Citations
Citations
Citations
Citations
Citations
Citations
Citations
Citations
To investigate the relationship between the buttoning test and Jebsen-Taylor Hand Function Test (JTHFT), and to determine the validity of using the buttoning test as a tool to evaluate hand disability in patients with stroke.
This was a retrospective study of the medical records of 151 ischemic stroke patients affecting the dominant hand. Patients underwent the buttoning test and JTHFT for their affected hand. All patients were divided into three groups depending on how quickly they fastened a button (group A, not completed; group B, slowly completed over 18 seconds; and group C, completed within 18 seconds).
The button fastening time was negatively correlated with the total score and subtest scores of the JTHFT. Patients who experienced difficulty during the buttoning test had lower mean scores in the JTHFT (group A, 28.0±23.9; group B, 62.9±21.7; group C, 75.4±13.3; p<0.0001, Jonckheere-Terpstra test). We observed significant differences in JTHFT scores among the three groups (p<0.017, Mann-Whitney U-test), although there were considerable overlaps in JTHFT scores between the groups. Significant differences were also found in the subtest scores of the JTHFT, which include fine hand motor function (writing letters, p=0.009; moving small objects, p=0.003; stacking checkers, p=0.001 between groups B and C), among the three groups.
Considering its relationship with the JTHFT and validity, the buttoning test can be considered appropriate for evaluation of hand disability in patients with stroke.
Citations
To investigate the relationship between grip and pinch strength and independence in activities of daily living (ADL) in stroke patients.
Medical records of 577 stroke patients from January 2010 to February 2013 were retrospectively reviewed. Patients' grip and pinch strength of both hemiplegic and non-hemiplegic hands and the Korean version of Modified Barthel Index (K-MBI) score were collected. These patients were divided into three groups: group A (onset duration: ≤3 months), group B (onset duration: >3 months and <2 years), and group C (onset duration: ≥2 years). The correlation between grip and pinch strength and the K-MBI score was analyzed.
In group A (95 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of both hands in patients with right hemiplegia. Significant (p<0.05) correlation between the K-MBI score and the grip and pinch strength of the hemiplegic hand was shown in patients with left hemiplegia. In group B (69 patients) and group C (73 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of the hemiplegic hand.
Stroke patients in subacute stage mainly performed activities of daily living using their dominant hand. However, independence in ADL was associated with the strength of the affected dominant hand. For stroke patients in chronic and late chronic stages, their hand power of the affected hand was associated with independence in ADL regardless whether the dominant hand was affected.
Citations
To assess the utility of handwriting rehabilitation (HR) in Parkinson disease (PD) patients who experienced difficulties with handwriting and signing.
Sixty PD patients were prospectively studied with graphological evaluations. Thirty PD patients were assigned to HR for 9 weeks. At the end of this training, all patients were evaluated again and results of basal vs. final evaluations were compared.
At final evaluation, the group assigned to HR showed significantly larger amplitude of the first 'e' in the phrase, larger signature surface area, and superior margin. A trend of increase in letter size was also observed. Handwriting with progressively decreasing size of letters and ascending direction with respect to the horizontal were prominent findings in both groups of patients and they did not change after HR.
Rehabilitation programs for handwriting problems in PD patients are likely to be helpful. Larger randomized studies are needed to confirm these results.
Citations
To investigate the sleep state of mild stroke patients and relationship between sleep disturbance and functional status.
A total of 80 acute stroke patients were enrolled in this study. The criteria for inclusion in the study was as following: 1) first stroke, 2) cognitive function preserved enough to perform the test (Mini Mental State Examination ≥24), 3) good functional levels (Modified Rankin Scale ≤3), 4) upper extremity motor function preserved enough to perform occupational tests (hand strength test, Purdue pegboard test, 9-hole peg test, and Medical Research Council score ≥3), and 5) less than 2 weeks between the stroke and the assessment. Quality of sleep was assessed by using Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Stanford Sleepiness Scale (SSS). Activities of daily living was assessed by using the Modified Barthel Index (MBI) and depressed mood was assessed by using the Beck Depression Inventory (BDI). Gross and fine motor function of the upper extremity was assessed by using hand strength test (Jamar dynamometer), Purdue pegboard test, and the 9-hole peg test.
