Assessment of Malnutrition in Rehabilitation Inpatients

BACKGROUND: The purposes of this study are to determine the prevalence of malnutrtion and its trend of change and to establish its relationship with dysphagia and functional outcome in rehabilitation patients. METHOD: We included 39 patients who were admitted into rehabilitation ward, and we evaluated nutri- tional parameters(serum albumin, serum lymphocyte, and weight loss) and dysphagia at the time of admi- ssion and four weeks after admission. We analyzed total rehabilitation inpatients and stroke patients who were major inpatients of rehabilitation ward. We measured Functional Independence Measure(FIM) and length of stay as clinical outcome scales. RESULTS: Malnutrition was observed in 76.9% of total patients and 69.6% in stroke patients at the time of admission. After four weeks, malnutrition was observed in 65.4% and 66.7%, respectively. Prevalence of dysphagia was 25.0% in non-malnourished patients and 22.0% in malnourished patients at the time of admission. It was not changed significantly after four weeks of rehabilitation. The length of stay was 31.3+/-16.0 days in non-malnourished patients and 39.8+/-19.4 days in malnourished patients. The FIM effi- ciency was 1.0+/-0.6 in non-malnourished patients and 2.3+/-6.5 in malnourished patients. CONCLUSION: Our findings suggest that malnutrition was highly prevalent in rehabilitation inpatients and it did not improved significantly through four weeks of rehabilitation. Therefore, it is important to be concerned about malnutrition and it needs proper and active management.

Leg Length Discrepancy in Children with Hemiplegic Cerebral Palsy

OBJECTIVE: The purpose of this study was to define the leg length discrepancy (LLD) in hemiplegic cerebral palsy compared with normal control group and to evaluate the contributing clinical factors to LLD. METHOD: The study included 27 children with hemiplegic cerebral plasy and 12 normal control group who were taken Bell-Thomson's view x-ray for measuring of leg length. The patient group was divided into the group with LLD and the group without LLD. Then we evaluated the relationship between the rate of leg length shortening (LLS) and clinical factors. RESULTS: Of the total 27 cerebral palsy children, 18 children (66.7%) had LLD, whose average rate of LLS was 2.0 percent. Nine children didn't have LLD, whose average rate of LLS was 0.6 percent. There was no specific relationship between the rate of LLS and the age, muscle power or spasticity, but there was negative correlation between the rate of LLS and the score of gross motor functional measure (GMFM). CONCLUSION: It is necessary to define the LLD in children with hemiplegic cerebral palsy by the rate of LLS and to be concerned about the LLD due to its possible correlation with poor functional outcome.

Traumatic Cauda Equina Syndrome Due to Spinal Stenosis in an Achondroplastic Patient: A Case Report

Achondroplasia is a congenital developmental condition characterized pathologically by defective enchondral ossification, affecting chiefly the long bones, and clinically by peculiar dwarfism with short extremities and normal trunk. One of the most common neurologic manifestation in achondroplastic patients in adulthood is spinal stenosis where the prominent characteristics of lumbar vertebrae structure are shortening of interpedicular distance and hypertrophy of vertebral pedicle. There has been no case report of traumatic cauda equina syndrome resulted in paraparesis among achondroplasic patients in Korea. We experienced a 30 year-old achondroplastic man sustained paraparesis as the result of an accidental slipping down. After the surgical decompression, the patient made slow recovery in all aspects of function via rehabilitation therapy.