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1.
J Korean Med Sci ; 38(7): e26, 2023 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-36808542

RESUMEN

BACKGROUND: To examine the incidence of traumatic spinal cord injury (TSCI) from all etiologies, we measured and compared the incidence of TSCI from three national or quasi-national databases in South Korea, namely, the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). METHODS: We reviewed patients with TSCI reported in the NHIS database between 2009 and 2018, and in the AUI and IACI databases between 2014 and 2018. TSCI patients were defined as those first admitted to the hospital with a diagnosis of TSCI according to the International Classification of Diseases (10th revision) criteria. Age-adjusted incidence was calculated using direct standardization using the 2005 South Korean population or the 2000 US population as the standard population. The annual percentage changes (APC) of TSCI incidence were calculated. The Cochrane-Armitage trend test was performed according to the injured body region. RESULTS: In the NHIS database, age-adjusted TSCI incidence using the Korean standard population increased significantly from 2009 to 2018 (from 33.73 per million in 2009 to 38.14 per million in 2018, APC = 1.2%, P = 0.014). Contrarily, age-adjusted incidence in the AUI database significantly decreased from 13.88 per million in 2014 to 11.57 per million in 2018 (APC = - 5.1%, P = 0.009). In the IACI database, the age-adjusted incidence showed no significant difference, while crude incidence showed a significant increase (from 22.02 per million in 2014 to 28.92 per million in 2018, APC = 6.1%, P = 0.038). According to the age group, all the three databases showed high incidences of TSCI in those in their 60s and 70s or older. Among those in their 70s or older, the incidence of TSCI increased dramatically in the NHIS and IACI databases, while no significant trend was found in AUI database. In 2018, the number of TSCI patients was the highest among those over 70 years of age in the NHIS, whereas among those in their 50s were the highest in both AUI and IACI. The proportion of patients with cervical spinal cord injury was the most common in all these databases. CONCLUSIONS: The differences in trends in the incidence of TSCI may be due to the different etiologies and different characteristics of subjects depending on insurance type. These results imply the need for tailored medical strategies for the different injury mechanisms represented by three national insurance services in South Korea.


Asunto(s)
Seguro , Traumatismos de la Médula Espinal , Anciano , Anciano de 80 o más Años , Humanos , Accidentes de Trabajo , Automóviles , Incidencia , República de Corea
2.
Dysphagia ; 36(3): 351-361, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-32519149

RESUMEN

The Eating and Drinking Ability Classification System (EDACS) was developed to evaluate dysphagia in children with cerebral palsy (CP). This study aimed to investigate the interrater reliability and validity of the EDACS in adults with CP. This cross-sectional study included 117 community-dwelling adults (mean age, 37.9 ± 12.5 years) with a confirmed CP diagnosis. A swallowing occupational therapist (SwOT) conducted detailed interviews with participants and/or caregivers to classify the EDACS. Another SwOT and participants/caregivers evaluated the EDACS. Correlations were evaluated between the EDACS and Functional Oral Intake Scale (FOIS), Swallowing Quality of Life (SWAL-QOL), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification System (MACS). Interrater reliabilities between SwOTs (κ = 0.866, intraclass correlation coefficient (ICC) = 0.867), and between SwOT and participant/caregiver (κ = 0.884, ICC = 0.717) were reported. The EDACS correlated with the FOIS, SWAL-QOL, and MACS, although no significant correlation was found with the GMFCS. The EDACS of spastic-type showed better correlation than that of dyskinetic-type with the FOIS, MACS, and GMFCS. There was a significant correlation between the EDACS and the GMFCS in those aged ≤ 30 years, whereas there was no correlation in those aged ≥ 30 years. The EDACS is a reliable and valid tool for classifying eating and drinking ability in adults with CP. The correlation between the EDACS with gait or hand function was more prominent in individuals with spastic CP and in younger individuals. The EDACS is a valuable adjunct to comprehensive functional classification in adults with CP.


