Impact of Co-occurring Dysarthria and Aphasia on Functional Recovery in Post-stroke Patients

OBJECTIVE: To elucidate the impact of co-occurring dysarthria and aphasia on functional recovery in post-stroke patients. METHODS: The medical records, including results of primary screening tests and secondary definite examinations for language problems, of 130 patients admitted to our institute's Department of Rehabilitation Medicine were retrospectively reviewed. Functional outcomes were assessed longitudinally using the Functional Ambulation Category (FAC), Mini-Mental State Examination-Korean version (MMSE-K), European Quality of Life-5 Dimensions 3-Level version (EQ-5D-3L), the Korean version of the Modified Barthel index (K-MBI), and Motricity Index (MI) of the hemiplegic side. RESULTS: Patients were classified into four groups regarding language function: aphasia only (group A, n=9), dysarthria only (group D, n=12), aphasia and dysarthria (group AD, n=46), and none (group N, n=55). The initial functional outcome scores in the group AD were significantly poor compared to those of the groups N and A. Within groups, there were significant improvements in all outcome measurements in the groups AD and N. A between-group analysis revealed significant improvements in K-MBI for the group AD after adjusting for the initial severity and patient's age compared to other groups. CONCLUSION: Post-stroke patients suffering from aphasia with dysarthria showed significantly lower initial functional level and relatively wide range of recovery potential in activities of daily living compared to patients without language problems.

Prevalence and Characteristics of Musculoskeletal Pain in Korean Farmers

OBJECTIVE: To investigate the prevalence and characteristics of musculoskeletal pain (MSK) pain in Korean farmers using initial survey data of Farmers' Cohort for Agricultural Work-Related MSK pain (FARM) study. METHODS: Farmers (534 females and 479 males; mean age 57.2±7.5 years) who owned or rented a farm and belonged to an agricultural cooperative unit were recruited. Presence of pain for each body part (neck, shoulder, arm/elbow, wrist/hand/finger, low back, leg/foot), and characteristics of MSK pain (prevalence, location, duration, severity, and frequency) during the last year was assessed. Additionally, demographic data such as farming duration, history of prior injury, and workload (low, moderate, somewhat hard, or hard) were collected using structured questionnaires. RESULTS: Almost all subjects (n=925; 91.3%) complained of pain in more than one body part. The frequency order was low back (63.8%), leg/foot (43.3%), shoulder (42.9%), wrist/hand/finger (26.6%), arm/elbow (25.3%), and neck (21.8%). Low back pain was more frequent in those with over 30 years of farming experience (odds ratio [OR], 1.40; 95% confidence interval, 1.08-1.81). MSK pain was related to history of prior injury (OR, 2.18-5.24; p<0.05) in all body parts except for leg/foot, and very hard workload was associated with low back, leg/foot, neck, shoulder, and wrist/hand/finger pain (OR, 2.88-10.83; p<0.05). CONCLUSION: Most Korean farmers experience MSK pain; furthermore, there is a significant association between pain, history of prior injury, and workload, suggestive of the necessity of coping and preventive strategies to reduce injury or workload.