Fluid Thickeners in Patients with Mild Dysphagia / 대한연하장애학회지

Objective@#To compare the changes in blood urea nitrogen/creatinine (BUN/Cr) ratio, a dehydration status indicator, among patients with mild dysphagia depending on the addition of fluid thickeners. @*Methods@#A total of 81 patients who underwent serial dietary trials of the videofluoroscopic swallowing study (VFSS) and displayed penetration signs with a penetration-aspiration scale of 4 or less during the liquid trials were enrolled and classified into two groups according to the dietary instructions from the VFSS results. Group A comprised patients who were permitted to freely consume water with a regular diet. Group B comprised patients allowed to take a regular diet but with the addition of a fluid thickener while ingesting water. To analyze whether the patients of each group were dehydrated, we calculated the serum BUN/Cr ratio using blood tests, which were performed within 1 week of the VFSS test date and 1 month later. @*Results@#There were 4 cases of suspected pneumonia within 1 month after the VFSS test, with no significant differences between the two groups. The BUN/Cr ratio of the 1-month follow-up blood test when compared to the initial blood test showed a significant decrease in Group A (P=0.022) compared with Group B (P=0.033). @*Conclusion@#Patients with mild dysphagia who consumed water freely showed a decrease in the BUN/Cr ratio compared to those who added fluid thickeners to their drinking water.

Hemidystonia after Pontine Hemorrhage Successfully Treated with Pharmacotherapy and Intensive Rehabilitation: a Case Report

Dystonia is a movement disorder characterized by involuntary contraction of muscles resulting in repetitive or twisting movements. Dystonia is generally caused by basal ganglia dysfunction.Recent studies have reported an association between dystonia and brainstem disorders. However, the pathological mechanism is uncertain, and detailed management strategies are limited. Here, we report a case of hemidystonia with abnormal posture and impaired proprioception after pontine hemorrhage that was effectively treated with pharmacotherapy combined with early intensive comprehensive rehabilitation. A 45-year-old man presented with abnormal posture and dystonic movement in the right hand and foot after a pontine hemorrhagic stroke. Pharmacotherapy with clonazepam and benztropine was administered, and comprehensive rehabilitation programs were implemented intensively from the early stages of symptom onset. After 3 months, the patient was able to walk independently, go up and down a few stairs without the use of a handrail, and was able to perform activities of daily living with minimal assistance.

Review for the Curriculum and License Exam of Physical Therapists in the United States

PURPOSE: This study was conducted to review the curriculum and license examination of physical therapists in the United States. METHODS: The doctor of physical therapy (DPT) curriculum was evaluated by a review Course Work Tool version 6 (CWT6) data and current physical therapy licensure examination (National Physical Therapy Exam, NPTE) category in the United States. RESULTS: The results indicated that they were required to meet the doctor of physical therapist degree based on ‘Guide to Physical Therapist Practice’ of American Physical Therapy Association (APTA). This includes general education in the areas of communications and humanities, physical science, biological science, social and behavioral science, and mathematics. A minimum of one course must be completed successfully in each area of general education. Moreover, there should be at least 68 didactic credits of professional education and 22 clinical education credits, which is a minimum of two full-time clinical internships with no less than 1050 hours in total, which were supervised by a physical therapist. Regarding the physical therapy licensure examination, National Physical Therapy Exam (NPTE, 2016) consisted of a physical therapy examination (26.5%), evaluation, differential diagnosis, baseline of prognosis (32.5%), intervention (28.5%), protection, responsibility, and research (6.5%) based on the ‘Guide to Physical Therapist Practice’. CONCLUSION: Based on the study results provided above, it is considered a standard to meet domestic reality as the Guide to Physical Therapist Practice of APTA for South Korean physical therapists.