ABSTRACT
Background@#Patients with Parkinson’s disease (PD) experience both motor and non-motor symptoms, including dysphagia. Although PD is closely associated with dysphagia, the prevalence or risk of dysphagia in PD is unclear, especially in Asian countries. @*Methods@#The prevalence of PD and dysphagia with PD in the general population was analyzed using the Korean National Health Insurance Service (NHIS) database. The prevalence per 100,000 persons of PD and dysphagia with PD from 2006 to 2015 was analyzed in the general population aged ≥ 40 years. Patients newly diagnosed with PD between 2010 and 2015 were compared with those without PD. @*Results@#The prevalence of PD and dysphagia in patients with PD increased continuously during the study period and was highest in the ninth decade of life. The percentage of patients with dysphagia in patients with PD increased with age. Patients with PD showed an adjusted hazard ratio of 3.132 (2.955–3.320) for dysphagia compared to those without PD. @*Conclusion@#This nationwide study showed increasing trends in the prevalence of PD and dysphagia among patients with PD in Korea between 2006 and 2015. The risk of dysphagia was three times higher in patients with PD than that in those without PD, highlighting the importance of providing particular attention.
ABSTRACT
Objective@#To translate the 22-item Longer-term Unmet Needs after Stroke (LUNS) questionnaire, validate it in the Korean stroke population, and assess the reliability of face-to-face and telephone surveys. @*Methods@#Sixty-six adult patients with stroke from Seoul National University Bundang Hospital and Kangwon National University Hospital were involved in the validation. Participants were interviewed twice using the LUNS Korean version: first, a face-to-face survey for validation, and second, a telephone survey for test-retest reliability. Participants completed the Frenchay Activities Index (FAI) and Short Form 12 (SF-12) Mental and Physical Component Summary (MCS and PCS) scores at the first interview. For concurrent validity, the differences in health status (FAI, SF-12 MCS and PCS) between the groups that reported unmet needs and those that did not were analyzed for each item. Cohen’s kappa and percentage of agreement between the first and second administrations were calculated for each item to determine the test-retest reliability. @*Results@#The average age of the participants was 61.2±12.8 years and 74.2% were male. Fifty-seven patients were involved in the second interview. Depending on the unmet needs, SF-12 MCS, PCS, and FAI were significantly different in 12 of 22 items. In the test-retest reliability test, 12 items had a kappa of 0.6 or higher, and two had a kappa of <0.4. @*Conclusion@#The LUNS instrument into Korean (LUNS-K) is a reliable and valid instrument for assessing unmet health needs in patients with stroke. In addition, telephone surveys can be considered reliable.
ABSTRACT
Objective@#To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. @*Methods@#The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach’s alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. @*Results@#Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants’ sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach’s alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). @*Conclusion@#The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.
ABSTRACT
OBJECTIVE: To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome. METHODS: A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo). RESULTS: The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080). CONCLUSION: Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI.