RESUMEN
Purpose@#The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. @*Methods@#Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. @*Results@#For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. @*Conclusion@#The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.
RESUMEN
Educational evaluation involves data collection and the analysis of various education-related factors to make decisions that improve educational quality. Systematic educational evaluation is essential for enhancing the quality of education. This study reports a case of student-conducted process evaluation of a medical school’s student support system and the procedure for devising improvement plans. Sixteen Inje University College of Medicine students participated in the Education Evaluation Committee (IUCM-EEC) to understand the educational improvement process as learners and actively achieve improvement. The Quality Improvement Committee of the Inje University College of Medicine (IUCM-QIC) decided to reform its student support system based on a previous educational evaluation in 2019. The evaluation of the student support system was conducted for 10 months in 2021 by the student subcommittee, under the guidance of the IUCM-EEC. The CIPP (context-input-process-product) evaluation model was used for a systematic evaluation. Accordingly, the subcommittee developed evaluation criteria and indicators, and analyzed relevant data collected from surveys and the previous literature. For further recommendations and revision ideas, the student subcommittee members interviewed faculty members from six other medical schools and also conducted a focus group interview with the dean and vice deans of IUCM. Finally, the student subcommittee submitted a report to the IUCM-QIC. Communication with various stakeholders is essential for a successful evaluation process. In this case, students, as key stakeholders in education, evaluated the student support system. Their active participation helped improve their understanding of the evaluation process.
RESUMEN
Purpose@#There has been a lack of study on the pains of Korean archers, who have been getting remarkable results in international competitions. In this study, we investigated the epidemiology of shoulder pain, which is known as the most commonly complained symptom of Korean archers. @*Methods@#The participants were 58 elite archers in the city of Gwangju, South Korea. The method of the study was a retrospective cohort study by questionnaire and ultrasound and physical examination. Variables of individual characteristics, training patterns, the character of pain were analyzed in different age groups. Furthermore, groups were divided into those with shoulder pain and those without pain to analyze each group’s shoulder function. @*Results@#The most common injury was shoulder injury (65.6%), and hand injury was the second-highest prevalent injury (29.3%). These two injuries were most prevalent in all age groups. Among 58 participants, 40 showed shoulder pain, but most were mild (n=30, 51.7%) and severe pain was observed in some participants (n=2, 3.5%). Mild pain was most common in each group and it showed the highest prevalence in college students (70.0%). Pain was most observed in the drawing arm, and it was triggered most when drawing the bow. In the shoulder function test category, Constant-Murley score and American Shoulder and Elbow Surgeons score were observed the lowest in the group with shoulder pain with statistical significance. @*Conclusion@#Shoulder injury had a high prevalence in Korean archers. Correspondingly, those with shoulder pain had lower shoulder function test scores.
RESUMEN
Objective@#Although the effects of head lift exercise (HLE) in the reclining position have been reported, there is insufficient clinical evidence of the effects. This study compared the effects of HLE in the 0° supine position and 45° reclining position on the swallowing function and the compliance of patients with dysphagia after stroke after both exercises. @*Methods@#This was a randomized, assessor-blinded clinical trial. Thirty-five patients with stroke and dysphagia were assigned randomly to HLE in the 0° supine group (n=18) or HLE in the 45° reclining group (n=17). Patients in both groups performed HLE five days a week for four weeks and received the same conventional dysphagia therapy. The videofluoroscopic dy sphagia scale (VDS) was used to evaluate the swallowing function. The dropout rate and subjective feedback related to compliance with the two exercises were monitored. @*Results@#No significant differences in the baseline characteristics were observed between the two groups. Patients in both groups showed significant improvement in the oral and pharyngeal phases of VDS (P<0.05). After the intervention, no significant differences were observed between the groups (P>0.05). Dropout rates of 22% and 6% owing to neck discomfort or fatigue were observed in the HLE in 0° supine group and the HLE in 45° reclining group, respectively. @*Conclusion@#HLE in the 45° reclining position has a similar effect on the swallowing function in patients with dysphagia after stroke to that of HLE in the 0° supine position and is associated with better exercise compliance.
