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Original Articles

Spinal cord injury

Epidemiology of Spinal Cord Injury: Changes to Its Cause Amid Aging Population, a Single Center Study
Ha Seong Kim, Kil-Byung Lim, Jiyong Kim, Joongmo Kang, Hojin Lee, Sang Wan Lee, Jeehyun Yoo
Ann Rehabil Med 2021;45(1):7-15.   Published online February 9, 2021
DOI: https://doi.org/10.5535/arm.20148
Objective
To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital.
Methods
This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed.
Results
Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%).
Conclusion
The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

Citations

Citations to this article as recorded by  
  • Prevalence of opioid use in adults with spinal cord injury: A systematic review and meta-analysis
    Samantha J. Borg, Cate M. Cameron, Karen Luetsch, Adam Rolley, Timothy Geraghty, Steven McPhail, Victoria McCreanor
    The Journal of Spinal Cord Medicine.2025; 48(2): 170.     CrossRef
  • The potential role of RhoA/ROCK-inhibition on locomotor recovery after spinal cord injury: a systematic review of in-vivo studies
    Armin Khavandegar, Negar Sadat Ahmadi, Maryam Alsadat Mousavi, Zahra Ramezani, Elaheh Khodadoust, Mahgol Sadat Hasan Zadeh Tabatabaei, Zahra Hasanpour Segherlou, Arman Zeinaddini-Meymand, Fatemeh Nasehi, Maral Moafi, Kimia RayatSanati, Rasool Masoomi, Sor
    Spinal Cord.2025; 63(3): 95.     CrossRef
  • Animal Models of Spinal Cord Injury
    Vladislav E. Sobolev, Yuriy I. Sysoev, Tatiana V. Vyunova, Pavel E. Musienko
    Biomedicines.2025; 13(6): 1427.     CrossRef
  • Research Progress of Early Tracheotomy in Patients with Cervical Spinal Cord Injury
    娇 彭
    Nursing Science.2024; 13(01): 42.     CrossRef
  • Assessing Regional Weather’s Impact on Spinal Cord Injury Survivors, Caregivers, and General Public in Miami, Florida
    Danielle Hildegard Bass, Pardis Ghamasaee, Gregory E. Bigford, Mandeville Wakefield, Lunthita M. Duthely, Daniel Samano
    International Journal of Environmental Research and Public Health.2024; 21(4): 382.     CrossRef
  • Pathophysiology of spinal cord injury and potential health benefits of omega-3 fatty acid
    Waliullah Shah, Ara Zeenat, Lafi Al-Otaibi Mohammed, Alam Khurshid, Shatakshi
    International Journal of Medicine and Medical Sciences.2024; 16(1): 15.     CrossRef
  • The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement
    Beverley Catharine Craven, Emma A. Bateman, Heather Flett, Farnoosh Farahani, Dalton L. Wolfe, Sussan Askari, Maryam Omidvar, Mohammad Alavinia
    Healthcare.2024; 12(11): 1084.     CrossRef
  • The burden and psychosocial impact on immediate caregivers of patients with spinal cord injury in a tertiary health facility, Edo State, Nigeria
    Timothy Aghoghko Ehwarieme, Uzezi Josiah, Auwuli Emina
    Journal of Integrative Nursing.2024; 6(2): 103.     CrossRef
  • Ozone therapy vs. classical treatment in musculoskeletal disorders
    Maricela Dragomir, Claudiu Mereuță, Carmen Gheorghe
    Balneo and PRM Research Journal.2024; 15(Vol.15, no): 739.     CrossRef
  • Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review
    Lucie Bourguignon, Louis P. Lukas, Bethany R. Kondiles, Bobo Tong, Jaimie J. Lee, Tomás Gomes, Wolfram Tetzlaff, John L. K. Kramer, Matthias Walter, Catherine R. Jutzeler
    Communications Medicine.2024;[Epub]     CrossRef
  • p53/HIF-1α regulates neuronal aging and autophagy in spinal cord ischemia/reperfusion injury
    Xingzhen Liu, Jia Wang, Kangping Shen, Wenjie Jin
    Mechanisms of Ageing and Development.2024; 222: 112000.     CrossRef
  • Improving current understanding of cognitive impairment in patients with a spinal cord injury: A UK-based clinician survey
    Hamish Patel, Daniel Blackburn, Ram Hariharan, Krishnan Padmakumari Sivaraman Nair, Simon M. Bell
    The Journal of Spinal Cord Medicine.2024; : 1.     CrossRef
  • The Role of Psychological Variables in Predicting Rehabilitation Outcomes After Spinal Cord Injury: An Artificial Neural Networks Study
    Marta Mascanzoni, Alessia Luciani, Federica Tamburella, Marco Iosa, Emanuela Lena, Sergio Di Fonzo, Valerio Pisani, Maria Carmela Di Lucente, Vincenzo Caretti, Lucia Sideli, Gaia Cuzzocrea, Giorgio Scivoletto
    Journal of Clinical Medicine.2024; 13(23): 7114.     CrossRef
  • Trends in the Incidence and Etiology of Non-Traumatic Spinal Cord Injury in Korea: A Nationwide Population-Based Study From 2007 to 2020
    Yoonjeong Choi, Ja-Ho Leigh, Jooeun Jeon, Goo Joo Lee, Hyung-Ik Shin, Moon Suk Bang
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data
    Nancy P. Thorogood, Vanessa K. Noonan, Xiaozhi Chen, Nader Fallah, Suzanne Humphreys, Nicolas Dea, Brian K. Kwon, Marcel F. Dvorak
    Frontiers in Neurology.2023;[Epub]     CrossRef
  • Epidemiology and Assessment of Traumatic Spinal Cord Injury With Concomitant Brain Injury: An Observational Study in a Regional Trauma Center
    Tae Woong Yang, Dong Ho Yoo, Sungchul Huh, Myung Hun Jang, Yong Beom Shin, Sang Hun Kim
    Annals of Rehabilitation Medicine.2023; 47(5): 385.     CrossRef
  • The Correlation between Lumbosacral Transitional Anatomy and Pars Defect
    Gabriel S. Gonzales-Portillo, Mauricio J. Avila, Omar Rizvi, Travis M. Dumont
    Indian Spine Journal.2022; 5(2): 209.     CrossRef
  • Impact of Mechanism of Injury on Long-term Neurological Outcomes of Cervical Sensorimotor Complete Acute Traumatic Spinal Cord Injury
    Alex B. Bak, Ali Moghaddamjou, Anahita Malvea, Michael G. Fehlings
    Neurospine.2022; 19(4): 1049.     CrossRef
  • 7,098 View
  • 157 Download
  • 15 Web of Science
  • 18 Crossref

Spinal cord injury

Correlation Between Duration From Injury and Bone Mineral Density in Individuals With Spinal Cord Injury
Hyehoon Choi, So-youn Chang, Jaewan Yoo, Seong Hoon Lim, Bo Young Hong, Joon Sung Kim
Ann Rehabil Med 2021;45(1):1-6.   Published online February 9, 2021
DOI: https://doi.org/10.5535/arm.20169
Objective
To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI).
Methods
Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients’ most recent dual energy X-ray absorptiometry images were reviewed. According to the 2007 International Society for Clinical Densitometry guidelines, vertebrae with a local structural change were excluded when deriving spine BMD. If one or no vertebra is suitable for evaluation, spine BMD was judged as “improper for assessment”. Correlation analysis was performed between duration from injury and BMD Z-scores of the hip and spine.
Results
Among 83 individuals with SCI, the spines of 44 were judged as improper for assessment. The correlation analysis showed a significant negative relationship between the duration from injury and femur neck BMD (r=-0.40, p<0.01) and total proximal femur BMD (r=-0.39, p<0.01). However, no significant correlation was found between the duration from injury and spine BMD Z-score.
Conclusion
The duration of SCI correlated with hip BMD, but not with spine BMD. Further, more than half of the individuals with SCI could not undergo spinal assessment due to local structural changes. Therefore, spine BMD measurement is not an appropriate method for predicting future fracture risk in those with SCI.

Citations

Citations to this article as recorded by  
  • “I think it was helpful but not as helpful as it could have been” - a qualitative study of the experiences and perspectives of using fitness apps among manual wheelchair users with spinal cord injury
    Claire Hickey, Éimear Smith, Sara Hayes
    Disability and Rehabilitation.2025; 47(3): 633.     CrossRef
  • Bone Mineral Density Post a Spinal Cord Injury: A Review of the Current Literature Guidelines
    Georgia Antoniou, Ioannis S Benetos, John Vlamis, Spyros G Pneumaticos
    Cureus.2022;[Epub]     CrossRef
  • 5,494 View
  • 203 Download
  • 2 Web of Science
  • 2 Crossref

Image in This Issue

Delayed Lymphedema due to Activated Axillary Lymph Node Dysfunction in a Patient With Breast Cancer
Dong Gyu Lee
Ann Rehabil Med 2020;44(6):510-511.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20059

Citations

Citations to this article as recorded by  
  • Estimation of Hand Function Impairment in Breast Cancer Survivors with Lymphedema
    Sandeep B. Shinde, Pooja P. Jain, Diksha S. Jagwani, Sanjay K. Patil, Anand Gudur, Ravindra V. Shinde
    South Asian Journal of Cancer.2025; 14(01): 023.     CrossRef
  • Can Tissue Stiffness Measured Using Shear-Wave Elastography Represent Lymphedema in Breast Cancer?
    Dong Gyu Lee, Jang Hyuk Cho
    Lymphatic Research and Biology.2022; 20(6): 607.     CrossRef
  • Lymphoscintigraphy in patients with breast cancer-related lymphedema after sentinel lymph node dissection and axillary radiation therapy
    Se Hyun Oh, Ju Hyeon Kim, Seung Tae Seong, Jun Young Park, Jae Hyun Lee, Ghi Chan Kim, Ho Joong Jeong, Young Joo Sim
    Medicine.2022; 101(49): e31985.     CrossRef
  • 4,086 View
  • 96 Download
  • 3 Web of Science
  • 3 Crossref

Original Articles

Knee Extensor Strength Measurement in Patients With Limited Physical Activity Using a Supine Dynamometer Anchoring Frame
Min-Yong Lee, Kwan-Sik Sung, Hyungsuk Ham, You Gyoung Yi, Hyung-Ik Shin
Ann Rehabil Med 2020;44(6):502-509.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20056
Objective
To investigate the reliability of knee extensor strength measurements using a supine hand-held dynamometer (HHD) anchoring frame in patients with limited physical activity. Although an HHD is suitable for bedside use, its inter-rater reliability is low because measurements can be influenced by tester strength.
Methods
Maximal knee extensor isometric strength was measured using an HHD anchored to the supine frame. Three trials of three maximal contractions were assessed by two raters.
Results
A total of 33 inpatients who were non-ambulatory due to acute illness participated in the study. The intraclass correlation coefficients were 0.974 (inter-rater) and 0.959 (intra-rater). The minimal detectable changes in intra- and inter-observer measurements were 29.46 N (24.10%) and 36.73 N (29.26%), respectively. The limits of agreement ranged from -19.79% to 24.81% for intra-rater agreement and from -21.45% to 37.07% for inter-rater agreement.
Conclusion
The portable dynamometer anchoring system can measure the isometric strength of the knee extensor reliably in the supine position, and could be used for measurements in patients who have difficulty visiting the laboratory and maintaining a seated posture.

