Vascular dementia (VD) is a dementia syndrome associated with cerebrovascular disease. Among the several subtypes of VD, most common subtypes are multi-infarct dementia, single-infarct dementia, and subcortical vascular dementia. In patients with multi-infarct dementia, dementia occurs with a close temporal relationship to stroke episodes. Brain imaging usually shows multiple territory cortico-subcortical infarcts. Single-infarct dementia, in contrast, is caused by a single infarct in specific regions of the brain such as thalamus, caudate nucleus, capsular genu, angular gyrus, or hippocampus. In subcortical VD, primary lesion is lacunar infacts or ischemic white matter lesions that are located in subcortical regions, i.e., deep nuclei (basal ganglia and thalamus) or white matter (periventricular and deep white matter). The diagnosis of subcortical vascular dementia is challenging, since stroke episodes are often unrecognized, thus temporal relationship between onset of dementia and stroke is lacking. This article describes 1) subtypes of VD, 2) illustrative cases with vascular dementia, 3) research criteria for VD, 4) treatment of VD, and 5) a general guideline on caregiving for patients with VD, which will enable clinicians to provide better diagnosis and management of patients with VD. (Korean Acad Rehab Med 2002; 26: 639-646)

Objective
To examine the validity of the fuctional reach test (FRT) for evaluation of standing balance in hemiplegic patients. Method: Twenty three hemiplegic patients who were capable of standing without assistive devices were assessed on the FRT only with intact upper limb, the one-legged stance, the timed up and go test (TUG), the 10 meter walking time (10 mWT), the 'Hauser' ambulation index (AI), and the standing balance of Bohannon. Results: The forward reach of FRT demonstrated significant correlation with the TUG and the 10 mWT (p＜0.01), but no significant relationship with the one-legged stance, standing balance of Bohannon and AI. Conclusion: The forward reach of FRT may be simple and useful tool for assessing the clinical balance function and reflecting gait ability and fall-down risk in hemiplegic patients. (J Korean Acad Rehab Med 2002; 26: 647-651)

Objective
The purpose of this study was to determine the effect of balance board training combined with tactile stimulation on the affected leg of hemiplegic patients in improving the ability of balance control. Method: Thirty hemiplegic patients participated. In the study group, two pieces of adhesive tapes were attached on the skin of affected lower leg. And then, they performed balance training on a balance board. The training was performed for 4 weeks. The control group received conventional gait training program for the same period. Subjects in both groups were tested for their balance control abilities using Balance Master before and after the training period. Results: In the study group, there were statistically significant improvements in the abilities of the weight bearing, body sway control, and rhythmic weight shift (p＜0.05) after balance board training. After the training, there were statistically significant differences in the abilities of weight bearing and rhythmic weight shift (p＜0.05) between the two groups. Conclusion: The training with balance board combined with tactile stimulation to the affected leg and foot was proved to be effective for the treatment of balance control abilities in hemiplegic patients. (J Korean Acad Rehab Med 2002; 26: 652-657)

Objective
To measure anterior displacement of the humeral head and to observe its relationship with clinical findings in the subluxed hemiplegic shoulders. Method: Seventeen hemiplegic patients, having the subluxed shoulder over one finger breadth were subjected. We measured shoulder pain, muscle power of the shoulder abductors, Brunnstrom stage and spasticity in the affected upper extremity. To measure the humeral displacement of the shoulder subluxation, the AP and transthoracic lateral views of simple radiologic picture were taken on both affected and unaffected shoulders, and repeated after donning three kinds of arm slings. Results: Its anterior displacement as well as the inferior displacement occured in all subjects, and was significantly related with the value of shoulder pain and spasticity, and the inferior displacement with Brunnstrom stage and muscle power of the shoulder abductors in the subluxed hemiplegic shoulder (p＜0.05). Correction of the humeral displacement occured significantly in anterior direction as well as inferior by use of all tested arm slings. Conclusion: Clinical implications of the shoulder subluxation were different according to direction of the humeral displacement, and anterior displacement will be considered for its symptom in hemiplegic shoulder. (J Korean Acad Rehab Med 2002; 26: 658-666)