RESUMEN
@#Background & Objective: Mirror therapy has been shown to be effective in restoring upper extremity function in stroke patients through changes in the central nervous system. Therefore, it is important to evaluate the effectiveness of various tasks to induce central nervous system excitation. This study investigated the effect of using a complex task with multi-joint-based mirror therapy on upper extremity function and activities of daily living (ADL) in patients with hemiplegia after a stroke. Methods: In this study, 25 stroke patients were recruited and assigned randomly to the experimental or control group. The experimental group received a complex task using multi-joint-based mirror therapy, and the control group received a simple task using single-joint-based mirror therapy. Both groups received the same standard rehabilitation treatment 5 days per week for 4 weeks. An upper extremity evaluation was performed using the Fugl-Meyer Assessment (FMA) and Motor Activity log (MAL). The FMA includes an upper extremity subsection (FMA-UE) as well as upper arm (FMA-UA) and wrist/hand (FMA-WH) subparts. The MAL includes quality of movement (QOM) and amount of use (AOU) subsections. ADL were evaluated using the Korean version of the Modified Barthel Index (K-MBI). Results: Compared with the control group, the experimental group showed greater improvement on the FMA-UE, -UA, and -WH (p = 0.034, 0.047, and 0.013, respectively); MAL-AOU and -QOM (p = 0.048 and 0.034, respectively); and K-MBI (p = 0.031). The following effect sizes (Cohen’s d) were observed: FMA-UE, -UA, and -WH (1.0); MAL-AOU (0.2); MAL-QOM (1.6); and K-MBI (0.2). Conclusions: This study demonstrates that a complex task using multi-joint-based mirror therapy is more effective in restoring upper limb function and ADL in stroke patients than simple task-based mirror therapy.
RESUMEN
The aim of this article was to review various methods used to evaluate the accuracy of digital dental models. When evaluating the accuracy of digital models, the errors can be reduced by educating examiners and using artificial landmarks. The accuracy evaluation methods of digital dental models are divided into linear measurement, 2-dimensional cross-sectional analysis, and 3-dimensional best fit measurement. As the technology of scanners develops, many studies have been conducted to compare the accuracy of digital impression and conventional impression. According to improvement of scan technologies and development of 3-dimensional model analysis software, the ability to evaluate the accuracy of digital models is becoming more efficient. In this article, we describe the methods for evaluating the accuracy of a digital model and investigate effective accuracy analysis methods for each situation.
Asunto(s)
Estudios Transversales , Modelos Dentales , MétodosRESUMEN
PURPOSE: The aim of this study was to evaluate the effect of delayed time, surface treatment, and repair materials on repair of bisacryl composite resin through comparison of shear bond strength and to evaluate the utility of bis-acryl composite resin repair using polymethyl methacrylate resin. MATERIALS AND METHODS: A total of 90 bis-acryl composite resin specimens were fabricated and classified into 9 test groups, each of 10 pieces according to delayed time, surface treatment and repair material. The shear bond strength of each specimen was measured using a universal testing machine immediately after fabrication and analyzed using a statistical analysis program (IBM SPSS statistics 20). After the shear bond strength measurement, the fracture surface of the specimen was observed. RESULTS: The highest shear bond strength (17.54 ± 3.14 MPa) was observed in the experimental group bonded immediately with a light-curing flowable composite resin using a bonding agent. CONCLUSION: When repairing bis-acryl composite resin, it is necessary to consider whether to remake according to the delayed time. For effective repair, it is desirable to consider appropriate materials and surface treatment methods according to the site or purpose of use.
Asunto(s)
Polimetil MetacrilatoRESUMEN
OBJECTIVE: Dysphagia after stroke can cause a range of complications, especially aspiration pneumonia, which can be life-threatening. Therefore, rehabilitation methods to reduce aspiration in patients with dysphagia are important. This study examined the effects of neuromuscular electrical stimulation combined with saliva or dry swallowing on the swallowing function of stroke patients with dysphagia. METHODS: The participants were assigned to either the experimental group (n=9) or control group (n=8). The experimental group received neuromuscular electrical stimulation combined with saliva or dry swallowing, whereas the control group received only voluntary swallowing. Both groups received training 5 days per week for 4 weeks. The oropharyngeal swallowing function was assessed using the video fluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) based on a video fluoroscopic swallowing study. RESULTS: After the intervention, the experimental group showed greater improvement in the pharyngeal phase of the VDS and PAS scores than the control group (P=0.038, 0.027, respectively). CONCLUSION: Neuromuscular electrical stimulation combined with saliva or dry swallowing improves the pharyngeal swallowing function of stroke patients with dysphagia better than saliva or dry swallowing alone.