Citations

Citations to this article as recorded by  
  • Mim-pong: a serious game for assessment and treatment of the lower limb in hemiparetic stroke patients
    Fernando L. F. Eichinger, Fabrício Noveletto, Susana C. Domenech, Thierry Moulin, Yoshimasa Sagawa, Antonio Vinicius Soares
    Archives of Physiotherapy.2025; : 59.     CrossRef
  • Toe Grip Strength Is Associated with Improving Gait Function in Patients with Subacute Stroke
    Jin-Whan Ryu, In-Su Hwang, Sol Jin, Soo-A Kim, Min-Su Kim
    Brain Sciences.2024; 14(3): 215.     CrossRef
  • Development and validation of a portable articulated dynamometry system to assess knee extensor muscle strength
    Youho Myong, Sungwoo Park, Minwoo Cho, Seung Yeon Cho, Woo Hyung Lee, Byung-Mo Oh, Sungwan Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • 5,836 View
  • 130 Download
  • 4 Web of Science
  • 3 Crossref
Effects of Chin-Down Maneuver on Pharyngeal Pressure Generation According to Dysphagia and Viscosity
Sun Myoung Lee, Ban Hyung Lee, Jung Woo Kim, Joon Young Jang, Eun Gyeong Jang, Ju Seok Ryu
Ann Rehabil Med 2020;44(6):493-501.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20016
Objective
To demonstrate the effects of chin-down maneuver on swallowing by using high-resolution manometry (HRM).
Methods
HRM data of 20 healthy subjects and 64 dysphagic patients were analyzed. Participants swallowed 5 mL of thin and honey-like liquids in neutral and chin-down positions. HRM was used to evaluate maximal velopharyngeal pressure/area, maximal tongue base pressure/area, maximal pharyngeal constrictor pressure, pre-/post-swallow upper esophageal sphincter (UES) peak pressure, minimal UES pressure, UES activity time, and nadir duration.
Results
Compared to the neutral position, the chin-down maneuver significantly increased tongue base pressure in both normal and dysphagic groups as well as for both honey-like and thin viscosities, although the honey-like liquid did not reach statistical significance in the dysphagic group. Regarding pharyngeal constrictors and pre-swallow peak UES pressure, the healthy group showed a significant decrease in thin liquid swallowing and decreasing tendency in honeylike liquid swallowing. UES nadir duration was significantly decreased for honey-like liquid swallowing in the dysphagic group and for both thin and honey-like liquids in the healthy group. UES nadir duration of honey-like and thin flow swallowing in the dysphagia group was 0.26 seconds after the chin-down maneuver, which was severely limited.
Conclusion
This study showed a different kinetic effect of the chin-down maneuver between the healthy and dysphagic groups, as well as between thin and honey-like viscosities. The chin-down maneuver increased tongue base pressure and decreased UES nadir duration, which the latter was severely limited in dysphagic patients. Therefore, appropriate application of the chin-down maneuver in clinical practice is required.

Citations

Citations to this article as recorded by  
  • Physiology and Execution of Swallowing Maneuvers in 3D Videos: Integrating the Technology into Patient Care
    Marina Gatti, Chao Lung Wen, Renata Lígia Vieira Guedes, Giédre Berretin-Felix
    Dysphagia.2025; 40(3): 541.     CrossRef
  • The effectiveness of chin‐down manoeuvre in patients with dysphagia: A systematic review and meta‐analysis
    Mengchao Li, Shaochun Huang, Yaping Ding, Xianwen Li, Yan Cui, Shen Chen
    Journal of Oral Rehabilitation.2024; 51(4): 762.     CrossRef
  • Normative High-Resolution Pharyngeal Manometry: Impact of Age, Size of System, and Sex on Primary Metrics and Pressure Stability
    Corinne A. Jones, Jilliane F. Lagus, Suzan M. Abdelhalim, Caroline M. Osborn, Sophia M. Colevas, Timothy M. McCulloch
    Dysphagia.2024; 39(4): 648.     CrossRef
  • Short-term cortical activation changes associated with postural compensation in swallowing
    Kelsey L. Murray, Seng Mun Wong, Erin Kamarunas
    Experimental Brain Research.2024; 242(11): 2623.     CrossRef
  • Correlation Between Articulatory Diadochokinetic Parameters and Dysphagia Parameters in Subacute Stroke Patients
    Back Min Oh, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Su Jung Park, Beom Jin Kim, Hyun Jung Kim
    Annals of Rehabilitation Medicine.2023; 47(3): 192.     CrossRef
  • A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans
    Tarini V. Ullal, Stanley L. Marks, Peter C. Belafsky, Jeffrey L. Conklin, John E. Pandolfino
    Frontiers in Veterinary Science.2022;[Epub]     CrossRef
  • Recent Kinetic and Kinematic Findings of Swallowing Maneuvers and Posture Techniques
    Yoko Inamoto
    The Japanese Journal of Rehabilitation Medicine.2022; 59(9): 903.     CrossRef
  • The upper esophageal sphincter in the high-resolution manometry era
    Pedro Norton, Fernando A. M. Herbella, Francisco Schlottmann, Marco G. Patti
    Langenbeck's Archives of Surgery.2021; 406(8): 2611.     CrossRef
  • 5,266 View
  • 153 Download
  • 7 Web of Science
  • 8 Crossref
Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study
Sora Baek, Yuncheol Ha, Jaemin Mok, Hee-won Park, Hyo-Rim Son, Mi-Suk Jin
Ann Rehabil Med 2020;44(6):481-492.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20084
Objective
To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed.
Methods
Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65–74 years) and old-old (≥75 years) female subjects were compared.
Results
Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05).
Conclusion
We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.

Citations

Citations to this article as recorded by  
  • Impact of digital health management on clinical outcomes during post-PCI outpatient care in patients with acute coronary syndrome: study protocol for a multicentre, randomized controlled trial
    Hang Yu, Wei Zhang, Guoliang Li, Tao Chen, Shaonong Dang, Xiaofeng Ma, XiaoWei Zhang, Xiaofeng Ma, Zhibin Hong, Pengyi He, Xiaohui Xu, Xiuying Chen, Yanyan Geng, Xinjun Lei
    Frontiers in Cardiovascular Medicine.2025;[Epub]     CrossRef
  • Fact Sheet on Cardiac Rehabilitation for Cardiovascular Disease in South Korea
    Ki-Hong Kim, Jae-Young Han
    Annals of Rehabilitation Medicine.2023; 47(5): 318.     CrossRef
  • Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization
    Michael P. Thompson, Hechuan Hou, James W. Stewart, Francis D. Pagani, Robert B. Hawkins, Steven J. Keteyian, Devraj Sukul, Donald S. Likosky
    Circulation: Cardiovascular Quality and Outcomes.2023;[Epub]     CrossRef
  • Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study
    Chul Kim, Jidong Sung, Jae-Young Han, Sungju Jee, Jang Woo Lee, Jong Hwa Lee, Won-Seok Kim, Heui Je Bang, Sora Baek, Kyung Lim Joa, Ae Ryoung Kim, So Young Lee, Jihee Kim, Chung Reen Kim, Oh Pum Kwon
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Do Patients Maintain Proper Long-Term Cardiopulmonary Fitness Levels After Cardiac Rehabilitation? A Retrospective Study Using Medical Records
    Chul Kim, Hee Eun Choi, Jin Hyuk Jang, Jun Hyeong Song, Byung-Ok Kim
    Annals of Rehabilitation Medicine.2021; 45(2): 150.     CrossRef
  • Community-Based Aerobic Exercise Program for Primary Prevention of Cardiovascular Disease in Adults With Visual or Auditory Impairments: A Feasibility Study
    Sora Baek, Yuncheol Ha, Jaemin Mok, Haekyung Lee, Woojoo Song
    Annals of Rehabilitation Medicine.2021; 45(3): 204.     CrossRef
  • Short-term community-based exercise programs in low-income older women: Does exercise intensity and modality matters?
    Vanessa Teixeira do Amaral, Bianca Fernandes, Awassi Yuphiwa Ngomane, Isabela Roque Marçal, Gabriel de Souza Zanini, Emmanuel Gomes Ciolac
    Experimental Gerontology.2021; 156: 111591.     CrossRef
  • Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea
    Chul Kim, Jidong Sung, Jae-Young Han, Sungju Jee, Jang Woo Lee, Jong Hwa Lee, Won-Seok Kim, Heui Je Bang, Sora Baek, Kyung-Lim Joa, Ae Ryoung Kim, So Young Lee, Jihee Kim, Chung Reen Kim, Oh Pum Kwon
    Journal of Clinical Medicine.2021; 10(21): 5079.     CrossRef
  • 6,078 View
  • 102 Download
  • 8 Web of Science
  • 8 Crossref
Exercise Program Improves Functional Capacity and Quality of Life in Uncorrected Atrial Septal Defect-Associated Pulmonary Arterial Hypertension: A Randomized-Control Pilot Study
Annis Rakhmawati, Indera Noor Achmad, Anggoro Budi Hartopo, Dyah Wulan Anggrahini, Irsad Andi Arso, Noriaki Emoto, Lucia Kris Dinarti
Ann Rehabil Med 2020;44(6):468-480.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20100
Objective
To assess the effect of combined hospital and home-based exercise programs on functional capacity and quality of life (QoL) among uncorrected atrial septal defect-associated pulmonary arterial hypertension (ASD-PAH) patients.
Methods
This study was a randomized controlled trial with uncorrected ASD-PAH patients as the subjects. They were allocated randomly into control and exercise groups. Exercise group subjects performed hospital and home-based exercise programs, completing baseline 6-minute walking test (6MWT) and EQ-5D-3L QoL test (Utility Index and EQ-VAS scores), and were followed up for 12 weeks. The primary outcomes were 6MWT distance and EQ-5D-3L score at week 12. The N-terminal pro B-type natriuretic peptide (NT-proBNP) level was also assessed. A repeated-measure ANOVA was performed to detect endpoint differences over time.
Results
The exercise group contained 20 subjects and control group contained 19. In total, 19 exercise group subjects and 16 control group subjects completed the protocol. The 6MWT distance, Utility Index score, and EQ-VAS score incrementally improved significantly in the exercise group from baseline until week 12, with mean differences of 76.7 m (p<0.001), 0.137 (p<0.001) and 15.5 (p<0.001), respectively. Compared with the control group, the exercise group had significantly increased 6MWT distance and utility index score at week 12. The EQ-VAS score increased in the exercise group at week 12. The NT-proBNP level decreased at week 12 in the exercise group.
Conclusion
Combined hospital and home-based exercise program added to PAH-targeted therapy, improving functional capacity and QoL in uncorrected ASD-PAH patients.

