• Title/Summary/Keyword: 척수장애

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Improvement of Functional Recovery by Cell Transplantation after Spinal Cord Injury (척수손상 후 세포이식에 의한 운동기능의 회복증진)

  • 이배환;이경희;성제경;황세진;김계성
    • Science of Emotion and Sensibility
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    • v.7 no.2
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    • pp.179-186
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    • 2004
  • Acute spinal cord injury can produce neurologic injury with many physical, psychological and social ramifications. It has been shown that two separate components combine to produce neurologic damage in acute spinal cord injury : the primary and secondary injuries. The primary mediators of spinal cord injury include the actual mechanical tissue disruption which is a passive process that occurs immediately following the trauma. A secondary injury cascade follows which appears mediated by cellular and molecular processes working through complex mechanisms. Both the primary and secondary injury cascades produce cell death both in neuronal and supporting cell tissues. Recovery from central nervous system(CNS) disorders is hindered by the limited ability of the vertebrate CNS to regenerate injured cells, replace damaged myelin sheath, and re-establish functional neuronal connections. Of many CNS disorders including multiple sclerosis, stroke, and other trauma, spinal cord injury is one of the important diseases because of the direct association with the functional loss of the body. Previous studies suggest that substantial recovery of function might be achieved through regeneration of lost neuronal cells and remyelination of intact axon in spinal cord injury which is occurred frequently. As a therapeutic approach in spinal cord injury, recently, cell transplantation provides a potential solution for the treatment of spinal cord injury. This review describes the characteristics of spinal cord injury and presents some evidence supporting functional recovery after cell transplantation following spinal cord injury.

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Status and Characteristics of Applying Medical Use Analysis of intervertebral Disc Disorder Patients - Focusing on cervical spinal disease (추간판 장애 환자의 의료이용 현황 및 특성 -경추질환을 중심으로-)

  • Seo, Young-Woo;Park, Cho-Yeal
    • Journal of the Health Care and Life Science
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    • v.9 no.1
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    • pp.103-115
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    • 2021
  • The purpose of this study is to understand the annual trend of patients with cervical vertebrae disability and improve their health service utilization in the general description (200 TABLE) of patients with cervical vertebrae disability.The main results of this study are as follows. All patients with cervical vertebrae disability were women aged 50 to 59. Compared to 2010, the proportion of patients with disease increased year by year in all subjects in 2018, with men under 30-39 years of age and women under 19 years of age increasing the highest.

Protective Effects of Trimetazidine in a Rabbit Model of Transient Spinal Cord Ischemia (허혈성 척수 손상의 동물실험모델에서 Trimetazidine의 척수 보호효과)

  • 장운하;최주원;김미혜;오태윤;한진수;김종성;이수윤
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.255-260
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    • 2002
  • Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. Material and Method: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n= 17); TMZ group(Group 2, n= 16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. Result: The average motor function score was significantly higher in the TMZ group(3.20 $\pm$ 0.77 vs 1.13 $\pm$ 1.25 at 2 hours, 3.50 $\pm$ 0.76 vs 1.45 $\pm$ 1.57 at 24 hours, and 3.91 $\pm$ 0.30 vs 1.86 $\pm$ 1.86 at 48 hours after operation; p value$\leq$0.05). Histologic observations were correlated with the motor scores. Conclusion: The results suggested that trimetazidine reduced spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery:

Functional Outcome After Complete Spinal Cord Injury With Left Below Elbow Amputation, Medial Nerve Palsy at Right Hand: A Case Report (척수손상과 좌측하박절단, 우측 손의 정중신경손상 등 복합장애를 가진 척수손상 환자의 재활치료: 증례연구)