Asunto(s)
Humanos , Trastornos de Deglución , Deglución , Estimulación Eléctrica , Neumonía por Aspiración , Rehabilitación , Saliva , Accidente CerebrovascularRESUMEN
Suprahyoid muscles play an important role in normal swallowing by providing muscle contractions involved in airway protection and upper esophageal sphincter opening. However, these muscles can be weakened by neurological disease or aging, which can result in pharyngeal dysphagia. Therefore, strengthening of the suprahyoid muscles is a clinically important treatment. In addition, it is important to know exactly how and which method is optimal. Many therapeutic exercise methods have been reported to strengthen the suprahyoid muscles, and new methods related to this have recently been reported. Therefore, this study will briefly summarize the representative traditional methods and the recently reported, relatively new methods for strengthening the suprahyoid muscles.
Asunto(s)
Envejecimiento , Deglución , Trastornos de Deglución , Esfínter Esofágico Superior , Ejercicio Físico , Métodos , Contracción Muscular , Músculos , RehabilitaciónRESUMEN
Otalgia consists of primary otalgia associated with disorders of the ear itself and referred otalgia due to disorders of organs that share the same innervation with the ear. Disorders of the oral cavity and laryngopharynx served by the glossopharyngeal and vagus nerves are common causes of referred otalgia. Chest pain from myocardial infarction spreads through the afferent pain pathway, especially through the sympathetic nerves in the cardiac plexus and the phrenic nerve, resulting in a typical chest pain or referred pain in the left upper extremity. However, pain spreading through the vagus nerve can theoretically cause referred otalgia. This association between the heart and ear has not been widely acknowledged, even though a referred otalgia can occasionally be the only symptom of the tragic disease, myocardial infarction, and should be taken seriously. We report a patient who complained of left otalgia as the only symptom of myocardial infarction.
Asunto(s)
Humanos , Cardiomiopatías , Dolor en el Pecho , Oído , Dolor de Oído , Corazón , Hipofaringe , Infarto , Boca , Infarto del Miocardio , Dolor Referido , Nervio Frénico , Extremidad Superior , Nervio VagoRESUMEN
BACKGROUND AND OBJECTIVES: The purpose of this study was to examine the effect of endoscopic sinus surgery (ESS) on nasalance in patients with chronic rhinosinusitis (CRS). SUBJECTS AND METHOD: Eighty-one CRS patients were enrolled. The nasalance scores for oral, oro-nasal, and nasal passages were measured by nasometry and the nasal cavity volume was measured by acoustic rhinometry before and at 1 and 3 months after ESS. We divided the patients into four groups according to the following surgical interventions employed: unilateral anterior ethmoidectomy (group I), bilateral anterior ethmoidectomy (group II), bilateral total ethmoidectomy (group III), and bilateral pansinus surgery (group IV). We also divided the patients into three groups according to the CT scoring system and polyp grading system. RESULTS: In group III and IV, the nasalance scores for all passages and nasal cavity volume were significantly increased after ESS but did not return to its preoperative level at 3 months after surgery. However, there were no significant changes in nasalance scores or in the nasal cavity volume in group I. Similarly, there were no significant changes in nasalance scores in the mild group (CT scoring system) or no polyp group, whereas the nasalance scores were significantly increased postoperatively in the moderate to severe groups (CT scoring system), and in groups that have nasal polyp group. CONCLUSION: The nasalance scores and nasal cavity volumes were increased after ESS and remained unchanged until postoperative 3 months. Postoperative changes in nasalance scores were more remarkable in patients who had more severe disease and who underwent more extensive surgery.
