In Vitro Evaluation of Implant Surface Decontamination Methods Based on Removal and Regrowth of Microorganisms.

PURPOSE: The efficiency of bacterial removal using mechanical and chemical methods and recurrence rates was evaluated based on infected implant surface removal modalities. MATERIALS AND METHODS: The study comprises two main parts: in vitro bacterial removal (n = 49) and regrowth (n = 42) suppression tests on implant surfaces. Microorganisms were attached to each implant, and various methods were applied to clean the infected implants. The groups were allocated as follows: (1) no treatment, (2) cotton + saline, (3) brush, (4) scaler, (5) brush + scaler, (6) cotton + 3% H2O2, and (7) brush + 3% H2O2. All groups were further divided into two subgroups of mechanical treatment (3, 4, 5) vs mechanical + chemical treatment (2, 6, 7). After treatment for each group, immunofluorescence analysis and measurement using an ultraviolet-visible light spectrophotometer were performed. RESULTS: In the mechanical treatment group, the brush, scaler, and brush + scaler groups, all of which had strong polishing abilities, exhibited superior removal efficiency compared with the other groups (P < .001). In the regrowth experiment, 3% H2O2 effectively restrained biofilm formation. In particular, the brush + 3% H2O2 group exhibited significant differences from the mechanical treatment group (vs brush: P < .001, vs scaler: P = .023, vs brush + scaler: P = .005). CONCLUSION: Mechanical methods, including brushes and scalers, effectively removed bacteria. Biofilm formation was effectively restrained by H2O2. In particular, the brush + H2O2 group exhibited a superior ability to suppress bacterial regrowth compared with the other groups.

Influence of Electrotherapy with Task-Oriented Training on Spasticity, Hand Function, Upper Limb Function, and Activities of Daily Living in Patients with Subacute Stroke: A Double-Blinded, Randomized, Controlled Trial.

The effects of electrotherapy with task-oriented training on upper limb function in subacute stroke patients are unclear. This study investigated the influence of transcutaneous electrical nerve stimulation (TENS) with task-oriented training on spasticity, hand function, upper limb function, and activities of daily living in patients with subacute stroke. Forty-eight patients with subacute stroke were randomly assigned to either the TENS group (n = 22) or the placebo-TENS group (n = 21). High-frequency (100 Hz) TENS with below-motor threshold intensity or placebo-TENS was applied for 30 min/day, five times a week, for 4 weeks. The two groups also received task-oriented training after TENS. The Modified Ashworth Scale (MAS), Jebsen-Taylor Hand Function Test (JTHFT), Manual Function Test (MFT), and Modified Barthel Index (MBI) were used to assess spasticity, hand function, upper limb function, and activities of daily living, respectively. There was a significant time-group interaction with the MFT (p = 0.003). The TENS group showed significantly improved MAS (p = 0.003), JTHFT (p < 0.001), MFT (p < 0.001), and MBI (p < 0.001) scores after the intervention. The placebo-TENS group showed significantly improved JTHFT (p < 0.001), MFT (p = 0.001), and MBI scores (p < 0.001). There was a significant correlation between the MFT and MBI scores (p = 0.025). These results suggest that electrotherapy with task-oriented training can be used to improve upper limb function in patients with subacute stroke.

Factors Influencing Self-Rated Oral Health in Elderly People Residing in the Community: Results from the Korea Community Health Survey, 2016.

OBJECTIVES: The aim of this study was to examine the factors influencing perceived oral health in elderly individuals residing in the community. METHODS: This study used raw data from the Korea community health survey, 2016. Of the 64,223 participants that were elderly (aged ≥ 65 years), 61,280 (95.4%) were included for analysis. Self-rated oral health was the dependent variable and 6 independent variables including age, gender, type of area of residence (metropolitan or provincial), educational level, income, and living status with spouse were assessed. Oral function was studied based on mastication, pronunciation, and use of dentures, and oral health behavior included brushing teeth after breakfast, after lunch, after dinner, and before sleep). The EQ-5D questionnaire measured health-related quality of life (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). RESULTS: Among the general characteristics, age, gender, educational level, income, and living status with spouse were the factors that affected self-rated oral health. Mastication, pronunciation, use of dentures, and brushing after lunch, dinner, and before sleep were the factors that influenced self-rated oral function. All domains of the EQ-5D (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression) were factors that affected self-rated oral health. CONCLUSION: The results of the current investigation suggest that the development of management and education strategies for oral health promotion in the elderly, should focus on improving oral function and oral health behavior, taking into account the socio-economic and demographic characteristics that have been shown to be associated with poor self-rated oral function.

Effect of a Multicomponent Intervention Program on Community-Dwelling People With Intellectual Disabilities.

OBJECTIVE: To investigate the effectiveness of a novel and complex intervention in community-dwelling people with intellectual disabilities. METHODS: Forty-three participants completed the experiment. The subjects were randomly assigned the experimental (n=33) or control (n=10) groups. The multicomponent intervention program comprised exercise and nutrition management and behavior modification. The intervention was performed for 60 minutes once weekly for 10 weeks. The assessment included anthropometric data, body composition and blood pressure analysis, and blood tests. In addition, pulmonary function, physical function, and health-related quality of life were measured before and after the intervention. RESULTS: No adverse events occurred during the intervention. After the intervention, the experimental group showed a significantly higher increase in high-density lipoprotein cholesterol level than did the control group (effect size=0.152, p=0.019). CONCLUSION: This innovative intervention was effective in improving cardiovascular health. Even greater effects could be achieved through improvements in implementation strategies to increase compliance.

Factors Affecting Activity Limitation in the Elderly: Data Processed from the Korea National Health and Nutrition Examination Survey, 2016.

OBJECTIVES: The aim of this study was to compare the sociodemographic characteristics, depression, and the health-related quality of life outcome, among the Korean elderly population, with and without activity limitation. METHODS: The data used was drawn from the raw data of the seventh Korea National Health and Nutrition Examination Survey (N = 8,150). There were 1,632 records for individuals aged 65 or older extracted from the seventh Korea National Health and Nutrition Examination Survey database, 199 of those had missing responses (n = 1,433). Differences within the sociodemographic characteristic, the Patient Health Questionnaire-9, and the EuroQol-5 Dimension were analyzed using logistic regression analysis according to the presence or absence of activity limitation. RESULTS: The prevalence of activity limitation among the elderly individuals surveyed was 19.9%. In the unadjusted regression analysis, the odds ratios of all independent variables (age, gender, education level, type of region, family income, the Patient Health Questionnaire-9, all 5 domains of the EuroQol-5 Dimension) between the elderly individuals with and without activity limitation, were significant. Although, in the adjusted logistic regression analysis, it was observed that the only factors that were significantly associated with activity limitation were the Patient Health Questionnaire-9, EuroQol-5 Dimension, type of region, and family income. CONCLUSION: These findings demonstrated that activity limitation in elderly individuals is associated with the sociodemographic characteristics of family income and type of region of residence, as well as depression and the health-related quality of life outcome.

An Investigation into Chronic Conditions and Diseases in Minors to Determine the Socioeconomic Status, Medical Use and Expenditure According to Data from the Korea Health Panel, 2015.

OBJECTIVES: This study compared the socioeconomic status, medical use and expenditures for infants (1-5 years), juveniles (6-12 years), and adolescents (13-19 years) with a chronic condition or disease to determine factors affecting health spending. METHODS: Data from 3,677 minors (< 20 years old, without disabilities) were extracted from the Korea Health Panel (2015) database. RESULTS: Minors with chronic conditions or diseases were older (juveniles, and adolescents; p < 0.001), and included a higher proportion of Medicaid recipients (p = 0.004), a higher use of hospital outpatient care (p < 0.001), and higher medical expenditure (p < 0.001) compared to minors without chronic conditions or diseases. Boys were more likely to have a chronic condition or disease than girls (p = 0.036). Adolescents and juveniles were more likely than infants to have a chronic condition or disease (p = 0.001). Medicaid recipients were more likely to have a chronic condition or disease than those who were not Medicaid recipients (p = 0.008). Minors who had been hospital outpatients were more likely to have a chronic condition or disease, compared with minors who had not been an outpatient (p = 0.001). Having a chronic condition or disease, was a factor increasing medical expenditure (p = 0.001). Medical expenditure was higher in infants than in juveniles and adolescents (p = 0.001). Infants had higher rates of medical use when compared with juveniles and adolescents (p = 0.001). CONCLUSION: These findings suggest that systematic health care management for minors with chronic conditions or diseases, is needed.

The Effects of Task-Oriented Circuit Training Using Rehabilitation Tools on the Upper-Extremity Functions and Daily Activities of Patients with Acute Stroke: A Randomized Controlled Pilot Trial.

OBJECTIVES: The purpose of this study was to investigate the effect of task-oriented circuit training (TOCT) using the rehabilitation tools for upper extremity function upon the daily life of patients with acute stroke. METHODS: Eighteen patients with acute stroke were randomly allocated into either the experimental group or the control group. The experimental group performed the TOCT program using rehabilitation tools, whilst the control group had neuro-developmental treatment. Both groups received 30 minutes of treatment per session, 5~6 times per week, for 4 weeks. The assessments conducted were the Fugl-Meyer assessment, motor activity log and stroke impact scale to compare the upper extremity function and activities of daily living. RESULTS: The results showed a significant improvement in the TOCT group compared with the neuro-developmental treatment group in the amount of motor activity use and high stroke impact score, indicating recovery (p < 0.05). CONCLUSION: The TOCT program using rehabilitation tools could have a positive impact on acute stroke patients use of their upper extremity.

Effect of a cervical support pillow on sternocleidomastoid activity and satisfaction in asymptomatic participants.

[Purpose] The aim of this study was to examine the changes in sternocleidomastoid muscle (SCM) activity when using a cervical support pillow (CSP) and to determine the pillow's effect on satisfaction in asymptomatic participants. [Subjects and Methods] This study followed a cross-over design and the order of the measurements was counterbalanced. Twenty asymptomatic participants were positioned supine for 5 minutes by using either a CSP or a general pillow (GP) while the activity of the SCM was measured using surface electromyography. [Results] The CSP significantly decreased the activity of the SCM compared with the GP, and satisfaction after use of the CSP was significantly greater than that after use of the GP. [Conclusion] This study suggests that the CSP may be effective in preventing unnecessary neck muscle activation during sleep in asymptomatic people.

The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia: a preliminary randomized clinical trial.

Tongue pressure strength and accuracy training (TPSAT) has been proposed as an intervention to improve dysphagia. However, the effects of TPSAT on dysphagia in subacute stroke patients remain unclear. The aim of this study was to investigate the effects of TPSAT on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. Sixteen subacute stroke patients were assigned randomly to two groups: the TPSAT group (n=8) or the control group (n=8). In the former, both TPSAT and traditional dysphagia therapies were performed for 30 min each per day; in the latter, only traditional dysphagia therapy was performed for 30 min twice a day. Both groups performed each daily intervention five times per week for 8 weeks. To assess the tongue pressure strength, maximum isometric tongue pressures (MIPs) of the anterior and posterior tongue using the Iowa Oral Performance Instrument were measured before and after the intervention. Mann Assessment of Swallowing Ability (MASA) and Swallowing-Quality of Life (SWAL-QOL) were also used to assess the swallowing function and quality of life, respectively. TPSAT with traditional dysphagia therapy significantly improved MASA, SWAL-QOL, and MIPs both anteriorly and posteriorly, and traditional dysphagia therapy significantly increased MASA, SWAL-QOL, and MIPs anteriorly (P<0.05). The TPSAT group showed a significant improvement in anterior and posterior MIPs and tongue movement score in MASA compared with the control group (P<0.05). Our findings suggest that TPSAT may significantly improve dysphagia management in subacute stroke patients.

Effects of chin tuck exercise using neckline slimmer device on suprahyoid and sternocleidomastoid muscle activation in healthy adults.

[Purpose] This study investigated the effect of chin tuck exercise (CTE) using a neckline slimmer device on suprahyoid (SH) and sternocleidomastoid (SCM) muscle activation in healthy adults. [Subjects and Methods] We measured activation of the SH and SCM muscles using surface electromyography in 20 healthy adults during head lift exercise (HLE) and CTE using a neckline slimmer device. The order of exercises was randomized and the mean and peak values of each muscle's activation were assessed. [Results] During the CTE using a neckline slimmer device, SH activation was significantly greater and SCM activation was significantly lower than during the HLE. [Conclusion] This study suggest that chin-tuck exercise using a neckline slimmer device may be more helpful than HLE for swallowing training.

Effects of lumbar lordosis assistive support on craniovertebral angle and mechanical properties of the upper trapezius muscle in subjects with forward head posture.

[Purpose] The aim of this study was to investigate the effect of lumbar lordosis assistive support (LLAS) on craniovertebral angle (CVA) and mechanical properties of the upper trapezius (UT) muscle in subjects with forward head posture (FHP). [Subjects and Methods] This study recruited 20 subjects with FHP. CVA and muscle tone, viscoelasticity, and stiffness of the UT were measured using Myoton in all subjects in a sitting position with LLAS and in a neutral sitting position. The order of measurements was randomized and the mean values were calculated twice. [Results] The sitting position with LLAS showed a significantly greater improvement than the neutral sitting position with regard to CVA and muscle tone, viscoelasticity, and stiffness of the UT. [Conclusion] We suggest that the sitting position using LLAS induces the maintenance of normal neck posture and a reduction in the muscle tone of the UT in the subjects with FHP.

The effects of task-oriented training on hand dexterity and strength in children with spastic hemiplegic cerebral palsy: a preliminary study.

[Purpose] The purpose of this study was to investigate the effects of task-oriented training (TOT) on hand dexterity and strength in children with spastic hemiplegic cerebral palsy. [Subjects and Methods] Twelve children with spastic hemiplegic cerebral palsy were randomly assigned to either the TOT group (n=6) or the control group (n=6). In both groups, conventional occupational therapy was performed 40-min/day, 2 times a week, for 4 weeks. In the TOT group, TOT was additionally performed for 20 min, and the control group received usual care. The box and block test (BBT) was performed to assess hand dexterity. Hand strength was also assessed using hand dynamometer. [Results] After intervention, the TOT group showed a significant improvement of hand dexterity. In the control group, BBT and grip strength were not significantly improved after intervention. [Conclusion] In clinical settings, we suggest that TOT may be used as an intervention to improve hand dexterity in children with spastic hemiplegic cerebral palsy.

The Mechanical Properties and Biometrical Effect of 3D Preformed Titanium Membrane for Guided Bone Regeneration on Alveolar Bone Defect.

The purpose of this study is to evaluate the effect of three-dimensional preformed titanium membrane (3D-PFTM) to enhance mechanical properties and ability of bone regeneration on the peri-implant bone defect. 3D-PFTMs by new mechanically compressive molding technology and manually shaped- (MS-) PFTMs by hand manipulation were applied in artificial peri-implant bone defect model for static compressive load test and cyclic fatigue load test. In 12 implants installed in the mandibular of three beagle dogs, six 3D-PFTMs, and six collagen membranes (CM) randomly were applied to 2.5 mm peri-implant buccal bone defect with particulate bone graft materials for guided bone regeneration (GBR). The 3D-PFTM group showed about 7.4 times higher mechanical stiffness and 5 times higher fatigue resistance than the MS-PFTM group. The levels of the new bone area (NBA, %), the bone-to-implant contact (BIC, %), distance from the new bone to the old bone (NB-OB, %), and distance from the osseointegration to the old bone (OI-OB, %) were significantly higher in the 3D-PFTM group than the CM group (p < .001). It was verified that the 3D-PFTM increased mechanical properties which were effective in supporting the space maintenance ability and stabilizing the particulate bone grafts, which led to highly efficient bone regeneration.

