Citations
To investigate the relationship between the buttoning test and Jebsen-Taylor Hand Function Test (JTHFT), and to determine the validity of using the buttoning test as a tool to evaluate hand disability in patients with stroke.
This was a retrospective study of the medical records of 151 ischemic stroke patients affecting the dominant hand. Patients underwent the buttoning test and JTHFT for their affected hand. All patients were divided into three groups depending on how quickly they fastened a button (group A, not completed; group B, slowly completed over 18 seconds; and group C, completed within 18 seconds).
The button fastening time was negatively correlated with the total score and subtest scores of the JTHFT. Patients who experienced difficulty during the buttoning test had lower mean scores in the JTHFT (group A, 28.0±23.9; group B, 62.9±21.7; group C, 75.4±13.3; p<0.0001, Jonckheere-Terpstra test). We observed significant differences in JTHFT scores among the three groups (p<0.017, Mann-Whitney U-test), although there were considerable overlaps in JTHFT scores between the groups. Significant differences were also found in the subtest scores of the JTHFT, which include fine hand motor function (writing letters, p=0.009; moving small objects, p=0.003; stacking checkers, p=0.001 between groups B and C), among the three groups.
Considering its relationship with the JTHFT and validity, the buttoning test can be considered appropriate for evaluation of hand disability in patients with stroke.
Citations
To evaluate the effectiveness of intensive neurodevelopmental treatment (NDT) on gross motor function for the children having developmental delay (DD), with or without cerebral palsy (CP).
Forty-two children had intensive NDT three times weekly, 60 minutes a day, for 3 months, immediately followed by conventional NDT once or twice a week, 30 minutes a day, for another 3 months. We assessed Gross Motor Function Measure (GMFM) over three time points: before conventional NDT, before and after intensive NDT, and after 3 months of additional conventional NDT.
The GMFM score in DD children significantly improved after intensive NDT, and the improvement maintained after 3 months of conventional NDT (p<0.05). The children were further divided into two groups: DD with CP and DD without CP. Both groups showed significant improvement and maintained the improvements, after intensive NDT (p<0.05). Also, there was no significant difference in treatment efficacy between the two groups. When we calculate the absence rate for comparing the compliance between intensive and conventional NDT, the absence rate was lower during the intensive NDT.
Intensive NDT showed significantly improved gross motor function and higher compliance than conventional NDT. Additionally, all improvements were maintained through subsequent short-term conventional NDT. Thus, we recommend the intensive NDT program by day-hospital centers for children with DD, irrespective of accompanying CP.
Citations
Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options
To evaluate the effectiveness of lower energy flux density (EFD) extracorporeal shock wave therapy (ESWT) in the early stage of avascular necrosis (AVN) of the femoral head.
Nineteen patients and 30 hips were enrolled. All subjects received 4 weekly sessions of ESWT, at different energy levels; group A (n=15; 1,000 shocks/session, EFD per shock 0.12 mJ/mm2) and group B (n=15; 1,000 shocks/session, EFD per shock 0.32 mJ/mm2). We measured pain by using the visual analog scale (VAS), and disability by using the Harris hip score, Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). To determine the effect of the lower EFD ESWT, we assessed the VAS, Harris hip score, HOOS, WOMAC of the subjects before and at 1, 3, and 6 months.
In both groups, the VAS, Harris hip score, HOOS, and WOMAC scores improved over time (p<0.05).
Lower EFD ESWT may be an effective method to improve the function and to relieve pain in the early stage of AVN.
Citations
To translate, adapt, and test the reliability, validity, and responsiveness of the Korean version of the Shoulder Disability Questionnaire (SDQ) and the Shoulder Rating Questionnaire (SRQ).
The international guideline for the adaptation of questionnaires was referenced for the translation and adaptation of the original SDQ and SRQ. Correlations of the SDQ-K and SRQ-K with the Shoulder Pain and Disability Index (SPADI) and the Numeric Rating Scale (NRS) were assessed to determine the reliability and validity of the questionnaires. To evaluate reliability, surveys were performed at baseline and a mean of 6 days later in 29 subjects who did not undergo any treatment for shoulder problems. To evaluate responsiveness, assessments were performed at baseline with 4-week intervals in 23 subjects with adhesive capsulitis who were administered triamcinolone injection into the glenohumeral joint.
Fifty-two subjects with shoulder-related problems were surveyed. Cronbach alpha for internal consistency was 0.82 for the summary SDQ-K and 0.75 for the summary SRQ-K. The test-retest reliability of the SDQ-K, SRQ-K, and domains of the SRQ-K ranged from 0.84 to 0.95. The SDQ-K and SRQ-K summary scores correlated well with the SPADI and NRS summary scores. Generally, the effect sizes and standardized response means of the summary scores of the SDQ-K, SRQ-K, and domains of the SRQ-K were large, reflecting their responsiveness to clinical changes after treatment.
