The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

Two Cases of Korean Medicine Treatment for Patients with Parkinson's Disease Evaluated Using a Three-Dimensional Gait Analysis System

3차원 보행분석기로 평가한 보행장애 및 자세불안정을 주소로 하는 파킨슨병 환자 한의 치험 2례

  • Hye-jin Lee (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Ye-chae Hwang (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Kyeong-hwa Lee (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Dong-joo Kim (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Seung-yeon Cho (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Jung-mi Park (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Chang-nam Ko (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Seong-uk Park (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong)
  • 이혜진 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 황예채 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 이경화 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 김동주 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 조승연 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 박정미 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 고창남 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 박성욱 (강동경희대학교병원 뇌신경센터 한방내과)
  • Received : 2023.08.29
  • Accepted : 2023.10.06
  • Published : 2023.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study examined the effectiveness of Korean medicine treatments in two patients with Parkinson's disease complaining of discomfort stemming from postural instability and gait disturbance (PIGD). Methods: Two patients were treated for 3 months. They visited the clinic once a week for the first month and thereafter once every 2 weeks. The Unified Parkinson's Disease Rating Scale (UPDRS) and a three-dimensional gait analysis were performed at the first visit and at 1, 2, and 3 months thereafter. Results: In Case 1, gait speed, stride length, and swing phase increased. Double support decreased until 2 months after treatment but increased slightly after 3 months. Among the kinematic parameters, tilt and rotation increased. The total UPDRS Part III score decreased from 51 points to 29 points after 3 months of treatment. In Case 2, gait speed, stride length, and swing phase increased, but double support decreased. Among the kinematic parameters, tilt, rotation, and obliquity decreased. The total UPDRS Part III score decreased from 11 points to 7 points after 3 months of treatment. Conclusions: This study suggests that Korean medicine can be an effective treatment for patients with Parkinson's disease who experience discomfort due to PIGD.

본 증례에서는 파킨슨병으로 인한 보행장애 및 자세불안정을 호소하는 환자 2명에 대하여 한의 치료를 시행한 결과 시공간적 보행지표, 운동형상학적 보행지표, UPDRS part III 점수에서 호전이 있었으며, 향후 보행장애 및 자세불안정을 호소하는 파킨슨병 환자에 한의 치료를 활용할 수 있음을 제시하였기에 증례를 보고하는 바이다.

