Effect of Game-Based Balance Training with CIMT on Pain, Muscle Strength, Range of Motion and Dynamic Balance in Female Patients with Total Knee Replacement

PURPOSE: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. METHODS: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. RESULTS: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p < 0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p < 0.05). CONCLUSION: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

Effects of Galvanic Vestibular Stimulation on the Subjective Visual Vertical / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to determine the otolithic effects of galvanic vestibular stimulation on the perception of subjective visual vertical in normal subjects. SUBJECTS AND METHOD: Fifteen normal subjects were selected on the basis of medical history and neurological examination. We measured subjective tilt of a central vertical line during galvanic vestibular stimulation (0, 1.0, 2.5, 4.0 mA). Binaural and monaural electric current was applied to each subject's mastoid and forehead for vestibular stimulation. RESULTS: Anodal stimulation of the right mastoid led to clock-wise subjective visual vertical. Anodal stimualtion of the left mastoid led to counter clock-wise subjective visual vertical. There was a correlation between the amount of the measured parameter and the strength of the applied current. More consistent parameters were obtained from the binaural stimulation than the monaural stimualtion. CONCLUSION: Galvanic vestibular stimulation had effects on the vestibular functions, making changes in the subjective visual vertical. Since the galvanic stimulation had consistency with the direction of the stimulation and was proportionate to the intensity, it is thought to be a useful method for assessing otolith functions.

A Clinical Study of Submandibular Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Submandibular space might be estimated as the most common space of deep neck infection. It may, in certain cases, be treated conservatively with no need for early open surgical drainage. The purpose of this study is to review the clinical course and outcome in treatment of submandibular abscess. SUBJECTS AND METHOD: A retrospective study was peformed for 9 years on 49 cases admitted from June 1994 to January 2003 for deep neck infection limited to the submandibular space. All patients were treated with intravenous antibiotics. The conservative group was treated with antibiotics only or combination therapy with needle aspiration. The surgical group was treated with intraoral or external drainage. Contrast enhanced computed tomography (CT) imaging was conducted for all cases and had confirmed that they all had an abscess in the submandibular space. RESULTS: The mean period of hospitalization was 7.6 days, with 35 patients treated with IV antibiotics only and 3 patients with aspiration in the conservative group. On the other hand, 3 patients were treated with intraoral drainage and 8 patients with external drainage in the surgical group. One patient required tracheotomy because of severe dyspnea. There was no complication observed in any cases. CONCLUSION: SSubmandibular abscess is an infection of deep neck space and is considered as the most common infection. Conservative treatment is a good therapeutic choice in cases with localized submandibular absess.

Comparison of Vestibule-ocular Reflex of Eccentric Rotation with Centric Rotation in Normal Subjects

BACKGROUND AND OBJECTIVES:Conventional vestibular rotation testing with the head centered on the axis stimulates the semicircular canals evoking compensatory eye movements. By placing subjects off from the axis of rotation, the otolithic organ may also be simultaneously stimulated by additional linear acceleration forces. In the present study, we compared the rotation with subjects placed on axis to those placed in an eccentric position. MATERIALS AND METHOD:In the eccentric rotation, the head of subject was facing outward and placed eccentrically for 33cm on naso-occipital axis. Slow harmonic acceleration test and velocity step test were performed. RESULTS:The sinusoidal eccentric rotation at 0.32, 0.64 Hz produced a significantly higher vestibulo-ocular reflex gain than did on axis rotation. In velocity step test, initial slow component velocity was significantly higher in eccentric rotation than in centric rotation. CONCLUSION:These finding suggest that the gain enhancement due to eccentric rotation is a result of tangentiallinear acceleration, probably sensed by the otolithic organ. This study raises the possibility of using eccentric rotation for the diagnosis of the patients with otolithic dysfunction.