Asunto(s)
Parálisis Cerebral , Calidad de Vida , Adulto , Parálisis Cerebral/complicaciones , Niño , Estudios Transversales , Evaluación de la Discapacidad , Ingestión de Alimentos , Humanos , Persona de Mediana Edad , Reproducibilidad de los Resultados
3.
J Pediatr Gastroenterol Nutr ; 71(5): 686-691, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33093379

RESUMEN

OBJECTIVES: The functional oral intake scale (FOIS), developed for adults based on the categories of consumable food has been adapted for infants. A FOIS for children is necessary as oral motor development continues after 1 year of age. This study proposed a FOIS for children and investigated the reliability and validity of the scale. METHODS: We adapted the original FOIS into a scale for children by removing 2 item levels to generate a 5-point scale. This retrospective study included 194 children ages 1 to 7 years. Their nutrition records were evaluated separately by 2 raters using the FOIS for children. Dysphagia and aspiration severity were evaluated based on the findings from a videofluoroscopic swallowing study. For children partially dependent on tube feeding, medical records were investigated to determine whether full oral feeding was accomplished within 1 year. RESULTS: The inter-rater reliability of FOIS for children had 97.4% agreement (weighted kappa = 0.985, intraclass correlation coefficient = 0.994). Significant associations were identified between the FOIS for children and aspiration severity (P < 0.001, r = 0.315) and dysphagia severity (P < 0.001, r = 0.287). The rate of reaching full oral feeding within 1 year was greater (71.4% vs 30%) in children at the FOIS 3 level (tube and oral feeding in parallel) than for children at FOIS 2 (tube-dependent with minimal oral intake). CONCLUSIONS: The FOIS for children showed adequate reliability and validity and could be appropriate for documenting children's eating abilities and evaluating the effectiveness of interventions.


Asunto(s)
Trastornos de Deglución , Adulto , Niño , Preescolar , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Ingestión de Alimentos , Humanos , Lactante , Psicometría , Reproducibilidad de los Resultados , Estudios Retrospectivos
4.
Clin Rehabil ; 34(5): 667-676, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32164455

RESUMEN

OBJECTIVE: This study aimed to develop and validate an instrument that measures the attitudes of healthcare professionals toward persons with disabilities. DESIGN: The Delphi survey consensus method was used to compose a preliminary questionnaire for survey. Then, healthcare professionals responded to the questionnaire online, and the results were used for psychometric analysis. SETTING: Three tertiary hospitals. SUBJECTS: A total of 993 healthcare professionals. INTERVENTIONS: Not applicable. MAIN MEASURES: Attitudes of healthcare professionals toward persons with disabilities. RESULTS: A 28-item preliminary questionnaire was initially developed after a two-round Delphi survey with 16 experts. Through an online survey, the final 20 items were categorized as follows: behaviors in clinical situation, knowledge and skills, emotional response, and responsibility of healthcare professionals. The Cronbach's alpha coefficient for the total score was 0.890 and varied between 0.856 and 0.892 in the four subdomains. The newly developed tool showed an acceptable model fit. Healthcare professionals who participated in an education module showed higher scores in behavior and knowledge/skills subdomains than those who did not, whereas participants who had clinical experience with persons with disabilities demonstrated higher scores in emotional response and knowledge/skills subdomains. CONCLUSIONS: We developed a scale to measure the attitudes toward persons with disabilities of healthcare professionals. The scale demonstrated a sensitivity to measure a difference by participation in an education module or clinical experience with persons with disabilities.


