Onyoo Kim

Study design Randomized controlled trial, clinical trial. Objective Impact evaluation of combined occupational therapy (OT) and transcranial magnetic stimulation (rTMS) on upper limb function in patients with spinal cord injury (SCI). Setting National Rehabilitation Center, Seoul, Korea. Methods This randomized controlled trial included patients with cervical SCI. One treatment group received OT and rTMS, while the other received OT and sham-rTMS, three times per week for 5 weeks. The primary study outcome (change in upper limb function) was assessed using the graded and redefined assessment of strength, sensibility, and prehension (GRASSP) and hydraulic hand dynamometer. Secondary outcomes included results from the Korean versions of the Spinal Cord Independence Measure III (KSCIM-III), visual analog scale (VAS), modified Ashworth scale (MAS), and Beck Depression Inventory-II. Results Intervention (IG) and control groups (CG) included 14 and 15 randomly assigned patients, respectively. The IG showed substantial improvements in strength, sensation, and perception when compared to CG. The KSCIM-III results showed greater improvements in IG than in CG. VAS, MAS, and BDI scores increased for pain, spasticity, and depression, respectively, in both groups. Shoulder pain increased significantly in the CG and BDI scores increased significantly in both groups. Conclusion OT and rTMS combination therapy may contribute to upper extremity function improvements and more independence for patients with SCI.

The World Health Organization’s International Classification of Impairments, Activities, and Participation defines participation as ‘the nature and extent of a person’s involvement in life situatio...

Objective: To explore factors affecting the paid employment of individuals with spinal cord injury (SCI) in South Korea.Methods: Data collected from previously and currently community-dwelling adults with SCI (n=538) who responded to the 125-item self-reported International Spinal Cord Injury Survey questionnaire were analyzed using random forest and decision tree modeling.Results: In total, 75.1% responders were male, 53.9% were unmarried, 90.1% lived with family, and 84.8% received daily living assistance; the most frequent education level was high school or below (56.1%), and the percentage of participants with paraplegia and complete injuries was 57.2% and 58.7%, respectively. Average age and mean SCI duration were 46.31 and 15.25 years, respectively. Factors with a positive effect on engaging in paid employment included greater total monthly household income, younger age, higher self-efficacy, better quality of life and satisfaction, access to vocational rehabilitation services, absence of disability benefits, no need for daily living assistance, greater independence, no difficulties engaging in activities, absence of sleep disturbances, higher education level, and being unmarried.Conclusion: Employing the random forest method and a large dataset, we identified key predictors of paid employment, corroborating previous findings and establishing a foundation for policy development for employment opportunities.

Spinal cord injury (SCI) reduces quality of life and causes chronic inflammation. Mindfulness-based interventions may improve these symptoms. However, few studies have examined the benefits of mindfulness-based interventions in individuals with SCI. This study evaluated a tailored Mindfulness-Based Cognitive Therapy (MBCT) program. We conducted a non-randomized controlled trial at a national rehabilitation hospital in the Republic of Korea, involving 51 adult inpatients with SCI who were assigned to either the MBCT (n = 26) or treatment-as-usual (TAU) (n = 25) group. The 4-week MBCT program included 12 sessions emphasizing breathing - and auditory-based practices while excluding yoga and walking meditations. Additional components addressed illness acceptance and pain coping. Primary outcomes were quality of life and spiritual well-being. Secondary outcomes included inflammatory biomarkers. Assessments were conducted at baseline (T0), post-intervention (T1), and four weeks later (T2). Linear mixed-effects models were estimated. No significant group-by-time interaction was observed with the FACT-G or FACIT-Sp-12 overall. However, the FACIT-Sp-12 showed a significant group effect. Among participants with normal-to-mild baseline depression, significant group-by-time and group-by-baseline depression interactions were observed. Biomarker analyses revealed increased IL-10, decreased sTNFR2, and lower CRP levels in the MBCT group. Tailored MBCT may enhance spiritual well-being and inflammatory profiles in patients with SCI, particularly in those with lower baseline depression. However, further randomized trials are warranted for greater robustness.Trial Registration: Not applicable (non-randomized pilot study).

