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Premature infants often face oral feeding problems. The videofluoroscopic swallow study (VFSS) is a commonly used method to detect subglottic aspiration. However, there is no consensus to date regarding the association of aspiration observed on VFSS and incidence of aspiration pneumonia in preterm infants. This study investigated the occurrence of aspiration pneumonia in preterm infants on oral feeds after aspiration has been confirmed by VFSS. This study included 50 preterm infants who had undergone VFSS. Among them, 13 patients with no aspiration, two patients who were lost to follow-up, and nine patients with massive aspiration were excluded from the analysis. In VFSS, the frequency and amount of aspiration, nasal penetration, suck-swallow ratio, and sucking power were assessed. We analyzed 26 patients with aspiration confirmed on VFSS but who had initiated oral feeding. The frequency of aspiration (percentage of the number of aspirations to the total number of swallowing) was 10.22±3.62 (%). The mean amount of aspiration was 2.28±1.02 (%). One preterm infant, born with very low-birthweight developed aspiration pneumonia 10days after the initiation of full oral feeding. He was diagnosed with respiratory distress syndrome and had weak sucking power. In the absence of massive aspiration, most infants with aspiration confirmed on VFSS tolerated oral feeding, especially when oral feeding was partially initiated.
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Objective@#Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. @*Methods@#Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. @*Results@#Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. @*Conclusion@#This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.
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Background@#Subjects with chronic obstructive pulmonary disease (COPD) have a higher risk of ischemic heart disease (IHD) than individuals without COPD; however, longitudinal evidence is lacking. Therefore, we aimed to estimate the risk of IHD between COPD and control cohorts using a longitudinal nationwide database. @*Methods@#We used 2009–2017 data from the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC). Adult participants at least 20 years of age who underwent health examinations and without a history of COPD or IHD were included (n = 540,976). Participants were followed from January 1, 2009, until death, development of IHD, or December 31, 2019, whichever came first. @*Results@#At baseline, there were 3,421 participants with incident COPD and 537,555 participants without COPD. During a median of 8.0 years (5.3–9.1 years) of follow-up, 2.51% of the participants with COPD (n = 86) and 0.77% of the participants without COPD (n = 4,128) developed IHD, with an incidence of 52.24 and 10.91 per 10,000 person-years, respectively. Participants with COPD had a higher risk of IHD (adjusted hazard ratio, 1.55;95% confidence interval, 1.25–1.93) than subjects without COPD. Demographics such as age, sex, body mass index, and personal health behaviors including smoking status and physical activity did not show significant interaction with the relationship between COPD and IHD (P for interaction > 0.05 for all). @*Conclusion@#The results indicate that COPD is associated with the development of IHD independent of demographic characteristics and health-related behaviors. Based on these results, clinicians should closely monitor the onset of IHD in subjects with COPD.
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Background@#We aimed to evaluate the nationwide trend of the prevalence of frailty in older adults in Korea from 2008 to 2020 to inform future geriatric healthcare policies. @*Methods@#The study used data of individuals aged 65 years and older from the Korea National Health and Nutrition Examination Survey, a nationwide repeated cross-sectional survey.Frailty was defined using frailty index, classified as non-frail (frailty index ≤ 0.15), pre-frail (0.15 0.25). @*Results@#The study included 17,784 individuals, with the mean age of 72.4 and mean frailty index of 0.2. The prevalence of frailty in older adults in South Korea decreased significantly from 2008 (41.1%) to 2020 (23.1%). The decrease in the frailty index was observed in all age groups (all P < 0.05). As components of frailty index, we found that certain comorbidities, such as dyslipidemia, diabetes mellitus, and cardiovascular disease, have increased over time, while factors such as chewing difficulty, activity limitation, and smoking, have decreased. @*Conclusion@#The prevalence of frailty in older adults in South Korea has decreased significantly during the study period. Historical improvements in healthcare access and preventive measures may have contributed to this trend.