The effects of spinal support device on pain and extensibility of the hamstrings in patients with non-specific low back pain.

[Purpose] The objective of this study was to investigate the effects of spinal support device (SSD) on pain and hamstring extensibility in patients with non-specific low back pain (NSLBP). [Subjects and Methods] 20 patients with NSLBP were recruited and randomly assigned to either the SSD group or the control group. In the SSD group, SSD was applied; in the control group, bed rest in supine position was performed. Both groups underwent treatment 20 min/day, 3 times a week, for a duration of 4 weeks. To assess the hamstring extensibility, sit and reach test (SRT) was performed. To assess pain pressure threshold (PPT) of the sacroiliac joint, a pressure algometer was used. Visual analog scale (VAS) was used to quantify pain. [Results] The SSD group showed a significant improvement in sacroiliac joint pain with increased VAS, and the control group showed a significantly increased VAS after intervention. In the SSD group, VAS was significantly increased, but SRT was not changed compared with the control group. [Conclusion] These results demonstrated that an application of SSD effectively attenuates low back pain. Therefore, SSD may be a suitable intervention for pain control in patients with NSLBP.

Effects of lingual strength training on lingual strength and articulator function in stroke patients with dysarthria.

[Purpose] This study investigated the effects of lingual strength training (LST) on lingual strength and articulator function in stroke patients with dysarthria. [Subjects and Methods] 16 stroke patients with dysarthria were randomly assigned into two groups: the experimental group (n=8) or the control group (n=8). Both groups received the conventional rehabilitation therapy at 30 min/day, 5 times for week, and during 4 weeks, and the experimental group received an additional 30 min of LST using the Iowa Oral Performance Instrument (IOPI). The Maximum Isometric Tongue Pressures (MIPs) was used to assess the lingual strength and the Alternating-Motion Rate (AMR) and Sequential-Motion Rate (SMR) were used to measure the articulator function. [Results] After the intervention, the experimental group showed a significant improvement in MIPs and AMR (/tə/) than the control group. [Conclusion] Findings of this study suggest that LST provides positive effects on lingual strength and articulator function, and thus can be used as an interventional method in stroke patients with dysarthria.

Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia.

[Purpose] This study was conducted to identify the effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia. [Subjects and Methods] A total of 18 stroke patients with dysphagia were enrolled in the study. All participants were randomly assigned to either an experimental group (n=9) or a control group (n=9). All participants performed traditional-swallowing rehabilitation therapy in 30-minute sessions five times a week for four weeks; however, only the experimental group received expiratory muscle strength training. [Results] Both groups showed significant improvements after mediation. When compared with the control group, the functional dysphagia scale, vallecular residue, and penetration-aspiration scale were significantly improved in the experimental group. [Conclusion] Expiratory muscle strength training is an effective intervention for impaired swallowing function in acute strike patients with dysphagia.

Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain.

[Purpose] The purpose of this study was to analyze the effect of Graston Technique on hamstring extensibility and pain intensity in patients with nonspecific low back pain. [Subjects and Methods] Twenty-four patients with nonspecific low back pain (27-46 years of age) enrolled in the study. All participants were randomly assigned to one of two groups: Graston technique group (n=12) and a static stretching group (n=12). The Graston Technique was used on the hamstring muscles of the experimental group, while the static stretching group performed static stretching. Hamstring extensibility was recorded using the sit and reach test, and a visual analog scale was used to measure pain intensity. [Results] Both groups showed a significant improvement after intervention. In comparison to the static stretching group, the Graston technique group had significantly more improvement in hamstring extensibility. [Conclusion] The Graston Technique is a simple and effective intervention in nonspecific low back pain patients to improve hamstring extensibility and lower pain intensity, and it would be beneficial in clinical practice.