http://schca-ir.schmc.ac.kr/handle/2022.oak/141 2026-10-22T20:59:33Z http://schca-ir.schmc.ac.kr/handle/2022.oak/4930 Title: The Effect of Skating Exercises as High-Intensity Interval Training on Elderly Stroke Patients All Author(s): Min-Su Kim Abstract: Background/objectives: High-intensity interval training (HIIT) can optimize recovery by complementing the low cardiovascular fitness intensities typically achieved in stroke rehabilitation programs. Skating exercise is an HIIT workout developed based on ice skating movements, and we investigated the effects of this exercise on the cardiorespiratory fitness of elderly patients with minor stroke. Methods: Participants aged 65 or older with a National Institutes of Health Stroke Scale score of 3 or lower were recruited. This study was designed as a randomized controlled trial, in which the intervention group engaged in skating exercises following HIIT, while the control group underwent moderate-intensity continuous training (MICT). Both groups of participants performed either HIIT or MICT for 20 min per day, four times a week, over three months. Results: A total of 34 elderly patients with minor stroke were recruited, with an average age of 70.7 years. For three months, no fall-down injuries or adverse cardiovascular or cerebrovascular events were reported among patients undergoing HIIT or MICT. Both the intervention and control groups showed significant increases in the measures of aerobic capacity after the intervention. However, the patients in the intervention group exhibited significantly greater improvements in peak oxygen uptake, ventilatory threshold, and peak MET (p = 0.005, p = 0.002, and p = 0.024, respectively). Additionally, the Berg Balance Scale (BBS) scores and the skeletal muscle mass index showed significantly greater enhancements in the intervention group compared to the control group (p = 0.032 and p = 0.032). Conclusions: In conclusion, skating exercise could be a safe and effective HIIT protocol for elderly people who have experienced a minor stroke. 2024-12-31T15:00:00Z http://schca-ir.schmc.ac.kr/handle/2022.oak/4901 Title: Standardized Measurement of Physical Performance and Muscle Strength for Sarcopenia: Expert-based Delphi Consensus All Author(s): Seung-Kyu Lim; Jaewon Beom; Sang Yoon Lee; Kyunghoon Min; Seong-Eun Byun; Yonghan Cha; Jun Hwan Choi; Jung-Yeon Choi; Jae-Young Han; Hak-Chul Jang; Hee-Won Jung; Kwang-Il Kim; Younji Kim; Young-Sang Kim; Jong Hwa Lee; Jong In Lee; Seung Yeol Lee; Kil-Byung Lim; Bumjo Oh; Sae-Jong Park; Ga Yang Shim; Wook Song; Chang Won Won; Jun-Il Yoo; Seung Don Yoo; Jae-Young Lim Abstract: Background: Despite updated sarcopenia guidelines, inconsistent protocols still cause clinical confusion and may compromise diagnostic and outcome accuracy. This Delphi study aimed to establish expert consensus to support the standardization of muscle strength and physical performance assessments for sarcopenia. Methods: A two-round modified Delphi study was conducted with 26 experts in geriatrics and sarcopenia. Participants completed two rounds of anonymous questionnaires evaluating 39 items across seven domains using a nine-point Likert scale or choice-based questions. Consensus was defined as ≥75% agreement. Results: In total, 27 of 38 statements (71.1%) reached consensus across two rounds Experts supported further standardization of assessments in alignment with the Asian and Korean Working Group on Sarcopenia (AWGS and KWGS) guidelines. For handgrip strength, consensus was achieved on using both mechanical and hydraulic dynamometers, hydraulic protocols, value selection, measurement time, and positioning, but not on mechanical protocols, repetitions, recovery intervals, repetitions, or unified cutoff values. For calf circumference, consensus was reached on measurement position, method, and value selection, but not on guideline application. In gait speed assessment, agreement was reached on speed, repetitions, assistive device use, and equipment type, but not on value selection, distance, acceleration/deceleration phases, or device interchangeability. For the 400-m walk test, the KWGS guideline and speed were endorsed. Chair stand test (CST) and Timed up-and-go (TUG) test reached consensus on armrest use, value selection, and repetitions, but not on seat height, (CST), or speed (TUG). Conclusion: This study highlights areas of agreement and ongoing uncertainty, supporting future standardization efforts sarcopenia assessment methods. 