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Humans , B-Lymphocytes , Blood Cell Count , Colorectal Neoplasms , Lymphocyte Subsets , LymphocytesABSTRACT
Background@#Prohibitin (PHB) regulates intracellular signal pathways, transcription, and cell cycles. Aberrant expression of the PHB gene is known to be related totumorigenesis, tumor progression, and chronic metabolic and inflammatory diseases. The present study aimed to develop a one-step quantitative reverse transcription PCR (RT-qPCR) kit for quantifying PHB mRNA levels and evaluate its performance in the laboratory. @*Methods@#TaqMan chemistry was used to develop the one-step PHB1 and PHB2 RT-qPCR kit. Normal peripheral blood cells from healthy individuals (N=20) and leukemia cells from patients initially diagnosed with acute myeloid leukemia (AML, N=20), chronic myeloid leukemia (CML, N=13), and acute lymphoid leukemia (ALL, N=7) were enrolled to evaluate the laboratory performance of the kit using commercially available total human RNA controls. @*Results@#The intra-assay and inter-assay precision of the kit developed in this study was less than 2%. The distribution of PHB1 mRNA expression of AML, CML, and ALL was 0.898-0.993 (median: 0.936), 0.817-0.976 (0.918), and 0.844-1.074 (0.973), respectively. The distribution of PHB2 mRNA expression of AML, CML, and ALL was 0.957-1.024 (median: 0.985), 0.988-1.047 (1.002), and 0.937-1.059 (1.004), respectively. The sensitivity, specificity, positive and negative predictive value, and test effectiveness of the developed PHB1 and PHB2 kit were greater than 50% for each parameter. @*Conclusions@#Our developed kit would be useful for diagnosing leukemia as well as detecting residual disease. Additionally, this kit could be used for monitoring and conducting molecular pathophysiological studies of obesity, metabolic, and inflammatory diseases.
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Objective@#The purpose of this study was to understand the mechanism of normal hyoid movement during swallowing by calculating the activity of each muscle involved in the hyoid movement and propose a new kinetic modeling of hyoid movement using videofluoroscopy images. @*Methods@#Eight healthy volunteers with an average age of 56.8 swallowed 2-ml of diluted barium under videofluoroscopy. A video image was digitized to analyze the movement of the hyoid bone. The activity of the muscles acting on the hyoid bone was calculated from the movement of the hyoid bone using kinetic modeling. A surface electromyogram was measured simultaneously with videofluoroscopy, and the muscle force calculated by kinetic modeling was compared with the muscle force measured by surface EMG. @*Results@#The muscles acting on the hyoid bone were divided into three groups according to the direction of force and analyzed. The contraction of the retractor muscle group was observed as a median of 433 ms (95% CI 264-602, P=0.012) earlier than the contraction of protractor muscle group in all subjects. Generally, the peak activity of each muscle group was observed in the order of retractor (0 ms), protractor (592 ms, 95% CI 429-755), and depressor (717 ms, 95% CI 535-899) muscle group. The contraction of the protractor muscle measured by surface electromyography showed an earlier onset latency with a median of 82 2 ms (95% CI 615-102 9, P=0.012 ) compared to the contraction of the protractor muscle calculated by kinetic modeling. @*Conclusion@#Kinetic modeling reflects the pattern of contraction in the order of retractor, protractor, depressor muscle groups, as previously known. And it was possible to evaluate the activity of the retractor muscle, which is difficult to evaluate by electromyogram.
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Purpose@#To compare the thickness of the processed pericardial patch graft for glaucoma implant tube coverage using anterior segment optical coherence tomography (AS-OCT). @*Methods@#Thicknesses of seven samples of two pericardial patch grafts (Tutoplast pericardium, IOP Inc, Costa Mesa, CA, USA; pericardium LYO, DCI Donor Services, Inc., Nashville, TN, USA) were measured using AS-OCT (CASIA2, Tomey Corporation, Nagoya, Japan). The thickness of each sample was measured at the center and eight points with 45-degree angular distance, 2 mm from the center. The thickness was measured using AS-OCT program tools. @*Results@#The median thicknesses were 219 μm for Tutoplast pericardium and 157 μm for pericardium LYO. Tutoplast pericardium was significantly thicker than pericardium LYO (p = 0.001); pericardium LYO had a wider interquartile range within each sample, compared to Tutoplast pericardium (p = 0.017). @*Conclusions@#The thickness of the Tutoplast pericardium was greater and less variable than that of the pericardium LYO. These findings should be considered when choosing processed pericardium for coverage of glaucoma implants.