Asunto(s)
Actitud del Personal de Salud , Personas con Discapacidad , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Adulto , Técnica Delphi , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Sensibilidad y Especificidad , Encuestas y Cuestionarios
5.
Arch Phys Med Rehabil ; 100(3): 495-500.e1, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-29958905

RESUMEN

OBJECTIVES: To investigate the characteristics of oropharyngeal dysphagia in adults with dyskinetic cerebral palsy (DCP) and cervical dystonia (CD). DESIGN: Exploratory observational cross-sectional study. SETTING: University hospital. PARTICIPANTS: Seventeen patients with DCP (8 men, 9 women; age, 45.7±6.3y) enrolled in a randomized controlled trial on the effects of botulinum toxin injection on CD. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Baseline clinical assessments and videofluoroscopic swallowing studies (VFSSs) were conducted. VFSS findings were evaluated using the videofluoroscopic dysphagia scale (VDS) and the penetration-aspiration scale (PAS). The Gross Motor Function Classification System (GMFCS) and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were also assessed. Relationships between outcomes were evaluated using Spearman's rank correlation. RESULTS: The clinical assessment revealed abnormalities in chewing (n=10, 58.8%), tongue movement (n=10, 58.8%), and laryngeal elevation (n=8, 47.1%). The most common abnormality on the VDS was inadequate mastication (n=13, 76.5%), followed by premature bolus loss, vallecular residue, and penetration/aspiration (all: n=10, 58.8%). A maximum PAS score of 8 was observed in 8 of 17 patients (47.1%). Total and pharyngeal VDS scores were significantly correlated with TWSTRS scores (ρ=0.543, P=.024 and ρ=0.539, P=.026, respectively); the VDS oral score did not correlate with the TWSTRS score (ρ=0.446, P=.073). There was no significant correlation between VDS score and GMFCS level (ρ=0.212, P=.414). CONCLUSIONS: This preliminary observational study presents the characteristics of oropharyngeal dysphagia in adults with DCP and CD. Pharyngeal stage difficulties were negatively correlated with severity of CD, but not with GMFCS level. Screening for dysphagia may be recommended in adults with DCP and severe CD.


Asunto(s)
Parálisis Cerebral/fisiopatología , Trastornos de Deglución/fisiopatología , Tortícolis/fisiopatología , Adulto , Parálisis Cerebral/complicaciones , Cinerradiografía , Estudios Transversales , Deglución , Trastornos de Deglución/etiología , Femenino , Humanos , Masculino , Masticación , Persona de Mediana Edad , Faringe/fisiopatología , Índice de Severidad de la Enfermedad , Lengua/fisiopatología , Tortícolis/complicaciones
6.
BMC Pediatr ; 19(1): 440, 2019 11 14.
Artículo en Inglés | MEDLINE | ID: mdl-31722705

RESUMEN

BACKGROUND: Stress signals during sucking activity such as nasal flaring, head turning, and extraneous movements of the body have been attributed to incoordination of sucking, swallowing, and respiration (SSR) in premature infants. However, the association of uncoordinated sucking pattern with developmental outcomes has not yet been investigated. The aim of this study was to investigate whether uncoordinated sucking pattern during bottle-feeding in premature infants is associated with the developmental outcomes at 8-12 and 18-24 months of age (corrected for prematurity). METHODS: We retrospectively reviewed the medical records and video recordings for the Neonatal Oral-Motor Assessment Scale (NOMAS) of premature infants and divided them into two groups based on the presence or absence of incoordination. The Bayley-III cognition composite scores of the incoordination-positive and incoordination-negative group were compared at 8-12 and 18-24 months of age. RESULTS: Seventy premature infants exhibited a disorganized sucking pattern according to the NOMAS. The average Bayley-III cognition composite scores at 8-12 months of age were 92.5 ± 15.6 and 103.0 ± 11.3 for the incoordination-positive (n = 22) and incoordination-negative groups (n = 48), respectively (p = 0.002). The average Bayley-III cognition composite scores at 18-24 months were 90.0 ± 17.9 and 100.7 ± 11.5 for the incoordination-positive (n = 21) and incoordination-negative groups (n = 46), respectively (p = 0.005). A multiple linear regression analysis indicated that the presence of uncoordinated sucking pattern, grade 3 or 4 germinal matrix hemorrhage-intraventricular hemorrhage, and moderate to severe bronchopulmonary dysplasia were independently associated with cognitive development at 18-24 months of age. CONCLUSIONS: Uncoordinated sucking pattern in premature infants was independently associated with a higher risk of abnormal developmental outcome in the cognitive domain of the Bayley-III at both 8-12 and 18-24 months. There may be a need for periodic follow-up and early intervention for developmental delay when incoordination of SSR that results in stress signals on the NOMAS is observed before 40 weeks postmenstrual age.


