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To evaluate the effects of rowing exercise on body composition, laboratory data, fitness and scoliosis in visually impaired people. The majority of visually impaired people do not participate in active sports due to efficiency and safety issues. Rowing is a safe whole-body exercise with aerobic and anaerobic components.
Twenty subjects were recruited from among those admitted to a facility for visually impaired people (16 men and 4 women). Laboratory data, body composition, physical fitness, Cobb's angle, and fall index were checked before and after 6 weeks (5 days a week) of indoor rowing using Concept2 Model E.
After the training, fat mass and total body fat percent decreased significantly. In the fitness test, back strength and trunk flexion score increased significantly. Laboratory data showed significant increases in serum protein and albumin and decreases in low-density lipoprotein (LDL) cholesterol. There were 9 subjects with scoliosis and after the training Cobb's angle decreased by 1.11°±1.55°, though this was not statistically significant.
Visually impaired people frequently have abnormal body composition, low physical fitness, and scoliosis. A rowing exercise program can be helpful, with a positive effect on body composition and physical fitness; however, with respect to scoliosis, we need an earlier intervention program in visually impaired people.
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To compare and analyze the clinical characteristics of children with delayed language acquisition due to two different diagnoses, which were specific language impairment (SLI, a primarily delayed language development) and global developmental delay (GDD, a language delay related to cognitive impairment).
Among 1,598 children who had visited the developmental delay clinic from March 2005 to February 2011, 467 children who were diagnosed with GDD and 183 children who were diagnosed with SLI were included in this study. All children were questioned about past, family, and developmental history, and their language competences and cognitive function were assessed. Some children got electroencephalography (EEG), in case of need.
The presence of the perinatal risk factors showed no difference in two groups. In the children with GDD, they had more delayed acquisition of independent walking and more frequent EEG abnormalities compared with the children with SLI (p<0.01). The positive family history of delayed language development was more prevalent in children with SLI (p<0.01). In areas of language ability, the quotient of receptive language and expressive language did not show any meaningful statistical differences between the two groups. Analyzing in each group, the receptive language quotient was higher than expressive language quotient in both group (p<0.01). In the GDD group, the Bayley Scales of Infant Development II (BSID-II) showed a marked low mental and motor quotient while the Wechsler Intelligence Scale showed low verbal and nonverbal IQ. In the SLI group, the BSID-II and Wechsler Intelligence Scale showed low scores in mental area and verbal IQ but sparing motor area and nonverbal IQ.
The linguistic profiles of children with language delay could not differentiate between SLI and GDD. The clinicians needed to be aware of these developmental issues, and history taking and clinical evaluation, including cognitive assessment, could be helpful to diagnose adequately and set the treatment plan for each child.
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To investigate the somatosensory findings of pusher syndrome in stroke patients.
Twelve pusher patients and twelve non-pusher patients were enrolled in this study. Inclusion criteria were unilateral stroke, sufficient cognitive abilities to understand and follow instructions, and no visual problem. Patients were evaluated for pusher syndrome using a standardized scale for contraversive pushing. Somatosensory finding was assessed by the Cumulative Somatosensory Impairment Index (CSII) and somatosensory evoked potentials (SEPs) at 1 and 14 weeks after the stroke onset. Data of SEPs with median and tibial nerve stimulation were classified into the normal, abnormal, and no response group.
In the baseline characteristics (sex, lesion character, and side) of both groups, significant differences were not found. The score of CSII decreased in both groups at 14 weeks (p<0.05), but there were no significant differences in the CSII scores between the two groups at 1 and 14 weeks. There were no significant differences in SEPs between the two groups at 1 and 14 weeks after the stroke onset.
It appears that somatosensory input plays a relatively minor role in pusher syndrome. Further study will be required to reveal the mechanism of pusher syndrome.
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To evaluate characteristics of cognitive impairments according to the location of aneurysmal subarachnoid hemorrhage (SAH) using a computerized neuropsychological test (CNT).
A total of 211 patients were transferred to our rehabilitation department after becoming neurologically stable following aneurysmal SAH. Twenty four of the 211 patients met the inclusion criteria and participated in a screening test using the mini-mental state examination (MMSE). Twenty patients with a MMSE score <26 were followed prospectively with a CNT and Beck depression inventory (BDI). Eleven patients had anterior communicating artery (ACoA) aneurysms and the other 9 had middle cerebral, internal carotid or posterior communicating artery aneurysms.
There were no differences in age, education, Hunt and Hess grade, or Fisher grade between the patients with ACoA aneurysmal SAH compared to patients with other aneurysmal SAH. In patients with ACoA aneurysmal SAH, scores of BDI (p=0.020), verbal learning test were lower than those of other aneurysmal SAH patients. In contrast, patients with non-ACoA aneurysmal SAH took significantly more time in auditory (p=0.025) and visual continuous performance tests (p=0.028). The cognitive deficit following aneurysmal SAH could be characterized by its location using CNT.
Using CNT in aneurysmal SAH patients could be a useful tool for evaluating the characteristics of cognitive impairment and planning rehabilitation programs according to each characteristic.
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Objective: To identify the neurobehavioral impairment in the traumatic brain injured (TBI) patients and to determine the relationship between the neurobehavioral impairment and functional recovery.
Method: We analyzed and compared Functional Independence Measure (FIM) scores and neurobehavioral psychometry results in 16 patients with severe TBI. The neurobehavioral psychometry tests included Minimental Status Examination (MMSE), Galvestone Orientation and Amnesia Test (GOAT) as screening tools, Korean Wechsler Intelligence Scale (KWIS) for intelligence, Wechsler Memory Scale-Revised (WMS-R) test for memory function, Color Trail test (CTT) 1 and 2 for attention and concentration, Grooved Pegboard Test (GPT) and Finger Tapping Test (FTT) for motor function, Wisconsin Card Sorting Test (WCST) for executive function, and Symptom Checklist-90-Revision (SCL-90-R) for personality.
