Research Designs and Statistical Methods Trends in the Annals of Rehabilitation Medicine.

OBJECTIVE: To investigate trends of the research designs and statistical methods in the Annals of Rehabilitation Medicine (ARM) published from 2005 to 2015 through a comparison of articles with the Archives of Physical Medicine and Rehabilitation (APMR). METHODS: The authors reviewed all articles published in ARM and APMR for the years 2005 and 2015 in order to determine their research designs as well as their statistical methods used in each article. RESULTS: In ARM, randomized controlled trials increased from 4.5% in 2005 to 6.5% in 2015. In APMR, randomized controlled trials increased from 8.1% in 2005 to 14.0% in 2015, meta-analyses increased to 5.3%, and systematic reviews increased to 6%. The number of studies using statistical methods increased in ARM from 1.9 to 2.6 per article and in APMR, from 2.7 to 3.1. Use of advanced methods in ARM also showed an increase from 2005 to 2015. CONCLUSION: This study concludes that there is a trend of increased awareness and attempts to use varied research approaches in ARM articles. There should also be more in-depth discussions and opportunities for researchers to share their experiences regarding statistical methods in the clinical field.

Erratum: A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea.

[This corrects the article on p. 793 in vol. 30, PMID: 26028934.].

Heterotopic ossification in a tetraplegic patient with prolonged fever.

OBJECTIVE: Prolonged fever is rare in patients with spinal cord injury. Fever has been shown to be associated with hetero-topic ossification, but prolonged fever is very rare. We report here a case of prolonged fever in a tetraplegic patient who was eventually diagnosed with heterotrophic ossification, and provide a review of the literature. Treatment with sodium etidronate resolved the fever. CASE REPORT: A 51-year-old man with C3 tetraplegia developed prolonged fever (37.5-39.4°C). Fever workup did not reveal a definite origin of the fever. Non-infectious disease was suspected. The patient was diagnosed with heterotopic ossification after 3-phase bone scintigraphy. Oral sodium etidronate treatment was started immediately at a dose of 20 mg/kg/day after diagnosis. On the 14th day of administration, the patient's body temperature decreased to the normal range and remained stable. CONCLUSION: Heterotopic ossification should be taken into consideration when examining patients with spinal cord injury who have prolonged fever. This case shows that hetero-topic ossification can be treated successfully with sodium etidronate.

A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea.

Objective personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI), might be more sensitive to reflect subclinical personality and be more state-dependent in an individual's lifetime, so they are good scales to predict the psychological distress regarding certain states. The aim of this study was to identify the specific pattern between body mass index (BMI) and psychological distress using the objective personality test. For this study, we investigated BMI and the Korean Military Multiphasic Personality Inventory (MPI). A retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2007 to January 2010. Of 1,088,107 examinees, we enrolled 771,408 subjects who were psychologically apparent healthy possible-military-service groups. Afterwards, we reviewed and analyzed directly measured BMI and MPI results. In terms of the validity scales, the faking-good subscale showed an inverted U-shaped association, and faking-bad and infrequency subscales showed a U-shaped association with BMI groups. In terms of the neurosis scales, all clinical subscales (anxiety, depression, somatization, and personality disorder) also showed a U-shaped association with BMI groups. For the psychopath scales, the schizophrenia subscale showed a U-shaped association, and the paranoia subscale showed a near-positive correlation with BMI. In conclusion, a specific U-shaped pattern was observed between BMI and the MPI in 19-yr-old men in Korea. Underweight and obesity are related to psychological distress, so supportive advice and education are needed to them.

Necessity to develop a tool to evaluate activity of daily living for electric powered indoor/outdoor chair users.