The results of the occupational assessment were fine in the good sleepers. The PSQI, ESS, and ISI were correlated with some of the assessment tools (BDI, MBI, Purdue pegboard, 9-hole peg, and hand strength).
In conclusion, this study emphasizes that sleep disturbance can affect the functional status in mild acute stroke patients. Therefore, clinicians must consider sleep status in stroke patients and need to work to control it.
Citations
To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery.
We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb.
All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups.
The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball.
Citations
To determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales.
The study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient's HGS and MPQ score.
ANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS.
The HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities.
Citations
To find a multiple amputee more severe than a triple amputee is not easy. This is a report of a 36-year-old patient with right knee disarticulation, left trans-femoral amputation and right elbow disarticulation due to peripheral ischemic necrosis, when he was applied vasopressor in septic shock condition. His left hand was also 2nd, 3rd, 4th, and 5th distal interphalangeal joint disarticulation status, and it was more difficult for him to do rehabilitation program, such as donning and doffing the prostheses. For more efficient rehabilitation training program, we first focused on upper extremities function, since we believed that he might need a walking aid for gait training later. After 13 weeks of rehabilitation program, he has become sit to stand and walk short distance independently with an anterior walker. Although he still needs some assistance with activities of daily living, his Functional Independence Measure score improved from 48 to 90 during the course of 13 weeks.
Citations
Objective To evaluate the prevalence of generalized joint hypermobility (GJH) in healthy female Koreans and to determine whether the degree of GJH differs between children and adults.
Two groups of females were enrolled, a group of girls from an elementary school (n=404) and women from a call center (n=266). GJH was diagnosed using the Beighton score, which is composed of an evaluation of bilateral knees, elbows, thumbs, and fifth fingers as well as thoracolumbar joint. The GJH and localized hypermobility of each joint was compared between the two groups, and the pattern of hypermobility according to age and dominant hand was investigated.
Total prevalence of GJH was 50.0% (335/750), and it was more frequently observed in the group of girls (58.9%, 238/404) than women (36.5%, 97/266). The degree of GJH expressed in terms of Beighton score was inversely correlated with age (p<0.05). Significant differences in localized hypermobility of the thumb and fifth finger were found between the two groups and were postulated as the cause for the decline in GJH with age. The pattern of decreased mobility proportional to aging differed between the two joints. Decreased mobility occurred equally on both sides of the thumb but was biased toward the fifth finger of the dominant side (mostly the right).
The female Koreans appeared to have a high prevalence of GJH. The incidence of GJH decreased as age increased as a result of decreased mobility of the fifth finger on the dominant side.
Citations
To describe a hand-stretching device that was developed for the management of hand spasticity in chronic hemiparetic stroke patients, and the effects of this device on hand spasticity.
Fifteen chronic hemiparetic stroke patients with finger flexor spasticity were recruited and randomly assigned to an intervention group (8 patients) or a control group (7 patients). The stretching device consists of a resting hand splint, a finger and thumb stretcher, and a frame. In use, the stretched state was maintained for 10 minutes per exercise session, and the exercise was performed twice daily for 4 weeks. Spasticity of finger flexor muscles in the two groups was assessed 3 times, 4 weeks apart, using the Modified Ashworth Scale (MAS). Patients in the intervention group were assessed twice (pre-1 and pre-2) before and once (post-1) after starting the stretching program.
Mean MAS (mMAS) scores at initial evaluations were not significantly different at pre-1 in the intervention group and at 1st assessment in the control group (p>0.05). In addition, no significant differences were observed between mMAS scores at pre-1 and pre-2 in the intervention group (p>0.05). However, mMAS scores at post-1 were significantly lower than that at pre-2 in the intervention group (p<0.05). Within the control group, no significant changes in mMAS scores were observed between 1st, 2nd, and 3rd assessments (p>0.05). In addition, mMAS scores at post-1 in the intervention group were significantly decreased compared with those at the 3rd assessment in the control group (p<0.05).
