Citations
To investigate the effects of real repetitive peripheral magnetic stimulation (rPMS) treatment compared to sham rPMS treatment on pain reduction and functional recovery of patients with acute low back pain.
A total of 26 patients with acute low back pain were randomly allocated to the real rPMS group and the sham rPMS group. Subjects were then administered a total of 10 treatment sessions. Visual analogue scale (VAS) was assessed before and after each session. Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ) were employed to assess functional recovery at baseline and after sessions 5 and 10.
Real rPMS treatment showed significant pain reduction immediately after each session. Sustained and significant pain relief was observed after administering only one session in the real rPMS group. Significant functional improvement was observed in the real rPMS group compared to that in the sham rPMS group after sessions 5 and 10 based on ODI and after session 5 based on RMDQ.
Real rPMS treatment has immediate effect on pain reduction and sustained effect on pain relief for patients with acute low back pain compared to sham rPMS.
Citations
To determine the incidence and risk factors for medical complications in Korean patients suffering from stroke and the impact of such complications on post-stroke functional outcomes.
We assessed patients enrolled in a prospective cohort study. All recruited patients had suffered a first acute stroke episode and been admitted to nine university hospitals in Korea between August 2012 and June 2015. We analyzed patient and stroke characteristics, comorbidities, prevalence of post-stroke medical complications, and functional outcomes at time of discharge and 3, 6, and 12 months after stroke onset.
Of 10,625 patients with acute stroke, 2,210 (20.8%) presented with medical complications including bladder dysfunction, bowel dysfunction, sleep disturbance, pneumonia, and urinary tract infection. In particular, complications occurred more frequently in older patients and in patients with hemorrhagic strokes, more co-morbidities, severe initial motor impairment, or poor swallowing function. In-hospital medical complications were significantly correlated with poor functional outcomes at all time points.
Post-stroke medical complications affect functional recovery. The majority of complications are preventable and treatable; therefore, the functional outcomes of patients with stroke can be improved by providing timely, appropriate care. Special care should be provided to elderly patients with comorbid risk factors.
Citations
Objective: To investigate the effect of rehabilitation therapy on functional recovery in chronic stroke patients.
Method: Brunnstrom stage for neurologic recovery, modified Barthel index (MBI) for functional recovery, and possibility of gait were assessed in 66 chronic stroke patients. MBI and possibility of gait were compared the patients who received rehabilitation therapy (Rehab patients) with the patients who did not receive rehabilitation therapy (non- Rehab patients) in each Brunnsrom stage.
Results: In Brunnstrom stage III, 13 of 15 Rehab patients could walk 10 m or more, but none of 7 non-Rehab patients could walk independently, and this difference was statistically significant. MBI score was also significantly higher in Rehab patients than non-Rehab patients (71.3 vs 18.9, p=0.000) in Brunnstrom stage III. In Brunnstrom stage IV, V, VI, MBI score and possibility of gait were higher in Rehab patients than non-Rehab patients, but not significant.
Conclusion: We can confirm the effect of rehabilitation therapy on functional recovery, and this effect seems to be more decisive in neurologically low recovery status patients. (J Korean Acad Rehab Med 2002; 26: 370-373)
Objective: The purposes of this study were (1) to determine the effectiveness of intensive rehabilitation on ambulatory recovery in patients after hip fracture with previous cerebrovascular accident; (2) to define the difference in the ambulatory outcome of the hip fracture patients according to their previous history of stroke.
Method: One hundred and seventy-three cases with hip fracture were studied. All patients were divided into two groups: Group A with and Group B without a history of stroke prior to the fracture. The following information was obtained in each patients: age, sex, type and side of fracture, side of hemiplegia, duration of hospitalization, concurrent disease. Ambulatory status was divided as satisfactory (walking with quad-cane or walking frame or mono-cane) or nonsatisfactory (confined to wheelchair or to a bed) accordong to their recovery after rehabilitation.
Results: Twenty three percent of patients have the history of stroke with hip fracture on hemiplegic side and 51.4% of them regained their prefracture level of ambulation. No significant difference was found in the incidence of concurrent disease, length of hospital stay, and functional recovery between hip fracture patients with and without a history of stroke.
Conclusion: We conclude that rehabilitation of the stroke patient with hip fracture is worthwhile and comprehensive rehabilitation should be done in hip fracture patients with or without hemiplegia.
Possible mechanisms of neurologic recovery in spinal cord injury were postulated by Ditunno Jr. JF in 1987. The first window encompasses recovery from neurapraxia within 6 to 8 weeks. The second window covers the period from 2 to 8 months after the injury. Recovery during this period might be due to peripheral sprouting of intact nerves to denervated muscle and hypertrophy of functioning muscles. The third window of recovery happens usually beyond 8 to 12 months when axonal regeneration may play a role in further increases in strength.
On the basis of these possible mechanisms, we measured the neurological and functional recovery rate according to the periods of these possible mechanisms of motor recovery through 12 months following injury in 21 traumatic spinal cord injury patients.
The results were as follows:
1) Neurologically, the most rapid recovery was shown within 6 to 8 weeks after injury, during the phase of recovery from neurapraxia.
2) Most of functional recovery occured in the period between 2 month and 8 month of the compensatory phase.
3) Statistically significant correlation between motor and functional recovery was shown among the incomplete spinal cord injury group.
These data would be helpful in planning a timely appropriate rehabilitation program by understanding the time-course of neurologic recovery and prognostication of neurologic and functional recovery in the spinal-cord injured.
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