• Title/Summary/Keyword: 보행성 평가

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Clinical Results of Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring Tendon (슬괵건을 이용한 관절경적 전방십자인대 재건술)

  • Song, Eun-Kyoo;Seo, Hyoung-Yeon;Lee, Geun-Bae;Yoon, Taek-Rim;Shim, Sang-Don
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.17-23
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    • 1999
  • Purpose : We intend to review clinical results after Anterior cruciate ligament(ACL) reconstruction using hamstring tendon arthroscopically. Materials & Methods : Sixty two patients who had underwent arthroscopic ACL reconstruction using hamstring tendon from Mar. 1996 to Mar. 1997 were reviewed. The average follow-up was 16 months and average age at operation was 27 years old. Clinical results were evaluated with physical examination, Lysholm Knee score and instrumented anterior laxity test with Telos Results : The average preoperative Lysholm knee score was 57.0 and postoperative average of that was 91.8. All cases of 62 patients had normal range of motion of knee and were able to walk with no problems at follow-up. On the Lachmann test, there were mild(+) instability in 24 cases, moderate(++) in 24 cases, severe(+++) in 14 cases preoperatively and 48 cases were converted to negative, 14 cases mild postoperatively. On instrumented anterior laxity test with Telos, difference between normal and affected knee on 20 lb which was 13.4mm preoperatively was decreased to 4.7mm at follow-up and anterior stability was regained(P<0.05). Parapatellar complications such as crepitus in 18 cases(29.5%), atrophy of quadriceps in 23 cases(36.5%) were observed. There were 2 cases of inaccuracy of guide pin of semifix screw intraoperatively and 3 cases of malposition of semifix screw postoperatively. Conclusion : ACL reconstruction using hamstring tendon seems to be a effective procedure to establish the stability of knee joint but is technically demanding procedure and leaves some parapatellar complications.

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Clinical Evaluation of TightRope Cranial Cruciate Ligament Technique for Treatment of Cranial Cruciate Ligament Deficiency in Dogs (전방 십자인대 결손을 보이는 개에서 TightRope을 이용한 치료방법 평가)

  • Yoon, Hun-Young;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.455-459
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    • 2012
  • Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

A Systematic Review on the Effects of Virtual reality-based Telerehabilitation for Stroke Patients (뇌졸중 환자를 위한 가상현실 기반의 원격재활 효과에 관한 체계적 고찰)

  • Lim, Young-Myoung;Lee, ji-Yong;Jo, Seong-Jun;Ahn, Ye-Seul;Yoo, Doo-Han
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.1
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    • pp.59-70
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    • 2017
  • Objective : The purpose of this study was to examine the effect of virtual reality-based remote rehabilitation on stroke patients systematically and to look for its effect and how to apply it domestically. Methods : In order to search data, EMBASE and CINAHL database were used. Relevant research used those terms of virtual reality, telerehabilitation, and stroke. A total of 10 studies satisfying the selection criteria was analyzed according to their qualitative level, general characteristics, and PICO method. Results : Based on the selected 10 studies, virtual reality-based telerehabilitation system was applied. Sensory and motor feedback was provided with inputting visual and auditory senses through a video in the home environment, and it stimulated changes in the client's nervous system. Tools to measure the results were upper extremity function, balance and gait, activities of daily living, etc. Those virtual reality-based telerehabilitation method had an effect on upper extremity function and ability of sense of balance in all studies, and on the activities of daily living partially. Telerehabilitation service to make up environmental specificity improved satisfaction of client. That meaned the effect of the intervention to maintain the function. Conclusion : The virtual reality-based telerehabilitation system was applied to upper extremity function, sense of balance, and activities of daily living largely, and it showed that it helped to improve functions through intervention, supervision, and training of therapist in the home environment as well. This study suggests the basis and possibility of clinical application on virtual-reality based telerehabilitation. Additional research is needed to diverse virtual reality intervention methods and the effect of telerehabilitation in the future.

Is a Fast-track Critical Pathway Possible in Gastric Cancer Surgery? (위암 수술 후 조기회복을 위한 임상진료 지침서의 활용이 가능한가?)

  • Yi, Jeong-Min;Hur, Hoon;Kim, Sung-Keun;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.18-25
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    • 2009
  • Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.

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