National Rehabilitation Center Research Articles

Long-term changes in bone mineral density and associated risk factors in individuals with spinal cord injury: A retrospective study.

Individuals with spinal cord injury (SCI) experience a notable decrease in bone mass below the level of injury. While studies have primarily focused on the acute phase with a small cohort, this study aimed to provide comprehensive insights into bone loss patterns over time. A total of 427 individuals with SCI who underwent dual-energy X-ray absorptiometry (DXA) testing at the Korea National Rehabilitation Center (2010-2021) were included and analyzed by categorizing the DXA results into 1-year intervals based on postinjury duration. Demographic characteristics (age, sex, body mass index, and alcohol/smoking history) and SCI-related factors (etiology, severity, extent of injury, motor score, and Korean Spinal Cord Independence Measure 3rd edition) were collected and analyzed. Linear mixed models and Bonferroni post hoc tests were performed to assess temporal changes in bone mass and linear regression analysis to assess the associations between possible risk factors and bone loss. DXA results revealed that substantial annual bone loss occurred in the total hip site up to 3 years postinjury and in the femoral neck site up to 2 years postinjury. Old age, women, and low body mass index were significant risk factors for bone loss in the SCI population. Additionally, during the chronic phase, lower Korean Spinal Cord Independence Measure 3rd edition scores were associated with low bone mass. Significant annual bone loss in the hip region persists for up to 3 years postinjury in individuals with SCI. While prioritizing the risk factors for osteoporosis commonly used in the general population, applying the SCIM score in the chronic phase may provide additional information on bone loss risk.

The National Therapeutic and Rehabilitation Center for Children - A New Model for Children Mental Health Care in Albania

The National Therapeutic and Rehabilitation Center for Children - A New Model for Children Mental Health Care in Albania

Significance of physical factors on activities of daily living in patients with tetraplegia after spinal cord injury: a retrospective study

BackgroundTetraplegia is a debilitating sequela of spinal cord injury (SCI). However, comprehensive approaches for determining the influence of various factors on activities of daily living (ADL) in patients with tetraplegia are limited. Therefore, this study aimed to determine the influence of physical factors on ADL in patients with tetraplegia after adjusting for demographic, SCI-related, and cognitive factors.MethodsThis retrospective cross-sectional study enrolled 201 patients with tetraplegia who underwent inpatient rehabilitation at the National Rehabilitation Center in South Korea between 2019 and 2021. Patients’ mean age was 50.5 years (standard deviation, 16.3), and 170 (84.6%) were men. The Korean Spinal Cord Independence Measure III (K-SCIM III) was used as the main outcome measure to assess patients’ ADL ability. Hierarchical multiple regression modeling was conducted with K-SCIM as the dependent variable to examine the level of functioning and relative influencing factors.ResultsUpper-extremity motor score (UEMS), upper-extremity spasticity and sitting balance scores were significant predictors of self-care; lower-extremity motor score (LEMS), musculoskeletal pain of shoulder, and sitting balance were significant predictors of respiratory and sphincter management; UEMS, LEMS, and sitting balance score were significant predictors of mobility; and UEMS, LEMS, musculoskeletal pain of shoulder, and sitting balance scores were significant predictors of the K-SCIM III total score after adjustment for demographic, SCI-related, and cognitive factors.ConclusionsPhysical factors had the greatest impact on all subscores and the K-SCIM III total score. Upper- and lower-extremity muscle strength and sitting balance significantly affected functional ability across all subscores.

HAP-PEE: A Danish National Study of Challenges Related to Urinating When Away from Home in Women with Neuromuscular Diseases, Impact on Activity and Participation and Prevalence of Lower Urinary Tract Symptoms.

Little is known about the challenges faced by women with a neuromuscular disease (NMD) when having to go to the toilet in other places than home; a topic that is highly important for participation and bladder health. The aim was to investigate whether women with NMD have problems in going to the toilet when not at home, the problems' impact on their social activities, education, and working life, which strategies they use to manage the problems, and the prevalence of lower urinary tract symptoms (LUTS). A national survey containing questions on type of NMD, mobility, impacts on social activities, education, working life, and bladder health was developed by women with NMD and researchers. LUTS were assessed by the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS). Female patients≥12 years (n = 1617) registered at the Danish National Rehabilitation Centre for Neuromuscular Diseases were invited. 692 women (43%) accepted the invitation; 21% were non-ambulant. 25% of respondents avoided going to the toilet when not at home. One third of respondents experienced that problems in going to the toilet impacted their social life. 43% of respondents refrained from drinking to avoid voiding when not at home, 61% had a low frequency of urinating, 17% had experienced urinary tract infections, and 35% had experienced urine incontinence. Problems were seldom discussed with professionals, only 5% of participants had been referred to neuro-urological evaluation. The results highlight the difficulties in urinating faced by women with NMD when not at home and how these difficulties impact functioning, participation, and bladder health. The study illustrates a lack of awareness of the problems in the neuro-urological clinic. It is necessary to address this in clinical practice to provide supportive treatment and solutions that will enable participation for women with NMD.

Long-Term Pulmonary Function Postspinal Cord Injury

ObjectiveTo investigate mean values of pulmonary function tests (PFT) at specific time points to assess long-term progression in patients with spinal cord injury (SCI). DesignRetrospective cohort study from 1997-2022. SettingNational rehabilitation hospital, providing scheduled admission for potential SCI-related issues. Follow-up assessments are recommended annually, guiding the observation period into consecutive 1-year intervals. ParticipantsThis study included 1394 adult patients who were admitted at least twice to the National Rehabilitation Center between 1997 and 2022, selected from an initial pool of 1510. Overall, 116 patients were excluded owing to the absence of any PFT results. InterventionsNot applicable. Main Outcome MeasuresChanges in PFT values over time, specifically assessing for a potential 2-phase pattern after injury. The hypothesis that PFT values would initially improve before declining was formulated based on existing literature. ResultsSignificant changes in pulmonary function were noted among 1394 adults with SCI. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) initially increased within the first 1-2 years after injury but declined to below baseline levels after 6 years. Pronounced changes occurred between <1 year and 1-2 years after injury (FVC: Δ=4.89, SE=0.87, P<.001; FEV1: Δ=4.28, SE=1.09, P=.002) and 1-2 years to >6 years (FVC: Δ= −5.83, SE=0.94, P<.001; FEV1: Δ= −6.49, SE=1.18, P<.001). No significant changes in the FEV1/FVC ratio. Motor completeness was significantly associated with the increase and decline phase, showing a steeper increase and less decline compared with the motor-incomplete group. ConclusionsPulmonary function in SCI initially increases but declines over time, falling below initial levels by 6 years. Further evaluation with more complete datasets is warranted to elucidate the factors influencing these changes.

CSP2023: 210 - The National Rehabilitation Centre (NRC): The vision of a technically advanced and digitally enabled rehabilitation environment to revolutionise rehabilitation

CSP2023: 210 - The National Rehabilitation Centre (NRC): The vision of a technically advanced and digitally enabled rehabilitation environment to revolutionise rehabilitation

Predicting adoption of the assistive technology open platform: extended unified theory of acceptance and use of technology

Purpose The Assistive Technology (AT) Open Platform supports people with disabilities, older people, and developers in co-creating new assistive products outside the business realm. To address dissatisfaction with and non-adoption of commercial assistive products, the National Rehabilitation Centre in South Korea created an AT Open Platform as an open-source AT sharing platform to research and develop appropriate assistive technology suitable for users’ needs. The emerging concept of AT Open Platform is new for both assistive product users and developers in South Korea. The Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) was utilised to understand the factors influencing the adoption of the AT Open Platform and to gain further insights on its design and future use. Materials and methods Interviews were conducted with six potential AT Open Platform users to develop a questionnaire for predicting behavioural intention. Subsequently, we surveyed 175 potential users to validate the UTAUT2. Results The results revealed that behavioural intention was significantly predicted by social influence, performance expectancy, facilitating conditions, and hedonic motivation. Conclusions The AT Open Platform should focus on both online and offline platforms to educate and facilitate the co-creation of ATs for assistive product users and makers. This study, which targeted assistive product users and developers, has significant implications for policymakers and future research in using and adopting the AT Open Platform as it reflects the actual voices of the platform’s stakeholders.

