 180⁗/sec in dominant and non-dominant limb were 58 watts in both.

7) The mean total work knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 511 ft-lbs, 507 ft-lbs, respectively, and the mean average power of knee flexors at speed of 180⁗/sec in dominant and non-dominant limb were 58 watts, 59 watts, respectively.

8) The mean work ratio of knee flexors to extensors at speed of 180⁗/sec were 75%, in both limbs.

9) The mean average range of motion of knee extension at speed of 180⁗/sec in dominant and non-dominant limb were 82⁗, 80⁗, respectively, and the mean average range of motion of knee flexion at speed 180⁗/sec in dominant and non-dominant limb were 82⁗, 81⁗, respectively.

Significant differences of isokinetic strengths between dominant and non-dominant limb in all subjects were not found and male subjects showed superiority in overall test parameters except endurance ratio compared with female subjects.

Brachial plexus injuries often present major problems of diagnosis and management, They commonly occur with trauma to multiple systems, Even in patients whose plexus Injuries are sole lesion, the resulting problems are multifaceted. The long and expensive recovery period makes accurate diagnosis and prognosis, as well as scrupulously relevent therapy, mandatory, Using present diagnostic aids, delay can be minimized and earlier treatment initiated, Electromyography, nerve conduction studies, contrast myelography, axon reflex testing and other electrodiagnostic studies, in conjunction with careful clinical evaluation, allow the physician to devise a specific plan of treatment within 3 to 4 months after injury.

A retrospective analysis of 76 consecutive cases of brachial plexus injury (except birth trauma), seen from August 1998 to August 1990 in the department of Rehabilitation Medicine, Catholic University Medical College, was done, The results were as follows;

1) The sex distribution showed more involve in young men the women.

2) The mean age of brachial plexus injuries were 34.5 years old in male and 42.4 years old in female.

3) The causes of injury were traffic accident, contusion, fall down, idiopathic, unknown, post operation complication, occupational accident, stab wound in orders. Traffic accidents was consisted of pedestrian's TA, motor cycle rider's TA, diver's TA, cultivator driver's TA and others, in orders.

4) The site of lesion was trunk level in 32 cases, the most frequent lesion, root level in 29 cases, cord level in 20 cases, branch level in 4 cases and uncertain in 3 cases.

5) Peripheral nerve injury was combined in 40 cases (53%) with fracture, compartement syndrome, of degloving injury, except in 8 cases, The most frequent site of peripheral nerve injury was musculocutaneous or axillary nerve.

6) Sensory nerve conduciton was normal in 23 cases (79.4%), abnormal in 6 cases (20.6%), in root lesion, And normal in 22 cases (46.8%), abnormal in 25 cases (53.2%) below trunk level.

We studied cervical root stimulation technique in 10 patients with clinical symptoms and signs of unilateral cervical radiculopathy, stimulation of nerve root was done with monopolar needle in paraspinal muscle 1.5cm lateral from and level of spinous process of cervical verebra, Recording of CMAP was done by surface electrodes on biceps brachii, triceps brachii, abductor digiti minimi, We concluded as follow:

1) Cevical root stimulation technique is accurate, reproducible and safe electrodiagnostic method.

2) Cevical root stimulation technique helps to detect cervical radiculopathy especially when needle EMG does not show definite denervation evidence; as in acute stage of radiculopathy less than 4 weeks after symptom and in chronic stage with repeated denervation and reinnervation.

The median palmar cutaneous nerve aries from radial aspect of median nerve. about 5.5cm proximal to the radial styloid and supplies sensation to the thenar eminence and proximal radial aspect of the palm, The nerve may be injured by direct trauma or accidently traumatized during surgical procedure such as carpal tunnel release although it is not involved in carpal tunnel syndrome.

The conduction study of median palmar cataneous nerve was performed in Korean 60 normal individuals (120 nerves) and 11 patients with carpal tunnel syndrome (15 nevers) to estabilish the normal values and be helpful in differential diagnosis of carpal tunnel syndrome,

The mean values of conduction study of median palmar cutaneous nerve were 1.84±0.16 msec for distal latency, 20.20±4.79 ㎶ in amplitude, 1.75±0.10 msec in duration and 54.79±4.02m/sec in conduction velocity, All those showed no significant difference in both side and sex. The study of median palmar cutaneous nerve in patient with carpal tunnel syndrome revealed normal values except two patients with ganglion and with laceration wound at radial aspect of wrist.

