Annals of Rehabilitation Medicine

Clinical Utility of Swallowing Provocation Test and Water Swallowing Test in Stroke Patients.: Kim, Ji Hoon , Cheon, Seung Wook , Ju, Sung Ryeol , Lee, So Young , Choi, In Sung , Kim, Jae Hyung , Lee, Sam Gyu; J Korean Acad Rehabil Med 2006;30(2):116-121.

Abstract
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Objective
To assess the clinical utility of the swallowing provocation test (SPT) and water swallowing test (WST) as a predictive factor of supraglottic penetration (SP) and subglottic aspiration (SA) in stroke patient with dysphagia. Method: Fourty-one patients suffered from ischemic stroke with dysphagia and 20 normal controls were recruited. We performed 2-step SPT (0.4 ml, 2.0 ml) via nasopharyngeal tube and 2-step WST (10 ml, 30 ml) per oral, combined with the videofluoroscopic swallowing study (VFSS) to determine the presence of SP and SA. Results: The cutoff values of the swallowing provocation latency in SPT for the detection of SP and SA were 2.45 sec, 2.75 sec (first step) and 2.25 sec, 2.34 sec (second step). For SPT, the sensitivity and specificity were 78.8%, 64.3% (first step) and 71.4%, 77.8% (second step) for the SP, and 77.8%, 76.7% (first step) and 75.0%, 66.7% (second step) for the SA. For WST, the sensitivity and specificity were 66.7%, 90.9% (first step) and 70.0%, 90.9% (second step) for the SP, and 61.1%, 56.5% (first step) and 72.2%, 60.9% (second step) for the SA. Conclusion: SPT was more useful for the detection of SA than WST in stroke patient with dysphagia. (J Korean Acad Rehab Med 2006; 30: 116-121)

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Pain Provocation and Disc Degeneration in Lumbar Discography.: Ko, Hyun Yoon , Park, Jae Heung , Kim, Hoon , Yang, Jin Hwan; J Korean Acad Rehabil Med 2003;27(5):747-752.

Abstract
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Objective
To determine the relationship between pain prov- ocation and level and disc degeneration in lumbar discography.

Method: Seventy-one patients with lumbar discogenic pain and total 109 discography were studied. During contrast mediun injection, the patient's pain response was reported. The patients were invited to choose among the following options: 'no pain or only pressure feeling', 'dissimilar', 'similar', and 'exact'. And pain location was chosen among the followings: 'low back', 'buttock', 'anterior thigh', 'posterior thigh', and 'lateral thigh'. Correlation between degeneration and provocation response was analyzed. And discography level and provocation area were evaluated.

Results: Low back and buttock area was the most common provocation pain site, but it was not specific by disc level. And provocation pain frequently appeared in irregular and fissured types, but the existence of provocation pain was significantly low in ruptured type.

Conclusion: There was no correlation between provocation pain area and discography level. And existence rate of provocation pain in ruptured disc was very low. It might be due to low mechanical compression with little stimulation of nociceptor. We suggested that if patients have a ruptured disc with chemical irritation, provocation pain was not a good indicator of diagnosis of discogenic back pain.

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The Educational and Vocational Status of Muscular Dystrophy Patients.: Im, Sang Hee , Moon, Jae Ho , Park, Yoon Ghil , Kim, Dong Soo , Kim, Hyung Kyun , Song, Myung Ho; J Korean Acad Rehabil Med 2008;32(1):51-55.

Abstract
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Objective: To investigate the current condition of education and vocation of patients with muscular dystrophy in Korea and to identify the factors determining their educational and vocational status. Method: This study included 129 patients with muscular dystrophy. Functional level of patients was evaluated by modified Barthel index (MBI). The current condition of education and vocation of patients was evaluated by self-reports. The mean age of the patients was 23.5 years and 84.5% were men. Results: Education duration of patients was 11.8 years, similar to that of general Korean population. University graduation rate of patients was 29.8%, which is higher than average rate of general Korean population. The unemployment rate of patients was 77.4%, which is much higher than average rate of general Korean population. Education duration was correlated with the onset age of disease symptom and with the functional level at the end of education period. The vocational status was related with education duration and functional level. The factor which influenced most negatively on maintaining education and vocation was physical limitation. Conclusion: For muscular dystrophy patients with physical limitation, equal opportunities and environment for exercising their ability should be secured with the specific policies and regulations, which consider their physical disabilities and interconnect educational field with vocational field. (J Korean Acad Rehab Med 2008; 32: 51-55)

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Study of Upper Extremity Strength Using Jamar Dynamometer, Pinch Gauge, and Multiple Work Simulator in Normal Subjects.: Yoon, Tae Sik , Lee, Ju Young , Whang, Jin Won , Kim, Eun Jong; J Korean Acad Rehabil Med 1998;22(4):966-973.

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Objective: To evaluate the components for vocational rehabilitation program including the strengths and job simulation, and to provide the data of the upper extremity strengths for a successful return to work.

Method: Sixty normal untrained subjects(male 30, female 30) were examined for the grip and pinch strengths using Jamar dynamometer and Preston pinch gauge, and the strengths of five simulated tasks using work simulation of Cybex 6000 Testing and Rehabilitation System(Cybex, Division of Lumex, inc., USA).

Results: The values during the tasks were significantly different in males compared to females(p＜0.01). Strengths of the right upper extremity by Jamar dynamometer, Preston pinch gauge, gripping device, T-handle(radial direction), and flutted knob(radial direction) were significantly different compared to the left(p＜0.01). Grip strengths between Jamar dynamometer and gripping device of Cybex were highly correlated(p＜0.01). All the measured values were significantly correlated with both weight and height(p＜0.01).

Conclusion: The results of this study can be used as a baseline data for the vocational rehabilitation in patients with a disability of upper extremity.

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