The reliability, validity, and responsiveness of the SDQ-K and SRQ-K were excellent. The SDQ-K and SRQ-K are feasible for Korean patients with shoulder pain or disability.
Citations
To evaluate changes in activity of daily living before and after provision of electric-powered indoor/outdoor chair (EPIOC), discuss problems of current activities of daily living (ADL) evaluating tools for EPIOC users, and provide preliminary data to develop ADL evaluation tool for EPIOC user.
A total of 70 users who were prescribed EPIOC and had been using for more than 1 year were recruited in this study. Before and after provision of EPIOC, MBI and FIM scores were measured and a questionnaire consisting of six categories (general socioeconomic states, currently using state, whether EPIOC was helpful for social participation and occupational chances, psychiatric influences, self-reported degrees of independency, and barriers of using EPIOC) was used.
No difference in MBI scores before and after provision of EPIOC was observed. However, the wheelchair ambulation category showed a significant difference. While motor FIM was not significantly different from MBI, FIM score were significantly (p<0.05) higher than MBI. For questions regarding social participation frequency, helpfulness of EPIOC on confidence, refreshing patients' emotions and self-reported degrees of independence, all of them showed positive responses. Especially, EPIOC users' self-reported degree of independency showed favorable results. There was discrepancy in MBI or FIM measured by physicians.
Our study showed that there was a gap between the existing ADL evaluation tool and the ADL level that EPIOC users were actually feeling. Thus, it is necessary to develop an evaluation tool specifically for EPIOC.
Citations
To investigate the relationship between gross motor function and daily functional skill in children with cerebral palsy (CP) and to explore how this relationship is moderated by the Gross Motor Function Classification System, Bimanual Fine Motor Function (BFMF), neuromotor types, and limb distribution of CP.
A cross-sectional survey of 112 children with CP (range, 4 years to 7 years and 7 months) was performed. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and functional skill was assessed with the Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS).
GMFM-66 scores explained 49.7%, 67.4%, and 26.1% of variance in the PEDI-FSS scores in the self-care, mobility, and social function domains, respectively. Significant moderation by the distribution of palsy and BFMF classification levels II, III, and IV was found in the relationship between GMFM-66 and PEDI-FSS self-care. Further significant moderation by the distribution of palsy was also observable in the relationship between GMFM-66 and PEDI-FSS mobility.
These findings suggest that limb distribution and hand function must be considered when evaluating gross motor function and functional skills in children with CP, especially in unilateral CP.
Citations
Method: Thirty-five registered disabled persons after stroke were evaluated by two physiatrists to assess the grades of disability according to CDGG and PDGG, which were in use. The evaluations of disabled persons for the grading were done by the physiatrists through house-visit and at the hospital according to CDGG (hereinafter called CDGG-visit and CDGG-OPD) and PDGG (hereinafter called PDGG-grade). These re-evaluated disability grades were compared with the initial disability grades recorded in their disability registries.
Results: There was a low level of agreement between the registered grade and the re-evaluated grades; however, there has shown a high level of agreement amongst the re-evaluated grades. The degree in the registered grade was evaluated upward compared to the degree in other reevaluated grades.
Conclusion: The difference degree between CDGG and PDGG of established was insignificant; however, a new candidate who wants to be evaluated using CDGG has possibilities of facing unfairness when compared to the disabled people with relatively higher registered degrees. (J Korean Acad Rehab Med 2003; 27: 329-334)
ated disability grades were compared with the initial disability grades recorded in their disability registries.
Results: There was a low level of agreement between the registered grade and the re-evaluated grades; however, there has shown a high level of agreement amongst the re-evaluated grades. The degree in the registered grade was evaluated upward compared to the degree in other reevaluated grades.
Conclusion: The difference degree between CDGG and PDGG of established was insignificant; however, a new candidate who wants to be evaluated using CDGG has possibilities of facing unfairness when compared to the disabled people with relatively higher registered degrees. (J Korean Acad Rehab Med 2003; 27: 329-334)
Objective: To evaluate the effect of compensation or secondary gain on the pain behavior and psychometric characteristics.
Method: We examined 88 patients who complained of chronic low back pain by the various pain questionnaires, electrodiagnostic study and magnetic resonance imaging (MRI). Total patients were classified into two groups (46 patients who wanted disability evaluation and 42 patients who did not).
Results: Mean score of visual analogue scale, total sum of McGill pain questionnaire and pain rating index on sensory, affective and miscellaneous dimensions were significantly higher in patients related to disability compensation than those in patients without compensation. Mean scores of pain disability index and symptom checklist-90-revision were significantly higher on various subclass in patients with compensation. Various pain scales were significantly correlated to each other in both group but the severity of electrodiagnostic study and MRI findings were not related with the degree of pain index score in both group.
Conclusion: Compensation or secondary gain affect pain behavior and psychometric characteristics in chronic low back patients. So when we evaluate or treat the patients with chronic low back pain, we should consider above results.
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