Phrenic nerve studies are clinically helpful in the evaluation of the disease of the peripheral nerves and in therapeutic implications.

In this study, phrenic nerve function was evaluated by transcutaneous stimulation in the neck at the posterior border of the sternocleidomastoid muscle, at the level of the thyroid cartilage and recording the diaphramatic potential from surface electrode placed at the ipsilateral eighth intercostal space and the xiphoid process.

The purpose of this study is to determine the normal value of the phrenic nerve conduction in the Korean adult.

The subject was composed of 44 normal adults who had been visited to Kyung Hee university Hospital.

The results were as follows;

1) The latency is 6.45±0,85 msec at right, 6.40±0.98 msec at left and the mean latency is 6.42±0.92 msec

2) THe amplitude is 530.68±145.78 ㎶ at right, 524.12±193.99 ㎶ at left and the mean amplitude is 527.94±186.28 ㎶ .

3) In man, the latency is 6.67±0.85 msec and the amplitude is 564.71±178.85 ㎶ , And in women, the latency is 5.97±0,86 msec and the amplitude is 462.48±182. 37 ㎶

4) There were no significant correlation between the latercy and the amplitude (r=0.09).

5) No significant difference was observed between the right and the left (p>0.01).

6) There were no significant correlation between the latency an the age (r=0.38).

Osteoporosis is common complication in patients with rheumatoid arthritis, It is most apparent in the subchondral bone of involved joints, but it may be present in a generalized distribution. In patients who have received corticosteroids chronically and/or prolonged immobilization, osteoporosis would be developed.

Using dual photon absorptiometry, bone mineral density (BMD) measurement on lumbar vetebrae was done in 163 normal women (age ranging 20-76) and 48(age ranging 21-77) patients with rheumatoid arthritis.

The mean values of BMD of the patients with rheumatoid arthritis were similar with those of normal women before age 50, but were significantly reduced in age 50-69 (P<0.05) than those of normal women, Functional impairment influenced spinal BMD significantly but disease duration did not influence spinal BMD.

Results suggested the the patients with rheumatoid arthritis in age 50-69 are high group for the development of osteoporosis and functional impairment may be a main risk factor.

The quality of life after head injury is highly dependent on the adequacy of cognitive recovery.

The intellectual sequelas of head injury impede social and occupational reintergration more than physical disabilities do.

The present study assessed the relationship between the severity of head injury, ADL (Activities of Daily Living) and cognitive function in head injured patient.

The results were as follows;

1) Final ambulatory status was more dependent in the severe head injury group (p<0.05).

2) Intellectual function, especially recent memory was significantly lower in the severe head injury gorup (p<0.05)

3) Glasgow Outcome Scale(GOS) was more lower and ADL was more dependent in the severe head injury group (P<0.05).

4) Final ambulatory status and ADL were more dependent in the group of lower Cognitive Capacity Screening Examination (CCSE) score (P<0.01).

Adolescence is period of the most marked growth and change. A physical handicap places a greater burden on the teenager. The increase in body weight and size, coupled with poor motor control, spasticity, and impaired balance reactions, makes it impossible to transport the added weight efficiently.

The purpose of this study is to assess changes in motor skills in the areas of gait, writing, and speech in adolescence, The subjects of this study were 77 adolescents with cerebral palsy, aged 13~20 years (mean, 16.7 years) who were attending the special middle and high school.

The results were as follows;

1) Then mean ages started walking and speech were 6.1, 6.8 and 3.6 years, respectively.

2) Those cases who show continuous improvement in the adolescent years in walking were 51.9% (40/77), in writing and speech were 55.8% (43/77), respectively.

3) Those who experienced worse in gait during adolescence were 41.6% (32/77), in writing 10.4% (8/77), and in speech 18.2 (14/44).

4) The factors related to worse in gait were marked growth, diseases, stoppage of treatment, and trauma.

5) The group who experienced worse in gait showed higher frequency of the development of contractures (78.1%), the use of orthoses (59.4%), and receiving treatment (87.5%) than the group who did not with the frequency of contractures 37.8%, wearing orthoses 28.9%, and receiving treatment 64.4% (P<0.01).

Low back pain is thought to occur in almost 80% of adults at some point in their lives. Among chronic conditions, back problems are the most frequent cause of limitation of activity.

A large variety of treatment is available, but in light of our present knowledge the most effective and economic method is backschool.

We studied 90 back pain patients who had completed backschool.