Citations

Citations to this article as recorded by  
  • Pulmonary Hypertension: Exercise Intolerance and the Benefits of Respiratory Muscle and Exercise Training
    Seshika Ratwatte, Derek Tran, David S. Celermajer, Rachael Cordina
    Advances in Pulmonary Hypertension.2024; 23(1): 11.     CrossRef
  • The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review
    Angela T. Burge, Adelle M. Gadowski, Lorena Romero, Guido Vagheggini, Anna Spathis, Natasha E. Smallwood, Magnus Ekström, Anne E. Holland
    European Respiratory Review.2024; 33(174): 240027.     CrossRef
  • Examining the Role of Exercise Training in Enhancing Life for Adult Congenital Heart Disease: Systematic Review
    Tugba Siyah, Naciye Vardar Yagli, Ilker Ertugrul, Hayrettin Hakan Aykan, Melda Saglam
    Arquivos Brasileiros de Cardiologia.2024;[Epub]     CrossRef
  • O Papel do Treinamento Físico na Melhoria da Qualidade de Vida para Cardiopatia Congênita Adulta: Revisão Sistemática
    Tugba Siyah, Naciye Vardar Yagli, Ilker Ertugrul, Hayrettin Hakan Aykan, Melda Saglam
    Arquivos Brasileiros de Cardiologia.2024;[Epub]     CrossRef
  • Exercise-based rehabilitation programmes for pulmonary hypertension
    Norman R Morris, Fiona D Kermeen, Arwel W Jones, Joanna YT Lee, Anne E Holland
    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
  • Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines
    Lucia Kris Dinarti, Dyah Wulan Anggrahini, Oktavia Lilyasari, Bambang Budi Siswanto, Anggoro Budi Hartopo
    Global Heart.2021;[Epub]     CrossRef
  • 7,091 View
  • 185 Download
  • 4 Web of Science
  • 6 Crossref
Effect of Fascia Penetration in Lateral Femoral Cutaneous Nerve Conduction
Mi-Jeong Yoon, Hye Min Park, Sun Jae Won
Ann Rehabil Med 2020;44(6):459-467.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20022
Objective
To evaluate the effect of fascia penetration and develop a new technique for lateral femoral cutaneous nerve (LFCN) conduction studies based on the fascia penetration point (PP) identified using ultrasound.
Methods
The fascia PP of the LFCN was localized in 20 healthy subjects, and sensory nerve action potentials (SNAPs) were obtained at four different stimulation points—2 cm proximal to the PP (2PPP), PP, 2 cm distal to the PP (2DPP), and 4 cm distal to the PP (4DPP). We compared the stimulation technique based on the fascia penetration point (STBFP) with the conventional technique.
Results
The SNAP amplitude of the LFCN was significantly higher when stimulation was performed at the PP and 2DPP than at other stimulation points. Using the STBFP, SNAP responses were elicited in 38 of 40 legs, whereas they were elicited in 32 of 40 legs using the conventional technique (p=0.041). STBFP had a comparable SNAP amplitude and slightly delayed negative peak latency compared to the conventional technique. In terms of the time required, the time spent on STBFP showed a more consistent distribution than the time spent on the conventional technique (two-sample Kolmogorov–Smirnov test, p<0.05).
Conclusion
SNAP of the LFCN significantly changed near the fascia PP, and stimulation at PP and at 2DPP provided high amplitudes. STBFP can help increase the response rate and ensure stable and consistent procedure time of the LFCN conduction study.

Citations

Citations to this article as recorded by  
  • Meralgia Paresthetica as a Result of Surgery With an Emphasis on Harvesting Iliac Bone Grafts: A Review
    Sonia N. Singh, Ruby R. Taylor, Chaimae Oualid, Mutaz B. Habal, Seth R. Thaller
    Journal of Craniofacial Surgery.2024; 35(7): 1964.     CrossRef
  • Dorsal ulnar cutaneous nerve conduction study based on nerve ultrasound
    Eunjin Park, So-youn Chang, Hye Jung Park, Ho-geon Namgung, Sun Jae Won
    Scientific Reports.2024;[Epub]     CrossRef
  • 6,539 View
  • 129 Download
  • 2 Web of Science
  • 2 Crossref
Ultrasonographic Analysis of Optimal Needle Placement for Extensor Indicis
Jin Young Kim, Hyun Seok, Sang-Hyun Kim, Yoon-Hee Choi, Jun Young Ahn, Seung Yeol Lee
Ann Rehabil Med 2020;44(6):450-458.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20035
Objective
To determine the most optimal needle insertion point of extensor indicis (EI) using ultrasound.
Methods
A total 80 forearms of 40 healthy volunteers were recruited. We identified midpoint (MP) of EI using ultrasound and set MP as optimal needle insertion point. The location of MP was suggested using distances from landmarks. Distance from MP to medial border of ulna (MP-X) and to lower margin of ulnar head (MP-Y) were measured. Ratios of MP-X to Forearm circumference (X ratio) and MP-Y to forearm length (Y ratio) were calculated. In cross-sectional view, depth of MP (Dmp), defined as middle value of superficial depth (Ds) and deep depth (Dd) was measured and suggested as proper depth of needle insertion.
Results
Mean MP-X was 1.37±0.14 cm and mean MP-Y was 5.50±0.46 cm. Mean X ratio was 8.10±0.53 and mean Y ratio was 22.15±0.47. Mean Dmp was 7.63±0.96 mm.
Conclusion
We suggested that novel optimal needle insertion point of the EI. It is about 7.6 mm in depth at about 22% of the forearm length proximal from the lower margin of the ulnar head and about 8.1% of the forearm circumference radial from medial border of ulna.
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Prevalence and Characteristics of Neuropathic Pain in Patients With Spinal Cord Injury Referred to a Rehabilitation Center
Hae Young Kim, Hye Jin Lee, Tae-lim Kim, EunYoung Kim, Daehoon Ham, Jaejoon Lee, Tayeun Kim, Ji Won Shin, Minkyoung Son, Jun Hun Sung, Zee-A Han
Ann Rehabil Med 2020;44(6):438-449.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20081
Objective
To identify the prevalence and characteristics of neuropathic pain (NP) in patients with spinal cord injury (SCI) and to investigate associations between NP and demographic or disease-related variables.
Methods
We retrospectively reviewed medical records of patients with SCI whose pain was classified according to the International Spinal Cord Injury Pain classifications at a single hospital. Multiple statistical analyses were employed. Patients aged <19 years, and patients with other neurological disorders and congenital conditions were excluded.
Results
Of 366 patients, 253 patients (69.1%) with SCI had NP. Patients who were married or had traumatic injury or depressive mood had a higher prevalence rate. When other variables were controlled, marital status and depressive mood were found to be predictors of NP. There was no association between the prevalence of NP and other demographic or clinical variables. The mean Numeric Rating Scale (NRS) of NP was 4.52, and patients mainly described pain as tingling, squeezing, and painful cold. Females and those with below-level NP reported more intense pain. An NRS cut-off value of 4.5 was determined as the most appropriate value to discriminate between patients taking pain medication and those who did not.
Conclusion
In total, 69.1% of patients with SCI complained of NP, indicating that NP was a major complication. Treatment planning for patients with SCI and NP should consider that marital status, mood, sex, and pain subtype may affect NP, which should be actively managed in patients with an NRS ≥4.5.

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    Yinuo Liu, Xintong Cai, Bowen Shi, Yajie Mo, Jianmin Zhang, Wenting Luo, Bodong Yu, Xi Li
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    Simona Portaro, Angelo Alito, Giulia Leonardi, Nicola Marotta, Adriana Tisano, Daniele Bruschetta, Umile Giuseppe Longo, Antonio Ammendolia, Demetrio Milardi, Alessandro de Sire
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    Youngkyung Kim, Hyunggoo Kang, Young Wook Yoon
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    Arun Yadav, Mrinal Joshi
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    Zefu Li, Huiying Bai, Ruoyu Zhang, Bohan Chen, Junmin Wang, Bohan Xue, Xiuhua Ren, Jiarui Wang, Yanjie Jia, Weidong Zang, Jian Wang, Xuemei Chen
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Comparison of Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation on Upper Limb Recovery Among Patients With Recent Stroke
Ka Ying Doris Miu, Ching Kok, Sau Shan Leung, Elaine Y. L. Chan, Elaine Wong
Ann Rehabil Med 2020;44(6):428-437.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20093
Objective
To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on upper limb function recovery among patients who recently had stroke.
Methods
Subjects with recent stroke (within 1 month) were randomized to rTMS (n=25) and tDCS (n=26) applied over the non-lesioned hemisphere for three sessions per week, followed by tailored upper limb rehabilitation training for a total of 2 weeks. The primary outcomes were changes in the Motor Assessment Scale (MAS), Fugl-Meyer arm score test, Nine-Hole Peg Test (9HPT), hand grip strength, and modified Barthel Index at weeks 2 and 4. Both therapists responsible for training and assessment were blinded to the intervention allocated.
Results
There was an improvement in all the motor performance scales among both groups (p<0.001). These improvements persisted at discharge. However, there was no significant difference in any of the assessment scales between the two groups. The rTMS group showed a statistically non-significant greater improvement in MAS, 9HPT, and handgrip strength than the tDCS group.
Conclusion
Both interventions produce a statistically significant improvement in upper limb function. There was no statistically significant difference between the two intervention methods with respect to motor performance. It is suggested that a larger study may help to clarify the superiority of either methods.

Citations

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  • A protocol to optimize non-invasive brain stimulation for post-stroke rehabilitation
    Ayesha Juhi, Manul Das, Dinesh Bhatia, Suman Dhaka, Rajesh Kumar, Deepak Kumar, Shreya Sharma, Pritam Kumar Chaudhary, Chanchal Goyal, Md Asif Khan, Himel Mondal
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    Antonio Rodríguez, Laura Amaya-Pascasio, María Gutiérrez-Fernández, José García-Pinteño, Margarita Moreno, Patricia Martínez-Sánchez
    Neuroscience & Biobehavioral Reviews.2024; 156: 105485.     CrossRef
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    Wang Fu, Xiaoming Yu, Minghui Lai, Yuanli Li, Yingting Yang, Yong Qin, Min Yu, Feng Wang, Cong Wang
    Trials.2024;[Epub]     CrossRef
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    Aleksandra Markowska, Beata Tarnacka
    Biomedicines.2024; 12(7): 1560.     CrossRef
  • Repetitive Transcranial Magnetic Stimulation Coupled With Visual‐Feedback Cycling Exercise Improves Walking Ability and Walking Stability After Stroke: A Randomized Pilot Study
    Yixiu Wang, Xiaoming Chen, Menghuan Wang, Yingying Pan, Shiyi Li, Mengfei He, Feng Lin, Zhongli Jiang, Zhiyong Zhao
    Neural Plasticity.2024;[Epub]     CrossRef
  • Noninvasive Brain Stimulation for Cancer Pain Management in Nonbrain Malignancy: A Meta-Analysis
    Yung-Jiun Chien, Chun-Yu Chang, Meng-Yu Wu, Yung-Chen Chien, Hsin-Chi Wu, Yi-Shiung Horng, Saskia F. A. Duijts
    European Journal of Cancer Care.2023; 2023: 1.     CrossRef
  • Exploring the Potential of Transcranial Direct Current Stimulation for Relieving Central Post-Stroke Pain: A Randomized Controlled Pilot Study
    Ji-Soo Baik, Jung-Hyun Yang, Sung-Hwa Ko, So-Jung Lee, Yong-Il Shin
    Life.2023; 13(5): 1172.     CrossRef
  • Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation
    Qian Duan, Wenying Liu, Jinhui Yang, Ben Huang, Jie Shen, Laura Baroncelli
    Neural Plasticity.2023; 2023: 1.     CrossRef
  • A blended neurostimulation protocol to delineate cortico-muscular and spino-muscular dynamics following neuroplastic adaptation
    Filip Stefanovic, Julian A. Martinez, Ghazala T. Saleem, Sue Ann Sisto, Michael T. Miller, Yaa A. Achampong, Albert H. Titus
    Frontiers in Neurology.2023;[Epub]     CrossRef
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    Ishtiaq Ahmed, Rustem Mustafaoglu, Simone Rossi, Fatih A. Cavdar, Seth Kwame Agyenkwa, Marco Y.C. Pang, Sofia Straudi
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    Frontiers in Neurology.2023;[Epub]     CrossRef
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    Qingqing Zhao, Hong Li, Yu Liu, Haonan Mei, Liying Guo, Xianying Liu, Xiaolin Tao, Jiang Ma
    Frontiers in Neurology.2022;[Epub]     CrossRef
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    Helene Luise Walter, Anton Pikhovych, Heike Endepols, Steffen Rotthues, Johannes Bärmann, Heiko Backes, Mathias Hoehn, Dirk Wiedermann, Bernd Neumaier, Gereon Rudolf Fink, Maria Adele Rueger, Michael Schroeter
    Neurorehabilitation and Neural Repair.2022; 36(10-11): 701.     CrossRef
  • Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
    Tao Xue, Zeya Yan, Jiahao Meng, Wei Wang, Shujun Chen, Xin Wu, Feng Gu, Xinyu Tao, Wenxue Wu, Zhouqing Chen, Yutong Bai, Zhong Wang, Jianguo Zhang
    Journal of Clinical Medicine.2022; 11(20): 6162.     CrossRef
  • 5,918 View
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Novel Method of Classification in Knee Osteoarthritis: Machine Learning Application Versus Logistic Regression Model
Jung Ho Yang, Jae Hyeon Park, Seong-Ho Jang, Jaesung Cho
Ann Rehabil Med 2020;44(6):415-427.   Published online December 31, 2020
DOI: https://doi.org/10.5535/arm.20071
Objective
To present new classification methods of knee osteoarthritis (KOA) using machine learning and compare its performance with conventional statistical methods as classification techniques using machine learning have recently been developed.
Methods
A total of 84 KOA patients and 97 normal participants were recruited. KOA patients were clustered into three groups according to the Kellgren-Lawrence (K-L) grading system. All subjects completed gait trials under the same experimental conditions. Machine learning-based classification using the support vector machine (SVM) classifier was performed to classify KOA patients and the severity of KOA. Logistic regression analysis was also performed to compare the results in classifying KOA patients with machine learning method.
Results
In the classification between KOA patients and normal subjects, the accuracy of classification was higher in machine learning method than in logistic regression analysis. In the classification of KOA severity, accuracy was enhanced through the feature selection process in the machine learning method. The most significant gait feature for classification was flexion and extension of the knee in the swing phase in the machine learning method.
Conclusion
The machine learning method is thought to be a new approach to complement conventional logistic regression analysis in the classification of KOA patients. It can be clinically used for diagnosis and gait correction of KOA patients.