Objective
To evaluate the effect of repetitive bilateral arm training with rhythmic auditory cueing (BATRAC) on functional motor performances of the hemiplegic upper limb. Method: Twenty four subjects with stroke (12 males, 12 females) were enrolled and classified into two groups, experimental and control group. The control group received conventional rehabilitation therapy while the experimental group received additional BATRAC. The motor function of patient's upper extremity was assessed by Fugl-Meyer Motor Function Assessment (FMA), Manual Function Test (MFT), and Functional Independence Measure (FIM) before the treatment, at 4 weeks and at 6 weeks after begining of the treatment. Results: There were no differences in FMA between two groups before the treatment and the continual improvements in the function at 4 weeks and at 6 weeks after begining of the treatment (p＜0.05). Furthermore, the experimental group revealed higher performances in FMA than control group (p＜0.05). However, there were no differences in FIM and MFT before the treatment and in the improvements of function after the treatment between two groups (p＞0.05). Conclusion: BATRAC improves motor performance of the paretic upper extremity and will be useful as an additional tool of improving motor function in patients with stroke. (J Korean Acad Rehab Med 2002; 26: 667-671)

Objective
The aim of this study was to find out the factors related to the recovery of hand motor function in patients with subcortical hemorrhage. Method: We investigated 21 patients with subcortical hemorrhage prospectively. We used their CT and/or MR imaging for the localization and estimation of the size of lesion. The Hand Movement Scale (HMS) was used for evaluation of the hand function. Proprioception, initial shoulder and hand recovery were also measured every month for at least 6 months during the follow up periods. Results: There are 13 patients with putaminal hemorrhage and 8 patients with thalamic hemorrhage. There is no difference in general characteristics between the two groups. When recovery began within 4 weeks after onset, only thalamic hemorrhage patients showed significantly good recovery. Initial shoulder shrug, especially within 4 weeks after onset, could be one of the prognostic factors of good hand motor recovery. Putaminal hemorrhage patients, who had higher scores on the hand movement scale, showed early recovery of proprioceptive function. Conclusion: Among many other factors which can be involved in the recovery of hand function in patients with subcortical hemorrhage, the time of initial hand motor recovery, the time of initial shoulder shrug, and proprioceptive function were most important. (J Korean Acad Rehab Med 2002; 26: 672-680

Objective
To assess the frequency of traumatic basal ganglia hemorrhage (TBGH) and its functional recovery in traumatic brain injury (TBI). Method: Three hundred two patients with TBI were retrospectively analyzed via the medical records and radiologic findings. The subjects were divided into 4 groups according to the brain lesions: extraaxial lesion (subdural hemorrhage, epidural hemorrhage, subarachnoid hemorrhage), intraaxial lesion (diffuse axonal injury, white matter hemorrhage, gray matter hemorrhage), mixed lesion, and TBGH. Statistical comparison of cause, severity and prognosis between groups was performed wth Chi-square analysis. Results: Mean age was 41.6 years old. The most common lesion of TBI was extraaxial lesion. The most common cause was falls (47.5%). The incidence of TBGH group was 4.7%. Although TBGH group was of longer duration of hospital stay and lower GCS than the other brain lesions, there was no significant difference in GOS score. TBGH with extraaxial or mixed lesion was of lower GCS and GOS score compared with TBGH itself or TBGH with intraaxial lesion. Conclusion: The associated cerebral lesion, but not TBGH itself, could be considered to be an important factor in determining severity and recovery of TBI. (J Korean Acad Rehab Med 2002; 26: 681-686)

Objective
To evaluate the benefits of cold and warm stress Digital Infrared Thermographic Imaging (DITI) for detecting Reflex Sympathetic Dystrophy (RSD) in stroke patients compared with conventional non-stress DITI. Method: Twenty-three stroke subjects with clinical RSD and fifteen stroke subjects without RSD underwent stress and non-stress DITI. Stress DITI study was performed by continuously imaging both hand dorsum for 30 minutes while immersing an sound side lower limb in cold and warm water bath. The cold and warm water bath were kept at 12.0⁑1.4^oC and at 37.0⁑1.4^oC respectively. Results: The sensitivity and specificity of conventional non- stress DITI were 82.6% and 80.0% when side to side temperature difference was more than 1^oC. The sensitivity and specificity of cold stress DITI test were improved to 95.7% and 93.3%, those of warm stress DITI test to 86.9% and 86.7%. Conclusion: This study indicates that cold stress DITI study may be helpful method in identifying the RSD, which is not detected by conventional non-stress DITI test. (J Korean Acad Rehab Med 2002; 26: 687-692)