Asunto(s)
Ataxia/fisiopatología , Alimentación con Biberón , Desarrollo Infantil/fisiología , Recien Nacido Prematuro/crecimiento & desarrollo , Conducta en la Lactancia/fisiología , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos
7.
BMC Musculoskelet Disord ; 20(1): 320, 2019 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-31286912

RESUMEN

BACKGROUND: Muscle strength measurements using hand-held dynamometry (HHD) can be affected by the inadequate strength of the tester and lack of stabilization of the participants and the device. A portable HHD anchoring system was designed that enabled the measurement of isometric knee extensor muscle strength in a supine position. This can be used with individuals who are unable to assume the sitting position required for the measurement of knee extensor strength in conventional isokinetic dynamometry (IKD). The aim of this study was to evaluate the reliability and validity of knee extensor strength measurements using this device. METHODS: The maximal knee extensor isometric strength of the dominant leg in healthy adults aged 20 to 40 years was tested. Three trials of three contractions were assessed by two raters using the portable dynamometer anchoring system whilst the participant was in the supine position. After the three measurement trials, peak knee extensor torque was evaluated using IKD. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) for intra- and inter-rater reliability were obtained. RESULTS: Thirty-nine participants (19 male and 20 female, aged 30.08 ± 4.16 y), completed the three measurement trials. The ICC for intra-rater reliability was 0.98 for the maximum measurements of knee extensor strength (95% confidence interval [CI]: 0.96-0.98) and 0.98 (95% CI: 0.96-0.99) for inter-rater reliability. The mean difference (%) between the maximum knee extensor strength measurements of each trial was 1.02% (LOA range: - 11.13 to 13.16%) for intra-rater and - 1.44% (LOA range: - 13.98 to 11.08%) for inter-rater measurements. The Pearson correlation coefficient of the maximum voluntary peak torque measurements with the portable dynamometer anchoring system and IKD was 0.927. CONCLUSIONS: The portable dynamometer anchoring system is a reliable and valid tool for measuring isometric knee extensor strength in a supine position. Future clinical feasibility studies are needed to determine if this equipment can be applied to people with severe illness or disabilities. TRIAL REGISTRATION: KCT0003041 .


Asunto(s)
Articulación de la Rodilla/fisiología , Dinamómetro de Fuerza Muscular , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Adulto , Estudios Transversales , Femenino , Voluntarios Sanos , Humanos , Contracción Isométrica/fisiología , Masculino , Reproducibilidad de los Resultados , Posición Supina/fisiología , Adulto Joven
8.
Dysphagia ; 34(2): 201-209, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30612235

RESUMEN

There have been no quantitative studies on dysphagia and its impact on quality of life (QOL) of adults with cerebral palsy (CP). In this cross-sectional study, we aimed to investigate the characteristics of dysphagia symptoms and their impact on QOL in adults with CP on a full oral diet compared with healthy adults. Additionally, we aimed to determine the factors affecting dysphagia-related QOL in this population. We enrolled adults with CP on full oral diet (N = 117) and healthy individuals (N = 117) and interviewed them using the swallowing-quality of life (SWAL-QOL) questionnaire which includes 14 items regarding dysphagia symptoms and 30 items regarding swallowing-related QOL. The functional status of each participant with CP was evaluated using the gross motor function classification system, the manual ability classification system (MACS), and the Functional Oral Intake Scale (FOIS). Among pharyngeal symptoms, choking on food was reported most frequently (sometimes or more 76.9%), followed by coughing and choking on liquid. Among oral symptoms, chewing problems were reported most frequently (sometimes or more 59.8%), followed by food dribbling from the mouth (sometimes or more 53.8%). Compared to healthy adults, those with CP reported worse QOL across all SWAL-QOL items, with the lowest scores obtained for meal duration, followed by communication, burden, fatigue, sleep, and eating desire. On multiple linear regression analysis, higher MACS level, lower FOIS level, and older age were predictors of worse SWAL-QOL score. Among adults with CP, it is necessary to evaluate swallowing function and establish an active intervention plan even if a full oral diet is established.


