• Title/Summary/Keyword: 재활의학

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Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome (손목터널증후군의 한의표준임상경로 개발)

  • Hye-Jin Park;Hyun-Tae Kim;Sun-Young Park;In Heo;Man-Suk Hwang;Byung-Cheul Shin;Eui-Hyoung Hwang
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.2
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    • pp.57-76
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    • 2023
  • Objectives This study aims to develop Korean Medicine Clinical Pathway (CP) based on Clinical Practice Guideline of carpal tunnel syndrome to improve quality of treatment and reduce medical cost to maximize the quality of patient management. Methods A draft version of CP for carpal tunnel syndrome is developed by expert agreement and a prospective case study was carried out based on the draft CP. Twenty experts working at various medical institution answered validity verification survey of developed CP. Fifteen patients enrolled in the prospective case study answered survey on demand and satisfaction. Qualification and adjustment process of the draft CP was conducted based on results of both surveys. Results Final version of CP for carpal tunnel syndrome is confirmed after qualification and adjustment on the draft version. Conclusions CP for carpal tunnel syndrome will provide patients with standardized, high-quality Korean medicine treatment and also reduce financial burden of health insurance by reducing medical cost.

Postoperative Rehabilitation of Foot Fracture in Korean Medicine Treatment: Clinical Case Report (족부 골절수술 후 한방 재활치료의 효과: 증례보고)

  • Park, Na-Ri;Lee, Yun-Jin;Ahn, Hee-Duk;Yang, Doo-Hwa
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.165-172
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    • 2019
  • The objective of this study is to propose postoperative rehabilitation for foot fracture in Korean Medicine and to report its effectiveness. There were three patients who were got foot fracture surgery received korean medicine with acupuncture, herbal medicine, cupping and exercise treatment. Patients were evaluated numeric rating scale (NRS), range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score, foot function index (FFI) and EuroQol-5 dimension (EQ-5D) index. Case 1 and 2 were improved NRS from 6 to 3. Case 3 was improved NRS from 5 to 2. These cases were improved ROM in all directions, AOFAS score, FFI, EQ-5D and walking status. This study suggest that Korean medicine rehabilitation could be effective for patients who have received foot fracture operation.

The Effect of Diabetes Mellitus on Postoperative Electrodiagnostic Outcomes of Carpal Tunnel Syndrome (손목터널증후군 환자에서 당뇨병이 수술 후 전기생리학적 결과에 미치는 영향)

  • Kwak, Jung Min;Jeong, Young Ha;Kang, Seok;Yoon, Joon Shik
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.91-97
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    • 2018
  • Objective: The aim of this study was to compare the electrodiagnostic outcomes of carpal tunnel release in patients with and without diabetes with carpal tunnel syndrome (CTS), and to evaluate the effect of diabetes mellitus (DM) on electrodiagnostic outcomes. Method: We conducted a retrospective analysis of 67 patients with electro-diagnostic evidence of CTS. Patients were classified into two groups according to the presence of DM. Both groups were evaluated using nerve conduction studies preoperatively and 3 weeks and 3 months postoperatively. Results: There were no statistical differences in any of the electrodiagnostic parameters between groups 3 weeks postoperatively. However, there were statistical differences in the amplitude and the latency of compound muscle action potential, and sensory nerve conduction velocity 3 months postoperatively. Conclusion: Patients with DM did not show a significantly different outcome 3 weeks after surgery but showed a worse electrodiagnostic outcome 3 months after surgery than those without DM.

Neuralgic Amyotrophy of the Lower Extremity in a Neuropsychiatric Patient: A Case Report (신경정신병 환자의 하지에서 발생한 신경통성 근위축증: 증례보고)

  • Moon, Won Sik;Mo, Sang Jun;Bae, Min Joon;Hwang, Ki Hun
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.124-129
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    • 2018
  • Neuralgic amyotrophy (NA) is an idiopathic disease characterized by muscular atrophy accompanied by neuralgia, where acute pain in the limb, mostly including the shoulders, leads to muscle weakeness and atrophy in the limb days to weeks after the onset of pain. Although its exact pathogenesis is unknown, genetic and nongenetic factors, such as infection, surgery, and trauma are suspected contributors. We report this case as we diagnosed NA of the right lower limb via enhanced MRI as well as EMG and have followed up the patient's prognosis and radiologic changes for one and a half years. In addition, the patient had been diagnosed with neuropsychiatric disorders, such as major depressive disorder and somatic symptom disorder.

Bilateral Sciatic Neuropathy Following Rhabdomyolysis: A Case Report (횡문근융해증 이후 나타난 양측 좌골신경병: 증례보고)

  • Lee, Sang Yoon;Cha, Jun Min;Kim, Seong Woo;Jeon, Ha Ra
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.139-143
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    • 2018
  • Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.