Objective
To reveal basic mechanism regarding the swallowing difficulty in stroke and inflammatory myopathy patients, and to compare this with normal persons. Method: Five volunteers without any swallowing problems, three inflammatory myopathy patients and five stoke patients with swallowing difficulty and a similar movement of the hyoid bone were included in this study. Video-fluoroscopic swallowing studies were performed in all subjects, and their videofluroscopic motions were analyzed through 2-dimensional motion analysis using the APAS(Ariel Performance Analysis System). Results: The motions of the hyoid bone and the epiglottis of the inflammatory myopathy patients were much smaller than those of the volunteers but their pattern was similar to the volunteers. Although the difference in the displacement of the hyoid bone and epiglottis between the stroke patients and volunteers was low, the movement pattern between them was different. During an excursion of the hyoid bone, there was an interruption in its motion, which may be due to the spasticity of the cricopharyngeal muscle. Conclusion: In inflammatory myopathy patients, the cause of the dysphagia is a weakness of the upper esophageal constrictor muscle, i.e. the cricopharyngeal muscle, may be another cause. Relieving the spasticity of the cricopharyngeal muscle as well as strengthening of the swallow-related muscles should be considered when treating stroke patients with dysphagia. (J Korean Acad Rehab Med 2002; 26: 693-698)

Objective
To evaluate the effectiveness of local intramuscular botulinum toxin type A injection in patients with congenital muscular torticollis. Method: Six patients (mean age, 13.3 months) with congenital muscular torticollis who did not respond to physical therapy were participated with the informed consent of their parents. Twenty-five to fifty Speywood units of Dysport (Beaufour Ipsen, France) were injected into the palpated mass of the sternocleidomastoid muscle. The angle of tilt and range of motion of the neck in sitting position were obtained before and after injection. The size of the mass within the sternocleidomastoid muscle was measured with ultrasonogram. Results: Satisfactory improvement of 3 parameters at post- injection 6-month follow-up was achieved in all patients. The tilting angle and range of motion of the neck to rotation were normalized in 5 patients. The size of the mass within the sternocleidomastoid muscle was decreased significantly with ultrasonographic evaluation. Conclusion: Local intramuscular BTA injection might be effective for patients with congenital muscular torticollis who do not respond to conservative management. (J Korean Acad Rehab Med 2002; 26: 699-703)

Objective
To analyze the factors influencing the capacity of cough, the relationships between maximal respiratory pressure, lung compliance, capacity of cough, and assisted cough techniques were evaluated in tetraplegics. Method: The vital capacity (VC) in seated and supine position, maximum insufflation capacity (MIC), maximum inspiratory (MIP) and expiratory (MEP) pressure in seated position were measured. Unassisted and assisted peak cough flow (PCF) at two different conditions (a volume assisted method by the mechanical insufflation [PCFmic] and the manual assistance by abdominal compression [MPCF]) were evaluated in 44 tetraplegic patients. Results: The mean value of VC in supine was greater than that of seated position (p＜0.01). The MICs of the subjects were significantly higher than VCs in a same position (＜0.01). Both volume and manual assisted method showed significantly higher PCF than unassisted PCF (p＜0.01). MIP (r=0.53) correlated with UPCF as well as MEP (r=0.68), although MEP was better correlated with MPCF. Conclusion: Generally the therapists apply manual pressure only to increase capacity of cough, which assist the expulsive phase. The results of this study showed that both inspiratory and expulsive phases should be assisted to enhance the effectiveness of cough. (J Korean Acad Rehab Med 2002; 26: 704-708)