The devised stretching device was found to relieve hand spasticity effectively in chronic hemiparetic stroke patients.
Citations
To offer the basic data about the causes and distribution of hand tingling, symptoms and physical findings, and pressure pain threshold in desk workers.
Five physiatrists participated in the screening test composed of history and physical examination. A total of 876 desk workers were evaluated and of them 37 subjects with hand tingling were selected. For further analyzing, detailed history taking and meticulous physical examination were taken. Pressure pain threshold (PPT) at the infraspinatus, upper trapezius, flexor carpi radialis, rhomboideus, and flexor pollicis longus were examined. PPT measurements were repeated three times with two minute intervals by a pressure algometer. Electrodiagnostic study was done to detect potential neurologic abnormalities.
The causes of hand tingling in order of frequency were: myofascial pain syndrome, 68%; cervical radiculopathy, 27%; rotator cuff syndrome, 11%; tenosynovitis, 8%; and carpal tunnel syndrome, 5%. The location of trigger points in the myofascial pain syndrome, which were proven to evoke a tingling sensation to the hand in order of frequency were: infraspinatus, 65.4%; upper trapezius, 57.7%; flexor carpi radialis, 38.5%; rhomboideus 15.4%; and flexor pollicis longus 11.5%. The PPT of the affected side was significantly lower than that of the unaffected side in myofascial pain syndrome (p<0.05).
The most common cause of hand tingling in desk workers was myofascial pain syndrome rather than carpal tunnel syndrome. Common trigger points to evoke hand tingling were in the infraspinatus and upper trapezius.
Citations
Alien Hand Syndrome is defined as unwilled, uncontrollable, but seemingly purposeful movements of an upper limb. Two major criteria for the diagnosis are complaint of a foreign limb and complex, autonomous, involuntary motor activity that is not part of an identifiable movement disorder. After a cerebrovascular accident in the corpus callosum, the parietal, or frontal regions, various abnormal involuntary motor behaviors may follow. Although different subtypes of Alien Hand Syndrome have been distinguished, this classification clearly does not cover the wide clinical variety of abnormal motor behaviors of the upper extremity. And there are few known studies about the neurophysiology of this syndrome using transcranial magnetic stimulation (TMS). We recently experienced 2 rare cases of Alien Hand Syndrome which occurred after anterior cerebral artery (ACA) infarction. A 72 year-old male with right hemiplegia following a left ACA infarct had difficulty with voluntarily releasing an object from his grasp. A 47 year-old female with left hemiplegia following a right ACA infarct had a problem termed 'intermanual conflict' in which the two hands appear to be directed at opposing purposes. Both of them had neurophysiologic studies done, and showed reduced amplitude by single pulse MEP and a lack of intracortical inhibition (ICI) by paired pulse TMS. No abnormalities were found in SSEP.
Citations
Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.
Citations
To evaluate motor excitability and hand function on the non-dominant side according to the polarity of transcranial direct current stimulation (tDCS) on the motor cortex in a healthy person.
tDCS was applied to the hand motor cortex for 15 minutes at an intensity of 1 mA in 28 healthy right-handed adults. Subjects were divided randomly into four groups: an anodal tDCS of the non-dominant hemisphere group, a cathodal tDCS of the non-dominant hemisphere group, an anodal tDCS of the dominant hemisphere group, and a sham group. We measured the motor evoked potential (MEP) in the abductor pollicis brevis and Jabsen-Taylor hand function test (JTT) in the non-dominant hand prior to and following tDCS. All study procedures were done under double-blind design.
There was a significant increase in the MEP amplitude and a significant improvement in the JTT in the non-dominant hand following anodal tDCS of the non-dominant hemisphere (p<0.05). But there was no change in JTT and a significant decrease in the MEP amplitude in the non-dominant hand following cathodal tDCS on the non-dominant hemisphere and anodal tDCS of the dominant hemisphere.
Non-dominant hand function is improved by increased excitability of the motor cortex. Although motor cortex excitability is decreased in a healthy person, non-dominant hand function is maintained. A homeostatic mechanism in the brain might therefore be involved in preserving this function. Further studies are warranted to examine brain functions to clarify this mechanism.
