The Effect of Dual-Task Training on Balance and Cognition in Patients With Subacute Post-Stroke

OBJECTIVE: To investigate the effect of dual-task training on the recovery of balance ability and cognitive function in patients with subacute stroke. METHODS: Twenty patients (12 males and eight females; average age, 59.70 years) with subacute stroke were enrolled in this study. All participants were randomly assigned to one of two groups, the dual-task group (n=10) or the control group (n=10). The dual task was simultaneous balance and cognitive training using the BioRescue. All patients were evaluated with posturographic parameters and the Berg Balance Scale for balance ability, a computerized neuropsychological test and the Korean version of the Mini-Mental State Examination for cognitive function, the Fugl-Meyer Assessment for motor function, and the Korean-Modified Barthel Index for activities of daily living (ADL) function before and after 4 weeks of rehabilitation. RESULTS: The dual-task group showed significant improvements in the pressure of the weight distribution index (WDI), surface area, and length of the stability index during the eyes-open condition; surface area of the limit of stability (LOS) on the hemiparetic and intact sides, and the auditory continuous performance test and backward visual span test after rehabilitation. Although no significant difference was observed for the changes in balance ability or cognitive, motor, and ADL functions between the groups, changes in the WDI pressure during the eyes-open condition and in the area ratio of LOS (hemiparetic/intact) showed a tendency to improve in the dual-task group. CONCLUSION: Our findings suggest that dual-task training could be as effective as conventional balance training for improving balance and cognition in subacute post-stroke patients.

Effects of Adjuvant Hydrotherapy on Functional Status and Mental Relaxation in Patients with Knee Osteoarthritis: Preliminary Study

BACKGROUND: The aim of this study is to test if adjuvant hydrotherapy with viscosupplement is beneficial on management of pain, stiffness, function, and mental relaxation in knee osteoarthritis (OA). METHODS: Nineteen patients with OA were randomly assigned to hydrotherapy or control groups. All patients received viscosupplement injections once a week for 3 weeks. Hydrotherapy group (n=9) had a spa containing green tea, 3 days a week for 2 weeks. The control group (n=10) received only injections. All patients were assessed at baseline and after the third injection. All were assessed for pain (visual analog scale, VAS), pain severity, and functional status (Western Ontario and McMaster Universities osteoarthritis index, WOMAC), emotional status, quality of life (Euro quality of life health-related quality of life inventory five dimension, EQ-5D), and relative spectral power of alpha waves in electroencephalography (EEG). RESULTS: Both groups reported a statistically significant reduction of pain at the end of treatment and detailed assessment of pain, and function in WOMAC and the relative power of alpha in electroencephalogram showed statistical significant difference only in the hydrotherapy group. However, there were no significant intergroup differences, except for VAS score. CONCLUSION: Adjuvant 2-week hydrotherapy to viscosupplement might have a modest role in the management of pain and functional disability and the mental relaxation in patients with knee OA. Larger, randomized controlled trials with intervention of long term period to determine efficacy in treating knee OA are warranted.

Effectiveness of Commercial Gaming-Based Virtual Reality Movement Therapy on Functional Recovery of Upper Extremity in Subacute Stroke Patients

OBJECTIVE: To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. METHODS: Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. RESULTS: There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. CONCLUSION: These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients.

A Case of Hemiballism in Elderly Stroke Improved by Conventional Rehabilitation Therapy and Low Dose Quetiapine

Hemiballism describes involuntary severe, violent, arrhythmic, rotatory and large amplitude movements of limb from proximal joint. We experienced an elderly stroke patient with hemiballism accompanied dysphagia that persisted for several months severity was evaluated by the Universidade Federal de Minas Gerais Sydenham's chorea rating scale (USCRS) and video fluoroscopic swallowing study (VFSS). In this case, we observed the improvement of hemiballism by conventional rehabilitation therapy and low dose quetiapine. Therefore, we recommend geriatrists considers vthese therapies in elderly patients with hemiballism.