Objective
To provide informations on contributing factors analysis for the driving status in spinal cord injured people through basic statistics from an analysis of the survey results. Method: The survey was administered to 121 spinal cord injured persons with no evidence of head injury. Subjects were divided to driver group and non-driver group and compared to their general charateristics, neurologic characteristics, status of activity of daily living (ADL). Logistic regression was used to analyze contributing factors for the driving status. Results: Forty-four (36.4%) of 121 respondents were driving and among them male drivers were 35 (79.6%). The average age and the age at the time of injury were lower in the driver group than non-driver group. Among complete lesions, C7 was the highest level who could drive independently. The mean score of ADL was significantly higher in the driver group than non-driver group. The significant factors that affect the driving of spinal cord injured persons were sex, age, age at the time of injury, Frankel type, motor score, jobs after their injury, compensations for their accidents, means of ambulation, sports activities, and ADL status. Especilly significant factors were age at the time of injury, means of ambulation, ADL status. Conclusion: We suggested that the driver training should be an essential part of the rehabilitaion program for the spinal cord injured people to maximize their quality of life in the community. (J Korean Acad Rehab Med 2002; 26: 709-716)

Objective
The comparison of nerve conduction parameters of each laboratory is difficult because those are influenced by many factors. This study was performed to provide comprehensive normative nerve conduction parameters of median nerve by using a meta-analysis. Method: We searched MEDLINE between year 1965 to 2000. Among them we selected 7 articles that provided the mean, standard deviation and sample size of median nerve conduction study and estimated the reference value of median nerve conduction parameters using a meta-analysis. Results: The distal latency of median motor nerve was measured at 8 cm proximal to motor point of abductor pollicis brevis and the distal latency of median sensory nerve was measured at 14 cm proximal to interphalangeal joint of 2nd or 3rd finger. Mean of distal onset latency, amplitude, and conduction velocities of median motor nerve were 3.46 msec, 11.12 mV, and 57.10 m/sec, respectively. Mean of onset distal latency, peak distal latency, and amplitude of median sensory nerve conduction study were 2.72 msec, 3.34 msec, and 37.29 mV, respectively. Conclusion: Meta-analysis can summarize large quantity of studies and can maximize subject numbers, it can provide reference value approximate to the normal one. So this value can be used in interpretation of the reference value of each laboratories. (J Korean Acad Rehab Med 2002; 26: 717- 727)

Objective
To assess the correlation between the risk categories of diabetic foot screening test by 5.07 Semmes- Weinstein monofilament and the findings of standard nerve conduction studies of upper and lower extremities. Method: We studied 74 patients who were consulted to our department to rule out the diabetic neuropathy. We classified the patients to 4 risk groups by foot screening test using 5.07 Sememes-Weinstein monofilament, and performed the standard nerve conduction studies of upper and lower extremities. The risk categories of foot screening tests were compared to the findings of the nerve conduction studies. Results: When the risk category becomes higher, there were more delay in latencies (motor and sensory potentials of median and ulnar nerve, sensory potentials of sural and superficial peroneal nerve, median and peroneal F-wave), slower conduction velocities (median, ulnar, peroneal, posterior tibial nerve) and lower amplitudes (motor and sensory potentials of media and ulnar nerve, peroneal and posterior tibial nerve, sural nerve) (p＜0.05). Except for the amplitude of ulnar nerve and the latencies of peroneal and ulnar nerve, there were significant differences in the nerve conduction study data between the risk group 3 and the risk group 0 (p＜0.05). Conclusion: We confirmed that the risk category of diabetic foot screening test by Semmes-Weinstein monofilament can meaningfully reflect the severity of diabetic neuropathy. We also suggest that it is necessary to pay attention to the nerve conduction study in the patients with history of foot ulcer. (J Korean Acad Rehab Med 2002; 26: 728-733)

Objective
Multiple factors including age, sex, habituation, refraction, cooperation and technical variables are associated with P100 latency of Visual evoked potential (VEP). So we tried to evaluate the P100 latency of visual evoked potential according to refraction. Method: We studied 28 patients (12 males, 16 females) with myopia. Subjects were divided into 3 groups (mild, moderate, severe myopia) according to refraction and we evaluated the results of VEP studies. Results: Mean values of refraction and latency (P100) of naked eyes were ⁣4.27 D, 103.95 msec. and those of corrected eyes (in glasses) were ⁣0.25 D, 100.59 msec. Respectively, in mild, moderate and severe myopia, the each P100 latency of naked eyes were 101.27 msec, 102.59 msec, 107.99 msec and those of corrected eyes were 98.33 msec, 100.58 msec, 102.19 msec respectively (p＜0.05). There was significant negative correlation between refraction and P100 latency in myopia. Conclusion: Our results suggested that there were significant changes in VEP (P100 latency) according to refraction. In performing the VEP study, we should consider the refraction and visual acuity. (J Korean Acad Rehab Med 2002; 26: 734-738)