Citations
To assess the effectiveness of modified dynamic metacarpophalangeal joint flexion orthoses for treatment of post-burn hand contractures.
We enrolled 42 hand burn patients with limited range of motion at the metacarpophalangeal joints in this study. The patients were randomly assigned into either a control or an orthotic group. Both groups received the standard rehabilitation therapy focused on hand therapy; 21 subjects in the orthotic group wore a splint for 3 hours per day for 8 weeks. Hand function was measured by active range of motion, grip strength and other assessment tools. All parameters were estimated using the Mann-Whitney U test at the beginning and the end of the treatment after 8 weeks.
The 21 subjects that had an orthotic intervention showed significant improvement in the range of motion at 2nd, 3rd, 4th and 5th metacarpophalangeal joints (p<0.05). However, the grip strength was not significantly increased after the 8 weeks of treatment compared to control group (p>0.05). There was a significant difference in the hand function scales between the 2 groups (p<0.05).
The modified dynamic metacarpophalangeal joint flexion orthoses provide continuous flexion to metacarpophalangeal joint that is needed for the restoration of range of motion in post-burn hand contractures. For the clinical application of hand orthoses in patients with hand disorders, additional research into its affects are required.
Citations
Method: Thirty-six post-stroke hemiplegic patients with a lesion in the internal capsule were included in this study. Diffusion tensor imaging (DTI) was performed with a 3.0 tesla MR at about 1 month after stroke. FA ratio was measured in posterior limb of the internal capsule of the patients. Motor evoked potential (MEP) was obtained by magnetic stimulation of the motor cortex and recorded from the abductor pollicis muscle. Somatosensory evoked potential (SSEP) was obtained by electrical stimulation of the median nerve at the wrist and recorded from the somatosensory cortex. Hand movement scale was obtained at about 1 month and 3 months after stroke. Results: Hand movement scale at about 1 month and 3 months after stroke and FA ratio were reduced significantly in patients who showed no response on MEP. However, no significant differences were observed between the patients who showed SSEP response and those who did not. FA ratio and hand movement scale were highly correlated to each other. Conclusion: MEP and FA ratio can be helpful in assessing the hand function at about 1 month and 3 months in post-stroke hemiplegic patients. (J Korean Acad Rehab Med 2008; 32: 182-188)
Method: Forty two chronic stroke patients were enrolled and classified into two groups, experimental and control group. The experimental group took CIT for 2 weeks. CIT consisted of restraint of the unaffected upper extremity with massive training of the affected upper extremity. The motor function of patient's upper extremity was assessed by Manual Function Test (MFT) and Jebsen Hand Function Test before treatment, at 2 weeks and at 8 weeks after the treatment.
Results: The withdrawal rate was 46.7% during CIT period. There was substantial significant improvements in MFT and Jebsen Hand Function Test after 2 weeks of treatment in the experimental group (p＜0.05). The effects in the experimental group were maintained at 6 weeks after cessation of the treatment.
Conclusion: CIT is considered to be an effective treatment for motor function of the chronic hemiplegic upper extremity motor function, and will be useful as an additional therapeutic tool. (J Korean Acad Rehab Med 2003; 27: 813-818)
Objective: The purposes of this study were to investigate the factors influencing life satisfaction and quality of life (QOL) of the disabled persons and to help the planning and evaluation of Community Based Rehabilitation (CBR).
Method: Data were collected through personal interviews of 503 registrated disabled persons in Uiwang City. Demographic variables and scores of modified Barthel index (MBI), modified Lambeth disability screening questionnaire (MLDSQ), Craig handicap assessment and reporting technique (CHART) and life domain satisfaction measure (LDSM) were obtained.
Results: The score of LDSM was 4.0⁑1.0. Life satisfaction was related to the age, sex, employment status, severity of disability, educational level, housing and residence, level of instrumental activities of daily living and social integration. MLDSQ score was the most strong predictor of life satisfaction (p=0.00) followed by social integration (p=0.001) and total CHART scores (p=0.017). And the factors influencing the handicap were monthly income, severity of disability, employment, level of education and age.