Asunto(s)
Parálisis Cerebral/psicología , Trastornos de Deglución/psicología , Calidad de Vida , Adulto , Anciano , Parálisis Cerebral/complicaciones , Parálisis Cerebral/fisiopatología , Estudios Transversales , Deglución , Trastornos de Deglución/etiología , Trastornos de Deglución/fisiopatología , Evaluación de la Discapacidad , Ingestión de Alimentos , Nutrición Enteral , Femenino , Humanos , Modelos Lineales , Masculino , Comidas , Persona de Mediana Edad , Estado Nutricional , Factores de Tiempo , Adulto Joven
10.
Front Neurol ; 14: 1327383, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38269003

RESUMEN

Stroke is a common neurological disorder worldwide that can cause significant disabilities. Transcranial alternating current stimulation (tACS) is an emerging non-invasive neuromodulation technique that regulates brain oscillations and reshapes brain rhythms. This study aimed to investigate the effect of tACS on functional recovery in patients with stroke. The MEDLINE (PubMed), Cochrane Library, Embase, SCOPUS, and Web of Science databases were searched for English-language articles on tACS and stroke, published up to October 20, 2023. The following key search phrases were combined to identify potentially relevant articles: 'tACS,' 'transcranial alternating current stimulation,' 'stroke,' 'cerebral infarct,' and 'intracerebral hemorrhage.' The inclusion criteria for study selection were as follows: (1) studies involving patients with stroke and (2) studies that used tACS for functional recovery. A total of 34 potentially relevant studies were identified. Five articles were included in this review after reading the titles and abstracts and assessing their eligibility based on the full-text articles. Among the included studies, one investigated the improvement in overall functional status in patients with stroke after tACS, and two investigated the effect of tACS on motor function and gait patterns. Moreover, one study reported the efficacy of tACS on aphasia recovery, and one study evaluated the effect of tACS on hemispatial neglect. Our findings suggest that tACS improves functional recovery in patients with stroke. The application of tACS was associated with improved overall functional recovery, sensorimotor impairment, aphasia, and hemispatial neglect. The potential clinical application of tACS should be supported by high-quality, evidence-based studies.

11.
Healthcare (Basel) ; 11(19)2023 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-37830641

RESUMEN

(1) Background: Forward head posture (FHP) is one of the most common cervical postural deviations and is characterized by head protrusion or forward head placement in relation to the shoulder in the sagittal plane. Patients with FHP often experience neck pain and disability. The aim of this study was to investigate whether treatment programs are effective in the management of neck pain in patients with FHP. (2) Methods: A MEDLINE (PubMed), Embase, Cochrane Library, and Scopus database search was conducted for English language articles on patients with chronic neck pain and FHP published until 12 April 2023. To identify potentially relevant articles, the following key search phrases were combined: 'forward head posture' and 'pain'. After searching, 2516 potentially relevant articles were identified. After reading the titles and abstracts and assessing their eligibility based on full-text articles, 16 articles were included in this review. (3) Results: Among the 16 studies that investigated the efficacy of treatment programs for managing chronic pain in patients with FHP, 11 investigated the effect of exercise programs, and 5 investigated the effect of manual therapy. Patients reported significant improvement in pain and disability after receiving treatment programs such as corrective postural exercises and special manual therapy techniques. (4) Conclusions: Various treatment programs, including postural corrective exercises and manual therapy, are beneficial for improving pain and disability in patients with FHP.