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Response

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Letter to the Editor

Original Articles

What is the Adequate Cuff Volume for Tracheostomy Tube? A Pilot Cadaver Study
Dong Min Kim, Myung Jun Shin, Sung Dong Kim, Yong Beom Shin, Ho Eun Park, Young Mo Kim, Jin A Yoon
Ann Rehabil Med 2020;44(5):402-408.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19210
Objective
To determine the patterns of tracheostomy cuff pressure changes with various air inflation amounts in different types of tracheostomy tubes to obtain basic data for appropriately managing longterm tracheostomy.
Methods
We performed tracheostomy on a 46-year-old male cadaver. Three types of tracheostomy tubes (single-cuffed, double-cuffed, and adjustable flange), divided into 8 different subtypes based on internal tube diameters and cuff diameters, were inserted into the cadaver. Air was inflated into the cuff, and starting with 1 mL air, the cuff pressure was subsequently measured using a manometer.
Results
For the 7.5 mm/14 mm tracheostomy tube, cuff inflation with 3 mL of air yielded a cuff pressure within the recommended range of 20–30 cmH2O. The 7.5 mm/24 mm tracheostomy tube showed adequate cuff pressure at 5 mL of air inflation. Similar values were observed for the 8.0 mm/16 mm and 8.0 mm/27 mm tubes. Double-cuffed tracheostomy cuff pressures (7.5 mm/20 mm and 8.0 mm/20 mm tubes) at 3 mL air inflation had cuff pressures of 18–20 cmH2O at both the proximal and distal sites. For the adjustable flange tracheostomy tube, cuff pressure at 6 mL of cuff air inflation was within the recommended range. Maximal cuff pressure was achieved at inflation with almost 14 mL of air, unlike other tube types.
Conclusion
Various types of tracheostomy tubes showed different cuff pressures after inflation. These values might aid in developing guidelines For patients who undergo tracheostomy and are discharged home without cuff pressure manometers, this standard might be helpful to develop guidelines.

Citations

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  • Fluid-Filled Tracheal Tube Cuffs: Implications for Speech, Sealing, and Safety
    Thomas C. Blakeman
    Respiratory Care.2025;[Epub]     CrossRef
  • Impact of Low‐Volume, Low‐Pressure Tracheostomy Cuffs on Acute Mucosal Injury in Swine
    Alexandra J. Berges, Ioan A. Lina, Rafael Ospino, Hsiu‐Wen Tsai, Dacheng Ding, Jessica M. Izzi, Alexander T. Hillel
    Otolaryngology–Head and Neck Surgery.2022; 167(4): 716.     CrossRef
  • 7,201 View
  • 170 Download
  • 2 Web of Science
  • 2 Crossref
Efficacy of Extracorporeal Shockwave Therapy on Cervical Myofascial Pain Following Neck Dissection Surgery: A Randomized Controlled Trial
FatmaAlzahraa Hassan Kamel, Maged Basha, Ashwag Alsharidah, Islam Mohamed Hewidy, Mohamed Ezzat, Nancy Hassan Aboelnour
Ann Rehabil Med 2020;44(5):393-401.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.20055
Objective
To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on cervical myofascial pain following neck dissection in reducing pain and improving cervical range of motion (ROM).
Methods
Forty-six patients with cervical myofascial pain following neck dissection surgery were recruited and subdivided at random into two equal groups. The ESWT group received ESWT once a week for 4 weeks (0.25 mL/mm2, 1,000 shocks) and a topical non-steroidal anti-inflammatory drug (3 times/day for 4 weeks). The control group received only topical NSAID. The pain assessment was done by using the visual analog scale (VAS) and pressure algometry. A cervical ROM device was used for the assessment of the lateral flexion and rotation of the neck ROM on both sides. All measurements were collected at baseline, 2 weeks, and 4 weeks.
Results
The ESWT group revealed a significant improvement in all parameters at post I and post II than did the control group (p>0.001), that revealed a statistical decrease only in the VAS score at post I without any statistical difference in the pain threshold and neck ROM. However, there were statistical differences in all parameters at post II compared to those at pre-treatment and post I (p<0.001).
Conclusion
As a confirmation of the efficacy of ESWT in cervical myofascial pain control following neck dissection, we observed better results with no side effects in the ESWT group (Clinical Trial Registry No. PACTR202002648274347).

Citations

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  • Myofascial pain syndrome in small animal practice
    M. C. Petty, B. P. Monteiro, S. A. Robertson, A. R. Ajadi, C. Mosley, J. C. Murrell, N. Nadkarni
    Journal of Small Animal Practice.2025; 66(2): 75.     CrossRef
  • Effect of proprioceptive neuromuscular facilitation versus low level laser therapy on shoulder adhesive capsulitis post-neck dissection surgery
    Naiera Sabry Mohammed Shams, Ragab Ali Sherif, Karim Ibrahim Saafan
    Physiotherapy Quarterly.2024; 32(1): 111.     CrossRef
  • Effect of Extracorporeal Shock Wave on Upper Trapezius Trigger Points in Patients With Cervicogenic Headache
    Radwa F. Hammam, Ahmed M. Alshimy, Omar M. Elabd, Aliaa M. Elabd
    American Journal of Physical Medicine & Rehabilitation.2024; 103(11): 1000.     CrossRef
  • Local application of a transcutaneous carbon dioxide paste prevents excessive scarring and promotes muscle regeneration in a bupivacaine‐induced rat model of muscle injury
    Junya Hirota, Takumi Hasegawa, Atsuyuki Inui, Daisuke Takeda, Rika Amano‐Iga, Nanae Yatagai, Izumi Saito, Satomi Arimoto, Masaya Akashi
    International Wound Journal.2023; 20(4): 1151.     CrossRef
  • Shock wave therapy in oncology: in vitro, in vivo, rehabilitation
    T.I. Grushina, I.I. Orlov
    Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(3): 58.     CrossRef
  • Efficacy and Effectiveness of Extracorporeal Shockwave Therapy in Patients with Myofascial Pain or Fibromyalgia: A Scoping Review
    Marco Paoletta, Antimo Moretti, Sara Liguori, Giuseppe Toro, Francesca Gimigliano, Giovanni Iolascon
    Medicina.2022; 58(8): 1014.     CrossRef
  • Energy-Based Therapies for Erectile Dysfunction
    Raghav Pai, Jesse Ory, Carlos Delgado, Ranjith Ramasamy
    Urologic Clinics of North America.2021; 48(4): 603.     CrossRef
  • Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial
    Dina Al-Amir Mohamed, Ragia Mohamed Kamal, Manal Mohamed Gaber, Yasser M. Aneis
    Annals of Rehabilitation Medicine.2021; 45(4): 284.     CrossRef
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Effects of Extracorporeal Shockwave Therapy on Improvements in Lymphedema, Quality of Life, and Fibrous Tissue in Breast Cancer-Related Lymphedema
Kyeong Woo Lee, Sang Beom Kim, Jong Hwa Lee, Young Sam Kim
Ann Rehabil Med 2020;44(5):386-392.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19213
Objective
To evaluate the effects of extracorporeal shockwave therapy (ESWT) on improving lymphedema, quality of life, and fibrous tissue in patients with stage 2 lymphedema.
Methods
Breast cancer-related lymphedema patients referred to the rehabilitation center were recruited. We enrolled stage 2 lymphedema patients who had firmness of the skin at their forearm, a circumference difference of more than 2 cm between each arm, or a volume difference between upper extremities greater than 200 mL, confirmed by lymphoscintigraphy. The patients were randomly divided into the ESWT group and the control group. ESWT was performed for 3 weeks (two sessions per week); both groups received complex decongestive physical therapy. All patients were evaluated at baseline and at 3 weeks after treatment. The measurements performed included visual analog scale score, volume, circumference, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) score, bioelectrical impedance, and skin thickness.
Results
The patients in both groups (n=15 in each group) completed the 3-week therapy experiment. No significant differences were observed in demographic characteristics between groups. After the 3-week treatment period, improvement was noted in the circumference difference below the elbow, volume, ratio of extracellular water to total body water, and skin thickness in the ESWT group. A significant difference was found in all the above-mentioned areas except in circumference below the elbow in the ESWT group.
Conclusion
ESWT reduced edema and skin fibrosis without significant complications. Therefore, ESWT can be used together with complex decongestive physical therapy for treating lymphedema.