Objective
We studied the clinical utility of surface electromyography (SEMG) for the assessment of chronic low back pain (CLBP). Method: We compared electrical activity from electrodes placed on the 16 lumbar paraspinal areas between 25 CLBP patients and 25 control subjects in static neutral standing posture and dynamic flexion-reextension state. The CLBP patients and the control subjects were matched for age, gender, and body mass index (BMI) to adjust for any confounding effects. We analyzed amplitudes and areas of electrical activity on lumbar paraspinal muscles in neutral standing posture and dynamic flexion-reextension state. Results: In the static neutral posture, there are increased amplitudes of electrical activity in CLBP compared with controls (p＜0.01). In the dynamic flexion-reextension state, area ratio of electrical acitivity during the extension state to electrical acitivity during flexion state are significantly decreased in CLBP compared with controls (p＜0.01). The presence of lumbar radiculopathy or the severity of LBP is not well correlated with the electrical acitivity on SEMG. The sensitivity and the specificity of SEMG are 72% and 80% respectively. Conclusion: These results indicate that SEMG is a useful method for the assessment of CLBP. (J Korean Acad Rehab Med 2002; 26: 739-744)

Objective
To investigate the prevalence and risk factors of carpal tunnel syndrome in diabetic patients. Method: Electrodiagnostic study was performed to diagnose carpal tunnel syndrome and polyneuropathy in 266 (male 151, female 115) diabetic patients. General charateristics, diabetes related factors, anthropometric factors were compared between non-carpal tunnel syndrome and carpal tunnel syndrome groups to identify the risk factors for carpal tunnel syndrome. Results: Prevalence of carpal tunnel syndrome in diabetic patients was 16.2 % (43 subjects). Female, farming, wrist depth width ratio (≥0.7) were associated with carpal tunnel syndrome in diabetic patients. In right hand, odds ratio was 12.82 (95% confidence interval: 2.97∼55.3) in female, 5.15 (95% confidence interval: 1.17∼22.7) in farming, 28.53 (95% confidence interval: 1.80∼451.1) in wrist depth width ratio (≥0.7). The similar results were also observed in left hand. Conclusion: The results suggest that occupation, sex, and anthropometric factor like wrist shape were more associated with carpal tunnel syndrome in diabetic patients than diabetes mellitus itself. (J Korean Acad Rehab Med 2002; 26: 745-751)

Objective
To determine the prevalence of each risk category for diabetic foot ulcer by foot screening test with Semmes-Weinstein monofilament and to evaluate the correlation of the risk category with clinical data in diabetic inpatients. Method: Foot screening tests with Semmes-Weinstein monofilament was performed in 90 diabetic inpatients to determined the risk category for diabetic foot ulcer. An average age of patients was 55 years, and an average duration of the disease was 11 years. The correlation of risk category was evaluated with age, duration of the disease, FBS (fasting blood glucose) level, HbA1c value, and complications of diabetes including retinopathy, peripheral polyneuropathy, and renal failure. Results: Patients with risk category 0 had no loss of protective sensation in 34.4% of cases. Patients with risk category 1, 2, and 3 had loss of protective sensation in 16.7%, 28.9% and 20% of cases, respectively. The older a patient was and the longer the duration of the disease was, the higher the risk category was significantly (p＜0.05). There was no significant correlation of risk category with FBS level and HbA1c value. Among the complications associated with diabetes, retinopathy and peripheral polyneuropathy significantly correlated with risk category (p＜0.05), but renal failure was not significantly associated. Conclusion: The foot screening test with Semmes-Weinstein monofilament should be helpful for proper management of diabetic foot in inpatient. (J Korean Acad Rehab Med 2002; 26: 752-758)