12.
Malays Fam Physician ; 18: 1, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36969334

RESUMEN

Introduction: There is no global reference value for the 6-minute walking distance (6MWD) in paediatric populations, as it can vary greatly depending on local characteristics and anthropometric measures. This study aimed to identify a 6MWD reference value that could be applied in both local and regional settings. Method: This cross-sectional multicentre study investigated a healthy paediatric population aged 4-18 years in Indonesia. The 6-minute walk test (6MWT) was conducted in accordance with the American Thoracic Society guidelines. Data were presented as the 6MWD according to age and sex per year. Univariate and multivariate analyses were conducted on the basis of the 6MWDpred Rizky formula. Results: A total of 634 participants were included in this study. Age, sex, weight, leg length and height affected the 6MWD (P<0.001). In the regression model, sex and height were the predictors of 6MWD, with height as the best single predictor. Conclusion: The reference charts and 6MWDpred Rizky formula are applicable in multi-ethnic paediatric Indonesian populations but in limited settings.

13.
Physiother Theory Pract ; 38(11): 1770-1778, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33497286

RESUMEN

INTRODUCTION: Aquatic rehabilitation therapy can improve strength and functional ability. Previous studies measured outcomes on land but did not measure underwater functional ability. PURPOSE: This study aimed to validate the functional component of the Halliwick-ICF assessment scale, and to compare the scale between underwater and on-land activities. METHODS: Rehabilitation and medical charts of individuals with brain lesions and/or spine injuries who underwent aquatic therapy were retrospectively reviewed. Twenty-one functional components of the Halliwick-ICF assessment scale items were categorized through exploratory factor analysis: center of gravity alteration, basic functional activity, and progressive basic functional activity. Confirmatory factor analysis was performed to evaluate the validity of the functional components of the Halliwick-ICF assessment scale. Spearman's correlation analyses were conducted using Medical Research Council sum and modified Barthel index scores. RESULTS: Ninety-five participants (mean age: 53.4 years, range: 27-73 years) were included in the analysis. Convergence and discrimination validity for all three factors were established. Total scores of the scale showed correlations with the modified Barthel index (r = 0.636, p < .001) and Medical Research Council sum (r = 0.298, p = .01) scores. CONCLUSION: The functional components of the Halliwick-ICF assessment scale demonstrated validity with physical function on land, suggesting its usefulness in aquatic therapy.


Asunto(s)
Actividades Cotidianas , Evaluación de la Discapacidad , Análisis Factorial , Humanos , Persona de Mediana Edad , Estudios Retrospectivos
14.
Spinal Cord Ser Cases ; 8(1): 40, 2022 04 09.
Artículo en Inglés | MEDLINE | ID: mdl-35397619

RESUMEN

STUDY DESIGN: Retrospective electronic medical record review combined with a telephone interview. OBJECTIVES: The purpose of this study was to describe the neurological and socio-professional outcomes of patients with diving injuries of the cervical spine. SETTING: A tertiary hospital and its affiliated rehabilitation hospital in South Korea. METHODS: Electronic medical records were reviewed for medical and neurological information. Telephone interviews were then conducted with questionnaire regarding specific circumstances at the time of injury and social status. RESULTS: A total of 33 patients with spinal cord injury (SCI) due to diving accidents were analyzed, of which 27 responded to telephone interviews. Thirty-two (97%) participants were men and 27 (81.8%) were younger than 40 years at the time of injury. The American Spinal Injury Association grade A was the most common of all grades in 16 participants (48.5%), whereas C4 was the most common neurologic level of the injury (n = 13, 39.4%). SCI due to diving accidents most commonly occurred in swimming pools in holiday lodges (n = 12, 36.4%). Five out of 13 married couples with motor complete SCI were divorced or separated after injury. Eight persons resumed work or studies after the injury, with a mean return time of 33 (24.4) months. CONCLUSIONS: SCI resulting from a diving accident not only causes severe functional impairment but can also result in changes in marital and employment status. This study may be used as a basic source of education and awareness to prevent further SCI due to diving accidents.