Keywords

References

  1. World Health Organization (WHO). Newsroom, Fact sheets, Parkinson's disease [Internet]. Geneva (Switzerland): WHO; 2022 [cited 2023 August 2]. Available from: https://www.who.int/news-room/fact-sheets/detail/parkinson-disease 
  2. Armstrong MJ, Okun MS. Diagnosis and treatment of Parkinson disease: a review. JAMA 2020;323(6):548-60.  https://doi.org/10.1001/jama.2019.22360
  3. Sveinbjornsdottir S. The clinical symptoms of Parkinson's disease. Journal of neurochemistry 2016;139(Suppl. 1):318-24.  https://doi.org/10.1111/jnc.13691
  4. Mirelman A, Bonato P, Camicioli R, Ellis TD, Giladi N, Hamilton JL, et al. Gait impairments in Parkinson's disease. The Lancet Neurology 2019;18(7):697-708.  https://doi.org/10.1016/S1474-4422(19)30044-4
  5. Grabli D, Karachi C, Welter ML, Lau B, Hirsch EC, Vidailhet M, et al. Normal and pathological gait: what we learn from Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry 2012;83(10):979-85.  https://doi.org/10.1136/jnnp-2012-302263
  6. Matinolli M, Korpelainen JT, Sotaniemi KA, Myllyla VV, Korpelainen R. Recurrent falls and mortality in Parkinsons disease: a prospectivetwo-year follow-up study. Acta Neurol Scand 2011;123(3):193-200.  https://doi.org/10.1111/j.1600-0404.2010.01386.x
  7. Cho SY, Shim SR, Rhee HY, Park HJ, Jung WS, Park SU, et al. Effectiveness of acupuncture and bee venom acupuncture in idiopathic Parkinson's disease. Parkinsonism Relat Disord 2012;18(8):948-52.  https://doi.org/10.1016/j.parkreldis.2012.04.030
  8. Cho SY, Lee YE, Doo KH, Lee JH, Jung WS, Park SU, et al. Efficacy of combined treatment with acupuncture and bee venom acupuncture as an adjunctive treatment for Parkinson's disease. The journal of alternative and complementary medicine 2018;24(1):25-32.  https://doi.org/10.1089/acm.2016.0250
  9. Yang SB, Kim YJ, Lee HM, Lee SH, Cho SY, Park JM, et al. Effects of Korean Medicine on Postural Instability and Gait Difficulty in Patient with Parkinsonism: Retrospective Study. J Korean Med 2017;38(3):96-102.  https://doi.org/10.13048/jkm.17028
  10. Putorti A, Corrado M, Avenali M, Martinelli D, Allena M, Cristina S, et al. The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait. Frontiers in Neurology 2021;12:723468. 
  11. Zago M, Sforza C, Pacifici I, Cimolin V, Camerota F, Celletti C, et al. Gait evaluation using inertial measurement units in subjects with Parkinson's disease. J Electromyogr Kinesiol 2018;42:44-8.  https://doi.org/10.1016/j.jelekin.2018.06.009
  12. Jang JH, Park SS, An J, Choi JD, Seol IC, Yoo HR, et al. Gait disturbance improvement and cerebral cortex rearrangement by acupuncture in Parkinson's disease: A pilot assessor-blinded, randomized, controlled, parallel-group trial. Neurorehabilitation and Neural Repair 2020;34(12):1111-23.  https://doi.org/10.1177/1545968320969942
  13. Lei H, Toosizadeh N, Schwenk M, Sherman S, Karp S, Sternberg E, et al. A pilot clinical trial to objectively assess the efficacy of electroacupuncture on gait in patients with Parkinson's disease using body worn sensors. PloS one 2016;11(5):e0155613. 
  14. Ku JS, Jung C, Hwang JH. Toxicological Study of SU-Eohyeol Pharmacopuncture in an In Vivo Micronucleus Test in Sprague-Dawley Rats. Korean Journal of Acupuncture 2022;39(2):54-62.  https://doi.org/10.14406/acu.2022.008
  15. 박성욱. 약침의 정석 : 통증편. 1판. 서울: 우리 의학서적; 2020, p. 41-194. 
  16. Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The unified Parkinson's disease rating scale (UPDRS): status and recommendations. Movement Disorders 2003;18(7):738-50.  https://doi.org/10.1002/mds.10473
  17. Pistacchi M, Gioulis M, Sanson F, De Giovannini E, Filippi G, Rossetto F, et al. Gait analysis and clinical correlations in early Parkinson's disease. Funct Neurol 2017;32(1):28-34.  https://doi.org/10.11138/FNeur/2017.32.1.028
  18. Park JH. Characteristics of Gait in the Elderly: Normal vs. Abnormal. Journal of the korean neurological association 2017;35(4 suppl):1-4.  https://doi.org/10.17340/jkna.2017.4.23
  19. Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: variation in structure and function during gait. The Anatomical Record 2017;300(4):633-42.  https://doi.org/10.1002/ar.23552
  20. Smulders K, Dale ML, Carlson-Kuhta P, Nutt JG, Horak FB. Pharmacological treatment in Parkinson's disease: effects on gait. Parkinsonism & related disorders 2016;31:3-13.  https://doi.org/10.1016/j.parkreldis.2016.07.006
  21. Latt MD, Menz HB, Fung VS, Lord SR. Acceleration patterns of the head and pelvis during gait in older people with Parkinson's disease: a comparison of fallers and nonfallers. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 2009;64(6):700-6.  https://doi.org/10.1093/gerona/glp009
  22. Lee SH, Kang MW, Lee H, Lee SY. Effectiveness of Bee-venom Acpuncture and Ouhyul Herbal Acpuncture in Herniation of Nucleus Pulposus-comparison with Acpuncture Therapy Only. The Journal of Korean Acupuncture and Moxibustion Society 2007;24(5):197-205. 
  23. Yoon IJ. Effect of Jungsongouhyul herbal acupuncture therapy for neck pain patients. Journal of Haehwa Medicine 2007;16(2):1-5. 
  24. Kim HR, Jeong HS, Shin HY, Choi JW, Yang SB, Park SU, et al. A case of Korean medicine treatment on Parkinson's disease patient with postural instability, presenting as camptocormia. J Int Korean Med 2019;40(2):220-7.  https://doi.org/10.22246/jikm.2019.40.2.220
  25. Park EJ, Shin JC, Na GH, Lee DH, Han SG, Yoon YC, et al. Study on clinical effect of Cervus elaphus Herbal-acupuncture on Osteoarthritis in Knee joint. The Journal of Korean Acupuncture & Moxibustion Society 2004;21(2):275-86. 
  26. Park JS, Kim WY, Paek ST, Lee SD, Kim KS. The clinical observations of 4 case of De Quervain's Disease treated with Cervus elaphus Herbal-acupuncture. Jounral of acupuncture research 2004;21(6):259-67. 
  27. Lord S, Galna B, Rochester L. Moving forward on gait measurement: toward a more refined approach. Movement Disorders 2013;28(11):1534-43. https://doi.org/10.1002/mds.25545