Objective
The purpose of this study was to analyze the relationship between isokinetic measurement and electromyographic method in muscle power measurement of lumbar muscles. Method: The subjects were 23 chronic lower back pain patients and 17 normal adult. Isokinetic lumbar extensor strength test was performed at specific speeds (120^o/sec, 180^o/sec) with Cybex 770 and automatic turn/amplitude analysis of electromyogram (EMG) was performed with Viking EMG system. Results: The relationship between the parameters of isokinetic test and turn/sec of EMG study was not significantly correlated. The relationship between the para-meters of isokinetic test and amplitude of EMG study was significantly correlated. The relationship between the parameters of isokinetic test and ratio of turns to mean amplitude of EMG was not correlated significantly. The mean amplitude in 120^o/sec speed test and the ratio of turns to mean amplitude in 120^o/sec and 180^o/sec speed test were significantly lower in chronic lower back pain patients than that of normal controls. Conclusion: Turn/amplitude analysis of EMG method if performed with isometric or isokinetic muscle test will be clinically useful in muscle power measurement of lumbar muscles. (J Korean Acad Rehab Med 2002; 26: 759-763)

Objective
To determine the effect of prolotherapy on lateral epicondylitis, and the difference of treatment effect according to the findings of ultrasonography. Method: The subjects were 84 patients who were diagnosed as lateral epicondylitis. The pain score was evaluated by using VAS (Visual Analogue Scale) before treatment and 1 month and 6 months after the 3rd injection. Ultrasonography was done to 49 patients who were suspicious of tendinous tear. Results: In the comparison of the VAS before treatment and after the 3rd injection, it was 6.79⁑0.88, 2.95⁑1.90, respectively, which demonstrated statistical significant decrease (p＜0.01). We found more significant reduction of VAS in the subjects without tendinous tear (7.08⁑0.91 to 2.16⁑1.57) than those with partial tendinous tear (6.90⁑0.93 to 3.67⁑1.76) (p＜0.01). Among 71 patients whose symptom was improved after the treatment, 57 patients (80.2%) demonstrated sustained improvement at 9 months and 14 patients (19.7%) relapsed at 9 months. Conclusion: Prolotherapy is an effective treatment method in the lateral epicondylitis of elbow. Ultrasonography could be a useful diagnostic method which could predict the effect of prolotherapy. (J Korean Acad Rehab Med 2002; 26: 764-768)

Objective
To evaluate the effects of exercises after local steroid injection on the rabbit Achilles tendon. Method: Twenty-one rabbits were received local injection of triamcinolone acetonide in the Achilles tendons. Group I rabbits were exercised passively on the ankle for three consecutive days immediately after injection. Group II were left to rest for three days after the injections, and then exercised for three days. Group III were left to rest without exercise. Triamcinolone was injected intratendinously in the right Achilles tendons (subgroup a), and injected in the paratendinous tissue of the left Achilles tendons (subgroup b). The Achilles tendons were dissected at 7 days after injection. Results: Collagen concentration of group Ia was significantly lower than group IIa or IIIa. Collagen concentration of group Ib was significantly lower than group IIb. Collagen concentration of group Ia was significantly lower than group Ib. In tendons of group Ia, partial necrotic tissues with fragmented tendon fiber bundles were seen in light microscopic examinations. onclusion: These results demonstrate that intratendinous injection of triamcinolone and immediate exercise of injected tendon, regardless of the routes of the injection, may cause damage to the rabbit Achilles tendon. (J Korean Acad Rehab Med 2002; 26: 769-775)

Objective
The purpose of this study is to understand the distribution of golf-related pain and associated factors by analysing the questions posted at Internet golf site. Method: Total 69 questions and its access number of golfers at two Korean internet golf sites (www.rhygolf.com, www.golfsky.com) were analyzed in the period of June, 2000 to July, 2001. We also conducted a supplementary e-mail survey to know demographic data and other informations of those who posted the questions. Results: In both categories of numbers of questions and access rate, upper extremity including shoulder, elbow, wrist and hand was the most common area of pain complaints, followed by spine, lower extremity, chest in orders. Golf career of upper extremity pain group were significantly low compared with other groups (p＜0.05). Female golfers had more tendency to complain multiple pains than male golfers (p＜0.05). Conclusion: Golf itself relatively imposes more burden on upper extremity and spine. Among factors, sex and golf career were associated with anatomical distribution of golf-related pain. Even though the result is comparable to previous report, more complementary follow-up field study should be done. (J Korean Acad Rehab Med 2002; 26: 776-780)