Social Support and selected preventable lifestyle Determinants in People with vertebrogenic Difficulties

Introduction: Up to 80% of the population has encountered back pain in some form in their life. Back pain is among the 5 most common reasons for hospitalization and is the main cause of sick leave for people over 45 years of age. This has significant consequences for the entire society. Research aim and objectives: Our research included patients of the National Rehabilitation Center Kováčová who were undergoing active rehabilitation treatment due to vertebrogenic problems. All respondents had demonstrable structural changes in the area of the lumbar spine, and around 80% of respondents had already undergone one or more lumbar spine surgeries. Our goal was to determine the relationship between the mentioned difficulties and physical activity, weight as well as the perception of social support. Methods: We used a self-constructed questionnaire focused on selected socio-demographic data and identification of eating and exercise habits. In addition, we used a standardized questionnaire titled “the Multidimensional Scale of Perceived Social Support”. Results: The analysis confirms that overweight, obesity and a lack of physical activity are related to structural changes and increased persistence of back pain. Inadequate dietary measures and insufficient physical activity directly contribute to this. Social support has a positive effect on enduring and coping with this difficult situation. Conclusion: Back pain affects almost our entire population. Therefore, it is important to address this issue, especially if prevention is possible by optimizing weight and doing adequate physical activity. We must also not forget those who are going through a difficult life period due to long-term pain and give them a helping hand and support.

Comparison of the prevalence of osteoporosis in people with spinal cord injury according to bone mineral density reference values for the diagnosis of osteoporosis: a retrospective, cross-sectional study

BackgroundSpinal cord injury (SCI) is a complex cause of rapid low bone mass that easily predisposes the affected individuals to osteoporosis-induced fractures. Several studies have investigated osteoporosis pathophysiology in SCI; however, those associated with its diagnosis in SCI are limited. Additionally, errors in osteoporosis diagnosis and its prevalence vary based on the bone mineral density (BMD) reference values (BMDRV), and no studies have reported BMDRV application for osteoporosis diagnosis in individuals with SCI. Therefore, this study aimed to compare the prevalence of osteoporosis among Korean adults aged ≥ 50 years with SCI according to BMDRV for diagnosing osteoporosis.MethodsOverall, 855 patients with SCI who underwent BMD tests of the lumbar spine, femoral neck, and total hip at the National Rehabilitation Center (NRC) in Korea between 2010 and 2020 were included in this retrospective cross-sectional study. Osteoporosis was diagnosed in patients with SCI by comparing the differences in prevalence, diagnostic consistency, and risk factors according to the region-based BMDRV of the dual-energy x-ray absorptiometry (DXA) manufacturer and international BMDRV based on the Third National Health and Nutrition Examination Survey (NHANES III) data of females aged 20–29 years.ResultsThe prevalence of osteoporosis according to the T-score provided by a single reference population of the NHANES III (TNHA) (PONHA) (males: 26.69%; females: 69.35%) was significantly higher in females and males than that according to the T-scores provided by the DXA manufacturer (TDXA) (PODXA) (males: 15.32%; females: 43.15%). The lumbar spine and femoral neck were major osteoporosis diagnosis sites for the PODXA and PONHA, respectively. Risk factors for osteoporosis differed based on the probability of osteoporosis (also known as the OZ ratio) according to the BMD criteria; however, the risk factors were similar according to old age, female sex, low body mass index (BMI), and long SCI period. No significant relationship was noted between the different SCI-related clinical factors (p > 0.05).ConclusionsThe osteoporosis diagnostic site and prevalence in SCI differed according to the regional-based TDXA and international standards of the TNHA. Therefore, further studies on BMDRV are warranted to establish accurate diagnostic criteria for osteoporosis prevention in patients with SCI.

Association between functional outcomes and psychological variables in persons with spinal cord injury

We aimed to explore the association of functional outcomes with psychological variables, including depression, anxiety, sleep quality, and suicide risk, in persons with spinal cord injuries (SCIs). The secondary aim was to determine specific functions related to the psychological variables. This retrospective study included 259 persons with SCIs who were admitted to the Korean National Rehabilitation Center between 2019 and 2021. The participants were interviewed by a psychiatrist and completed questionnaires, including the Korean Beck Depression Inventory II (K-BDI-II), Korean Beck Anxiety Index, Insomnia Severity Index, and Mini International Neuropsychiatric Interview. To assess functional outcomes, the Spinal Cord Independence Measure III (SCIM III) and Walking Index for Spinal Cord Injury were determined by a physical therapist. The findings revealed a negative correlation of SCIM III subdivisions 1 and 3 with K-BDI-II. Specifically, feeding and mobility in bed and actions to prevent pressure injuries were functional factors associated with all four psychological variables. Our findings can guide clinicians to focus on improving functional independence and activities of daily living during the management of persons with SCI to prevent psychological consequences. Developing devices that aid in improving functional independence is crucial and may improve psychological problems in such individuals.