The Effects of Neuromuscular Electrical Stimulation on Cardiopulmonary Function in Healthy Adults

OBJECTIVE: To evaluate the effect of neuromuscular electrical stimulation (NMES) on cardiopulmonary function in healthy adults. METHOD: Thirty-six healthy adults without a cardiac problem were enrolled. All patients were randomly assigned to either a control (17 subjects, mean age 29.41) or an electrical stimulation group (19 subjects, mean age 29.26). The electrical stimulation group received NMES on both sides of quadriceps muscle using a Walking Man II(R) in a sitting position for 30 minutes over 2 weeks. Maximum oxygen consumption (VO2max), metabolic equivalent (MET), resting, maximal heart rate (RHR, MHR), resting, maximal blood pressure (RBP, MBP), and maximal rate pressure product (MRPP), exercise tolerance test (ETT) duration were determined using an exercise tolerance test and a 6 minute walk test (6MWT) before and after treatment. RESULTS: The electrical stimulation group showed a significant increase in VO2max (p=0.03), 6MWT (p<0.01), MHR (p<0.04), MsBP (p<0.03), ETT duration (p<0.01) and a significant decrease in RsBP (p<0.02) as compared with the control group after two weeks. NMES induced changes improved only in RsBP (p<0.049) and ETT duration (p<0.01). The effects of NMES training were stronger in females. CONCLUSION: We suggest that NMES is an additional therapeutic option for cardiopulmonary exercise in disabled patients with severe refractory heart failure or acute AMI.

Aesthetic Labia Minora Reduction with Medial Central Wedge Resection and Lateral Hockey Stick Resection / 대한폐경학회지

Aesthetic reduction of the labia minora has gained popularity. Hypertrophy of the labia minora is aesthetically and functionally unsatisfactory to some women. This study focused on one of the reduction techniques based on the degree of labial hypertrophy and the aesthetic preferences of the patient for labial edge color and contour. The five patients underwent labia minora reduction between August 2009 and August 2010. The ages ranged from 11~51 years (mean age, 29.2 years). All of the patients underwent medial central wedge resection and lateral hood resection of the labia minora. All patients were satisfied with the aesthetic appearance of the external genitalia, relief of chronic irritation, and improved hygiene; there were no complications. The patients reported no interference with usual daily activities or with intercourse. We describe a simple medial central wedge and lateral hood resection to reduce enlarged labia minora that depends on the degree of hypertrophy. These methods give the same satisfaction between pre- and post-menopausal women.

Aesthetic Labia Minora Reduction with Medial Central Wedge Resection and Lateral Hockey Stick Resection / 대한폐경학회지

Aesthetic reduction of the labia minora has gained popularity. Hypertrophy of the labia minora is aesthetically and functionally unsatisfactory to some women. This study focused on one of the reduction techniques based on the degree of labial hypertrophy and the aesthetic preferences of the patient for labial edge color and contour. The five patients underwent labia minora reduction between August 2009 and August 2010. The ages ranged from 11~51 years (mean age, 29.2 years). All of the patients underwent medial central wedge resection and lateral hood resection of the labia minora. All patients were satisfied with the aesthetic appearance of the external genitalia, relief of chronic irritation, and improved hygiene; there were no complications. The patients reported no interference with usual daily activities or with intercourse. We describe a simple medial central wedge and lateral hood resection to reduce enlarged labia minora that depends on the degree of hypertrophy. These methods give the same satisfaction between pre- and post-menopausal women.

Two Cases of Systemic Lupus Erythematosus Presenting Earlier as Retinal Microangiopathy / 대한류마티스학회지

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease of unknown etiology, which affects skins, joints and other parts of body. Retinopathies associated SLE occur in 3.3% to 28% of cases, the incidence rising with the severity of systemic disease, and generally are found late in the disease. The most common findings described are cotton wool spots, retinal hemorrhages, and optic disc edema. We report two cases of SLE who had retinopathies as early manifestation of disease.