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  • Advancements in Treatment and Surgery for Breast Cancer Related Lymphedema
    Alicia Huff Arnold, Christina H. Bae, Shawn M. Doss, Mohamed Nofal, Shaan Haider, Isha Darshane, Cameron Jackson, Sweta Munagapati, Christopher Painter, Kyra Urquhart-Foster, Katharine Tracy, Alexandra Metzger, Lauren A. Herrera, Hari Kashyap
    Current Breast Cancer Reports.2025;[Epub]     CrossRef
  • Role of Electro-Therapeutic Modalities in Breast Cancer-Related Lymphedema and Shoulder Dysfunction: A Systematic Review and Meta-Analysis
    Renu Pattanshetty, Asmita Shrestha, Nikita Pawar
    Indian Journal of Palliative Care.2025; 0: 1.     CrossRef
  • Conservative medical intervention as a complement to CDT for BCRL therapy: a systematic review and meta-analysis of randomized controlled trials
    Chuyu Deng, Zhiguo Wu, Zijie Cai, Xiaoyan Zheng, Chunzhi Tang
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Shock wave therapy in oncology: in vitro, in vivo, rehabilitation
    T.I. Grushina, I.I. Orlov
    Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(3): 58.     CrossRef
  • Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review
    Alessandro de Sire, Luigi Losco, Lorenzo Lippi, Davide Spadoni, Juste Kaciulyte, Gokhan Sert, Paola Ciamarra, Marco Marcasciano, Roberto Cuomo, Alberto Bolletta, Marco Invernizzi, Emanuele Cigna
    Medicina.2022; 58(7): 954.     CrossRef
  • The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial
    Mahboobeh Hemmati, Zahra Rojhani-Shirazi, Zeinab Sadat Zakeri, Majid Akrami, Nasrin Salehi Dehno
    BMC Musculoskeletal Disorders.2022;[Epub]     CrossRef
  • Long-Term Effects of Extracorporeal Shock Wave Therapy on Breast Cancer-Related Lymphedema
    Jong-Hwa Lee, Sang-Beom Kim, Kyeong-Woo Lee, Won-Wook Ha
    Journal of Clinical Medicine.2022; 11(22): 6747.     CrossRef
  • Pilot study of oncological safety of extracorporeal shock wave therapy for post-mastectomy lymphedema in patients with breast cancer
    T.I. Grushina, I.I. Orlov
    Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2022; 99(6): 30.     CrossRef
  • Effect of extracorporeal shock wave therapy on keratinocytes derived from human hypertrophic scars
    Hui Song Cui, So Young Joo, Yoon Soo Cho, Ji Heon Park, Yu Mi Ro, June-Bum Kim, Cheong Hoon Seo
    Scientific Reports.2021;[Epub]     CrossRef
  • A Risk Factor Analysis of Axillary Web Syndrome in Patients After Breast Cancer Surgery: A Single Center Study in Korea
    Sangah Jeong, Byung Joo Song, Jiyoung Rhu, Cheolki Kim, Sun Im, Geun-Young Park
    Annals of Rehabilitation Medicine.2021; 45(5): 401.     CrossRef
  • Extracorporeal Shock Wave Therapy Combined with Complex Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Systemic Review and Meta-Analysis
    Yu Lin Tsai, Ting Jie I, Ya Chi Chuang, Yuan Yang Cheng, Yu Chun Lee
    Journal of Clinical Medicine.2021; 10(24): 5970.     CrossRef
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The Predictive Value of Language Scales: Bayley Scales of Infant and Toddler Development Third Edition in Correlation With Korean Sequenced Language Scale for Infant
Joung Hyun Doh, Soo A Kim, Kiyoung Oh, Yuntae Kim, Nodam Park, Siha Park, Nam Hun Heo
Ann Rehabil Med 2020;44(5):378-385.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19198
Objective
To compare the relationship of the Bayley Scales of Infant and Toddler Development 3rd Edition (K-BSID-III) language score and the Sequenced Language Scale for Infant (SELSI) score and evaluate the sensitivity and specificity of K-BSID-III language score and optimal cutoff value with receiver operator characteristic (ROC) curve analysis in infants and toddlers with delayed language development.
Methods
A total of 104 children with suspected language developmental delay were included in this retrospective study. Subjects were tested using the K-BSID-III and SELSI and subdivided into several groups according to the severity of language scores. ROC curve analysis was performed to assess K-BSID-III for delayed language development.
Results
Receptive and expressive language subscales of the K-BSID-III showed markedly significant correlation with the SELSI scores (p<0.001). ROC analysis showed an area under the curve of 0.877 (p<0.001) in SELSI receptive score and 0.935 (p<0.001) in SELSI expressive score. The optimal cutoff value where sensitivity of 85% and specificity of 81% were achieved with the K-BSID-III receptive score was 1.50 (between average and low average) in the SELSI receptive score. The optimal cutoff value where sensitivity of 96% and specificity of 82% were achieved with the K-BSID-III expressive score was also 1.50 in the SELSI expressive score.
Conclusion
In this study, the correlations between K-BSID-III and SELSI language scores were statistically significant. However, the interpretation should be considered carefully in low average group due to tendency of underestimation of delayed language development.

Citations

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  • Neonatal outcomes of early preterm births according to the delivery indications
    Hyojeong Kim, Yu Mi Shin, Kyong-No Lee, Hyeon Ji Kim, Young Hwa Jung, Jee Yoon Park, Kyung Joon Oh, Chang Won Choi
    Early Human Development.2023; 186: 105873.     CrossRef
  • The effect of dexmedetomidine on neuroprotection in pediatric cardiac surgery patients: study protocol for a prospective randomized controlled trial
    Sang-Hwan Ji, Pyoyoon Kang, In-Sun Song, Young-Eun Jang, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim, Eun-Hee Kim
    Trials.2022;[Epub]     CrossRef
  • Characteristics of Functional Speech Sound Disorders in Korean Children
    Min Jeong Han, Sun Jun Kim
    Annals of Child Neurology.2021; 30(1): 8.     CrossRef
  • 6,796 View
  • 1,229 Download
  • 3 Web of Science
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Accuracy of Ultrasound-Guided and Non-guided Botulinum Toxin Injection Into Neck Muscles Involved in Cervical Dystonia: A Cadaveric Study
Yun Dam Ko, Soo In Yun, Dahye Ryoo, Myung Eun Chung, Jihye Park
Ann Rehabil Med 2020;44(5):370-377.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19211
Objective
To compare the accuracy of ultrasound-guided and non-guided botulinum toxin injections into the neck muscles involved in cervical dystonia.
Methods
Two physicians examined six muscles (sternocleidomastoid, upper trapezius, levator scapulae, splenius capitis, scalenus anterior, and scalenus medius) from six fresh cadavers. Each physician injected ultrasound-guided and non-guided injections to each side of the cadaver’s neck muscles, respectively. Each physician then dissected the other physician’s injected muscle to identify the injection results. For each injection technique, different colored dyes were used. Dissection was performed to identify the results of the injections. The muscles were divided into two groups based on the difficulty of access: sternocleidomastoid and upper trapezius muscles (group A) and the levator scapulae, splenius capitis, scalenus anterior, and scalenus medius muscles (group B).
Results
The ultrasound-guided and non-guided injection accuracies of the group B muscles were 95.8% and 54.2%, respectively (p<0.001), while the ultrasound-guided and non-guided injection accuracies of the group A muscles were 100% and 79.2%, respectively (p<0.05).
Conclusion
Ultrasound-guided botulinum toxin injections into inaccessible neck muscles provide a higher degree of accuracy than non-guided injections. It may also be desirable to consider performing ultrasound-guided injections into accessible neck muscles.

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  • Optimal target localization for botulinum toxin A in treating splenius muscles dystonia based on the distribution of intramuscular nerves and spindles
    Xiaojiao He, Sifeng Wen, Xuan Liu, Yutong Li, Shengbo Yang
    Anatomical Science International.2025;[Epub]     CrossRef
  • Efficacy and Safety of Botulinum Toxin Type A Injection for Trapezius Muscle Contouring: A Systematic Review
    Krishan Mohan Kapoor, Anmol Batra, Amrit Kaur, Aanandita Kapoor, Tim Papadopoulos
    International Journal of Aesthetic Plastic Surgery.2025; 1(1): 76.     CrossRef
  • Comparing Injection Methods of Botulinum Toxin A for Cervical Dystonia: A Systematic Review
    Hristo Shipkov, Petar Uchikov, Abdulrahman Imran, Zain Ul Hassan, Ivan Grozdev, Krasimir Kraev, Maria Kraeva, Nina Koleva, Maria Bozhkova, Stanislav Karamitev
    Life.2025; 15(6): 920.     CrossRef
  • Localization modalities for botulinum neurotoxin injection
    Barbara Illowsky Karp, Ann Ly, Katharine E. Alter
    Toxicon.2025; 264: 108460.     CrossRef
  • Botulinum Toxin for Isolated or Essential Head Tremor

    New England Journal of Medicine.2024; 390(4): 383.     CrossRef
  • Current use of neurotoxins for alleviating symptoms of cervical dystonia
    Stephen Aradi, Robert A. Hauser
    Expert Review of Neurotherapeutics.2024; 24(8): 787.     CrossRef
  • Surface anatomy and levator scapulae muscle injection: A cadaveric investigation
    So-Youn Chang, Hee Young Lim, Sang-Hyun Kim, Jung-Woo Choi, Yong-Seok Nam, Jong In Lee
    Medicine.2024; 103(25): e38598.     CrossRef
  • Enhancing Botulinum Toxin Injection Precision: The Efficacy of a Single Cadaveric Ultrasound Training Intervention for Improved Anatomical Localization
    Camille Heslot, Omar Khan, Alexis Schnitzler, Chloe Haldane, Romain David, Rajiv Reebye
    Toxins.2024; 16(7): 304.     CrossRef
  • A Bayesian Network Meta-Analysis and Systematic Review of Guidance Techniques in Botulinum Toxin Injections and Their Hierarchy in the Treatment of Limb Spasticity
    Evridiki Asimakidou, Christos Sidiropoulos
    Toxins.2023; 15(4): 256.     CrossRef
  • Improving the Efficacy of Botulinum Toxin for Cervical Dystonia: A Scoping Review
    Roberto Erro, Marina Picillo, Maria Teresa Pellecchia, Paolo Barone
    Toxins.2023; 15(6): 391.     CrossRef
  • Muscle Ultrasound in Clinical Neurology: Diagnostic Uses and Guidance of Botulinum Toxin Injection
    Uwe Walter
    Journal of Neurosonology and Neuroimaging.2023; 15(1): 38.     CrossRef
  • In-Plane Ultrasound-Guided Botulinum Toxin Injection to Lumbrical and Interosseus Upper Limb Muscles: Technical Report
    Alexandros Toliopoulos
    Cureus.2023;[Epub]     CrossRef
  • Shoulder Spasticity Treatment With Botulinum Toxin: A Nationwide Cross-Sectional Survey of Clinical Practices
    Sérgio Pinho, Alexandre Camões-Barbosa, Madjer Hatia, Frederico Moeda, Xavier Melo, João Tocha
    Cureus.2023;[Epub]     CrossRef
  • Does ultrasound-guidance improve the outcome of botulinum toxin injections in cervical dystonia?
    A. Kreisler, S. Djelad, C. Simonin, G. Baille, E. Mutez, A. Degardin, L. Defebvre, J. Labreuche, E. Cailliau, A. Duhamel
    Revue Neurologique.2022; 178(6): 591.     CrossRef
  • Morphological characteristics of the posterior neck muscles and anatomical landmarks for botulinum toxin injections
    Bilge İpek Torun, Simel Kendir, Luis Filgueira, R. Shane Tubbs, Aysun Uz
    Surgical and Radiologic Anatomy.2021; 43(8): 1235.     CrossRef
  • Ultrasound and Electromyography as Guidance Tools for the Botulinum Toxin Therapy in Cervical Dystonia
    G. Salazar, S. Ferreiro, M. Fragoso, J. Codas, H. Cruz
    Journal of Behavioral and Brain Science.2021; 11(02): 49.     CrossRef
  • The Role of Ultrasound for the Personalized Botulinum Toxin Treatment of Cervical Dystonia
    Urban M. Fietzek, Devavrat Nene, Axel Schramm, Silke Appel-Cresswell, Zuzana Košutzká, Uwe Walter, Jörg Wissel, Steffen Berweck, Sylvain Chouinard, Tobias Bäumer
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  • Novel approaches to the treatment of cervical dystonia. The concept of dual navigation control
    A. P. Kovalenko, Z. A. Zalyalova, A. F. Ivolgin
    Neurology, Neuropsychiatry, Psychosomatics.2021; 13(6): 124.     CrossRef
  • 7,731 View
  • 259 Download
  • 18 Web of Science
  • 18 Crossref
Motor Function in the Late Phase After Stroke: Stroke Survivors’ Perspective
Lina Bunketorp-Käll, Marcela Pekna, Milos Pekny, Hans Samuelsson, Christian Blomstrand, Michael Nilsson
Ann Rehabil Med 2020;44(5):362-369.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.20060
Objective
To examine the association between observer-assessed functional status and perceived recovery in the late phase after stroke. The study also aimed to determine whether observer-assessed functional improvements as a result of horse-riding therapy (H-RT) are related to enhanced perception of stroke recovery.
Methods
This is a descriptive correlational study using data derived from a three-armed randomized controlled trial in which 123 individuals were enrolled, among whom 43 received H-RT for 12 weeks. The measures included the Modified Motor Assessment Scale, Berg Balance Scale, Timed Up and Go, timed 10-m walk, and perceived recovery from stroke indicated by item #9 in the Stroke Impact Scale (version 2.0). Spearman rank order correlation (rs) was used in the analyses.
Results
There were moderate to strong positive or negative correlations between all four observer-assessed motor variables and participants’ ratings of perceived late-phase stroke recovery at trial entrance, ranging from rs=-0.49 to rs=0.54 (p<0.001). The results of the correlational analyses of variable changes showed that, after the end of the H-RT intervention, both self-selected and fast gait speed improvement were significantly correlated with increments in self-rated stroke recovery (rs=-0.41, p=0.01 and rs=-0.38, p=0.02, respectively).
Conclusion
This study provided data supporting the association between individual ratings of self-perceived recovery after stroke and observer-assessed individual motor function. The results further demonstrate that enhancement in perceived stroke recovery after completing the intervention was associated with objectively measured gains in both self-selected and fast gait speed.