7TH INTERNATIONAL SYMPOSIUM “SMART LION”. REHABILITATION IN UKRAINE, SEPTEMBER 26, 2023

The seventh international symposium, SMART LION, was held on September 26, 2023. It was to celebrate the 150th anniversary of the Shevchenko Scientific Society and the 125th anniversary of the Medical Commission. The topics concerned the challenges our country faces today. Organizers of SMART LION 2023 are Professors Valentyna Chopyak, Oksana Zayachkivska, and Vassyl Lonchyna. They managed to gather almost two hundred participants offline and over a thousand guests online.&#x0D; Olena Lazareva, Vira Rokoshevska, Oleh Bilianskyi, Oksana Hdyria, and Oleh Fitkalo delivered their reports on the development of rehabilitation in Ukraine and its main avenues.&#x0D; The emergence of post-traumatic stress disorder (PTSD) is a critical challenge for contemporary Ukraine and has long been a significant obstacle for global medicine. That is the reason why Oleh Berezyuk, Head of the Mental Health Service of the UNBROKEN National Rehabilitation Center, brought up the matter of difficulties in correctly diagnosing and treating PTSD in the context of a multidisciplinary hospital, while Professor Valentyna Chopyak and MD Svitlana Zubchenko focused the attention of attendees on PTSD immune-rehabilitation.&#x0D; During the concluding block of the symposium, which focused on the contemporary interpretation of physical therapy and occupational therapy, as well as interprofessional education, communication, and cooperation, attendees were afforded the chance to listen to highly intriguing reports presented by Renata Roman (Canada), Ellen Godwin (USA), Karl J. Sandin (USA), David Omut (USA), and Oksana Zayachkivska (Ukraine, USA).&#x0D; The scientific event concluded with a round table on the future of physical therapy and rehabilitation in Ukraine, with its outcomes leading to the resolution of the seventh international symposium, SMART LION 2023.

OFF-LOADING PRESSURE RELIEF WITH FOAM CUT OUT CUSHIONS: EXPERIENCES FROM RANCHO LOS AMIGOS NATIONAL REHABILITATION CENTER.

This paper explores the efficacy of the cushion fitting technique using foam cut out cushions for off-loading bony prominences in the sitting position, with a particular focus on reducing the high risk of developing pressure injuries among aging wheelchair users. This technique, historically employed at Rancho Los Amigos National Rehabilitation Center, has shown promising results in reducing pressure injuries for patients with spinal cord injuries. However, its widespread adoption remains limited. This manuscript aims to raise awareness about foam cut out cushions, its historical context, and its contemporary relevance by presenting customized solutions for individual patients with specific deformities. Key clinical points are highlighted, emphasizing the importance of skilled clinicians in the fitting process and the need to consider foam cut out cushions alongside other preventive measures. Case examples illustrate successful outcomes, demonstrating improved pelvic stability, posture, and off-loading of bony prominences. By promoting foam cut out cushions as a valuable cushioning option, this manuscript equips clinicians with knowledge to utilize this technique effectively.

Characteristics Associated with Bone Loss after Spinal Cord Injury: Implications for Hip Region Vulnerability.

In individuals with spinal cord injury (SCI), bone loss progresses rapidly to the area below the level of injury, leading to an increased risk of fracture. However, there are limited data regarding SCI-relevant characteristics for bone loss and the degree of bone loss in individuals with SCI compared with that in non-SCI community-dwelling adults. Data from men with SCI who underwent dual-energy X-ray absorptiometry at the National Rehabilitation Center (2008 to 2020) between 12 and 36 months after injury were collected and analyzed. Community-dwelling men were matched 1:1 for age, height, and weight as the control group, using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008 to 2011). A comparison of the SCI and the matched control group revealed significantly lower hip region T-scores in the SCI group, whereas the lumbar spine T-score did not differ between groups. Among the 113 men with SCI, the paraplegia group exhibited significantly higher Z-scores of the hip region than the tetraplegia group. Participants with motor-incomplete SCI showed relatively preserved Z-scores of the hip region compared to those of the lumbar region. Moreover, in participants with SCI, the percentage of skeletal muscle displayed a moderate positive correlation with femoral neck Z-scores. Men with SCI exhibited significantly lower bone mineral density of the hip region than community-dwelling men. Paraplegia rather than tetraplegia, and motor incompleteness rather than motor completeness were protective factors in the hip region. Caution for loss of skeletal muscle mass or increased adiposity is also required.