  • Kim, Tack-Hoon;Cynn, Heon-Seock;Lee, Jae-Ho
    • Physical Therapy Korea
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    • v.6 no.4
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    • pp.30-35
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    • 1999
  • 본 증례연구는 복합손상을 가진 척수손상환자의 재활치료과정을 소개하여 유사한 사례의 치료에 도움이 되고자 하는 것이다. 증례연구의 대상자인 26세의 남자환자는 흉수 4번 완전손상과 사고 당시 전기화상에 의한 좌측하박 절단과 우측손의 정중신경이 마비되었다. 치료초기에는 일상생활동작 검사에서 MBI (Modified Barthel Index) 점수가 22점으로 독립적으로 가능한 것은 거의 없었고, 기능적으로도 모든 도움이 필요한 상태였으나 재활치료결과 독립적으로 가능한 기능수행 능력은 돌아눕기, 일어나 앉기, 침상에서 의자차로 이동하기, 의자차 굴리기였고 제한적이기는 하지만 독립적으로 가능한 일상생활동작은 식사, 상의 입기, 의자차와 같은 높이의 이동 등이 가능하여 MBI 점수가 47점을 나타내었다. 이 환자의 초기의 장기치료목표는 전동 의자차를 이용하여 보호자의 도움을 줄이는 것이었다. 그러나 환자가 익숙하게 의지를 사용하였으며 일반 의자차 사용을 위해 필요한 만큼의 근력증가가 있었고, 의자차에 앉은 상태의 균형감각이 증가하여 목표를 수정하여 일반 의자차를 사용하도록 하였다. 환자 본인이 가지고 있는 재활 잠재력을 최대로 이끌어낼 수 있도록 유도한 결과 부분적으로 제한이 있었지만 실내에서는 의자차를 이용하여 독립적인 생활이 가능하였다.

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Predictors of Participation Restriction in Community-dwelling Persons With Spinal Cord Injury (지역사회 거주 척수장애인의 참여 제약에 영향을 미치는 예측요인)

  • Kim, Yeon-Ju;Park, Ji-Hyuk;Kim, Jung-Ran;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.19-30
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    • 2018
  • Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

The Effects and Development of a Hospital Based Community Reintegration Support Program for Patients with Spinal Cord Injury (척수손상 환자를 위한 병원기반 사회복귀지원 프로그램의 개발 및 효과)

  • Ho, S.H.;Yu, S.Y.;Kim, Y.S.;Bang, M.S.;Lee, B.S.;Kim, D.A.;Kim, E.J.;Kim, H.K.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.2
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    • pp.89-103
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    • 2015
  • The purpose of this research attempted to developed the Community Reintegration support Program(H-CRsP) on patients with Spinal Cord Injury(SCI) and identity the effect. To assess the effectiveness of a Hospital based H-CRsP with a comprehensive team approach for treating inpatients with Spinal Cord Injury(SCI), offered by the Korea National Rehabilitation Hospital. Participants with SCI were recruited from the Korean National Rehabilitation Hospital. Twenty-five participants who met inclusion criteria were provided with a H-CRsP. A H-CRsP with modules related to the training of daily living skills, driving, vocations and school support activities, leisure or recreational activities, peer counseling, sexual rehabilitation, and others support activities. The 25 enrolled patients had been treated with average of 6.1 programs 2 times a week for over 2 or 3months. COPM, HADS, WHOQOL-BREF, AD-R were administered before the treatment(pre-test) and also at the time of discharge(post-test) to compare the treatment outcomes in the 25 program participants. Measured level of community integration by CIQ at discharge. The data were analyzed by such statistical methods as frequency and paired t-test analysis. Significant improvements were found on the Occupational Performance and Satisfaction, Acceptance of Disability, Quality of Life score in the COPM, AD-R, WHOQOL-BREF (p<0.05). In addition, 10 of the 25 patients returned to home, work or school. These results demonstrated the effectiveness of the H-CRsP in helping patients with SCI return their communities to which they belong. It considered development of the variety of programs and prepare systematically related system.

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Model Construction of Sexual Adjustment of Patients with Spinal Cord Injury (척수장애인의 성적적응과 관련요인에 관한 모형구축)

  • Kang, Hyun-Sook;Koh, Jung-Eun;Shu, Yeon-Ok
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1018-1034
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    • 2000
  • The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows : 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.