Objective
The purpose of this study is to measure the skin-pleura distance (SPD) of interscapular intercostal space and to correlated SPD with the individual constitutional data such as body-weight, height, obesity and body mass index (BMI; kg/m²). Method: We examined 50 patients (36 men and 14 women) who had no pathological abnormality in interscapular intercostal space. We measured the SPD in chest CT (GE sytec 3000i) study and also measured individual constitutional data of patients. Results: The average age of the subjects was 47.0⁑15.3 years, average weight was 59.0⁑9.7 kg, average height was 167.0⁑8.7 cm, average obesity was 98.4⁑14.9%, average BMI was 21.1⁑3.2 kg/m²and average SPD was 3.7⁑0.7 cm. There was no correlation of statistical significance between SPD, height and age. But there were statistically significant correlations between SPD, weight, obesity and BMI (p＜0.01). Linear regression analysis of these data showed significant correlations between SPD and weight (p＜0.01, y=0.109x⁣2.744), obesity (p＜0.01, y=0.092x⁣5.367) and BMI (p＜0.01, y=0.380x⁣4.301). Conclusion: We conclude that the approach considering the correlations between SPD and obesity or BMI will be helpful in reducing pleural puncture during any injection on interscapular intercostal space. (J Korean Acad Rehab Med 2002; 26: 781-784)

Objective
The aim of this study was to evaluate the changes of foot breadth and ball girth according to the height of shoes heel in the people without foot problems. Method: 480 subjects were evaluated with clinical examination, foot length, foot breadth and ball girth of right foot with and without shoes heel. The examination without shoes heel was performed without weight bearing. The examination with shoes heel was performed with weight bearing. 20 mm, 25 mm and 30 mm shoes heel were used for men, respectively. 30 mm, 40 mm and 60 mm shoes heel were used for women, respectively. Results: There was significant increment in foot breadth and ball girth in the case with weight bearing, and significant increment in foot breadth and ball girth in the case of using higher shoes heel. But in women, foot breadth and ball girth using 60 mm shoes was shorter than that using 40 mm shoes. Conclusion: The breadth and the ball girth of the shoes according to the height of shoes heel should be considered to make more practical shoes. (J Korean Acad Rehab Med 2002; 26: 785-789)

Objective
To survey the cause of the cardiacs' low participation rate and poor compliance in cardiac rehabilitation. Method: Among those who admitted in the department of cardiology and chest surgery for acute care and then discharged, group 1 included 104 patients who never participated in cardiac rehabilitation, and group 2 included 47 patients who once joined in but discontinued before 7 sessions, and group 3 included 25 patients who continued it more than 18 sessions with good compliance. Questions related to the low participation rate and discontinuity and personality, psychological status, education level were asked. By SPSS, basic discriptive data were calculated. To compare the data among groups, independent t-test and Chi-square test were done. Results: In group 1, the main causes of low participation rate was lack of recognition about it (78 patients, 75%), doubt on effect (48 patients, 46.2%), poor physical condition (38 patients, 36.5%). In group 2, the main cause of discontinuity was lack of time (12 patients, 25.5%), thought of being able to perform at home (11 patients, 23.4%), poor physical condition (7 patients, 14.9%). Conclusion: To raise the participation rate and compliance in cardiac rehabilitation, it is very important to make a pitch for cardiac rehabilitation and improve program service for patient's convinience. (J Korean Acad Rehab Med 2002; 26: 790-796)

Objective
To investigate the safety of exercise program under medical supervision for cardiac patients in their early phase from cardiac events, and the types and the frequency of possible cardiovascular complications during or after exercise. Method: 197 cardiac patients who participated in phase 2 cardiac rehabilitation were selected and they performed aerobic exercise program by individualized exercise prescription under ECG monitoring 3 times a week for 6 weeks. Throughout total 2,429 sessions of exercise, abnormal symptoms, hemodynamic responses and ECG abnormalities were analyzed. Results: Cardiovascular complications ocurred in 25 patients (12.7%). ECG abnormalities in 14 sessions (0.58%) of 13 patients, chest pain during exercise in 17 sessions (0.67%) of 13 patients, abnormal hemodynamic responses in 8 sessions (0.33%) of 8 patients were observed. Cardiac arrest and myocardial infarct didn't happened. 18 patients (72%) experienced these complications during warming-up period, 6 patients (24%) during cool-down period and one patient (4%) during resting period. Conclusion: During exercise, there was some possibility of abnormal ECG changes, chest pain, hemodynamic responses but these potentially dangerous situations could be prevented from advancing on real emergency by intense attention and monitoring. Even cardiac patients of acute stage can tolerate adequate amount of exercise load safely under careful clinical supervision. (J Korean Acad Rehab Med 2002; 26: 797-801)

