저산소성 허혈성 뇌손상 후 재활치료

이자호,오병모 대한뇌신경재활학회 2014 뇌신경재활 Vol.7 No.1

The number of survivors after hypoxic-ischemic encephalopathy has been increasing due to recent progressin medical system and care. Impairment after injury ranges from mild memory deficit to vegetative stateor death. Cognitive impairment is particularly common in the survivors, because the hippocampus andmedial temporal lobe are vulnerable to ischemic insult. Medication and cognitive rehabilitation shouldbe initiated to minimize the impact of various cognitive deficits. Instead of Glasgow-Pittsburgh CerebralPerformance Categories, which is insensitive to functional change, standardized functional assessmenttools should also be used in research as well as in rehabilitation settings.

학생표준화환자를 사용한 한의과대학 진료수행시험(CPX)에 대한 학생 인식 조사

조학준,노정두,성현경,박정수,Jo, Hak-Jun,Roh, Jeong-du,Sung, Hyun Kyung,Park, Jeong-Su 대한예방한의학회 2020 대한예방한의학회지 Vol.24 No.3

Objectives : The objective of this survey was to examine students' perception of the clinical performance examination (CPX) in college of traditional Korean medicine using student standardized patients. Methods : College of traditional Korean medicine students who completed the first-semester clinical practice education were selected as the subjects, and they participated in a survey asking questions about the following matters: satisfaction with CPX, self-evaluation, difficulties experienced during the CPX course, level of prior knowledge of clinical practice education, and usefulness of and intimacy with Student Standardized Patients (SSP). Results : Satisfaction with CPX was calculated to be 4.10 (5 being the perfect score), and self-evaluation of CPX was calculated to be 4.12. The subjects chose physical examination as the most difficult item relating to CPX. 80.5% responded positively to the question relating to diverse experiences in practice education, and 52.8% responded positively to the question relating to prior knowledge of diverse standardized patients. 55.6% responded positively to the question relating to performance proficiency of SSP, 63.9% responded positively to the question relating to usefulness of SSP to prepare for CPX, and 69.4% responded positively to the question relating to usefulness of SSP in evaluating CPX, and 55.6% responded positively to the questions relating to intimacy with SSP. It was confirmed that there was a strong quantitative correlation between prior knowledge of clinical practice education and usefulness of SSP, and that there was a strong quantitative correlation between performance proficiency of SSP and usefulness of SSP. It was confirmed that there was a middle-level correlation between performance proficiency of SSP and intimacy with SSP, and that there was a middle-level quantitative correlation between intimacy with SSP and usefulness of SSP. Conclusions : It was confirmed that senior students enrolled in college of traditional Korean medicine were mostly satisfied with the clinical performance examination in college of traditional Korean medicine using SSP, and that usefulness of SSP had a quantitative correlation with prior knowledge of diverse clinical practice educations, performance proficiency of SSP, and intimacy with SSP.

뇌신경재활 영역에서 치매의 이해와 역할

김연희 대한뇌신경재활학회 2015 뇌신경재활 Vol.8 No.1

Dementia is defined as a primary decline of intellect and/or comportment due to a structural and chemical brain disease to the point that customary activities of daily living (ADLs) become compromised. Korean society is rapidly becoming an aging society where average age increases, and dementia is becoming more prevalent. Therefore, prevention, early de- tection, and proper management of dementia patients are health- and social-care priorities of Korean society. Neurorehabilitationist means a specialist for rehabilitative care of neurologically compromised patients including stroke, traumatic brain injury, degenerative brain disease, and dementia. However, the role of neurorehabilitationists for the diag- nosis and treatment of dementia are not well established compared to that of neurologist and psychiatrist. Therefore, this article deals a role of neurorehabilitationist for proper management of patients with dementia in a way that preventing the functional deterioration as well as reduction of national welfare burden.

Brain Tumor Rehabilitation: Symptoms, Complications, and Treatment Strategy

박진영,박윤길 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

Brain tumors are receiving increasing attention in cancer rehabilitation due to their high rate of neurological deterioration. Motor dysfunction, cognitive deterioration, and emotional problems are commonly present in patients with brain tumors. Other medical complications, such as seizures, headache, and dysphagia are also common. An individualized multidisciplinar y rehabilitation inter vention is necessar y to treat functional impairment due to the tumor itself and/or treatment-related dysfunction. Herein, we discuss rehabilitation treatment strategies in relation to the neurological and functional complications that commonly occur in patients with brain tumors

Classification and Diagnosis of Adult Glioma: A Scoping Review

Byun Yoon Hwan,박철기 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

Gliomas are primar y central ner vous system tumors that arise from glial progenitor cells. Gliomas have been classically classified morphologically based on their histopathological characteristics. However, with recent advances in cancer genomics, molecular profiles have now been integrated into the classification and diagnosis of gliomas. In this review article, we discuss the clinical features, imaging findings, and molecular profiles of adult-type diffuse gliomas based on the new 2021 World Health Organization Classifications of Tumors of the central ner vous system

Gene Expression Profile Changes in the Stimulated Rat Brain Cortex After Repetitive Transcranial Magnetic Stimulation

Hwang Wonjae,Choi Joong Kyung,방문석,Park Woong-Yang,Oh Byung-Mo 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