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  • Knowledge, attitude, practice and illness perception toward subarachnoid hemorrhage prevention and management among intracranial aneurysm patients
    Suiling Liu, Ping Zhang, Yeqing Wu, Dan Huang, Mengqiang Yu, Mingming Zhang
    Clinical Neurology and Neurosurgery.2024; 242: 108347.     CrossRef
  • Enhanced Gait Recovery in Chronic Post-COVID-19 Stroke: The Role of Combined Physical Rehabilitation
    Hunor Pál Fodor, Hunor Dávid, Attila Czont, Ildikó Miklóssy, Kálmán-Csongor Orbán, Gyöngyi Tar, Abony Fodor, Zita Kovács, Beáta Albert, Pál Salamon
    Reports.2023; 6(4): 51.     CrossRef
  • The effect of animal-assisted interventions on the course of neurological diseases: a systematic review
    Veronika Mittly, Cecilia Farkas-Kirov, Ágnes Zana, Kata Szabó, Veronika Ónodi-Szabó, György Purebl
    Systematic Reviews.2023;[Epub]     CrossRef
  • Analysis of Clinical Effects of Comprehensive Nursing Based on Enhanced Recovery after Surgery in Patients with Embolization for Intracranial Aneurysms
    Jing Liu, Kunxian Zhang, Bei Wang, Qin Hu, Qing Zhang, Lei Wan, Xianpu Wang, Wenping Xiong, Min Tang
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Influence of Evidence-Based Nursing on Psychological Status, Neurological Function, and Life Quality of Patients with Acute Poststroke Depression
    Yan Song, Fei Wang, Yakun Yang, Xing Liu, Chenghong Zhu, Zhongjie Shi
    Disease Markers.2022; 2022: 1.     CrossRef
  • 5,216 View
  • 129 Download
  • 5 Web of Science
  • 5 Crossref
Association Between Latency of Dermatomal Sensory-Evoked Potentials and Quantitative Radiologic Findings of Narrowing in Lumbar Spinal Stenosis
Dong Chan Yang, Ho Jun Lee, Jin-Woo Park, Kiyeun Nam, Shengshu Kim, Keun-Tae Cho, Bum Sun Kwon
Ann Rehabil Med 2020;44(5):353-361.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19164
Objective
To identify the difference of quantitative radiologic stenosis between a normal latency group and an abnormal latency group, and to investigate the association of dermatomal somatosensory-evoked potential (DSEP) with magnetic resonance imaging (MRI) findings of narrowing in patients with lumbar spinal stenosis (LSS).
Methods
We retrospectively reviewed the clinical records and P40 latencies of L5 DSEP of 40 patients with unilateral symptoms of LSS at the L4–5 disc level. Quantitative assessments of stenosis in lumbar spine MRI were performed with measurements of the anteroposterior diameter (APD), cross-sectional area (CSA) of the dural sac, ligamentous interfacet distance (LID), CSA of the neural foramen (CSA-NF), and subarticular zone width. Analyses were conducted through comparisons of radiologic severity between the normal and abnormal latency groups and correlation between radiologic severity of stenosis and latency of DSEP in absolute (APD <10 mm) and relative (APD <13 mm) stenosis.
Results
The radiologic severities of lumbar stenosis were not significantly different between the normal and abnormal latency groups. In absolute and relative stenosis, latency showed a significant negative correlation with APD (r=-0.539, r=-0.426) and LID (r=-0.459, r=-0.494). In patients with relative stenosis, a weak significant positive correlation was found between latency and CSA-NF (r=0.371, p=0.048). LID was the only significant factor for latency (β=-0.930, p=0.011).
Conclusion
The normal and abnormal DSEP groups showed no significant differences inradiologic severity. The latency of DSEP had a negative correlation with the severity of central stenosis, and LID was an influencing factor.

Citations

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  • Dermatomal somatosensory evoked potentials and cortical somatosensory evoked potentials assessment in congenital scoliosis
    Zhenxing Zhang, Yi Wang, Tao Luo, Huaguang Qi, Lin Cai, Yang Yuan, Jingfeng Li
    BMC Neurology.2022;[Epub]     CrossRef
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  • 138 Download
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  • 1 Crossref
Sequential Activation of AMPA Receptors and Glial Cells in a Pain Model of Lumbar Spine Disc Herniation
Dong Gyu Kwak, Dong Gyu Lee
Ann Rehabil Med 2020;44(5):343-352.   Published online September 28, 2020
DOI: https://doi.org/10.5535/arm.19202
Objective
To investigate the glial cell and AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor activity after surgery for disc herniation pain model.
Methods
In total, 83 Sprague-Dawley rats were randomly assigned to the following groups: control (n=16), sham-operated (n=4), rats for pain behavior evaluation (n=3), nucleus pulposus-exposed groups for AMPA receptors (n=30), and glial cell (n=30). The rats were tested for mechanical allodynia; immunohistochemical staining for AMPA receptors (GluA1 and GluA2) and glial cells (OX-42 and glial fibrillary acid protein [GFAP]) in the spinal dorsal horn was performed on postoperative days 3, 7, and 14.
Results
Mechanical withdrawal thresholds decreased after surgery, and this effect was maintained for up to 14 days. Immunohistochemical expression of GluA1 and GluA2 in the spinal dorsal horn had increased quantitatively on postoperative days 3 and 7 (p<0.05) to levels similar to that of the controls on postoperative day 14. Moreover, immunohistochemical expression of OX-42 and GFAP showed similar changes to AMPA receptors after surgery. Although the activity of AMPA receptors and glial cells achieved normalcy, the mechanical withdrawal threshold of the hind paw remained decreased 38 days after surgery.
Conclusion
The rat model of lumbar disc herniation showed increased expression of AMPA receptor and glial cell activity in the spinal dorsal horn 3 and 7 days after surgery, which deceased to control levels at 14 days. The AMPA receptors and glial cell activations showed similar patterns after disc herniation surgery.

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  • Regulating AMPA Receptors with Isoxazole-4-Carboxamide Derivatives: An Electrophysiological Study
    Mohammad Qneibi, Mohammed Hawash, Sosana Bdir, Mohammad Bdair, Tala Idais, Iyas Sarhan, Joud Touqan
    Journal of Xenobiotics.2025; 15(2): 40.     CrossRef
  • Predictive value of S100B and brain derived neurotrophic factor for radiofrequency treatment of lumbar disc prolapse
    Wael Fathy, Mona Hussein, Rehab Magdy, Hatem Elmoutaz, Neveen A Youssef, Marwa F Abd Alla, Ahmed M El Shaarawy, Mohamed Abdelbadie
    BMC Anesthesiology.2024;[Epub]     CrossRef
  • Animal Models of Intervertebral Disc Diseases: Advantages, Limitations, and Future Directions
    Jin Young Hong, Hyunseong Kim, Wan-Jin Jeon, Changhwan Yeo, Hyun Kim, Junseon Lee, Yoon Jae Lee, In-Hyuk Ha
    Neurology International.2024; 16(6): 1788.     CrossRef
  • 4,702 View
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Case Report

Unilateral Diaphragm Paralysis Associated With Neurosyphilis: A Case Report
Sungchul Huh, Jae Heun Chung, Han Jo Kwon, Hyun-Yoon Ko
Ann Rehabil Med 2020;44(4):338-341.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19216
Diaphragm dysfunction can originate from various etiologies, and bilaterality of the dysfunction depends on the cause. Symptoms of diaphragm dysfunction vary depending on the degree of phrenic nerve denervation, spinal cord lesion, and involvement of the diaphragm. Several infectious diaphragmatic dysfunctions have been reported, including the human immunodeficiency virus, poliovirus, West Nile virus, and dengue virus. Here, we report a case of unilateral diaphragm paralysis in a 34-year-old man with neurosyphilis.

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  • TEMPORARY REMOVAL : Diagnóstico de parálisis diafragmática de novo en el estudio de disnea en atención hospitalaria
    M.J. Pablo Zaro, I. Benavente Aguilar, Y. Lasierra Périz, D. Herrero Navarro, E. Briz Muñoz, F.J. Garrapiz López, J. Cegoñino de Sus, S. García Sáez, L. Borderías Clau
    Neurología.2025;[Epub]     CrossRef
  • Diaphragm Muscle Atrophy Contributes to Low Physical Capacity in COVID-19 Survivors
    Janusz Kocjan, Mateusz Rydel, Jan Szczegielniak, Katarzyna Bogacz, Mariusz Adamek
    Life.2024; 14(9): 1117.     CrossRef
  • Diaphragm Function Parameters in Patients with Severe COVID-19
    A. Y. Yakovlev, A. A. Pevnev, M. S. Belous, V. N. Maksimychev, S. I. Chistyakov
    General Reanimatology.2022; 18(1): 17.     CrossRef
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  • 197 Download
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Original Articles
Effect of a Multicomponent Intervention Program on Community-Dwelling People With Intellectual Disabilities
Ye-Soon Kim, Jong-Hoon Moon, Bo Kyoon Hong, Seung Hee Ho
Ann Rehabil Med 2020;44(4):327-337.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19124
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.