Results: At discharge, neurobehavioral psychometry of the TBI patients showed impairment of the attention and concentration as demonstrated by severe and moderate impairment in CTT 1 and CTT 2, repectively. Memory disturbance was also noted by the result of mental retardation in WMS-R. But GOAT and MMSE showed normal, KWIS was below average. Motor dysfunction was seen in GPT and FTT and mild executive dysfunction in WCST. Functional recuperation was influenced by attention and concentration, as the FIM score has significant correlation with CTT 1 and FTT.
Conclusion: The TBI patients have the pervasive neurobehavioral impairment, especially severe dysfunction in the memory, attention and concentration. And functional recovery was significantly correlated with attention. The neurobehavioral psychometry will be useful in neurobehavioral evaluation in TBI patients. A further prospective study using Neurobehavioral psychometry would bring a more precise and valuable information.
According to the World Health Organization(WHO), handicaps exist when individual is unable to fulfill expected social roles. The purposes of this study were to assess the handicap in spinal cord injury(SCI) outpatients, and to investigate the correlation of handicaps, impairments, disabilities and depression.
Eighty-five SCI outpatients were evaluated by the Craig Handicap Assessment and Reporting Technique(CHART), Katz scale, neurologic level and Frankel classification and Beck Depression Inventory (BDI). Seventy(82.4%) were male and 15(17.6%) were female. Average age of the subjects was 34.5 years with the age range of 18 to 63. The subjects were devided into four groups: complete quadriplegics (9), incomplete quadriplegics(12), complete paraplegics(41) and incomplete paraplegics(23). There was no significant statistical difference in total CHART scores between male and female subjects. However, male subjects had higher mobility and social integration scores than female subjects. The occupation score was low and the social integration score was high in all groups. No correlation was found between sex, severity and the level of injury, time since injury and the CHART scores. However, significant correlation was noted between the CHART scores and BDI scores.
We can carefully conclude that the CHART can be a valuable tool in the assessment of handicaps of disabled people. Futher extensive studies are recommended to identify the factors which might influence the handicaps of spinal cord injury persons.
Objective: The purpose of this study is to determine clinical and phonological characteristics of the patients with specific language impairment (SLI).
Method: Subjects were 24 SLI patients without known mental retardation, cerebral palsy, epilepsy, hearing loss or structural brain lesion and 23 normal children. Developmental history, oropharyngeal abnormality, and brainstem auditory evoked potentials were obtained in SLI patients. Receptive language age and quotient were assessed by Peabody picture vocabulary test. Phonetic characteristics of subjects were analysed using Visi-PitchⰒ and computerized speech laboratory.
Results: In perceptual evaluation, 32.3% of SLI patients showed incomplete articulation pattern. The patterns of incomplete articulation were substitution, distortion, nasalization, and addition. The receptive language of SLI patients (0.89⁑0.28) was significantly lower than control group (1.16⁑0.18). In Visi-PitchⰒ analysis, diadochokinetic rate and maximal phonation time were decreased in SLI patients. The total duration of three syllables in SLI patients were significantly prolonged, especially for bilabial heavily asperated and glottalized consonants and alveolar and velar slightly asperated, heavily asperated, and glottalized consonants.
Conclusion: The patients with SLI showed characteristic defect in articulation as well as expressive and receptive language delayment. This articulatory defect may be resulted from disturbance of central programming and coordination of articulation. The objective and quantitative analysis of Phonological characteristics using computerized speech system in SLI patients can contribute to diagnose and evaluate the treatment outcome for the patients.
Kyphotic deformity arising from the failure in formation of a vertebral body is an uncommon condition showing late complications of gross spinal angulation, paraplegia, impaired bladder function and cardiopulmonary deficiencies. Congenital hemivertebra constitute approximately 6% of anomalies associated with congenital spinal deformities. The natural course of this disease remains unpredictable, especially regarding the development of neurological impairment. Only a few numbers of patients with severe kyphosis due to congenital dorsal hemivertebra have been reported.
We present a 40-year-old man with severe thoracic kyphosis. Gait difficulty due to paraplegia occurred at the age of fifteen with progressive development of the right lower limb pain and later impairment of bladder function. He had no cardiopulmonary deficiencies. Radiological findings showed a wedge shaped dorsal hemivertebra and cord compression at the eleventh level of thoracic vertebra. In view of the poor prognosis of surgical intervention he was fitted with an Jewett brace so that further neurological impairment was avoided. We report a rare case of congenital kyphosis due to dorsal hemivertebra in adult with progressive neurological impairment.
Objective: To determine the characteristic pattern of information processing in the children with specific language impairment (SLI) using the Kaufman-Assessment Battery (K-ABC) for children.
Method: Thirty patients were responded to K-ABC. Twenty-three of them were diagnosed as SLI without any abnormalities in other developmental areas, visual or auditory system. Seven patients showed language delay with other developmental abnormalities. Mean chronological age of SLI patients was 61.0 months. Patterns of information processing was measured using K-ABC. Sequential processing, simultaneous processing, mental processing, and achievement scales were obtained and compared between two groups.
Results: In SLI patients, sequential processing, simultaneous processing, mental processing, and achievement scales were 32.9⁑34.2, 54.3⁑26.9, 42.5⁑31.1, and 33.8⁑28.7, respectively. The SLI patients showed significantly poor scales in sequential than in simultaneous processing (p＜0.01).
Conclusion: The patients with SLI exhibited significant deficits in sequential processing, whereas simultaneous processing was better than that of the other group in this study. This characteristics of SLI patients will be useful for understanding and establishing proper therapeutic strategies for these patients.
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