Risk Factors for Suicidality in Individuals With Spinal Cord Injury: A Focus on Physical and Functional Characteristics.

: To demonstrate the association between the physical and functional characteristics of individuals with spinal cord injury (SCI) and suicidality, an area of research that is less understood than the association with demographic, social, and psychological characteristics. : A retrospective cross-sectional study was conducted with 259 patients with SCI admitted for rehabilitation at the National Rehabilitation Center, Seoul, between January 2019 and December 2021. Demographic, SCI-related, physical, and functional data were collected from their medical records. Suicide risk was assessed using the Mini International Neuropsychiatric Interview. : The 259 participants had an average age of 49.1 years, and 75.7% were male. The analysis revealed a statistically significant negative correlation between age and suicidality. No significant differences were found for sex, education, occupation, or SCI-related factors. Lower upper extremity motor score (UEMS) was significantly associated with higher suicide risk. Regarding functional factors, the inability to perform independent rolling, come to sit, wheelchair propelling, and self-driving were associated with increased suicidality. In the multiple linear regression analysis, lower UEMS, limited shoulder joint motion, upper extremity spasticity, and dependent wheelchair propulsion were predictors of higher suicide risk. : This study highlights the associations among physical status, functional dependency, and suicide risk in individuals with SCI. These findings emphasize the need to address psychological aspects and physical and functional factors in the management of individuals with SCI who are at a high risk of suicide.

2019년부터 2021년까지 국립재활원의 장애인 운전재활 프로그램 운영 실태조사

The purpose of this study is to investigate the actual situation using data collected from&#x0D; the National Rehabilitation Center's driving rehabilitation program for the disabled over&#x0D; the past three years. We analyzed the collected data of 621 people who participated in&#x0D; the driving rehabilitation experience program and 1,042 people who participated in the driving&#x0D; rehabilitation education program from 2019 to 2021, and conducted descriptive statistics&#x0D; to investigate the characteristics of the subjects and driving rehabilitation program. The paired t-test were conducted to compare changes before and after driving rehabilitation&#x0D; education program and the required time for driving training.&#x0D; According to results of this study, the most of subjects selected driving rehabilitation&#x0D; program to participate in economic and leisure activities, with physical disabilities and brain&#x0D; lesions. 42.5% of driving rehabilitation experience subjects, needed driving training. 64.9%&#x0D; of driving rehabilitation education subjects were driver's license holders, and as a result&#x0D; of comparing before and after driving training, there was a significant change in all driving&#x0D; ability, and driving training required time decreased significantly from 9.96 hours to 3.52&#x0D; hours. In order to increase accessibility to driving rehabilitation programs, it is necessary&#x0D; to establish the role of the National Rehabilitation Center, driving support centers for the&#x0D; disabled in each region, and specialized training programs. Also, it is necessary to establish&#x0D; a digital-based stable database to improve continuous driving rehabilitation programs.

Medical service utilization by children with physical or brain disabilities in South Korea

BackgroundChildren with physical or brain disabilities experience several functional impairments and declining health complications that must be considered for adequate medical support. This study investigated the current medical service utilization of children expressing physical or brain disabilities in South Korea by analyzing medical visits, expenses, and comorbidities.MethodsWe used a database linked to the National Rehabilitation Center of South Korea to extract information on medical services utilized by children with physical or brain disabilities, the number of children with a disability, medical visits for each child, medical expenses per visit, total medical treatment cost, copayments by age group, condition severity, and disability type.ResultsBrain disorder comorbidities significantly differed between those with mild and severe disabilities. Visits per child, total medical treatment cost, and copayments were higher in children with severe physical disabilities; however, medical expenses per visit were lower than those with mild disabilities. These parameters were higher in children with severe brain disabilities than in mild cases. Total medical expenses incurred by newborns to three-year-old children with physical disorders were highest due to increased visits per child. However, medical expenses per visit were highest for children aged 13–18.ConclusionMedical service utilization varied by age, condition severity, and disability type. Severe cases and older children with potentially fatal comorbidities required additional economic support. Therefore, a healthcare delivery system for children with disabilities should be established to set affordable medical costs and provide comprehensive medical services based on disability type and severity.