Asunto(s)
Buceo , Traumatismos de la Médula Espinal , Vértebras Cervicales/lesiones , Buceo/efectos adversos , Buceo/lesiones , Humanos , Masculino , República de Corea , Estudios Retrospectivos , Traumatismos de la Médula Espinal/rehabilitación , Resultado del Tratamiento , Estados Unidos
15.
Disabil Rehabil ; 43(12): 1750-1755, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-31583917

RESUMEN

BACKGROUND AND PURPOSE: The "Disability Attitudes in Health Care" scale contains 17 items and measures attitudes toward persons with disabilities in healthcare settings. This study aimed to analyze the psychometric properties of the Disability Attitudes in Health Care in order to improve its measurement quality. MATERIALS AND METHODS: The Disability Attitudes in Health Care scale was administered to 272 students at a medical school. Rasch analysis was conducted to assess the category use, the overall fit of the model, and the person-item fit. RESULTS: Compared to the previous 5-point Likert scoring system, the combination of category 1 (strongly disagree) and 2 (disagree), which transformed the Disability Attitudes in Health Care into a 4-point scale, was more appropriate. Items 2 and 13 had a poor fit with the model because of low construct homogeneity and low point-measure correlation, respectively; therefore, they were removed. However, there were not enough questions regarding the difficulty level for distinguishing medical students' attitudes toward persons with disabilities more sensitively. CONCLUSIONS: The results of this study suggest that constructing Disability Attitudes in Health Care with 15 items and using a 4-category scoring method could help to increase the scale's reliability and validity. The revised version of Disability Attitudes in Health Care could be of value to those who educate medical students and train rehabilitation professionals. IMPLICATIONS FOR REHABILITATIONConstructing a Disability Attitudes in Health Care scale with 15 items by using a 4-category scoring method could increase the reliability and validity of the scale.To improve the sensitivity of the Disability Attitudes in Health Care, it is necessary to add more difficult items to the scale.The Disability Attitudes in Health Care could be of value to those who educate medical students and train rehabilitation professionals.


Asunto(s)
Personas con Discapacidad , Estudiantes de Medicina , Actitud , Atención a la Salud , Humanos , Psicometría , Reproducibilidad de los Resultados , República de Corea , Encuestas y Cuestionarios
16.
Ann Rehabil Med ; 45(4): 331-340, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34496476

RESUMEN

OBJECTIVE: To develop and validate a scale to assess people's attitudes and perspectives toward persons with disabilities. METHODS: The three-stage development of the scale included a preliminary version drafted from the literature review and a nominal group process. Thereafter, the draft was examined further and revised through two rounds of Delphi survey by 16 disability experts. Lastly, the psychometric properties of the scale were assessed through an online survey of 1,359 employees at three university hospitals. RESULTS: A 32-item scale, defined after two Delphi surveys, was refined into 14 items with four subcategories: community integration, discomfort, charitability, and sense of burdening. The Cronbach's alpha coefficient was 0.839 and domain reliability from 0.638 to 0.845. Recent education on disabilities yielded more positive attitudes toward persons with disabilities. Meaningful acquaintances with disabilities yielded more positive attitudes toward persons with disabilities. CONCLUSION: This newly developed scale that measures attitudes toward persons with disability is reliable and valid. A future use of the scale could be to measure attitudinal improvements toward persons with disabilities after awareness education.