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Background@#Chromosomal analysis is essential for the diagnosis and risk stratification of all leukemia patients. Not surprisingly, racial differences in chromosomal aberrations (CA) in hematological malignancies could be found, and CA incidence in leukemia might change over time, possibly due to environmental and lifestyle changes. Thus, we compared the frequency and range of CA in patients with acute leukemia (AL) during two time periods (2006‒2009 vs. 2010‒2015) and compared them with other prior studies. @*Methods@#We enrolled 717 patients with AL during a six-year period (2010‒2015). We compared the results to those of our earlier study (2006‒2009) [1]. Conventional cytogenetics, a multiplex reverse transcriptase (RT)-PCR system, and fluorescence in situ hybridization were employed to assess bone marrow specimens or peripheral blood at the diagnostic stage in AL patients to detect CA. @*Results@#The incidence of CA changed in the leukemia subgroups during the two time periods.Notably, the most frequent CA of childhood acute myeloid leukemia (AML) was PML/RARA, and was followed by RUNX1/RUNX1T1 in the current study. In contrast, the most common CA was RUNX1/RUNX1T1 in a previous study [1] and was followed by PML/RARA. In this study, the most frequent CA of the mixed phenotype AL was BCR/ABL1, which was followed by KMT2A/MLLT3. In a previous report, [1] the most frequent CA was BCR/ABL1, which was followed by KMT2A/ELL. @*Conclusion@#The distribution of CA in Korean AL patients changed over time in a single institute. This change might be due to environmental and lifestyle changes.
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Background@#Chromosomal analysis is essential for the diagnosis and risk stratification of all leukemia patients. Not surprisingly, racial differences in chromosomal aberrations (CA) in hematological malignancies could be found, and CA incidence in leukemia might change over time, possibly due to environmental and lifestyle changes. Thus, we compared the frequency and range of CA in patients with acute leukemia (AL) during two time periods (2006‒2009 vs. 2010‒2015) and compared them with other prior studies. @*Methods@#We enrolled 717 patients with AL during a six-year period (2010‒2015). We compared the results to those of our earlier study (2006‒2009) [1]. Conventional cytogenetics, a multiplex reverse transcriptase (RT)-PCR system, and fluorescence in situ hybridization were employed to assess bone marrow specimens or peripheral blood at the diagnostic stage in AL patients to detect CA. @*Results@#The incidence of CA changed in the leukemia subgroups during the two time periods.Notably, the most frequent CA of childhood acute myeloid leukemia (AML) was PML/RARA, and was followed by RUNX1/RUNX1T1 in the current study. In contrast, the most common CA was RUNX1/RUNX1T1 in a previous study [1] and was followed by PML/RARA. In this study, the most frequent CA of the mixed phenotype AL was BCR/ABL1, which was followed by KMT2A/MLLT3. In a previous report, [1] the most frequent CA was BCR/ABL1, which was followed by KMT2A/ELL. @*Conclusion@#The distribution of CA in Korean AL patients changed over time in a single institute. This change might be due to environmental and lifestyle changes.