Conclusion: Based on our study, we suggest that the CBR program of Uiwang City need to focus on improving functional ability and social skill of disabled individual and housing, and also promoting their vocational and educational status. (J Korean Acad Rehab Med 2002; 26: 615-625)
Objectives: To provide proper standards of handicapped driver's ability test in Korea and evolve new driving aids.
Method: Thirty-six cervical cord injured persons (C5∼C7) were evaluated with Baltimore Therapeutic Equipment work simulator to which a straight handle was attached. The isotonic torque on a straight handle was measured during forward and backward movement and isometric torque was measured at neutral position. Analysis of variance (ANOVA) was used to compare torque among three groups (C5∼C7).
Results: The forward and backward torque of C7 tetraplegics was significantly higher than that of C6 tetraplegics
(p＜0.05). All of 12 persons with C5 tetraplegia could not pass the test. Only 1 out of 12 persons with C6 tetraplegia and all of 12 persons with C7 tetraplegia could pass the test. But 9 out of 12 persons with C5 tetraplegia and all of 12 persons with C6 tetraplegia could operate brake and accelerator with servo-hand control.
Conclusion: All of the C5 tetraplegics and 92% of the C6 tetraplegics could not pass the handicapped driver's ability test of Korea. Therefore it is necessary to evolve driving aids for the C5 and C6 tetrapleigics and to modify this test. (J Korean Acad Rehab Med 2002; 26: 32-36)
Objective: The purpose of this study was to evaluate the incidence of inability to flex proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint in normal Koreans. The opposition palm ratio and thumb index ratio was also of interest.
Method: Randomly selected eighty nine normal Korean adults of 48 men and 41 women, with ages 20 to 79 years. The finger flexion was measured using the standard flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) screening tests. Thumb index ratio and opposition palm ratio was also assessed additionally.
Results: In the sample population, 2 subjects (2.2%) were unable to bilaterally flex their fifth PIP joints independently. Four subjects (4.4%) were unable to flex one or both of their fourth or fifth DIP joints. These results show far less incidence of FDS dysfunction comparing with 52% of FDS dysfunction rate in Americans. The opposition palm ratio in men were 63.6% and in women 69.9%, indicating lower ratio in men. The thumb index ratio was not different statistically between the men and women.
Conclusion: These data suggest that the different incidences of FDS and FDP dysfunction should be considered in interpretation. The opposition palm ratio and thumb index ratio might be useful in the hand rehabilitation.
Objective: The purpose of this study is to determine the proper hand position during driving by measuring of the wheel rotation strength according to the wheel angle and hand position to the wheel.
Method: BTE Work Simulator was used to measure the clockwise and counter clockwise static wheel rotation force of twenty healthy men in three different hand position (2∼10 spot, 3∼9 spot, and 4∼8 spot) and two different wheel angle (45o and 60o, average and peak force were measured during maximal isometric contraction.
Results: The average and peak force was significantly different by the wheel angle, and hand position (p＜0.01), but the direction of rotation didn't an effect on the rotation force. The hand position was the most significant factor, especially wheel rotation force at 2∼10 spot hand position was significantly lower than that of 3∼9 spot and 4∼8 spot (p＜0.05). The rotation force by the wheel angle was influenced by hand position, and lower in 60o wheel angle in the 2∼10 spot (p＜0.05).
Conclusion: The rotation force of wheel was influenced by the hand position. Therefore proper hand position is recommended during driving to reduce muscle fatigue.
Objective: To observe the ipsilateral upper limb function after stroke comparing proximal with distal part and to determine how they recover after stroke.
Method: Cohort study of 72 patients with stroke in the middle cerebral arterial territory undergoing multidisciplinary stroke rehabilitation program. The main outcome was assessed by the Manual Function Test (MFT) for upper limb function, weekly.