Osteoporosis and fractures are significant secondary complications in individuals with traumatic spinal cord injury (TSCI). However, national-level data that can inform targeted screening and management strategies are limited. Retrospective cohort study. We measured the mean times for osteoporosis and fracture onset, analyzed the incidence of osteoporosis and fracture, and identified risk factors, using the National Health Insurance Service claims data (2012-2019). The mean times for osteoporosis and fracture onset were 1.7 and 2.5 years, respectively, among patients with TSCI. The risk of osteoporosis was 2.1- and 3.6-fold higher in those aged 65-79 and 80 years, respectively, than in those aged <50 years. Fracture risk was 0.8-fold lower in those aged 50-64 and 65-79 years, respectively, than in those <50 years. These results provide nationwide evidence supporting age - and sex-specific screening and prevention strategies for osteoporosis and fractures in patients with TSCI, which may help improve long-term outcomes and reduce secondary complications.

The study aimed to analyze the differences in learning satisfaction between in-person and synchronous virtually online among Cambodian trainees in the Dr.

Objective: To explore subjective vitality and mental health among individuals with spinal cord injury (SCI) in South Korea; specifically the relationship between subjective vitality and mental health and their associations with SCI-related factors, including health conditions, activity, environmental, and personal factors.Methods: This cross-sectional study utilized data from the International Spinal Cord Injury Community Survey conducted in South Korea between March and October 2017. Data from 688 community-dwelling individuals with SCI were included in this study. Correlation and multiple regression analyses were conducted to investigate the relationships between vitality, mental health, and their associated factors.Results: A strong positive correlation was identified between subjective vitality and mental health (r=0.78, p<0.001). In multiple regression analyses, common factors significantly associated with both domains included sleep problems, healthcare-related activities, financial burden, self-efficacy, and belongingness. Bowel problems were associated only with subjective vitality, while pressure injury and perceived social attitudes were associated only with mental health.Conclusion: These findings highlight the importance of comprehensive approaches that address secondary health complications, promote healthcare education, and alleviate financial burdens to enhance both subjective vitality and mental health in individuals with SCI. Additionally, psychological interventions that foster belongingness and strengthen self-efficacy may further contribute to psychological well-being following SCI. Further research is needed to validate these associations and evaluate the long-term effects of such multidimensional strategies on subjective vitality and overall quality of life following SCI.

Non-invasive neuromodulation may be an effective treatment for stimulating motor and functional recovery of the upper extremities after spinal cord injury (SCI). We aimed to investigate the effects of combining repetitive transcranial magnetic stimulation (rTMS) with robotic therapy. We compared upper extremity function in patients who received rTMS and robot therapy to those who received sham rTMS and robot therapy. Randomized controlled trial. Rehabilitation center. Thirty patients with SCI were randomized into two groups: an intervention group (IG) receiving rTMS plus robotic therapy and a control group (CG) receiving sham rTMS with robotic therapy. The IG received 15 sessions of combined rTMS and robotic therapy over 5 weeks (3 sessions per week), while the CG received sham rTMS with robotic therapy. Functional assessments pre- and post-intervention included the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), grip strength, pain levels, the modified Ashworth scale (MAS), and the Korean version of the Spinal Cord Independence Measure III (KSCIM-III). Both groups showed significant post-treatment improvements in GRASSP domains (Strength, Sensation, Quantitative Prehension), with no significant intergroup differences. Grip strength, pain, and MAS scores improved in both groups without significant differences. In KSCIM-III, the IG showed significant gains in feeding and grooming, while the CG significantly improved in wheelchair-to-toilet/tub transfers. This study suggests that combining rTMS with upper extremity robotic therapy may have potential benefits for upper extremity function in patients with SCI. However, the addition of rTMS did not demonstrate clear superiority over robotic therapy alone. Further research with larger cohorts and optimized protocols is warranted to clarify its therapeutic value.Trial registration: Clinical Research Information Service, Republic of Korea identifier: KCT0004443.

Objective: To classify Koreans with spinal cord injury into groups with similar levels of life satisfaction and analyse the differences in life satisfaction between the groups, and identify the factors influencing their quality of life. Design: A cross-sectional study was conducted. Subjects: The International Spinal Cord Injury Survey of 711 persons with traumatic or non-traumatic spinal cord injury was used. Methods: The latent profiles were classified according to the sub-items of quality of life, and variables influencing the latent profiles were identified. The Mplus 8.0 program was used for the main analysis. Logistic regression analysis was performed to examine how the predictors were associated with latent profile membership. Results: The factors associated with a higher likelihood of belonging to the high quality of life group included marital status; having less bowel dysfunction and muscle spasms or spasticity; receiving vocational rehabilitation services and currently engaging in paid work; and negative social attitude and problematic financial status. Conclusion: Enhancing the quality of life of individuals with spinal cord injury necessitates providing medical care for bowel dysfunction or spasticity, providing vocational rehabilitation services, enabling successful return to work, improving negative perceptions regarding people with disabilities, and implementing policies to guarantee them an income.