Citations

Citations to this article as recorded by  
  • The effect of a walking, dancing, and strength training program on the functional fitness of adults with intellectual disability: A randomised controlled trial
    E. Steyn, P.H. Boer, G. Joubert
    Journal of Intellectual & Developmental Disability.2024; 49(2): 186.     CrossRef
  • Five-repetition sit-to-stand test validation in adolescents and adults with intellectual disabilities
    Claudio Farías-Valenzuela, Catalina Shepherd-Shepherd, Paloma Ferrero-Hernández, Guillermo F. López-Sánchez, Sebastián Espoz-Lazo, Cristian Cofre-Bolados, Pablo del Val-Martín, Eduardo R. de Victo, Gerson Ferrari
    Scientific Reports.2024;[Epub]     CrossRef
  • Programas de Intervención Socioeducativos para Personas con Discapacidad Intelectual: una Revisión Sistemática
    Norma SALGADO-ORELLANA, Juan Francisco LAGOS-LUCIANO, Jorge ALARCÓN-LEIVA, Palmenia PINOCHET-QUIROZ, Francisco GÁLVEZ-GAMBOA
    Revista Brasileira de Educação Especial.2022;[Epub]     CrossRef
  • Effects of Multicomponent Physical Exercise Programs on Physical Fitness in People with Intellectual Disabilities: A Systematic Review
    Claudio Farías-Valenzuela, Paloma Ferrero-Hernández, Gerson Ferrari, Cristian Cofre-Bolados, Sebastián Espoz-Lazo, Sebastián Álvarez-Arangua, Adilson Marques, Pedro Valdivia-Moral
    Sustainability.2022; 14(24): 16728.     CrossRef
  • A Systematic Review of Health Promotion Programs to Improve Nutrition for People with Intellectual Disability
    Sarah Dean, Josephine Marshall, Erin Whelan, Jo Watson, Christina Zorbas, Adrian J. Cameron
    Current Nutrition Reports.2021; 10(4): 255.     CrossRef
  • 5,597 View
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  • 4 Web of Science
  • 5 Crossref
Flat Foot and Postural Harmony in 6-Year-Old Caucasians: What is Their Relationship?
Teresa Paolucci, Letizia Pezzi, Alice Mannocci, Giuseppe La Torre, Rosa Grazia Bellomo, Raoul Saggini
Ann Rehabil Med 2020;44(4):320-326.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19091
Objective
To determine whether asymptomatic flexible flat feet show specific postural assessment with respect to neutral feet in 6-year-old children.
Methods
In this cross-sectional observational study, 164 subjects were observed and divided into two groups: 57 with flexible flat feet and 107 with neutral feet. A non-quantitative inspection by podoscopy and baropodometry were performed to evaluate plantar support, and a clinical examination to assess postural setting.
Results
The prevalence of flexible flat feet was 34.8%. The differenceinthe mean centre of pressure (CoP) between the two groups was significant (p=0.028), regarding the antero-posterior direction of CoP only. There was no significant differencein the presence of postural growth disharmony between the neutral and flat-feet groups.
Conclusion
The flattening of the plantar archseems to be linked to a displacement of CoP Y, more posterior in flat feet than in neutral feet; on the other hand, postural harmony in 6-year-old children during growth is not influenced by flat feet.

Citations

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  • The Relationship Between The Degree Of Arcus Pedis And The Degree Of Vertebral Curve In Children
    Adnan Faris Naufal, Nuristiqomah Dwi Putri , Arif Setiawan, Pramudya Kurnia, Anida Azkia Fitri
    FISIO MU: Physiotherapy Evidences.2025; 6(1): 92.     CrossRef
  • Effect of Thoracic Kyphosis and Lumbar Lordosis on the Distribution of Ground Reaction Forces on the Feet
    Arkadiusz Żurawski, Zbigniew Śliwiński, Edyta Suliga, Grzegorz Śliwiński, Żaneta Wypych, Wojciech Kiebzak
    Orthopedic Research and Reviews.2022; Volume 14: 187.     CrossRef
  • Kappa Active Orthosis: a preliminary biomechanical study on the immediate effect of a novel orthotic intervention for pediatric flexible flat foot
    Paolo RONCONI, Massimiliano MURGIA, Teresa PAOLUCCI, Michelina ARMANDO, Eugenio DI STANISLAO, Federica CAMUNCOLI, Manuela GALLI
    Minerva Orthopedics.2021;[Epub]     CrossRef
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  • 195 Download
  • 4 Web of Science
  • 3 Crossref
A Fully Immersive Virtual Reality Method for Upper Limb Rehabilitation in Spinal Cord Injury
Da Young Lim, Dong Min Hwang, Kang Hee Cho, Chang Won Moon, So Young Ahn
Ann Rehabil Med 2020;44(4):311-319.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19181
Correction in: Ann Rehabil Med 2025;49(1):60
Objective
To determine whether a fully immersive virtual reality (VR) intervention combined with conventional rehabilitation (CR) can improve upper limb function more than CR alone in patients with spinal cord injury (SCI), we conducted a prospective, randomized, controlled clinical trial.
Methods
Participants were randomly assigned to either the control group (CG; n=10) or experimental group (EG; n=10). The participants in the CG received 60 minutes of conventional therapy per day, 4 days per week for 4 weeks, whereas those in the EG received 30 minutes of VR training and 30 minutes of conventional therapy per day, 4 days per week for 4 weeks. The clinical outcome measures included Medical Research Council grade, the American Spinal Injury Association upper extremity motor score (ASIA-UEMS), and scores in the Hand Strength Test, Box and Block Test, Nine-Hole Peg Test, Action Research Arm Test, and Korean version of the Spinal Cord Independence Measure (K-SCIM). The assessments were performed at the beginning (T0) and end of the intervention (T1).
Results
Grip power and K-SCIM score significantly improved in the EG after the intervention. When comparing differences between the groups, elbow extensor, wrist extensor, ASIA-UEMS, grip power, lateral pinch power, and palmar pinch power were all significantly improved.
Conclusion
VR training of upper limb function after SCI can provide an acceptable adjunctive rehabilitation method without significant adverse effects.

Citations

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  • Creating adapted environments: enhancing accessibility in virtual reality for upper limb rehabilitation through automated element adjustment
    V. Herrera, J. Albusac, J. J. Castro-Schez, C. González-Morcillo, D. N. Monekosso, S. Pacheco, R. Perales, A. de los Reyes-Guzmán
    Virtual Reality.2025;[Epub]     CrossRef
  • Immersive Virtual Reality in Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Its Efficacy in Upper Limb Recovery
    Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
    Journal of Clinical Medicine.2025; 14(6): 1783.     CrossRef
  • AdaptRehab VR: Development of an Immersive Virtual Reality System for Upper Limb Stroke Rehabilitation Designed for Low- and Middle-Income Countries Using a Participatory Co-Creation Approach
    Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
    Bioengineering.2025; 12(6): 581.     CrossRef
  • Applying a Virtual Art Therapy System Based on the Michelangelo Effect in Patients with Spinal Cord Injury
    Michela Franzò, Sara De Angelis, Marco Iosa, Gaetano Tieri, Giorgia Corsini, Giovanni Generoso Cellupica, Valentina Loi, Fabiano Bini, Franco Marinozzi, Giorgio Scivoletto, Federica Tamburella
    Sensors.2025; 25(13): 4173.     CrossRef
  • Virtual Rehabilitation in Spinal Cord Injury Patients: Realities and Future Perspectives. A Systematic Review
    Claudia Vinciguerra, Antonio Federico
    Current Physical Medicine and Rehabilitation Reports.2024; 12(4): 425.     CrossRef
  • Case report: Virtual reality-based arm and leg cycling combined with transcutaneous electrical spinal cord stimulation for early treatment of a cervical spinal cord injured patient
    Xiaolei Chu, Shuaiyi Liu, Xiaoxuan Zhao, Tao Liu, Zheng Xing, Qingwen Li, Qi Li
    Frontiers in Neuroscience.2024;[Epub]     CrossRef
  • Application of immersive virtual reality in the training of wheelchair boxers: evaluation of exercise intensity and users experience additional load– a pilot exploratory study
    Jacek Polechoński, Alan Langer, Anna Akbaş, Anna Zwierzchowska
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  • Technological Features of Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Systematic Review
    Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
    Sensors.2024; 24(11): 3546.     CrossRef
  • Lower Extremity Exoskeleton for Human Spinal Cord Injury: A Comprehensive Review
    Tianci Wang, Zaixin Song, Hao Wen, Chunhua Liu
    IEEE Open Journal of the Industrial Electronics Society.2024; 5: 575.     CrossRef
  • Characterizing the Effects of Adding Virtual and Augmented Reality in Robot-Assisted Training
    Xupeng Ai, Victor Santamaria, Sunil K. Agrawal
    IEEE Transactions on Neural Systems and Rehabilitation Engineering.2024; 32: 2709.     CrossRef
  • Virtual Reality as a Therapeutic Tool in Spinal Cord Injury Rehabilitation: A Comprehensive Evaluation and Systematic Review
    Matteo Scalise, Tevfik Serhan Bora, Chiara Zancanella, Adrian Safa, Roberto Stefini, Delia Cannizzaro
    Journal of Clinical Medicine.2024; 13(18): 5429.     CrossRef
  • Remote Extended Reality With Markerless Motion Tracking for Sitting Posture Training
    Xupeng Ai, Sunil K. Agrawal
    IEEE Robotics and Automation Letters.2024; 9(11): 9860.     CrossRef
  • Effects of virtual reality rehabilitation after spinal cord injury: a systematic review and meta-analysis
    Likun Wang, Hong Zhang, Haibo Ai, Yuxi Liu
    Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef
  • Immersive virtual reality for learning exoskeleton-like virtual walking: a feasibility study
    Antonio Rodríguez-Fernández, Alex van den Berg, Salvatore Luca Cucinella, Joan Lobo-Prat, Josep M. Font-Llagunes, Laura Marchal-Crespo
    Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef
  • Effects of digital-based interventions on muscular strength in adults: a systematic review, meta-analysis and meta-regression of randomized controlled trials with quality of evidence assessment
    Armin Paravlic, Luka Šlosar, Ensar Abazovic, Uros Marusic
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  • The cognitive basis for virtual reality rehabilitation of upper-extremity motor function after neurotraumas
    Sophie Dewil, Shterna Kuptchik, Mingxiao Liu, Sean Sanford, Troy Bradbury, Elena Davis, Amanda Clemente, Raviraj Nataraj
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    Farhah Amaliya Zaharuddin, Nazrita Ibrahim, Azmi Mohd Yusof
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    Sean Sanford, Brian Collins, Mingxiao Liu, Sophie Dewil, Raviraj Nataraj
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The Formula for Health and Well-Being in Individuals With Cerebral Palsy: Cross-Sectional Data on Physical Activity, Sleep, and Nutrition
Patrick G. McPhee, Olaf Verschuren, Mark D. Peterson, Ada Tang, Jan Willem Gorter
Ann Rehabil Med 2020;44(4):301-310.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19156
Objective
To determine physical activity, sleep, and nutrition patterns in individuals with cerebral palsy (CP) and investigate the association of Gross Motor Function Classification System (GMFCS) and age with these health behaviors.
Methods
A cross-sectional study was conducted in an outpatient setting. Participants included adolescents and adults with CP (n=28; GMFCS level I–V; mean age 35.1±14.4 years). An Exercise Questionnaire or Leisure Time Physical Activity Questionnaire was used to measure physical activity in adolescents and adults, respectively. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). An adapted version of the PrimeScreen questionnaire was used to assess nutrition. Linear regression analyses were performed to investigate the association between GMFCS and age with physical activity, sleep, and nutrition.
Results
The average total physical activity was 29.2±30.0 min/day. Seventy-five percent of the participants had poor sleep quality (PSQI score >5). Seventy-one percent reported “fair” eating behaviors; none reported “excellent” eating behaviors. Neither GMFCS nor age were significantly associated with PSQI score, PrimeScreen score, or total physical activity. A negative correlation existed between sleep quantity (hr/night) and PSQI score (r=-0.66, p=0.01).
Conclusion
The triad of health components, consisting of physical activity, sleep, and nutrition, was not associated with GMFCS or age in our sample of 28 individuals with CP, suggesting that these three health behaviors should be assessed during clinical encounters of CP in adolescents and adults at all levels of the GMFCS.