Guillain-Barre Syndrome after Minimally Invasive Lumbar Procedure: A Case Report (요추부 최소침습적 시술 후 길랑-바레 증후군: 증례보고)

  • Lee, Bong-Yeon;Yoon, Seo-Ra;Ryu, Su-Ra;Choe, Yu-Ri
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.159-163
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    • 2018
  • Guillain-Barre syndrome (GBS) after trauma and general orthopedic surgery is rare. A 74-year-old woman showed ascending paralysis symmetrically, dysarthria, dysphagia and areflexia on 14 days after minimally invasive endoscopic thermoannuloplasty on L4-5 level. Brain and lumbar magnetic resonance imaging demonstrate no abnormal findings. The electrodiagnostic study showed prolonged distal motor, sensory latencies and F-wave latencies and reduced amplitude of compound muscle action potential in nerves of upper and lower extremities. In the cerebrospinal fluid (CSF) examination, total protein and IgG were increased. We diagnosed Guillain-Barre Syndrome based on clinical features, electrodiagnostic study and CSF examination and the patient improved symptoms after immunoglobulin injection and rehabilitation. Because the occurrence of GBS after minimally invasive procedure has not been reported, we report a case of GBS after minimally invasive procedure with literature review.

A Case of Posterior Interosseus Neuroapathy due to Intrasupinator Ganglion Mimicking Iatrogenic Injection Nerve Injury (의인성 신경손상을 모방한 손뒤침근내 결정종으로 인한 뒤뼈사이신경병증 증례)

  • Park, Hong Bum;Kim, Ki Hoon;Park, Byung Kyu;Kim, Dong Hwee
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.153-158
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    • 2018
  • Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.

Extracorporeal Shock Wave Therapy for Painful Heterotopic Ossification after Traumatic Transtibial Amputation (외상성 하퇴 절단지에 발생한 이소성 골화증에 대한 체외충격파 치료)

  • Jeon, Hyun Min;Yang, Hee Seung;Seo, Jin Seok;Han, Seok Cheol;Kim, Wan Tae
    • Clinical Pain
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    • v.19 no.1
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    • pp.28-31
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    • 2020
  • The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5~6 to 0~1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

Trends of Korean Medicine Conservative Treatment Using Low Back Pain Patients Registry Data: Analysis of Medical Records of 7 Korean Medical Hospital (요통 환자 레지스트리 데이터를 통한 한의 보존적 치료 경향: 7개 한방병원 의무기록 분석)

  • Lee, Kang-Joon;Oh, Min-Seok;Lee, Eun-Jung;Shin, Byung-Cheul;Hwang, Eui-Hyoung;Kim, Soon-Joong;Cha, Yun-Yeop;Ko, Youn-Seok;Song, Yun-kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.87-101
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    • 2019
  • Objectives The purpose of this study is to investigate characteristics of low back pain patients and trends of Korean medicine conservative treatment effects of low back pain patients by registry data. Methods A total of 78 patients were analyzed, statistical analysis was performed using a generalized linear model. The comparison between groups was performed using independent two samples t-test or Wilcoxon rank sum test according to the distribution of normality. Before and after the treatment effects, ANOVA and Kruskal-Wallis method were used for the comparison, Sheffe method was used for the post test. Results The average age of hospitalized patients was 31.8 years old and out-patient department (OPD) patients was 44.9 years old. Lots of OPD patients and hospitalized patients were classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis'. Both OPD patients and hospitalized patients classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis' showed statistically significant decrease in RMDQ (Roland-Morris disability questionnaire) and NRS (numeric rating scale) on 1 month and 3 month after clinical research start date. Comparing the treatment effects of Chuna manual therapy, both Chuna group and non-Chuna group showed statistically significant decrease in RMDQ and NRS on discharge date, 1 month and 3 month after clinical research start date. Conclusions We expect that a larger scale registry study will be carried out to provide a higher level of basis for the Korean medical treatment of low back pain.

A Rev iew of Bee Venom Acupuncture for Articular Diseases of Single Type Joint in the Journal of Korean Medicine (국내 임상연구 문헌고찰을 통한 단일 관절 질환의 봉약침요법 응용례 분석)

  • Kim, Hyo-Jun;Kim, Gook-Beom;Park, Joon;Kwon, Yong-Su;Yu, Jae-eun;Lee, Hee-Won;Bae, Jun-Hyo;Choi, Gyu-Cheol;Bae, Ji-Eun;Han, Su-Bin;Kim, Yang-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.119-135
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    • 2021
  • Objectives This review aims to analyze the current research trend in the usage of bee venom (BV) acupuncture for articular diseases of single type joint. Methods We collected 74 articles on BV acupuncture clinical study for articular diseases of single joint by searching Korean web databases 'Journal of Korean Medicine Rehabilitation', 'Oriental Medicine Advanced Searching Integrated System', 'Korean Traditional Knowledge Portal' from 1999 to 2020 August. Results We summarized the most frequent clinical treatment methods of BV acupuncture for articular diseases of single type joint. Research focused on specific diseases in application of BV acupuncture about some articular type diseases of single joint. It is assumed that the details of treatment for each joint are not related to the type of joint. In clinical study of BV acupuncture, reproducibility was mostly insufficient. Conclusions BV acupuncture clinical study for articular diseases of single joint should be proceed for a number of subjects, to treat various types of disease, by using more safe and detailed treatments.