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OBJECTIVE: To investigate the effect of family caregiving on depression in the first 3 months after spinal cord injury (SCI). METHODS: A retrospective study was carried out on 76 patients diagnosed with an SCI from January 2013 to December 2016 at the Department of Physical Medicine and Rehabilitation of Kyungpook National University Hospital, Korea. Clinical characteristics including age, gender, level of injury, completeness of the injury, time since injury, caregiver information, etiology, and functional data were collected through a retrospective review of medical records. Depression was assessed using the Beck Depression Inventory (BDI). Patients with 14 or more points were classified as depressed and those with scores of 13 or less as non-depressed group. RESULTS: Of the 76 patients, 33 were in the depressed group with an average BDI of 21.27±6.17 and 43 patients included in the non-depressed group with an average BDI of 4.56±4.20. The BDI score of patients cared by unlicensed assistive personnel (UAP) was significantly higher than that of patients cared by their families (p=0.020). Univariate regression analysis showed that motor complete injury (p=0.027), UAP caregiving (p=0.022), and Ambulatory Motor Index (p=0.019) were associated with depression after SCI. Multivariate binary logistic regression analysis showed that motor completeness (p=0.002) and UAP caregiving (p=0.002) were independent risk factors. CONCLUSION: Compared with UAP, family caregivers lowered the prevalence of depression in the first 3 months after SCI.
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Humans , Caregivers , Depression , Korea , Logistic Models , Medical Records , Physical and Rehabilitation Medicine , Prevalence , Retrospective Studies , Risk Factors , Spinal Cord Injuries , Spinal CordABSTRACT
BACKGROUND: Mitochondrial DNA (mtDNA) mutations may regulate the progression and chemosensitivity of leukemia. Few studies regarding mitochondrial aberrations and haplogroups in acute myeloid leukemia (AML) and their clinical impacts have been reported. Therefore, we focused on the mtDNA length heteroplasmies minisatellite instability (MSI), copy number alterations, and distribution of mitochondrial haplogroups in Korean patients with AML. METHODS: This study investigated 74 adult patients with AML and 70 controls to evaluate mtDNA sequence alterations, MSI, mtDNA copy number, haplogroups, and their clinical implications. The hypervariable (HV) control regions (HV1 and HV2), tRNA(leu1)gene, and cytochrome b gene of mtDNA were analyzed. Two mtDNA minisatellite markers, 16189 poly-C (¹⁶¹⁸⁴CCCCCTCCCC¹⁶¹⁹³, 5CT4C) and 303 poly-C (³⁰³CCCCCCCTCCCCC³¹⁵, 7CT5C), were used to examine the mtDNA MSI. RESULTS: In AML, most mtDNA sequence variants were single nucleotide substitutions, but there were no significant differences compared to those in controls. The number of mtMSI patterns increased in AML. The mean mtDNA copy number of AML patients increased approximately 9-fold compared to that of controls (P < 0.0001). Haplogroup D4 was found in AML with a higher frequency compared to that in controls (31.0% vs. 15.7%, P=0.046). None of the aforementioned factors showed significant impacts on the outcomes. CONCLUSION: AML cells disclosed more heterogeneous patterns with the mtMSI markers and had increased mtDNA copy numbers. These findings implicate mitochondrial genome instability in primary AML cells. Therefore, mtDNA haplogroup D4 might be associated with AML risk among Koreans.
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Adult , Humans , Cytochromes b , DNA, Mitochondrial , Genome, Mitochondrial , Leukemia , Leukemia, Myeloid, Acute , Minisatellite RepeatsABSTRACT
OBJECTIVE: Recently, a fixed combination of grazoprevir and elbasvir (GE) has been introduced to the arsenal of chemotherapeutics to fight against this virus. The study aimed to provide information on the efficacy and safety of GE for the treatment of HCV infection by performing a meta-analysis of literature data. METHODS: PubMed and EMBASE database searches were conducted. Among the literature retrieved, pivotal Phase III clinical studies were analyzed. Statistical analysis of the data was performed by RevMan. RESULTS: Four pivotal Phase III clinical studies compared the efficacy and safety of GE. When HCV patients were treated with GE for 12 weeks, the sustained virologic response, defined as the viral RNA level below the lower limit of quantification at 12 weeks after the cessation of therapy (SVR12), was 94.7%. The clinical advantage of GE involves its use by patients with cirrhosis and/or renal failure without dose adjustment. If the genotype (GT) of the causative virus was GT1a with NS5A polymorphism or GT4 with resistance to peginterferon/ribavirin, treatment with GE plus ribavirin for 16 weeks resulted in a better outcome compared to treatment with GE alone for 12 weeks. Adverse events reported during the four clinical studies were 71.09% in the GE arms and it was 76.61% in the non-GE arms, with the most frequent events being mild central nervous system symptoms. CONCLUSION: GE was generally safe and effective for the treatment of HCV infection. However, since HCV mutates very rapidly and becomes resistant to antiviral agents, long-term monitoring should be mandatory.