Citations

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  • Subjective measurement of physical activity and sedentary behaviour in children and adolescents with cerebral palsy: a scoping review
    Mette Johansen, Britt Laugesen, Katarina Lauruschkus, Helle M. Rasmussen
    Disability and Rehabilitation.2025; 47(11): 2709.     CrossRef
  • The 24-Hour Physical Activities in Adults With Cerebral Palsy and Their Adherence to the 24-Hour Movement Guideline
    Ilse Margot van Rijssen, Jan Willem Gorter, Johanna Maria Augusta Visser-Meily, Manin Konijnenbelt, Marieke van Driel, Mandy Geertruda Cornelia Carina van Drunen, Olaf Verschuren
    Archives of Physical Medicine and Rehabilitation.2025; 106(5): 696.     CrossRef
  • Measuring Physical Activity in Children Who Do Not Walk and With Cerebral Palsy: An Exploratory Case Series
    Nia Toomer-Mensah, Margaret O’Neil, Miguel Blacutt, Lori Quinn
    Pediatric Physical Therapy.2024; 36(3): 353.     CrossRef
  • Physical activity and sedentary behavior among ambulatory children with cerebral palsy using accelerometer: a cross-sectional study
    Njoud Aydhah Alamoudi, Maha F. Algabbani, Muhammad O. Al-Heizan, Adel A. Alhusaini
    Frontiers in Pediatrics.2024;[Epub]     CrossRef
  • Real‐time daily fatigue, sleep, physical activity, and health‐related fitness in adults with cerebral palsy
    Olaf Verschuren, Joyce L. Benner, Astrid C. J. Balemans, Herwin Horemans, Rita Johanna G. Van Den Berg‐Emons, Wilma M. A. Van Der Slot
    Developmental Medicine & Child Neurology.2023; 65(4): 509.     CrossRef
  • Prevalence and incidence of chronic conditions among adults with cerebral palsy: A systematic review and meta‐analysis
    Jennifer M. Ryan, Fatemah Albairami, Thomas Hamilton, Nigel Cope, Noor Amirah Amirmudin, Manjula Manikandan, Cherry Kilbride, Valerie L. Stevenson, Emma Livingstone, Jennifer Fortune
    Developmental Medicine & Child Neurology.2023; 65(9): 1174.     CrossRef
  • The Effect of Eight Weeks of Aquatic Exercises on Muscle Strength in Children with Cerebral Palsy: A Case Study
    Mehrnoosh Esmailiyan, Seyed Mohamad Marandi, Maryam Darvishi, Shaghayegh Haghjooy Javanmard, Atefeh Amerizadeh
    Advanced Biomedical Research.2023;[Epub]     CrossRef
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    Fatih ENZİN, Hazel ÇELİK GÜZEL, Sevgi FELEK
    Harran Üniversitesi Tıp Fakültesi Dergisi.2022; 19(2): 354.     CrossRef
  • Adults with Cerebral Palsy Require Ongoing Neurologic Care: A Systematic Review
    Sarah E. Smith, Mary Gannotti, Edward A. Hurvitz, Frances E. Jensen, Linda E. Krach, Michael C. Kruer, Michael E. Msall, Garey Noritz, Deepa S. Rajan, Bhooma R. Aravamuthan
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    Meagan C Brown, Christina M Marciniak, Ariane M Garrett, Deborah J Gaebler‐Spira
    Developmental Medicine & Child Neurology.2021; 63(10): 1221.     CrossRef
  • Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities
    Shane N. Sweet, Zhiyang Shi, Meredith Rocchi, Jean Ramsay, Véronique Pagé, Marie-Eve Lamontagne, Heather L. Gainforth
    Archives of Physical Medicine and Rehabilitation.2021; 102(9): 1746.     CrossRef
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    Jonathon Law, Colin G. Pennington
    International Journal of Physical Education, Fitness and Sports.2021; : 73.     CrossRef
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Relationship Between Line Bisection Test Time and Hemispatial Neglect Prognosis in Patients With Stroke: A Prospective Pilot Study
Shinyoung Kwon, Wookyung Park, MinYoung Kim, Jong Moon Kim
Ann Rehabil Med 2020;44(4):292-300.   Published online August 5, 2020
DOI: https://doi.org/10.5535/arm.19112
Objective
To determine the relationship between line bisection test (LBT) performance time and prognosis of hemispatial neglect (HSN) in stroke patients.
Methods
Data on stroke patients with HSN were prospectively collected. After patient recruitment and eligibility screening, the LBT, Motor-Free Visual Perception Test 3rd edition, and Korean version of Mini-Mental State Examination were performed at the time of admission and 4 weeks thereafter. The LBT performance time was also measured. All patients received conventional rehabilitation for 4 weeks. Based on the improvements in their LBT grades, the patients were divided into improved and non-improved groups. The evaluation results of the two groups were compared using Mann–Whitney U-tests and logistic regression was performed to predict the independence of each outcome.
Results
In total, 26 stroke patients with HSN were included, with 13 patients in each group. Significant differences were observed in the baseline LBT performance times between the improved and non-improved groups (p<0.05). Logistic regression analysis revealed associations between HSN prognosis, and baseline LBT performance time (odds ratio=0.95; 95% confidence interval, 0.90–1.00; p<0.05) and baseline Motor-Free Visual Perception Test 3rd edition (odds ratio=1.20; 95% confidence interval, 1.01–1.43; p<0.05).
Conclusion
A significant relationship was observed between the baseline LBT performance time and HSN prognosis.

Citations

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  • Application of immersive virtual reality for assessing chronic neglect in individuals with stroke: the immersive virtual road-crossing task
    Julia Belger, Sebastian Wagner, Michael Gaebler, Hans-Otto Karnath, Bernhard Preim, Patrick Saalfeld, Anna Schatz, Arno Villringer, Angelika Thöne-Otto
    Journal of Clinical and Experimental Neuropsychology.2024; 46(3): 254.     CrossRef
  • Preservation of Cerebellar Afferent Pathway May Be Related to Good Hand Function in Patients with Stroke
    Bo Kyung Shin, Hae-Yeon Park, Hanee Rim, Ji Yoon Jung, Sungwoo Paek, Yeun Jie Yoo, Mi-Jeong Yoon, Bo Young Hong, Seong Hoon Lim
    Life.2022; 12(7): 959.     CrossRef
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  • 4 Web of Science
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Preliminary Clinical Trial of Balance Compensation System for Improvement of Balance in Patients With Spinocerebellar Ataxia
Ji Seon Hong, Ji Hyun Kim, Sang Yeol Yong, Young Hee Lee, Sung Hoon Kim, Jun Young Park, Jung Kuk Lee, Ji Yoon Jang
Ann Rehabil Med 2020;44(4):284-291.   Published online August 5, 2020
DOI: https://doi.org/10.5535/arm.19165
Objective
To determine the immediate and short-term impact of the application of wearable balance compensation system (BCS) on balance impairment in patients with spinocerebellar ataxia (SCA).
Methods
The study enrolled 6 participants with SCA with varying degrees of balance impairment. After adjustment for individual fitting, wearable BCS with up to 3% body weight was placed in a garment on the trunk. Sway direction and magnitude were measured with sensors placed posteriorly at the lumbosacral junction, immediately before and after, and at day 1, day 2, and day 7 after wearing the BCS. Timed Up & Go test (TUG) and 25-foot timed walk test were performed, and static foot pressure was measured.
Results
A significant improvement in static and dynamic balance was found during the 25-foot timed walk and in static foot pressure measurement results after wearing the BCS, when compared with that at baseline (p=0.044 vs. p=0.011). Anterior and posterior sway showed improvements from baseline after wearing the BCS. Improvement in the lateral swaying movement control was also seen.
Conclusion
Application of the BCS might be beneficial in the improvement ofthe static and dynamic balance in patients with SCA. Further research on long-term effects and with a larger sample size is indicated.

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  • Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
    Kap-Soo Han, Myoung-Hwan Ko
    Geriatrics.2025; 10(1): 23.     CrossRef
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    Stella Wagner, Patrick Nenert, Arnaud Choplin
    Kinésithérapie, la Revue.2024; 24(267): 24.     CrossRef
  • Pharmacological and non-pharmacological management of spinocerebellar ataxia: A systematic review
    Kah Hui Yap, Shahrul Azmin, Jemaima Che Hamzah, Norfazilah Ahmad, Bart van de Warrenburg, Norlinah Mohamed Ibrahim
    Journal of Neurology.2022; 269(5): 2315.     CrossRef
  • Is Lateropulsion Really Related with a Specific Lesion of the Brain?
    Kyoung Bo Lee, Sang Won Yoo, Eun Kyu Ji, Woo Seop Hwang, Yeun Jie Yoo, Mi-Jeong Yoon, Bo Young Hong, Seong Hoon Lim
    Brain Sciences.2021; 11(3): 354.     CrossRef
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  • 3 Web of Science
  • 4 Crossref
Ultrasound Imaging of the Trunk Muscles in Acute Stroke Patients and Relations With Balance Scales
Yunho Kim, Jeeyoung Kim, Heesung Nam, Hyun Dong Kim, Mi Ja Eom, Sang Hoon Jung, Nami Han
Ann Rehabil Med 2020;44(4):273-283.   Published online July 28, 2020
DOI: https://doi.org/10.5535/arm.19125
Objective
To examine the correlation between ultrasonographic trunk muscle parameters and balance scales in mild acute stroke patients.
Methods
A total of 55 stroke patients with hemiparesis and motor power grade ≥4 in the manual motor test were included. The Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Trunk Control Test (TCT) were used to evaluate patient balance function. Ultrasonographic parameters were measured on both non-paretic and paretic sides of the rectus abdominis, external oblique, internal oblique, transversus abdominis, and erector spinae muscles. Resting thickness and contraction thickness were measured in all muscles, and contractility and contractility ratio were calculated based on measured thicknesses. The differences between paretic and non-paretic muscle parameters, and the correlation between ultrasonographic parameters and balance scales were analyzed. Stroke patients were divided into two groups according to their fall risk. Ultrasonographic measurements between the two groups were compared.
Results
All muscles’ contraction thickness and contractility were significantly different between paretic and non-paretic sides (p<0.001). Contractility ratios of all trunk muscles showed a significant correlation with SARA, BBS, TUG, and TCT (p<0.05). Contractility ratios of all muscles were significantly different between high- and low-risk fall groups (p<0.05).
Conclusion
The contractility ratio in stroke patients reflects their balance disturbance and fall risk and it may serve as a new parameter for ultrasound imaging of trunk muscles.

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    Asalet Aybüke Güp, Banu Bayar
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    Gülşah Sütçü, Levent Özçakar, Ali İmran Yalçın, Muhammed Kılınç
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    Chansol Park, Hwi-Young Cho, Chang-Ki Kang
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    I-Hsuan Chen, Pei-Jung Liang, Valeria Jia-Yi Chiu, Shu-Chun Lee
    Frontiers in Neurology.2021;[Epub]     CrossRef
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