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A Comparison of the Sexual Concerns of Men and Women with Spinal Cord Injuries (남녀 척수장애인의 성적관심, 성적적응과 관련요인 비교 연구)

  • Kang, Hyun-Sook;Suh, Yeon-Ok
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.198-206
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    • 2001
  • The purpose of this study is to compare sexual concerns and adjustment between men and women with spinal cord injuries. A total of 108 persons (67 men and 41 women), registered to the Spinal Cord Injury Organization or admitted at rehabilitation unit from February 1999 to February 2000, were selected as subjects of the study. Participants answered the questionnaires concerning importance of life events, sexual concern, sexual adjustment, relationship with a sex partner, and depression. The results are as follows : 1) There were no significant differences between men and women in the general characteristics except sexual dysfunction. 2) With respect to eleven different life areas, sex life ranked the fifth among men, whereas it occupied the lowest position for women among the 11 areas. However economic status was the most highly-ranked for both sex. 3) Men took much interest in the "methods and techniques for achieving sexual satisfaction", "Helping a partner cope emotionally with limitations on sexual activity", whereas women were interested in "Helping a partner cope emotionally with limitations on sexual activity" and "Ability to have children". 4) The means of sexual adjustment, relationship with a sex partner, and depression among men were higher than women. But there was no significant difference between two groups. As a result, the study suggests that there are no significant differences in the general characteristics between men and women with spinal cord injuries except sexual dysfunction. Men evaluated the sexual events highly compared to women, and differences were also shown in terms of sexual concerns between men and women. Therefore differential approaches to sexual rehabilitation are required; in both socio-psychological and physical aspects for men and particularly in socio-psychological respect for women.

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Sexual Interest and Adjustment for Spinal Cord Injury Patients (척수장애인의 성적관심과 성적적응에 관한 연구)

  • Kang, Hyun-Sook;Koh, Jung-Eun;Suh, Yeon-Ok;Yee, Oon-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.85-94
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    • 1999
  • The purposes of this study were to identify sexual interest and adjustment in patients with spinal cord injury and to determine the factors that relate to sexual adjustment. A total of 134 persons in this study was the members of spinal cord injury organization and the impatients in rehabilitation unit between February and June 1999. Five questionnaires were answered concerning importance of life events, sexual concern, sexual adjustment, relationship with a sex partner, and depression. The collected data were analyzed by Frequency, t-test, ANOVA and pearson correlation. The results were as follows : 1) Considering the importance among 11 areas of life, economic status occupied the top, sex life held the sixth rank, and the mean rating for social life being 3.78 was the lowest of all. 2) As regard to 7 topics related to sexuality, the most attention was drawn to methods and techniques achieving sexual satisfaction, and the next interest was for helping partners cope emotionally with sexual dysfunction. 3) The mean for sexual adjustment and depression was average, and the mean for sex partner relationship was high. 4) Sexual adjustment in spinal cord injury patients correlated with economic status and sex partner relationship. While It was inversely correlated with age and depression. It was found that lower age and less depression play a positive role on sexual adjustment by SCI people. Also, higher economic status and favorable sex partner relationship increase sexual adjustment. In conclusion, a sex partner relationship, depression, economic status, and age seemed to influence on their sexual adjustment after SCI. Also, psychosocial factors would be more important for satisfying sexual life and relation ship rather than physical factors.

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A Survey on the Present Situation and Satisfaction in Assistive Technology of Person with Physical Disabilities (지체장애인의 보조공학 이용 실태 및 만족도 조사)

  • Lee, Chun-Yeop;Kim, Eun-Joo;Noh, Dong-Hee;Moon, Seo-Jin;Park, Sung-Ho;Chae, Gang-Seok;Chang, Moon-young
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.21-31
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    • 2013
  • Objective : This study was aimed to survey the present situation and satisfaction in assistive technology of the physically disabled person. Method : 110 patients, being diagnosed with spinal cord injury and stroke, were chosen and structured interview was carried out using by a questionnaire. Result : The followings are the results of this study. First, spinal cord injury(76.2%) and stroke(72.5%) patients used the most wheelchair and mobility devices in assistive technology device. Second, they were satisfied in effectiveness of assistive technology device. Third, spinal cord injury(39.4%) patients used the most repair service in assistive technology service. Fourth, stroke(28.2%) patients used the most application and training service. Fifth, they were satisfied in professionality while were dissatisfied in service delivery program. Conclusion : The results of this study would contribute to better assistive technology for the physically disabled person.

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