Change in Electromyographic Activity of Wrist Extensor by Cylindrical Brace

PURPOSE: To verify the effect of a newly-developed cylindrical type forearm brace, which was designed to give focal counterforce perpendicularly on the muscle belly of the wrist extensor. MATERIALS AND METHODS: The dominant hands of 24 (12 males, 12 females) healthy subjects were tested. Two types of forearm braces (focal cylindrical type and broad pneumatic type) were examined. The braces were applied at the extensor carpi radialis brevis, 5 to 7 cm distal to the lateral epicondyle. Two surface electrodes were attached to the proximal and distal parts of the brace. By quantitative electromyography, the mean amplitudes of voluntary extensor carpi radialis brevis contraction before and after applying each brace were recorded and analyzed. RESULTS: The mean amplitudes of the focal cylindrical brace and broad pneumatic brace were reduced significantly compared to no brace (p<0.05), with a larger reduction for the cylindrical brace than the pneumatic brace (p<0.05). There was no significant difference between the proximal and distal mean amplitudes with each brace. CONCLUSION: A cylindrical type brace decreased electromyographic activity in the wrist extensor more effectively than did the pneumatic type brace.

Long Term Improvement of Dysphagia in Lateral Medullary Infarction: A Case Report / 이화의대지

This report concerns a male patient suffered from refractory dysphagia after subarachnoid hemorrhage. A 49-year-old man admitted with severe headache followed by mental change. Imaging studies revealed that subarachnoid hemorrhage was located in basal cistern, and demonstrated ruptured vertebral dissecting aneurysm. After operation, the patient recovered well except severe dysphagia. Initial VFSS showed aspiration in fluid trial, penetration in semisolid bolus, and large amount of pharyngeal residue with poor relaxation of upper esophageal sphincter. For about 5 months, his symptom and several follow-up VFSS findings did not show marked improvement by various treatments. On magnetic resonance imaging for further evaluation of his brain lesion, an old infarction in right lateral side of medulla was found. He kept dysphagia rehabilitation more than one year, and his symptom improved to the level of oral feeding at last.

Factors Affecting Test Results and Standardized Method in Quiet Standing Balance Evaluation

OBJECTIVE: To identify factors affecting test results of the quiet standing balance evaluation conducted by posturography and to investigate the standardized method by comparing results according to feet width. METHOD: The study cohort consisted of 100 healthy individuals. We assessed the quiet standing balance of subjects by using 3 different methods: standing on a force plate with feet width the same as shoulder width (test 1); with feet width the same as half the shoulder width (test 2); with feet width determined by the subject's comfort (test 3). Subjects underwent each test with their eyes open and closed for 30 seconds each time. Parameters for measuring standing balance included the mean mediolateral and anteroposterior extent, speed, and the velocity moment of center of pressure (COP) movement. RESULTS: All parameters showed better results when the subject's eyes were open rather than closed, and the mean AP extent and speed increased as the age of the subjects increased (p<0.01). However, there was no significant correlation between height and the study parameters, and no differences between men and women. Mean mediolateral extent and speed were significantly longer and faster in test 1 compared with tests 2 and 3 (p<0.01). The results of test 2 were better than the results of test 3, but the difference was not statistically significant. CONCLUSION: COP movements increased with age and when subjects closed their eyes in an evaluation of quiet standing balance conducted by posturography. Gender and height did not affect results of the test. We suggest that an appropriate method for conducting posturography is to have the subject stand on a force plate with their feet width the same as half the shoulder width, because this posture provided relatively accurate balance capacity.

Analysis of Stroke Patients with Hip Fracture

OBJECTIVE: To investigate the specific features of stroke patients with hip fracture, and the correlation of fracture occurrence with rehabilitation after stroke onset. METHOD: We retrospectively analyzed 181 stroke patients in a total of 892 patients who underwent an operation due to hip fracture. The assessment factors consists of age, the location of brain lesion, bone marrow density, body mass index, the presence of diabetes mellitus and anemia, laboratory findings of serum albumin, calcium and phosphate. We also analyzed subject's dominant hand side, experience of rehabilitation, and the duration between stroke onset and occurrence of hip fracture. RESULTS: Among 181 patients (56 male, 125 female), most common location of the brain lesion was the subcortex. About 70% of patients had osteoporosis, anemia and hypoalbuminemia. Among 34 hemiplegic patients, most of them had hip fracture on hemiplegic side (91.2%). The duration between stroke onset and occurrence of hip fracture of the patients who had experience of rehabilitation after stroke was longer than that of the patients without rehabilitation experience (p<0.05). CONCLUSION: Woman, osteoporosis, anemia and hypoalbuminemia are correlated with the hip fracture in stroke patient. The hip fracture of the stroke patient who did not have rehabilitation experience occurred earlier. The rehabilitation therapy including education for prevention of falling may be helpful to stroke patients with these factors.