Repetitive transcranial magnetic stimulation (rTMS) is gaining popularity as a research tool in neuroscience; however, little is known about its molecular mechanisms of action. The present study aimed to investigate the rTMS-induced transcriptomic changes; we performed microarray messenger RNA, micro RNA, and integrated analyses to explore these molecular events. Eight adult male Sprague-Dawley rats were subjected to a single session of unilateral rTMS at 1 Hz (n = 4) or sham (n = 4). The left hemisphere was stimulated for 20 minutes. To evaluate the cumulative effect of rTMS, eight additional rats were assigned to the 1-Hz (n = 4) or sham (n = 4) rTMS groups. The left hemisphere was stimulated for 5 consecutive days using the same protocol. Microarray analysis revealed differentially expressed genes in the rat cortex after rTMS treatment. The overrepresented gene ontology categories included the positive regulation of axon extension, axonogenesis, intracellular transport, and synaptic plasticity after repeated sessions of rTMS. A single session of rTMS primarily induced changes in the early genes, and several miRNAs were significantly related to the mRNAs. Future studies are required to validate the functional significance of selected genes and refine the therapeutic use of rTMS.

Use of Machine Learning in Stroke Rehabilitation: A Narrative Review

Choo Yoo Jin,장민철 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

A narrative review was conducted of machine learning applications and research in the field of stroke rehabilitation. The machine learning models commonly used in medical research include random forest, logistic regression, and deep neural networks. Convolutional neural networks (CNNs), a type of deep neural network, are typically used for image analysis. Machine learning has been used in stroke rehabilitation to predict recover y of motor function using a large amount of clinical data as input. Recent studies on predicting motor function have trained CNN models using magnetic resonance images as input data together with clinical data to increase the accuracy of motor function prediction models. Additionally, a model interpreting videofluoroscopic swallowing studies was developed and investigated. In the future, we anticipate that machine learning will be actively used to treat stroke patients, such as predicting the occurrence of depression and the recover y of language, cognitive, and sensor y function, as well as prescribing appropriate rehabilitation treatments

뇌간 병변이 있는 환자에서 관찰되는 운동 이외 증상 및 이의 재활치료

정세희 대한뇌신경재활학회 2014 뇌신경재활 Vol.7 No.2

The brainstem is a compact, stalklike structure. It carries nearly all information between the brain and the remainder of body. It is a corridor to all major sensory, motor, cerebellar, cranial nerve pathways but it is not simply a conduit for information. It has numerous nuclei of the cranial nerves. Therefore, when a patient has a lesion in the brainstem, he or she will demonstrate a variety of symptoms regarding level of consciousness, motor control, muscle tone, posture, vegetative function and other essential function. Here, we will discuss about the non-motor symptoms caused by the brainstem lesions and the strategy for the rehabilitation.

The Relationship Between Visuoconstructive Abilities and Language Performance in Patients With Aphasia After Stroke

황유미,Yi Hoyoung,Lee Jae-Ik,편성범 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

This study aimed to investigate the visuoconstructive abilities and the relationship between visuoconstructive function and language performance in aphasic patients. Right-handed 24 aphasic patients (males 14, females 10) with at least 3 months post-stroke and 32 age-matched healthy controls participated in this study. Visuoconstructive function was assessed by 3 levels of task difficulty: simple (drawing objects), intermediate (clock drawing), and complex (copy subtest of Rey complex figure test and block construction). Aphasic patients were divided into 3 sub-groups (mild, moderate to severe, and ver y severe group) according to severity of aphasia and compared with the control group, respectively. We analyzed the relation all levels of visuoconstructive tasks to aphasia quotient (AQ) and sub-domain scores of K-WAB. Moderate to severe aphasia group demonstrated no significant differences in scores of simple drawing objects compared to controls, but clock drawing, Rey complex figure copy and block design showed significantly decreased scores. Ver y severe group showed significantly lower scores in all levels of visuoconstructive tasks than the control. Correlation between all levels of visuoconstructive tasks except drawing objects and AQ were found to be statistically significant. Among the tasks, the clock drawing test revealed the highest correlation with language performance. Visuoconstructive abilities varied according to the severity of aphasia and the level of visuoconstructive tasks. Therefore, a thorough individual assessment of visuoconstructive function is needed to plan and predict the treatment and prognosis of aphasia and the clock drawing test may be a useful screening tool to evaluate this function.

Quantitative Measurement of Dysphonia Severity in Patients With Stroke With Unilateral Vocal Cord Palsy

Choi Min Kyu,Park Eo Jin,유승돈 대한뇌신경재활학회 2022 뇌신경재활 Vol.15 No.3

Unilateral vocal cord palsy (UVCP) is frequently obser ved in patients with stroke. This study aimed to evaluate the association between objective dysphonia severity and the classification of UVCP in patients with stroke by objectively and quantitatively measuring their phonetic function. We recruited patients with UVCP diagnosed using lar yngoscopy after stroke. Subgroups were divided according to UVCP type, and the dysphonia severity index (DSI) and maximum phonation time (MPT) were measured to objectively evaluate dysphonia. The DSI and MPT were compared between subgroups using analysis of variance with Tukey’s honest significant difference post hoc test. In total, 103 patients with stroke and UVCP were recruited. We found that a higher UVCP severity possibly had to do with lower DSI and MPT values. We objectively confirmed that phonetic function was worse in patients with stroke with higher UVCP severity, and the DSI and MPT tests can be helpful in determining the severity and need for additional evaluation