Life expectancy and healthy life expectancy of Korean registered disabled by disability type in 2014–2018: Korea National Rehabilitation Center database

BackgroundConducting a distinct comparison between the life expectancy (LE) and healthy life expectancy (HALE) of people with disabilities (PWDs) and the general population is necessary due to the various environmental and health conditions they encounter. Therefore, this study aimed to develop the life table for PWDs and calculate those of LE and HALE based on sex, severity, and disability types among the registered Korean PWDs.MethodsWe used aggregated data of registered PWDs from the Korea National Rehabilitation Center database between 2014 and 2018. Overall, 345,595 deaths were included among 12,627,428 registered PWDs. First, we calculated the LE for total PWDs and non-disabled people using a standard life table, extending the old age mortality among nine models. Subsequently, we calculated the LE for each type of disability using the relationship between the mortality of total PWDs and those of each type of disability. Finally, HALE was calculated using the Sullivan method for three types as follows: disability-free and perceived health (PH) using the National Survey, and hospitalized for ≥ 7 days using the Korea National Health Insurance System (NHIS) database.ResultsThe calculated LE/HALE–NHIS (years) at registration in males and females were 81.32/73.32 and 87.38/75.58, 68.54/58.98 and 71.43/59.24, 73.87/65.43 and 78.25/67.51, and 61.53/50.48 and 62.41/49.72 years among non-disabled, total PWDs, mild disabled, and severe disabled, respectively. LE/HALE-NHIS was lowest and highest in respiratory dysfunction and hearing disabilities, respectively.ConclusionsMales with disabilities had shorter LE and HALE at registration than females, except for those with severe disabilities, and there were variabilities in the LE based on the disability types.

Moderate-to-high Intensity Group Exercise Improves Function of Stroke Survivors (P12-8.009)

<h3>Objective:</h3> The aim of this study is to investigate the effect and feasibility of moderate-to-high intensity exercise in stroke survivors. <h3>Background:</h3> Post-stroke exercise need to be encouraged to facilitate optimal recovery and to improve both physical and mental health. However, stroke survivors are easily predisposed to sedentary lifestyle due to physical impairment and functional compromise. Moreover, many clinicians as well as patients tend to be discouraged by exercise-related risk of injury of falls or comorbidities. <h3>Design/Methods:</h3> This study is a randomized controlled trial. Subjects were randomly assigned to either intervention or control group. Subjects in intervention group completed 16 sessions of 90-minute moderate-to-high intensity group-based exercise for 8 weeks. Isometric muscle strength and grip strength of the affected and unaffected side, 10 repetition sit-to-stand test (STS10), 60 second sit-to-stand test (STS60), Short Physical Performance Battery (SPPB), multidirectional reach test, Berg’s Balance scale (BBS), 10-meter walk test, 6 minute walk test, Timed-up-and-go test, physiological cost index, Korean version of modified Barthel index, and Korean version of Montreal Cognitive Assessment (MoCA-K) were measured at baseline and postintervention. <h3>Results:</h3> Total 30 stroke survivors were enrolled in the study and 22 were randomized to group-based moderate-to-high exercise and 8 were randomzied to home-based low intensity exercise. Intervention group showed high compliance as well as high attendance rate. Adverse event was only 2 uneventful falls in 1 subject. After 8 weeks of moderate-to-high intensity group exercise, subjects showed significant improvement in isometric muscle strength of hip extensors and knee flexors and grip strength both in affected and unaffected limbs, and isometric muscle strength of affected shoulder abductor. Also, STS60, SPPB, BBS, and MoCA-K were significantly improved in the intervention group after 8-week of moderate-to-high intensity exercise. <h3>Conclusions:</h3> Moderate-to-high intensity group-based exercise is feasible and safe and improves physical and cognitive function of chronic stroke survivors. <b>Disclosure:</b> The institution of Prof. Jung has received research support from National Rehabilitation Center, Ministry of Health and Welfare, South Korea. Miss Cho has nothing to disclose. Mr. Yoon has nothing to disclose.