Asunto(s)
Humanos , Métodos , Cavidad Nasal , Pólipos Nasales , Pólipos , Rinometría Acústica , Sinusitis , Calidad de la VozRESUMEN
Benign paroxysmal positional vertigo (BPPV) is a common inner ear cause of vertigo, most of which can be treated by particle repositioning maneuver (PRM). However, in rare cases, positional vertigo could persist or frequently recur after several PRM. In these intractable cases, surgical treatments including singular neurectomy and semicircular canal occlusion have been used. Posterior semicircular canal occlusion has some advantages over singular neurectomy in hearing preservation and feasible surgical technique. Also free-floating endolymph particles causing intractable BPPV are known to occur in about 20% of the cases during canal occlusion surgery. Nevertheless, to the best of our knowledge, there has not been any report on the identification of those particles in the Korean literature. In this paper, we report a case of free-floating endolymph particle found during transmastoid posterior semicircular canal occlusion for intractable posterior canal BPPV.
Asunto(s)
Vértigo Posicional Paroxístico Benigno , Oído Interno , Endolinfa , Audición , Canales Semicirculares , VértigoRESUMEN
BACKGROUND AND OBJECTIVES: This study was designed to compare the nasalance between chronic rhinosinusitis (CRS) patients and normal controls and to determine the correlation of nasalance with nasal volume, nasal resistance, CT score, and polyp score in CRS patients. MATERIALS AND METHODS: This study enrolled 150 CRS patients and 154 normal adults. All subjects underwent acoustic rhinometry and rhinomanometry. Nasalance scores were measured with the nasometer. All CRS patients were graded according to the Lund-Mackay CT staging system and the degree of nasal polyp. RESULTS: Nasal volume was decreased and nasal resistance was increased in CRS patients compared with normal controls. However, the nasalance scores for oro-nasal and nasal passages were significantly higher in CRS patients compared with normal controls. In CRS patients, the nasalance score for the nasal passage showed positive correlation with nasal volume and negative correlation with nasal resistance and Lund-Mackay CT score. However, no significant correlation was found between nasalance score and endoscopic polyp score. CONCLUSION: Contrary to expectations, nasalance was increased in CRS patients despite decreased nasal volume and increased nasal resistance. Thus, nasal resonance likely depends on a multitude of factors other than changes in the sinonasal cavity.
Asunto(s)
Adulto , Humanos , Cavidad Nasal , Pólipos Nasales , Pólipos , Rinomanometría , Rinometría Acústica , Sinusitis , Calidad de la VozRESUMEN
OBJECTIVE: To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function. METHODS: We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study. RESULTS: The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP. CONCLUSION: These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.
Asunto(s)
Humanos , Deglución , Trastornos de Deglución , Iowa , Labio , Masticación , Hueso Paladar , Accidente Cerebrovascular , LenguaRESUMEN
OBJECTIVES: The aim of this paper is to assess the needs and roles of the Worker's Health Centers employed by small scale enterprises by investigating the requested services made to this type of Worker's Health Center. METHODS: The population of this research was taken from 1,145 business owners or managers of manufacturing companies employing less than fifty people in six industrial estates. Stratified sampling was used. Individual interviews were performed to assess the conditions and needs of these enterprises using a structured questionnaire and professional interviewers. RESULTS: According to the questionnaire survey, 941(82.2%) of the enterprises wish to use a Worker's Health Center. 946(83.3%) of the enterprises preferred an 'Expert visit to the enterprise or mixed' for the Delivery type. 486(42.4%) of the enterprises preferred the 'in the center of industrial complex' for the location of the Worker's Health Center. 789(69.1%) of the enterprises preferred 6-10 PM for the available open hours. A multiple regression analysis revealed a significantly positive association regarding the intention of using a Worker's Health Center and the Gyeonggi-Banwol (OR 2.49) or Gwangju-Hanam(OR 4.24) for the region. Compared to enterprises employing 1-4 worker, 30-49 worker enterprises show a 3.33 fold preference (95% CI 1.80~6.12) for the use of a Worker's Health Center. CONCLUSIONS: Generally, the intention regarding the use of a Worker's Health Center was high, Considering the time and spatial limits inherentin small scale enterprises, the 'expert visit to the enterprise' paradigm is important. It should be noted that when providing the service, a customized approach is necessary, determined by size, region, industry, and scale of the business, through the assessment of the small scale enterprises and the nature of the work environment when designing a Worker's Health Center operation.