Effects of Unilateral Brain Damage on Ipsilateral Upper Extremity Function in Hemiplegia

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.

Effect of Pregnancy on Knee Joint Contracture in the Rat

OBJECTIVE: To study the effect of pregnancy on knee joint contracture in the rat, because the laxity of peripheral joint increases during pregnacy. METHOD: We evaluated the difference of contracture between the pregnant and non-pregnant female rats after 3 week of knee immobilization using a wire. The femorotibial angle at immobilization status was 30o. After immobilization, the femorotibial angle were measured using X-ray after removal of wire at 50 g and 100 g weighted state on the tibia. To study the change of fibroblast in immobilized knee joint ligament, immunohistochemical staining for actin was performed using alpha-smooth muscle actin antibody (DAKO, Denmark). RESULTS: The femorotibial angles were 116.7+/-9.2o and 97.3+/-18.0o after wire removal, in the immobilized pregnant and nonpregnant rats respectively. The femorotibial angles at 50 g and 100 g weighted state were 136.8+/-7.2o and 144.7+/-3.8o, respectively in the immobilized pregnant rats and 129.4+/-12.7o and 136.3+/-8.9o in the immobilized non-pregnant rats. The angles of pregnant group were significantly larger than those of non-pregnant group (p<0.05). In immobilized pregnant and non-pregnant rats, the alpha-smooth muscle actin was moderately expressed in fibroblast of anterior and posterior cruciate ligaments of the knee by immunohistochemistry, while there was no expression of alpha-smooth muscle actin in fibroblast of the ligaments in the non-immobilized knee. CONCLUSION: Joint contracture develops to a lesser degree in pregnant rats than in non-pregnant rats and alpha-smooth muscle actin is expressed in fibroblast of contractured knee ligaments.

The Relationship of MMSE to Functional Improvement in Brain Injured Patients

OBJECTIVE: To determine the relationship of the Mini-Mental State Examination (MMSE) scores to the functional improvement of the brain-injured patients with a traumatic brain injury or cerebrovascular accident. METHOD: Thirty patients who were admitted to a rehabilitation hospital for their initial brain injury were retrospectively studied. Subjects were administerd a MMSE as cognitive assessment and a Functional Independence Measure (FIM) and Modified Barthel Index (MBI) as functional assessment upon referral for the rehabilitation and at discharge. RESULTS: MMSE scores, FIM scores and MBI scores at discharge increased significantly compared to the scores at the start of rehabilitation. The changes of MMSE scores significantly correlated with the changes of FIM scores and MBI scores in 30 brain injured patients (p<0.001). Among the subitems of FIM, the social cognition, communication, self care, and sphincter control were strongly correlated with the MMSE scores. CONCLUSION: We conclude that the MMSE can be a relevant predicting factor for the changes of functional status of brain-injured patients from a inpatient stroke rehabilitation and post brain- injury rehabilitation.