17.
Ann Palliat Med ; 10(5): 5825-5830, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32954740

RESUMEN

We report a rare case of a patient with corticobasal degeneration (CBD) who was also diagnosed with complex regional pain syndrome type I (CRPS I), which has similar clinical characteristics. A 76-year-old man who had been diagnosed with CBD several years prior presented with asymmetric severe pain, postural instability, limb rigidity, limb dystonia, tremor, ideomotor apraxia, and bradykinesia especially on his left upper extremity on admission at our rehabilitation center. Additional physical examination showed darkened skin color change, edema, reduced skin elasticity, cold skin temperature, wet skin, and limited range of motion (ROM) of the left side compared to the right side. A three-phase bone scan was done resulting CRPS I. Therefore, we initiated treatment for CRPS I, including steroid pulse therapies and non-steroidal anti-inflammatory drugs (NSAID); subsequently, his left extremity pain reduced from a visual analogue scale (VAS) score of 8-9 to 3 and his functional level also improved. To the best of our knowledge, this is the first case report of a CBD patient being also diagnosed with CRPS I. Due to the similar clinical characteristics that two diseases share, we would like to inform the physicians the importance of differentiating the CRPS I from CBD for the quick proper management.


Asunto(s)
Síndromes de Dolor Regional Complejo , Anciano , Brazo , Humanos , Masculino , Dolor
18.
J Spinal Cord Med ; 44(4): 627-630, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-31242091

RESUMEN

Objective: To evaluate the efficacy and safety of treatment for neurogenic heterotopic ossification (NHO) using extracorporeal shock wave therapy (ESWT) in persons with spinal cord injury (SCI).Design: Single case report.Setting: Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center.Participants: A 55-year-old male with cervical SCI, who developed painful NHO around the right hip joint.Interventions: Ultrasound-guided ESWT that used 4,000 shocks at the rate of 3 Hz and the energy flux density between 0.056 and 0.068 mJ/mm2 was applied to the NHO region a total of 7 times, weekly.Outcome Measures: We assessed the treatment outcomes using a visual analog scale (VAS) score, wheelchair sitting time and size of NHO.Result: After 7 weeks of ESWT treatment, his pain reduced from a VAS score of 7-8 to 3 and his wheelchair sitting time increased. However, there was no significant change of size of NHO.Conclusion: The application of ESWT could be a possible alternative to other treatments for NHO in persons with SCI.Clinical Trial Registry Number: 2019-03-003.


Asunto(s)
Tratamiento con Ondas de Choque Extracorpóreas , Osificación Heterotópica , Traumatismos de la Médula Espinal , Humanos , Masculino , Persona de Mediana Edad , Osificación Heterotópica/etiología , Osificación Heterotópica/terapia , Dolor , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/terapia , Ultrasonografía
19.
Ann Palliat Med ; 10(2): 1431-1437, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33183040

RESUMEN

BACKGROUND: Several radiologic imaging techniques have been used to predict the effects of treatment on lumbar facet joint (LFJ) pain. However, there are no reports on the use of contrast-enhanced magnetic resonance imaging (MRI) in the management of LFJ pain. In the current study, we aimed to evaluate the clinical ability of contrast-enhanced MRI to predict treatment outcomes for LFJ pain. METHODS: A total of 26 patients with LFJ pain were recruited and intraarticular (IA) corticosteroid injections were administered to each patient. We assessed the treatment outcomes using a numerical rating scale (NRS), and two radiologists independently investigated LFJ enhancement and osteoarthritis grading. No serious complications or adverse events were reported. RESULTS: IA corticosteroid injections were administered to 26 patients (12 women and 14 men; mean age: 65.19±11.05 years) with LFJ pain. Among the 26 patients, 16 patients were included in the facet joints with enhancement group, and the remaining 10 patients were included in the facet joints with non-enhancement group, based on contrast-enhanced MRI scans. In both the enhancement and non-enhancement groups, NRS scores significantly decreased at 1, 2, and 3 months after treatment (P<0.05). However, we saw no significant difference between the groups from pretreatment to three months after treatment (P>0.05). CONCLUSIONS: The routine use of contrast-enhanced MRI is not recommended in patients with LFJ pain.


Asunto(s)
Dolor de la Región Lumbar , Articulación Cigapofisaria , Anciano , Femenino , Humanos , Inyecciones Intraarticulares , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Articulación Cigapofisaria/diagnóstico por imagen
20.
Ann Rehabil Med ; 44(6): 502-509, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33440098

RESUMEN

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.

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