Objective
To analyse the sites of medical information by popular search engines and its appropriateness as guidance to medical information. Method: The search phrase "carpal tunnel syndrome" (CTS) and "stroke" were entered into four commonly used Korean web search engines. 24 and 21 web-sites from search engines were gathered, respectively. These web sites then were evaluated for authorship, content, and an informational value score was assigned to each. Results: According to authorship in CTS, 16.6 percent of the sites were commercial sites and 20.8 percent were authored by oriental medical doctors with 37.5 and 16.6 percent by general physicians and physiatrists, respectively. With stroke, 9.5 percent was commercial and each 71.4, 19.0, 0 percent was authored by oriental medical doctors, physician, physiatrist respectively. Each 75, 28.6 percent of the sites offered conventional information. The mean informational value of web sites was 51.1, 41.1 points. Conclusion: The information about CTS on the internet is of limited quality, inconsistent contentional value, despite of relatively high informational value. With stroke, information was offered by mainly oriental medical doctors, and was not so valuable. The public and medical communities need to recognize these limitations so that the quality of medical information on the internet can be improved. (J Korean Acad Rehab Med 2002; 26: 802-805)

Hiccup can be regarded as a failure of the usual alternating excitation-inhibition between glottis closure and inspiration. The coordinating center is located in the brain-stem reticular formation. A wide variety of pathological conditions can cause intractable hiccup: myocardial infarction, brain tumor, renal failure, prostate cancer, abdominal surgery, etc. Stroke is an unusual cause of intractable hiccup. Intractable hiccup is rare but disabling condition which can induce depression, weight loss, sleep deprivation, and even death. Etiological treatment is not always available and intractable hiccup treatment has classically relied on metoclopramide and chlorpromazine. We experienced a case of intractable hiccup induced by multiple cerebral infarct, and we present this rare case with the review of literature. (J Korean Acad Rehab Med 2002; 26: 806-810)

Sturge-Weber syndrome is a congenital neurocutaneous disorder of the vessels of the face, the leptomeninges and the brain. Clinically SWS consists of symptoms and signs including a facial nevus (port-wine stain), seizure, hemiparesis, mental retardation. But only a few reports related to atypical Sturge-Weber syndrome without facial nevus have been published. We report a patient with atypical Sturge-Weber syndrome without any clinical feature except hemiparesis. In neuroimaging studies using brain CT scan and MRI, leptomeningeal angiomatosis was demonstated that is the characteristic feature of Sturge- Weber syndrome. In atypical Sturge-Weber syndrome, there may be late- developed complications such as hemiparesis. In conclusion, neuroimaging study is recommended to confirm diagnosis in suspicious atypical SWS patient. (J Korean Acad Rehab Med 2002; 26: 811-814)

Cavernous hemangiomas occur throughout the central nervous system. Although they are most commonly found in the brain, the intraspinal lesion accounts for approximately 5% of all adult intramedullary lesions. Widespread use of MR imaging have led to an increase in the reported cases of intramedullary cavernous hamangiomas. Spinal intramedullary cavernomas are positioned in a particularly precarious location, and are more likely to cause clinically significant findings than cranial cavernomas. It is important to recognize cavernomas as a surgically manageable cause of myelopathy. Generally, surgery cannot cure the chronic myelopathy from cavernoma but can halt it's progression. These facts emphasize the need for early diagnosis. In our two cases, they developed initially low back pain and sensory changes of both legs and subsequently paraplegia. We report two cases of intramedullary cavernous hemangioma with the review of literatures. (J Korean Acad Rehab Med 2002; 26: 815-818)