The results were as follows;

1) Eighty two percent of patients had chronic low bac pain.

2) The performance ratio of proper posture and abdominal strengthening exercise after backschool is eighty percent.

3) The effect of backschool in good student was 23.6% of excellent, 79.8% of good.

4) The most helpful treatment modality was Back School(64.4%)

5) The causes of low back pain revealed that sixty percent of chronic low back pain was able to prevented by Back School.

In pelvic bone fracture the incidence of concomitant nerve injury is not known exactly. The factors promoting nerve injury in connection with closed skeletal trauma are; 1) proximity of the nerve to unyielding anatomical structures, 2) morphological characteristics of the neural elements and supporting structures and 3) inherent tolerance to trauma, What is the relation between lumbo-sacral nerve injury and the fracture pattern of the pelvis?

We studied 97 pelvic bone fracture patients under the physical findings, radiological findings and electrophysiologic findings.

The results of these studies were as follows;

1. In 97 pelvic bone fracture patients the incidence of concomitant nerve injury was 11 cases (11.3%)

2. In 11 lumbosacral nerve injury patients we seen stable fracture in 2 cases, unstable fracture in 9 cases, therefore nerve injuries were more correlate with unstable fracture than stable fracture.

3. In 9 lumbosacral nerve injury patients unstable pelvic bone, fracture, We seen only anterior pelvic ring instability in 0 case only posterior pelvic ring instability in 6 cases, both instability in 3 cases, therefore nerve injuries were more correlate with posterior pelvic ring instability than anterior pelvic ring instability.

4. In 11 lumbosacral nerve injury the sites of these injuries were lumbosacral trunk in 9 cases, obturator nerve in 7 cases, superior gluteal nerve in 5 cases, femoral nerve in 4 cases, sciatic nerve in 2 cases, therefore combined nerve injuries were common than single one

This experimental study was designed to evalute the effectiveness of intramuscular administration of dexamethasone and exogenous ganglioside on the recovery of somatosensory evoked potential(SSEP) in the acute compression neuropathy, Experimental compression neuropathy was made by mechanical compression of surgically exposed sciatic nerves of sixty rabbits.

Sixty adult rabbits divided into there groups (control group, dexamethasone group, and ganglioside group) were studied. P1 amplitude and P1 latency of SSEP were measured at pre-injury, just after injury, and eight times every three days till twenty-four days after the injury. Data of P1 amplitudes and latencies of SSEP obtained from fourty nine rabbits survived were analyzed statistically.

Correlations of P1 amplitude change of SSEP were higher than those of P1 latency of SSEP in all 3 groups, P1 amplitude of SSEP was better measurement then the latency in evaluating recovery of compression neuropathy by SSEP The slope of the regression line was considered at the recovery rate of P1 amplitude and latency of latency of SEEP for the 3 groups of the animals. The recovery rate of P1 amplitudes of SEEP was greater in dexamethasone group than ganglioside and control group. with significant difference among the 3 groups, But the recovery rate of P1 latercies of SSEP was not significantly different among the 3 groups

It is concluded that experimental neuropathy may produce axonal degeneration and transient local demyelination. Dexamethasone and ganglioside may facilitate the recovery of axonal regeneration than myelin regeneration. And dexamethasone may be more effective than ganglioside in the neural recovery.

Until present, a systematic analysis about status and changing pattern of admitted inpatients in rehabilitation medicine has not been done. So the purpose of this study was to analyze the status and changing pattern of 1.138 patients admitted in the department of rehabilitation medicine of Presbyterian Medical Center during recent 10 years from 1980 to 1989 to provide basic data and useful information for the development of comprehensive and systematic rehabilitation care.

The results were as follows;

1) The total number of cases was 1.138; the mean age was 39.1 years; and the ratio of males to female was 1.7;1

2) Spinal cord injury was th most frequent diagnosis and represented 18.3% of total inpatients while cerebrovascular accident and bone & soft tissue injury represented 18.0% and 15.3% respectively.

3) The most frequent cause fo disability was accidents representing 51.9%, Chronic diseases and infectious diseases were the second and third causes.

4) Among the accidents, traffic accident was most frequent cause and represented 30.3% of all while falling and industrial accidents represented 9.8% and 4.7 respectively.

5) The peak ages of disability occurrance were second to third decades in accident cases and fifth to sixth decades in chronic disease cases.