2024-12-31T15:00:00Z http://schca-ir.schmc.ac.kr/handle/2022.oak/4902 Title: Concurrent impact of sarcopenia and cognitive impairment on walking recovery after rehabilitation following hip fracture surgery All Author(s): Seung-Kyu Lim; Younji Kim; Jae-Young Lim Abstract: Background: Cognitive impairment and sarcopenia each negatively impact functional recovery after hip fracture, yet their combined effects remain underexplored. This study investigated the influence of these conditions on 1-year independent walking recovery in older adults undergoing post-fracture rehabilitation. Methods: This secondary analysis used data from the Fragility Fracture Integrated Rehabilitation Management (FIRM) clinical trial, a parallel-group, single-blind, multicenter superiority RCT, and its preliminary feasibility study. A total of 114 patients aged ≥65 years from three tertiary hospitals in South Korea were included. Patients were classified into four groups based on the presence of cognitive impairment and/or sarcopenia. Walking ability was assessed over a 12-month period. Kaplan-Meier analysis and multivariate Cox regression were used to evaluate independent ambulation rates and associated factors. Results: Patients with sarcopenia had lower independent ambulation rates than those without (71.9% vs. 84.4%; p = 0.025), as did those with cognitive impairment (65.2% vs. 89.1%; p = 0.010). The lowest rate was in patients with both conditions (60.8%, p = 0.022) and the highest in those without either (90.2%). Post hoc pairwise comparisons confirmed significant differences (p = 0.011). Cox regression showed cognitive impairment reduced independent ambulation likelihood by 45.8% (HR: 0.542, 95% CI: 0.340-0.865, p = 0.010), while both conditions together lowered it by 57% (HR: 0.431, 95% CI: 0.233-0.798, p = 0.007). Conclusions: Cognitive impairment, especially with sarcopenia, significantly hinders walking recovery after hip fracture. Targeted rehabilitation strategies are crucial to addressing their combined impact in older adults. 2024-12-31T15:00:00Z http://schca-ir.schmc.ac.kr/handle/2022.oak/4874 Title: Approach to Patients with Dysphagia: Clinical Insights All Author(s): Min-Su Kim Abstract: Dysphagia is a commonly encountered condition in clinical practice, with a rising incidence reported particularly in South Korea. It can be broadly classified into oropharyngeal dysphagia and esophageal dysphagia, and distinguishing between the two is crucial for establishing rehabilitation treatment strategies. Oropharyngeal dysphagia frequently occurs in central nervous system diseases such as stroke, dementia, and Parkinson's disease and has a significant impact on prognosis. Additionally, because there is a high risk of life-threatening aspiration pneumonia in patients complaining of dysphagia, an accurate diagnosis must be made during the early stages of the condition. Patients with oropharyngeal dysphagia may report difficulty initiating swallowing and may experience coughing, choking, nasopharyngeal reflux, aspiration, and a sensation of leftover food in the pharynx during swallowing. Patients with esophageal dysphagia may report a sensation of food getting stuck in the esophagus for a few seconds after the initiation of swallowing. Esophageal dysphagia should be characterized by analyzing whether the foods causing dysphagia are solid, liquid, or both, as well as by the progression of symptoms, whether they are progressive or intermittent; their severity; and associated symptoms such as weight loss, heartburn, or regurgitation. Video fluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), and esophagogastroduodenoscopy (EGD) are invaluable in determining the causes, severity, and treatment strategies for dysphagia. Since swallowing disorders are significant factors influencing the course and prognosis regardless of the type of disease, clinicians should adopt a systematic approach to such disorders. 2024-12-31T15:00:00Z