Results: The recovery time of the ipsilateral upper limb to maximum function was 32.4 ⁑ 15.4 days. The functions of the ipsilateral shoulder and hand after stroke decreased significantly. Even at the maximum recovery, complete recovery was not seen. For ipsilateral shoulder, more severe functional deficits were seen with subcortical lesion than with cortical lesion, whereas for ipsilateral hands, no difference was seen between them.
Conclusion: Therefore, the fact that recoveries of the shoulders and hands were different according to the presence of cerebral cortical or subcortical lesions suggests that the brain structures that control these areas or the recovery mechanisms might be different.
Objective: To evaluate the efficacy of botulinum toxin type A in the treatment of spasticitc and dystonic upper limbs in a group of cerebral palsy children
Method: Eighteen children with cerebral palsy who did not have fixed contractures in the wrist and hand were enrolled (mean age 9.0 years; range 6∼15). Measurements were obtained before and at 1 and 3 months after botulinum toxin A injections. Assessments included spasticity (modified Ashworth scale), range of motion of thumb and functional assessments including Melbourne assessment of unilateral upper limb function and Jebsen Taylor hand function test. Hand and forearm muscles were injected with 1∼3 u/kg botulinum toxin.
Results: Spasticity measured by modified Ashworth scale decreased by 1 month and diminished spasticity continued for 3 months. Range of motion of thumb increased by 1 and 3 months. In Jebsen hand function test, patients showed functional improvements in item 6 (lifting light weight object) and item 7 (lifting heavy object). Melbourne assessment of unilateral upper limb function scores improved from a mean value of 92 at baseline to a mean value of 101 at 1 month and a mean value of 105 at 3 months.
Conclusion: Botulinum toxin A would be helpful in some selected cerebral palsy patients with upper limb dysfunction. But further research including randomized controlled study is needed on the use of botulinum toxin A to improve function.
Objective: To evaluate the standards of handicapped driver's ability test in Korea and available driving aids in cervical cord injured persons.
Method: Forty-two cervical cord injured persons (C5∼C8) were evaluated with BTE (Baltimore Therapeutic Equipment) work simulator. The isotonic turning torque was measured during clockwise and counter-clockwise turning. And isometric turning torque was measured at 12 directions.
Results: By the isotonic measurement, the turning torque increased in the lower level of injury. In the C6 tetraplegics, the counter-clockwise turning torque was significantly higher than clockwise. Among 25 persons with C5 or C6 tetraplegia, only 2 with C6 tetraplegia could operate the power steering with the lowest wheel turning torque (3.0 Nm). Only three persons (1 person with C7 tetraplegia, 2 persons with C8 tetraplegia) could pass the handicapped driver's ability test of Korea (9.4 Nm). By the isometric measurement, turning torque was lowest at left upper quadrant (10 to 12 o'clock direction) in clockwise rotation.
Conclusion: Among the 42 cervical cord injured persons, only 3 persons with C7 and C8 tetraplegia could pass the handicapped driver's ability test of Korea. And among 25 C5 and C6 tetraplegia, only 2 persons with C6 tetraplegia could operate the power steering. It seems to be essential to modify the standards of handicapped drivers ability test and to evolve the driving aids for the C5 and C6 tetraplegics in Korea.
Objective: To evaluate the results of driver training program for the handicapped.
Method: Retrospective study on the 699 disabled who participated in the two-months driver training program at the NRC (National Rehabilitation Center) from January 1995 to May 1998.
Results: 1) Of these subjects, 70.4% were men and 29.6% were women. 2) According to the disability grading system by the Ministry of Health and Social Welfare of Korea, 19.2% of the subjects had the first grade disability, 28.2% the second grade, 26.3% the third grade, 18.3% the fourth grade, 6.3% the fifth grade, and 1.4% the sixth grade. 3) The licensing rate was 74.6% for the first grade, 64.7% for the second grade, 70.9% for the third grade, 73.6% for the fourth grade, 55.8% for the fifth grade, and 70% for the sixth grade. 4) The licensing rate was the highest in the subjects with spinal cord injury (79.2%) and the lowest in the subjects with stroke (45.0%). 5) Overall, 78.2% of subjects licensed with automatic transmission and 21.8% with hand- control. On the other hand, in the subjects with spinal cord injury, 42.5% licensed with automatic transmission and 57.5% with hand-control.