6) The mean length of hospitalization was 61.5 days and the mean length of rehabilitation was 33.1 days. The mean period form admission to transfer to rehabilitation department was 42.7 days,

7) The departments to which the patients were admitted most frequently were neurosurgery(30.2%), rehabilitation medicine(29.7%), and orthopedic surgery (26.7%).

Suction cup reference and ground electrodes were investigated for alternative of commonly used disc type surface electrode in electrodiagnostic study. Quantitative elctromyograplhy (Q-EMG) to evaluate difference of motor unit action potentials (MUAP) using disc type suction cup electrodes for referencd and ground electrode alternatively was done.

There was no statistically significant difference of parameters (duration, amplitude, area, and rise time) of MUQP between the groups.(P<0.05). We conclude that the suction cup electrodes are not resulting in change of MUAP parameters. And electrophysiologic study can be performed more comfortably and rapidly by using the suction cup electrodes.

Additionally, normal values of duration, amplitude, area, and rise time of MUAP in first dorsal interosseus that analysed using the suction cup electrodes were 5.78±0.99 msec, 439.08±100.91 ㎶, 508.46±116.24 mV. msec and 1.12±0.31 msec, respectively and using disc type surface electrodes were 5.83±0.96 msec, 445.29±99.47 ㎶, 517.32 + 125.15 mV. msec and 1.09±0.37 msec, respectively.

Motor and sensory nerve conduction study was done in 19 patients who showed neurologic symptom after cisplatin chemotherapy, and we concluded as follow;

1) The onset of neurologic syptom was about 4.3 months ranging 1.5 to 8 months after initial chemotherapy.

2) Mean cisplatin dose at symptom onset was 406.8±318.1 mg.

3) Sensory symptom, such as tingling and numbness, was present in all 19 patients.

4) Motor symptom was not remarkable, but 1 patients showed hand weakness.

5) Sensory examination was abnormal in 11 patients, especially for vibration sensation.

6) Deep tendon reflex was hyporeflexic in 10 patients.

7) Sensory nerve conduction study was abnormal in 10 patients, and motor nerve conduction was abnormal in 7 patients.

8) As a whole, the electrodiagnostic study was normal in 3 patients, motor neuropathy was seen in 1 case, sensory neuropathy in 7 cases, sensorymotor neuropathy in 4 cases. Only H-reflex was abnormal in 4 cases

9) There was statistical difference between normal and abnormal electrodiagnostic study group in the number of chemotherapy cycle, but no statistical difference in cisplatin dose at onset, cisplatin dose at study, duration of symptom.

Since the beginning of the training program in Rehabilitation Medicine for both undergraduate medical students and residents in Korea in 1792 with the foundation of the Korean Academy of Rehabilitation Medicine, 14 medical school among 31 in the country have started the undergraduate training in Rehabilitation Medicine with various curricula.

In order to evaluate present status of this education and to obtain baseline data for the guideline for approval of the curricula to improve the quality, of education, comprehensive data on undergraduate curricula were obtained from the school with the undergraduate program Rehabilitation Medicine and analyzed.

Fourteen medical schools had undergraduate curricula in Rehabilitation Medicine with lectures and 5 school had clinical clerkship, 3 of them being compulsory and 2 being elective.

Average duration of the lecture was 17 hours with 1 credit.

Among 2.650 prospective number of authorized graduates in the school year of 19991. 62% will have experiences of lectures in Rehabilitation Medicine and 25% of clerkship. Most of the lectures were allocated in their junior year and the clerkship in senior.

Curriculum contents from 9 schools consisted of physical medicine, electrodiagnosis, functional evaluation, spinal cord injury, amputation & prosthetics, pediatric rehabilitation, stroke & brain damage etc. in the order of frequency.

General instructional objectives and special behavioral objectives were set in only 2 schools and checklist to evaluate the students during clerkship was used only in 1 school.

Full time staff physiatrists in those schools were 38 in number. Six schools had only one staff each.

They were 12 professors, 7 associate professors, 1 assistant professor and 18 instructors.

Thirty seven percent of the Korean Board Certified physiatrists were involved in teaching medical students.

In conclusion, every effort is to be called,

1) to include, Rehabilitation Medicine in undergraduate medical education.

2) to increase apportunities of clinical clerkship in Rehabilitation Medicien

3) to include Rehabilitation Medicine in Medical Licensing Examination.

4) to improve the quality of the education in Rehabilitation Medicine, and

5) to support the junior teaching faculties to improve their teaching skills