The Therapeutic Effect of Neurologic Music Therapy and Speech Language Therapy in Post-Stroke Aphasic Patients

임길병,김용건,이홍재,유지현,황지연,김정아,김성균 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.4

Objective To investigate the therapeutic effect of neurologic music therapy (NMT) and speech language therapy (SLT) through improvement of the aphasia quotient (AQ) in post-stroke aphasic patients.Methods Twenty-one post-stroke, nonfluent aphasia patients who had ischemic/hemorrhagic stroke on radiologic evaluation were divided into the NMT and SLT groups. They received NMT and SLT for 1 month. Language function was assessed by Korean version-Western Aphasia Battery before and after therapy. NMT consisted of therapeutic singing and melodic intonation therapy, and SLT consisted of language-oriented therapy.Results Significant improvements were revealed in AQ, repetition, and naming after therapy in the NMT group and improvements in repetition in the SLT group of chronic stroke patients (p<0.05). There were significant improvements in language ability in the NMT group of subacute stroke patients. However, there was no significant improvement in the SLT group of subacute stroke patients.Conclusion We concluded that the two therapies are effective treatments in the chronic stage of stroke and NMT is effective in subacute post-stroke aphasic patients.

Shoulder Joint Infectious Arthritis and Acromioclavicular Joint Osteomyelitis due to Candida

임길병,Young-Sup Kim,Yee-Gyung Kwak,Kyung-Rok Park 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.4

Candida species inhabit the skin and mucous membranes of healthy individuals with low virulence, and osteomyelitis due to candida is very rare. However, the incidence of invasive candidal infection caused by intravenous drug use, broad-spectrum antibiotics, and indwelling central venous catheter is increasing. A 73-year old man visited the outpatient clinic complaining of right shoulder pain that radiated to the right acromioclavicular joint. He had undergone multiple injection procedures followed by nonsteroidal anti-inflammatory drug therapy for several weeks. The ultrasonographic findings showed a heterogeneous mass around the right acromioclavicular joint, while the right shoulder MRI and the overall findings of the body bone scan were suggestive of osteomyelitis. Pathologic findings of ultrasonographically guided joint aspiration fluid showed acute and chronic nonspecific inflammation, while the tissue culture and staining revealed Candida parapsilosis.

발란스 마스터 시스템을 이용한 요통환자의 균형능력 평가

임길병,이홍재,주성주,임성식 대한재활의학회 2007 Annals of Rehabilitation Medicine Vol.31 No.1

Effect of Low-Frequency rTMS and NMES on Subacute Unilateral Hemispheric Stroke With Dysphagia

임길병,이홍재,유지현,권용걸 대한재활의학회 2014 Annals of Rehabilitation Medicine Vol.38 No.5

Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia.Methods Subacute (<3 months), unilateral hemispheric stroke patients with dysphagia were randomly assigned to the conventional dysphagia therapy (CDT), rTMS, or NMES groups. In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks). In NMES group, electrical stimulation was applied to the anterior neck for 30 minutes per session (5 days per week for 2 weeks). All three groups were given conventional dysphagia therapy for 4 weeks. We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.Results Forty-seven patients completed the study; 15 in the CDT group, 14 in the rTMS group, and 18 in the NMES group. Mean changes in FDS and PAS for liquid during first 2 weeks in the rTMS and NMES groups were significantly higher than those in the CDT group, but no significant differences were found between the rTMS and NMES group. No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.Conclusion These results indicated that both low-frequency rTMS and NMES could induce early recovery from dysphagia; therefore, they both could be useful therapeutic options for dysphagic stroke patients.

분절상 신경섬유종증에 의한 둔부통증 - 증례 보고 -

임길병,박혜진,이홍재,김덕영,김성수 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.5

Neurofibromatosis (NF) is a dysplastic disease which consists of multiple café-au-lait spots and neurofibromas from neural sheath. The 61-year-old male patient complained of sudden severe pain on the left buttock started one month ago. On physical examination, multiple “lentigines” were seen on his left buttock which spreaded to the thigh and small soft protruding nodules were observed on the right side of the back and left shoulder. Histopathologic finding of a specimen obtained from a nodule was consistent with neurofibroma. Magnetic resonance imaging (MRI) and ultrasonography revealed asymmetrical hypertrophy of neurovascular bundle located in the left greater sciatic foramen. On diagnosing as NF, he was treated with medication, physical modalities and therapeutic intervention (caudal block). Visual analogue scale (VAS) went down to 3/10 with these treatments and he was discharged. We report successful treatment of buttock pain rarely associated with segmental neurofibromatosis.

