Effects of Electric Cortical Stimulation (ECS) and Transcranial Direct Current Stimulation (tDCS) on Rats With a Traumatic Brain Injury

OBJECTIVE: To evaluate the effects of electric cortical stimulation (ECS) and transcranial direct current stimulation (tDCS) on motor and cognitive function recovery and brain plasticity in focal traumatic brain injury (TBI) of rats model. METHODS: Forty rats were pre-trained to perform a single pellet reaching task (SPRT), rotarod test (RRT), and Y-maze test for 14 days, then a focal TBI was induced by a weight drop model on the motor cortex. All rats were randomly assigned to one of the three groups: anodal ECS (50 Hz and 194 μs) (ECS group), tDCS (0.1 mA, 50 Hz and 200 μs) (tDCS group), and no stimulation as a control group. Four-week stimulation, including rehabilitation, was started 3 days after the operation. SPRT, RRT, and Y-maze were measured from day 1 to day 28 after the TBI was induced. Histopathological and immunohistochemistry staining evaluations were performed at 4 weeks. RESULTS: SPRT was improved from day 7 to day 26 in ECS, and from day 8 to day 26 in tDCS compared to the control group (p < 0.05). SPRT of ECS group was significantly improved on days 3, 8, 9, and 17 compared to the tDCS group. Y-maze was improved from day 8 to day 16 in ECS, and on days 6, 12, and 16 in the tDCS group compared to the control group (p < 0.05). Y-maze of the ECS group was significantly improved on day 9 to day 15 compared to the tDCS group. The c-Fos protein expression was better in the ECS group and the tDCS group compared to the control group. CONCLUSION: Electric stimulation in rats modified with a focal TBI is effective for motor recovery and brain plasticity. ECS induced faster behavioral and cognitive improvements compared to tDCS during the recovery period of rats with a focal TBI.

The Effect of Lumbar Stability Exercise Program on Sedentary Life Female, Lumbosacral Region Angle, Muscular Strength, Physical Fitness and Pain Scale / 대한스포츠의학회지

The purpose of this study is to evaluate the effect of lumbar stabilization exercise on lumbosacral region angle, lumbar strength, lower muscle strength, physical fitness, and low back pain of sedentary women. Twenty females who spend more than 6 hours a day as sedentary at working were recruited. The subjects were assigned to two different groups which are exercise group (n=10) and non-exercise group (n=10). Exercise program was consisted with Swiss ball and lumber stability exercise, and it was performed 60 min/day and 3 times/wk for 8 weeks. Two-way analysis of variance was conducted to analyze experimental data. As a result, there was no significant difference between groups in lumbar lordosis angle and lumbar sacral angle. However, Isometric lumbar extension strength, isokinetic knee flexion and extension peak torque in angular velocity were significantly different between groups, and the pain was reduced. To conclude, this study identified the effectiveness of lumbar stabilization exercise on lumbar muscular, strength, Sargent jump, sit and reach test and reduced pain.

Effect of Pneumatic Compressing Powered Orthosis in Stroke Patients: Preliminary Study

OBJECTIVE: To evaluate the feasibility and effectiveness of a knee-ankle-foot orthosis powered by artificial pneumatic muscles (PKAFO). METHODS: Twenty-three hemiplegic patients (age, 59.6+/-13.7 years) were assessed 19.7+/-36.6 months after brain lesion. The 10-m walking time was measured as a gait parameter while the individual walked on a treadmill. Walking speed (m/s), step cycle (cycle/s), and step length (m) were also measured on a treadmill with and without PKAFO, and before and after gait training. Clinical parameters measured before and after gait training included Korean version of Modified Bathel Index (K-MBI), manual muscle test (MMT), and Modified Ashworth Scale (MAS) of hemiplegic ankle. Gait training comprised treadmill walking for 20 minutes, 5 days a week for 3 weeks at a comfortable speed. RESULTS: The 10-m walking time, walking speed, step length, and step cycle were significantly greater with PKAFO than without PKAFO, and after gait training (both p<0.05). K-MBI was improved after gait training (p<0.05), but MMT and MAS were not. CONCLUSION: PKAFO may improve gait function in hemiplegic patients. It can be a useful orthosis for gait training in hemiplegic patients.

Relationship of Plasma Glucose and Hemoglobin A1c Levels Among Emergency Department Patients with Unknown Diabetes Status in Korea

PURPOSE: Diabetes is underdiagnosed. Higher-risk populations, such as emergency department (ED) patients, may provide an opportunity for identification of undiagnosed diabetes. Prior studies have indicated that hemoglobin A1c (HbA1c) is effective in the screening detection of diabetes. The objective of this study was to evaluate the correlation between random plasma glucose and HbA1c in Korean ED patients with unknown diabetes status and to determine the value of ED glucose level as a screening tool for diabetes. METHODS: This was a prospective nonconsecutive case series of adults aged > or =18-years-of-age presenting to the ED with acute illness that involved acquisition of a a plasma glucose sample for clinical management. From June 1-June 30, 2009, consenting patients with no prior history of diabetes underwent additional testing for HbA1c level. ED glucose results were stratified based on outpatient American Diabetes Association Fasting Plasma Glucose classifications. Two HbA1c cut-off points (6.1% and 6.5%) were selected as the optimum cut-offs for identifying diabetes based on International Expert Committee. RESULTS: There were 423 patients enrolled. The ED glucose levels were correlated with the HbA1c levels (r=0.488, p or =200 mg/dL, but most (90%) had an elevated HbA1c level. CONCLUSION: Based on the frequencies of elevated HbA1c levels among patients with elevated ED glucose values, a clinically relevant portion of hyperglycemic patients may have undiagnosed diabetes. ED patients with hyperglycemia may warrant referral for confirmatory diabetes testing.

Relationship of Plasma Glucose and Hemoglobin A1c Levels Among Emergency Department Patients with Unknown Diabetes Status in Korea

PURPOSE: Diabetes is underdiagnosed. Higher-risk populations, such as emergency department (ED) patients, may provide an opportunity for identification of undiagnosed diabetes. Prior studies have indicated that hemoglobin A1c (HbA1c) is effective in the screening detection of diabetes. The objective of this study was to evaluate the correlation between random plasma glucose and HbA1c in Korean ED patients with unknown diabetes status and to determine the value of ED glucose level as a screening tool for diabetes. METHODS: This was a prospective nonconsecutive case series of adults aged > or =18-years-of-age presenting to the ED with acute illness that involved acquisition of a a plasma glucose sample for clinical management. From June 1-June 30, 2009, consenting patients with no prior history of diabetes underwent additional testing for HbA1c level. ED glucose results were stratified based on outpatient American Diabetes Association Fasting Plasma Glucose classifications. Two HbA1c cut-off points (6.1% and 6.5%) were selected as the optimum cut-offs for identifying diabetes based on International Expert Committee. RESULTS: There were 423 patients enrolled. The ED glucose levels were correlated with the HbA1c levels (r=0.488, p or =200 mg/dL, but most (90%) had an elevated HbA1c level. CONCLUSION: Based on the frequencies of elevated HbA1c levels among patients with elevated ED glucose values, a clinically relevant portion of hyperglycemic patients may have undiagnosed diabetes. ED patients with hyperglycemia may warrant referral for confirmatory diabetes testing.

Predictive Factors of Blood Transfusion Requirement in Blunt Trauma Patients Admitted to the Emergency Room

PURPOSE: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician's and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. METHODS: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. RESULTS: Of blunt trauma patients ,9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS 65 years, hemoglobin 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.