Conclusion: The mean licensing rate of this program was 69.2%. Further study is required for the effect of cognitive function on driving test and various driving aids to promote the licensing rate for the handicapped.
Objective: The purpose of this study was to determine the knee extension force of healthy Korean adults by using a hand-held dynamometer and evaulate the relationship of knee extension force between each decade.
Method: One hundred and twenty healthy subjects (60 males, 60 females) between the ages of 20 and 79 years were tested for knee extension force by using Nicholas Manual Muscle Tester (MMT). Data were analyzed for means, standard deviations, test-retest reliability and correlation with variables by using the SPSSⰒ software package.
Results: The mean value of the knee extension force was 25.9⁑5.8 kg in the males and 16.5⁑4.1 kg in the females. Significant difference between each decade was found in the males but not in the females. The knee extension force of the males was stastically correlated with all of variables, i.e., age, weight and height, but the knee extension force of the females, was correlated only with weight. Intratester correlation coefficients were high for the Nicholas MMT to measure the knee extension force for healthy adults. Also the difference between the dominant and nondominant side for the knee extensor force was not significant, stastically.
Conclusion: This MMT may be useful to quickly and objectively evaluate force in the clinical setting.
Objective: To collect the informations of the traumatic spinal cord injury persons in Suwon city.
Method: Seventy-five traumatic spinal cord injury persons were evaluated by the neurological level, American Spinal Injury Association scale, Functional Independence Measure (FIM), Craig Handicap Assessment and Reporting Technique (CHART), Beck Depression Inventory (BDI), and questionnaire on their voiding methods, complications, etc.
Results: The leading cause of 75 persons with traumatic spinal cord injury was a traffic accident. Among them, paraplegics were 46 persons. The most common complication was a pressure sore which was also the leading cause of their rehospitalization. Twenty-six persons voided by reflex. Among five dimensions of CHART, the physical independence score was the highest and the economic self sufficiency score was the lowest. The total CHART scores were significantly correlated with BDI scores, FIM scores, and level of injury.
Conclusion: This study revealed that physical impairment, disability and depression affect the handicaps of spinal cord injury persons. These data could be used to develop a social rehabilitation program for the spinal cord injury persons in the community.
Objective: The objective of this study is to determine the effect of unilateral brain lesion on hand strength and dexterity of ipsilateral side in hemiplegic patients and the change of strength and dexterity of ipsilateral hand after rehabilitation according to the side of brain lesion.
Method: Sixty four hemiplegic patients with unilateral brain lesion underwent hand function tests for the ipsilateral hand to the brain lesion. Grip strength, tip pinch, lateral pinch, and palmar pinch strength were measured, and Purdue pegboard test was performed. Results were compared with a group of forty age-matched healthy volunteers.
Results: There was significant decrement of hand strength and dexterity of ipsilateral side except grip strength in patients with unilateral brain lesion in the begining of rehabilitation compared with the controls. Hand strength and dexterity of ipsilateral hand was significantly improved after rehabilitation. There was no significant difference in hand strength and dexterity of ipsilateral side according to the side of hemispheric lesion.
Conclusion: Ipsilateral upper extremity function in hemiplegic patients may also be affected adversely, and therefore rehabilitation treatment for ipsilateral upper extremity function should be involved.
Enterovirus 71 (E-71) infection was first described in 1974 after isolation studies of specimens from a series of patients who had severe neurological disease. One important feature of E-71 is its ability to cause paralytic disease. In the summer of 1997, we identified 4 children with E-71 infection. The striking feature of this outbreak is the occurrence of all cases with polio-like paralytic disease. Other disease associated with E-71 infection included aseptic meningitis, meningoencephalitis, respiratory disease, gastroenteritis, and hand-foot-mouth disease. The spectrum of illness observed in our cases was compared to that seen in other outbreaks. It is suggested that the significance of E-71 infection lies in its neuropathogenic potential. There is no specific, therapeutic modality of E-71 infection but its prognosis is good except some cases.
First
Prev