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Humans , Antiviral Agents , Arm , Central Nervous System , Fibrosis , Genotype , Hepacivirus , Hepatitis C , Hepatitis , Renal Insufficiency , Ribavirin , RNA, ViralABSTRACT
BACKGROUND: Vincristine is an antimitotic agent used for treatment of leukemia, lymphomas, and cancers. Its main side effect is a dose-related, length-dependent axonal neuropathy.METHODS: We performed electrodiagnostic examinations in 18 children who had been treated with vincristine and who presented with the clinical picture of a peripheral neuropathy.RESULTS: The mean cumulative dose of vincristine was 37.7±26.5 mg/m². Electrodiagnostic examination showed an axonal neuropathy with a length-dependent pattern. All patients showed motor nerve abnormalities and sensory nerve abnormalities were observed in 13 patients (72.2%). The number of affected nerves was 2.67±1.1 (mean±SD) of four motor nerves and 1.5±1.4 of four sensory nerves. The mean reduction of the compound muscle action potential amplitude was 70.9±42.2% in the median nerve and 23.7±20.8% in the peroneal nerve compared to normal value. However, the mean change in the sensory nerve action potential amplitude was 139.9±78.5% in the median nerve and 246.9±169.7% in the superficial peroneal nerve. There was statistically significant difference between amplitude reduction of the compound muscle action potential and sensory nerve action potential.CONCLUSION: The quantitative analysis of electrophysiological motor predominance described differs from the mainly sensory neuropathy reported in adults. Incomplete myelination in motor nerve due to young age may have resulted in greater sensitivity of some nerves to neurotoxic agents.
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Adult , Child , Humans , Action Potentials , Axons , Drug Therapy , Leukemia , Lymphoma , Median Nerve , Myelin Sheath , Pediatrics , Peripheral Nervous System Diseases , Peroneal Nerve , Polyneuropathies , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Reference Values , VincristineABSTRACT
It is challenging to produce esthetic implant restoration in the narrow anterior maxilla region where insufficient volume of alveolar bone could limit the angle and position of implant fixture, if preceding bone augmentation is not considered. Ideal angle and position of implant fixture placement should be established to reproduce harmonious emergence profile with marginal gingiva of implant prosthesis, bone augmentation considered to be preceded before implant placement occasionally. In this case, preceding bone augmentation has been operated before esthetic implant prosthesis in narrow anterior maxilla region. Preceded excessive bone augmentation in buccal area allowed proper angulation of implantation, which compensates unfavorable implant position. Provisional restorations were corrected during sufficient period to make harmonious level of marginal gingiva and interdental papilla. The definite restoration was fabricated using zirconia core based glass ceramic. Functionally and esthetically satisfactory results were obtained.
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Ceramics , Gingiva , Glass , Maxilla , Prostheses and ImplantsABSTRACT
OBJECTIVE: To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. METHODS: We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95). RESULTS: The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups. CONCLUSION: We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding.
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Humans , Deglutition , Deglutition Disorders , Feeding Methods , Pneumonia, Aspiration , Retrospective Studies , StrokeABSTRACT
BACKGROUND: Vincristine is an antimitotic agent used for treatment of leukemia, lymphomas, and cancers. Its main side effect is a dose-related, length-dependent axonal neuropathy. METHODS: We performed electrodiagnostic examinations in 18 children who had been treated with vincristine and who presented with the clinical picture of a peripheral neuropathy. RESULTS: The mean cumulative dose of vincristine was 37.7±26.5 mg/m². Electrodiagnostic examination showed an axonal neuropathy with a length-dependent pattern. All patients showed motor nerve abnormalities and sensory nerve abnormalities were observed in 13 patients (72.2%). The number of affected nerves was 2.67±1.1 (mean±SD) of four motor nerves and 1.5±1.4 of four sensory nerves. The mean reduction of the compound muscle action potential amplitude was 70.9±42.2% in the median nerve and 23.7±20.8% in the peroneal nerve compared to normal value. However, the mean change in the sensory nerve action potential amplitude was 139.9±78.5% in the median nerve and 246.9±169.7% in the superficial peroneal nerve. There was statistically significant difference between amplitude reduction of the compound muscle action potential and sensory nerve action potential. CONCLUSION: The quantitative analysis of electrophysiological motor predominance described differs from the mainly sensory neuropathy reported in adults. Incomplete myelination in motor nerve due to young age may have resulted in greater sensitivity of some nerves to neurotoxic agents.
