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        Botulinum Toxin-A Injection in the Treatment of Spasticity in a Infantile-Onset Neurodegeneration With Brain Iron Accumulation: A Case Report

        도환권,조근열,권준구,김우진 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.2

        Pantothenate kinase-associated neurodegeneration (PKAN) is a neurodegenerative disorder characterized by iron accumulation in the globus pallidus (GP) of the brain (neurodegeneration with brain iron accumulation [NBIA]), which is characterized by dystonia and spasticity resulting in postural difficulties. A 33-month-old boy was admitted with a pronounced gait disturbance. Marked hypertonicity in the patient’s both calf muscles was noted, resulting in waddling with repeated slip-falls. NBIA was suspected by high T2 intensity in the GP on brain MRI, then it was confirmed by detecting PANK2 mutation. Botulinum toxin-A injection was administered to both calf muscles. After 2 weeks, a decrease in spasticity and an increase in range of motion were observed, and consequently, an increase in the patient’s gait stability with both heels touching the ground, enabling him to walk straight independently. A definitive treatment for NBIA has not been established, and a symptomatic therapy is currently the mainstay of treatment in this case. This is the first case report of botulinum toxin injection for treatment of gait disturbance caused by spasticity in an infantile-onset PKAN.

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        Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients

        이미은,조근열,도환권,최희은,김우진 대한재활의학회 2017 Annals of Rehabilitation Medicine Vol.41 No.3

        Objective To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients.Methods Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions.Results From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471± 0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404± 0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance.Conclusion ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities.

      • KCI등재후보

        Sciatic Nerve Palsy after Semi-Fowler’s Position during the Rotator Cuff Operation

        신민하,조근열,김우진,최희은,이미은,도환권,박상옥 대한근전도전기진단의학회 2014 대한근전도 전기진단의학회지 Vol.16 No.2

        Sciatic neuropathy following surgery performed in the hip flexed position is uncommon and has been discussedin only a few published case reports, particularly in the sitting position. We report a very rare caseof unilateral sciatic neuropathy after a right rotator cuff operation under general anesthesia in the semi-Fowler’s position. Awareness by surgeons of sciatic nerve injury during surgery in the semi-Fowler’s positionmay prevent such intraoperative complications.

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