고교 야구 선수 견관절의 이학적 검사와 초음파 검사 소견

임길병,이홍재,주성주,조영재,채지원 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.1

Objective: The purpose of this study was to investigate physical and ultrasonographic (US) imaging findings in pain-free shoulders of high school baseball players. Method: Physical examination including range of motion (ROM) and several pain provocative tests and US examination on both shoulders in forty-one high school baseball players were performed. The findings of these examinations were classified according to the dominance of shoulders and position of the players and described. Results: Neer, Jobe, Hawkins test, and acromioclavicular tenderness were positive in 33.3%, 4.8%, 28.6%, and 38.3% respectively. Dominant shoulders had larger ROM of exter- nal rotation and internal rotation than non-dominant shoulders (p<0.05). Dominant shoulders of pitchers group had larger ROM of external rotation and smaller ROM of internal rotation than those of non-pitchers group (p<0.05). Dominant supraspinatus tendons of pitchers group were thicker than those of non-pitchers group (p<0.05). Conclusion: About one third of pain-free shoulders of baseball players showed positive in pain provocative tests. There were several differences in shoulder ROM and ultrasonographic thickness of supraspinatus tendon according to the dominance of shoulders and position of players.

만성 근골격계 통증 환자에서 성별에 따른 통증 양상과 심리적 변인의 차이

임길병,이홍재,김덕영,김지영,김성수,김영섭,이경태 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.2

Chronic musculoskeletal pain, Gender difference, Psychological variables Objective: To investigate gender differences in pain patterns and psychological variables among patients with chronic musculoskeletal pain. Method: Thirty-five male and thirty-eight female patients who visited our outpatient clinic due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Chronic musculoskeletal pain was defined as pain lasting longer than 6 months. Patients were evaluated with visual analogue scale (VAS), pain site, pain duration and frequency. Beck depression inventory, state-trait anxiety index, somatization scale of symptom checklist-revised, symptom interpretation questionnaire, and pain catastrophizing scale were checked for psychological variables. Correlations among each variable were evaluated statistically. Results: Female patients with chronic musculoskeletal pain recorded higher scores on number of pain site, pain catastrophizing scale, rumination, magnification and catastrophic attribution than male patients (p<0.05). In female patients, VAS was correlated significantly with depression, static anxiety, somatization, catastrophizing thought. rumination, magnification, helpless, and catastrophic attribution. Pain frequency was correlated significantly with somatization, catastrophizing thought, rumination, and helpless. Number of pain site was correlated with somatization, catastrophizing thought, magnification, and helpless. The correlation between pain patterns and psychological variables was also observed in male patients, but statistically less significant than female patients. Conclusion: We found gender difference associated with pain patterns and psychological variables in chronic musculoskeletal pain patients. Consideration of psychological factors may be important for management in female patients with chronic musculoskeletal pain. (J Korean Acad Rehab Med 2010; 34: 197-203)

만성 근골격계 통증 환자에서 통증과 정서 및 인지-행동 요인과의 관계

임길병,김지영,이홍재,김덕영,김정민 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.4

Objective: To investigate the relations among pain, emotional factors and cognitive-behavioral factors in chronic musculoskeletal pain patients. Method: This study was designed as a questionnaire survey. 73 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They checked visual analogue scale (VAS), pain site and frequency. Beck depression inventory (BDI) and state-trait anxiety index (STAI) were checked for evaluation of emotional factors. Somatization scale of symptom checklist-revised (SCL-R- 90) and pain catastrophizing scale (PCS) were checked for cognitive-behavioral factors. Correlations among each variable were evaluated by statistical analysis. Results: VAS was correlated with pain frequency (r=0.538, p<0.01), somatization and catastrophizing thought. Rumination thought was correlated with VAS (r=0.443, p<0.01), pain frequency (r=0.446, p<0.01) and static anxiety (r= 0.449, p<0.01). Magnification thought was correlated with depression (r=0.403, p<0.01) and static anxiety (r=0.447, p<0.01). Helpless thought was correlated with VAS (r= 0.442, p<0.01), pain frequency (r=0.429, p<0.01), depression (r=0.510, p<0.01), static anxiety (r=0.640, p<0.01) and somatization (r=0.504, p<0.01). Duration was not correlated with VAS, depression, anxiety, somatization and catastrophizing thought in chronic musculoskeletal pain patients (p>0.05). Conclusion: Cognitive-behavioral factors such as catastrophizing thought are strongly correlated with both pain aspects and emotional factors. Consideration of cognitive- behavioral factors as well as emotional factors may be important for management of chronic musculoskeletal pain.

당뇨망막증의 운동요법

임길병 사단법인 한국당뇨협회 2002 당뇨 Vol.153 No.-

편마비 환자에서 촉각 자극과 균형 원판 훈련의 효과

임길병,나영무,이홍재,황현오 대한재활의학회 2002 Annals of Rehabilitation Medicine Vol.26 No.6