Subject(s)
Adult , Child , Humans , Action Potentials , Axons , Drug Therapy , Leukemia , Lymphoma , Median Nerve , Myelin Sheath , Pediatrics , Peripheral Nervous System Diseases , Peroneal Nerve , Polyneuropathies , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Reference Values , VincristineABSTRACT
BACKGROUND: To the best of our knowledge, the association between pediatric AML and mitochondrial aberrations has not been studied. We investigated various mitochondrial aberrations in pediatric AML and evaluated their impact on clinical outcomes. METHODS: Sequencing, mitochondrial DNA (mtDNA) copy number determination, mtDNA 4,977-bp large deletion assessments, and gene scan analyses were performed on the bone marrow mononuclear cells of 55 pediatric AML patients and on the peripheral blood mononuclear cells of 55 normal controls. Changes in the mitochondrial mass, mitochondrial membrane potential, and intracellular reactive oxygen species (ROS) levels were also examined. RESULTS: mtDNA copy numbers were about two-fold higher in pediatric AML cells than in controls (P<0.0001). Furthermore, a close relationship was found between mtDNA copy number tertiles and the risk of pediatric AML. Intracellular ROS levels, mitochondrial mass, and mitochondrial membrane potentials were all elevated in pediatric AML. The frequency of the mtDNA 4,977-bp large deletion was significantly higher (P< 0.01) in pediatric AML cells, and pediatric AML patients harboring high amount of mtDNA 4,977-bp deletions showed shorter overall survival and event-free survival rates, albeit without statistical significance. CONCLUSIONS: The present findings demonstrate an association between mitochondrial genome alterations and the risk of pediatric AML.
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Child , Female , Humans , Male , Bone Marrow Cells/metabolism , Case-Control Studies , Cohort Studies , DNA, Mitochondrial/chemistry , Flow Cytometry , Gene Deletion , Gene Dosage , Genome, Mitochondrial , Leukemia, Myeloid, Acute/genetics , Membrane Potential, Mitochondrial , Minisatellite Repeats/genetics , Odds Ratio , Reactive Oxygen Species/metabolism , Sequence Analysis, DNA , Survival RateABSTRACT
OBJECTIVE: To investigate the efficacy of balance control training using a newly developed balance control trainer (BalPro) on the balance and gait of patients with subacute hemiparetic stroke. METHODS: Forty-three subacute stroke patients were assigned to either a balance control training (BCT) group or a control group. The BCT group (n=23) was trained with BalPro for 30 minutes a day, 5 days a week for 2 weeks, and received one daily session of conventional physical therapy. The control group (n=20) received two sessions of conventional physical therapy every day for 2 weeks. The primary outcome was assessment with the Berg Balance Scale (BBS). Secondary outcomes were Functional Ambulation Category (FAC), the 6-minute walking test (6mWT), Timed Up and Go (TUG), the Korean version of Modified Barthel Index (K-MBI), and the manual muscle test (MMT) of the knee extensor. All outcome measures were evaluated before and after 2 weeks of training in both groups. RESULTS: There were statistically significant improvements in all parameters except MMT and FAC after 2 weeks of treatment in both groups. After training, the BCT group showed greater improvements in the BBS and the 6mWT than did the control group. CONCLUSION: Balance control training using BalPro could be a useful treatment for improving balance and gait in subacute hemiparetic stroke patients.