OBJECTIVE: To evaluate changes in activity of daily living before and after provision of electric-powered indoor/outdoor chair (EPIOC), discuss problems of current activities of daily living (ADL) evaluating tools for EPIOC users, and provide preliminary data to develop ADL evaluation tool for EPIOC user. METHODS: A total of 70 users who were prescribed EPIOC and had been using for more than 1 year were recruited in this study. Before and after provision of EPIOC, MBI and FIM scores were measured and a questionnaire consisting of six categories (general socioeconomic states, currently using state, whether EPIOC was helpful for social participation and occupational chances, psychiatric influences, self-reported degrees of independency, and barriers of using EPIOC) was used. RESULTS: No difference in MBI scores before and after provision of EPIOC was observed. However, the wheelchair ambulation category showed a significant difference. While motor FIM was not significantly different from MBI, FIM score were significantly (p<0.05) higher than MBI. For questions regarding social participation frequency, helpfulness of EPIOC on confidence, refreshing patients' emotions and self-reported degrees of independence, all of them showed positive responses. Especially, EPIOC users' self-reported degree of independency showed favorable results. There was discrepancy in MBI or FIM measured by physicians. CONCLUSION: Our study showed that there was a gap between the existing ADL evaluation tool and the ADL level that EPIOC users were actually feeling. Thus, it is necessary to develop an evaluation tool specifically for EPIOC.

Complete Oculomotor Nerve Palsy Caused by Direct Compression of the Posterior Cerebral Artery.

Oculomotor nerve palsy frequently occurs because of external compression by an internal carotid-posterior communicating artery aneurysm and diabetes mellitus. In addition, pontine infarction, cavernous sinus tumors, demyelinating disease, and autoimmune disorder are well-known causes of oculomotor nerve palsy. However, cases of complete oculomotor nerve palsy by neurovascular conflicts presented with a sudden onset of clinical symptoms are extremely rare. We experienced a rare case of complete oculomotor nerve palsy because of direct vascular compression of the oculomotor nerve by the posterior cerebral artery.

Central hyperthermia treated with baclofen for patient with pontine hemorrhage.

Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5℃ to 39.2℃. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6℃ to 38.2℃. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.

Analysis of publication status of abstracts presented at the annual meeting of the korean academy of rehabilitation medicine.

OBJECTIVE: To analyze publication rate, time to publication and the characteristics of the abstracts presented at the annual Korean Academy of Rehabilitation Medicine (KARM) meetings. METHODS: A total of 1,027 abstracts presented at the 2008 and 2009 annual KARM meetings were enrolled in the database and searched for their subsequent citation in PubMed, KoreaMed, and Google Scholar. RESULTS: The data analysis revealed that 317 (30.87%) abstracts, were published as full-length journal articles and publication rates by subject were not significantly different. The mean time to publication was 17.17±10.48 months, and the journals written in English (20.39±10.20) required a longer duration than those written in Korean (11.94±8.44) with statistical significance (p<0.001). There was no statistical difference (p=0.284) in the duration between domestic (17.61±10.37) and foreign (16.48±10.51) of the 220 domestic journal articles, 190 (86.76%) were published in the Annals of Rehabilitation Medicine and the 97 articles published in foreign journals were scattered over 60 different journals. CONCLUSION: The publication rate of abstracts presented at the 2008 and 2009 annual KARM meetings was 30.87% and the mean time to publication was 17.17±10.48 months.

Therapeutic effects of mechanical horseback riding on gait and balance ability in stroke patients.

OBJECTIVE: To investigate the therapeutic effects of mechanical horseback riding for gait and balance parameters in post-stroke patients. METHOD: This study was a non randomized prospective positive-controlled trial over a 12 week period. From May 2011 to October 2011, 37 stroke patients were recruited from our outpatient clinic and divided into two groups. The control group received the conventional physiotherapy while the intervention group received the conventional physiotherapy along with mechanical horseback riding therapy for 12 weeks. Outcome measurements of gait included the Functional Ambulation Category (FAC) and gait part of the Performance Oriented Mobility Assessment (G-POMA) while those of balance included the Berg Balance Scale (BBS) and the balance part of the Performance Oriented Mobility Assessment (B-POMA). These measurements were taken before and after treatment. RESULTS: There were no significant differences in the baseline characteristics and initial values between the two groups. When comparing baseline and 12 weeks post treatment in each group, the intervention group showed significant improvement on BBS (39.9±5.7 → 45.7±4.8, p=0.001) and B-POMA (10.4±2.6 → 12.6±2.1, p=0.001), but significant improvement on gait parameters. When comparing the groups, the dynamic balance category of BBS in post treatment showed significant difference (p=0.02). CONCLUSION: This study suggests that mechanical horseback riding therapy may be an effective treatment tool for enhancing balance in adults with stroke.