PATTERNS OF METHAMPHETAMINE USE AND ITS ASSOCIATIONS WITH PSYCHIATRIC SYMPTOMS IN PATIENTS UPON ADMISSION AT THE NATIONAL REHABILITATION CENTER LIDO BOGOR, INDONESIA

Objective: Methamphetamine (MA) is a substance that is heavily abused worldwide. This present study aimed to investigate the association between the patterns of methamphetamine use and psychiatric symptoms in patients upon admission at The National Rehabilitation Center, Lido Bogor.&#x0D; Methods: This was a cross-sectional study of MA abusers during the period of January 2016–December 2018 at The National Rehabilitation Center, Lido, Bogor. This study was done by assessing medical records. The inclusion criteria were MA abusers at the age of 18 y and above. Assessment of psychiatric symptoms was evaluated using Addiction Severity Index (ASI). Microsoft Excel and SPSS version 22.0 were used to process the data.&#x0D; Results: The inclusion criteria were fulfilled by 1842 MA abusers. We found that 770 (41.8%) of MA abusers were assessed with psychiatric symptoms according to ASI. Depression was the most prevalent psychiatric symptom (31.9%), followed by anxiety (24.5%), and psychosis (8.9%). According to the results of multivariate analysis, the demographic profile and the mode of MA administration that are associated with the psychiatric symptoms were: female [odds ratio (OR): 1.95; 95% confidence interval (CI): 1.25–2.96, p&lt;0.001], 5-year duration of use [OR 1.43; 95% CI: 1.43 (1.19–1.73), p&lt;0.001], smoking as the route of administration [OR 1.3; 95% CI: 1.08–1.56, p&lt;0.001, p = 0.006], and concomitant use with other narcotics [OR 1.76; 95% CI: 1.46–2.13, p&lt;0.001].&#x0D; Conclusion: Among MA abusers admitted to The National Rehabilitation Center, the main factors associated with psychiatric symptoms were: female, long duration of use, smoking as the route of administration, and concomitant use with other narcotics.

A Study On The Application Of Mobile Arm Support In Individuals With Cervical Cord Injuries

<h3>Research Objectives</h3> To investigate the change in the active range of motion (AROM) of the shoulder and elbow joints by applying the mobile arm support (MAS) in cervical injury patients with limitations in the proximal part of the upper extremities. Additionally, the user satisfaction with MAS was assessed. <h3>Design</h3> One group before-after trial. <h3>Setting</h3> Inpatients at the National Rehabilitation Center. <h3>Participants</h3> This study included five tetraplegic patients with at least one year since the onset and neurological level of injury at C3–C4 level. <h3>Interventions</h3> Participants were trained by applying the Wilmington Robotic Exoskeleton (WREX). Training was conducted based on the Jebsen–Taylor hand function test. Six sessions of the intervention were conducted for 30 minutes each, thrice a week for 2 weeks. <h3>Main Outcome Measures</h3> The AROM of the shoulder and elbow joints was measured. Additionally, Korean-Quebec User Evaluation of Satisfaction with Assistive Technology (K-QUEST) was used to evaluate the satisfaction. <h3>Results</h3> The AROM of the shoulder joint increased from 38.040±35.710° to 49.960±36.884° for flexion, 26.380±19.367° to 31.800±14.249° for extension, 18.980±12.765° to 21.340±14.570° for adduction, 44.180±24.547° to 53.620±24.253° for internal rotation, and 28.020±17.071° to 34.900±20.793° for external rotation, but without significant differences. The elbow joint showed no AROM change. K-QUEST assessed the satisfaction with the equipment, with a 5-point scoring system from 1 (not satisfied) to 5 (very satisfied). Most items showed a satisfaction level ≥4, confirming positive results with WREX. <h3>Conclusions</h3> MAS training in patients with chronic cervical injury demonstrated an increase in the AROM of the shoulder. Thus, MAS training can improve the upper extremity functions in cervical injury patients. Additionally, the K-QUEST results confirmed positive satisfaction with the WREX equipment in these patients. <h3>Author(s) Disclosures</h3> Jung-Eun Lim(1), Woo Yeung Kim(2), Onyoo Kim(2) (1)National Rehabilitation Research Institute, National Rehabilitation Center and Hospital, Seoul, South Korea (2)Department of Rehabilitation Medicine, National Rehabilitation Center and Hospital, Seoul, South Korea