Kim, Young-Jin;Cho, Hyun-Min;Yoon, Chee-Soon;Lee, Chan-Kyu;Lee, Tae-Yeon;Seok, June-Pill
Journal of Chest Surgery
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v.44
no.2
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pp.178-182
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2011
Background: We analyzed the results of surgical reduction and fixation of ribs under thoracic epidural anesthesia and analgesia (TEA) in patients who had no more than 3 consecutive rib fractures with severe displacement to examine the clinical usefulness of this method. Materials and Methods: From May 2008 to March 2010, 35 patients underwent surgical reduction and fixation of ribs under TEA. We reviewed the indications for this technique, number of fixed ribs, combined surgical procedures for thoracic trauma, intraoperative cardiopulmonary events, postoperative complications, reestablishment of enteral nutrition, and ambulation. Results: The indications of TEA were malunion or nonunion of fractured ribs in 29 (82.9%; first operation) and incompletely ribs under previous general anesthesia in 6 (17.1%; second operation). The average number of fixed ribs per patient was 1.7 (range: 1~3). As a combined operation for thoracic trauma, 17 patients (48.6%) underwent removal of intrathoracic hematomas, and we performed repair of lung parenchyma (2), wedge resection of lung (1) for accompanying lung injury and pericardiostomy (1) for delayed hemopericardium. No patient had any intraoperative cardiopulmonary event nor did any need to switch to general anesthesia. We experienced 3 postoperative complications (8.6%): 2 extrapleural hematomas that spontaneously resolved without treatment and 1 wound infection treated with secondary closure of the wound. All patients reestablished oral feeding immediately after awakening and resumed walking ambulation the day after operation. Conclusion: Thoracic epidural anesthesia and analgesia (TEA) may positively affect cardiopulmonary function in the perioperative period. Moreover, this technique leads to an earlier return of gastrointestinal function and early ambulation without severe postoperative complications, resulting in a shortened hospital stay and lowered costs.
The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI${\leq}$74 and MBI${\geq}$75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI${\leq}$74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI${\geq}$75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.
The purpose of this study was to determine the effect of systolic blood pressure, heart rate and myocardial oxygen consumption on 3-point nonweight bearing ambulation with axillary wooden crutch according to age. The subjects were fifty healty volunteers(22 male, 28 female), ages from 20 to 69(mean age of 43.8 years) with no history of cardiovascular or respiratory disease, diabetes mellitus, arthritis and orthopedic disorder within the past three years. This study was carried out from May 10 to August 10, 1996. The data were analyzed by percentage, mean and standard deviation and ANOVA. The results were as follows : 1. In systolic blood pressure(SBP), there was no significantly change between before walk and after 20 m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). 2. In heat rate(HR), there was no significantly change between before walk and after 20 m, 40 m in crutch walking with age, however, there did differ significantly after 60 m in crutch walking(p<0.05). 3. In myocardial oxygen consumption($MVO_{2}$), there was no significantly change between before walk and after 20m in crutch walking with age, however, there did differ significantly after 40 m and 60 m in crutch walking(p<0.01, p<0.001). These result showed that cardiovascular system had a great effect on the olderly when 3-point nonweight bearing ambulation with axillary wooden crutch. Therefore, when train for axillary crutch in the olderly, we needed suitably basis of walking distance.
The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.
The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was significantly increased in the experimental group(p<.05). In the comparison of vastus medialis root mean square(RMS) before and after experiment, the vastus medialis RMS was not significantly increased in the experimental group(p>.05). In the comparison of difference of the vastus medialis RMS between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly increased in the experimental group(p<.05). In the comparison of latency of somatosensory evoke potential(SSEP) before and after experiment, the latency of SSEP was significantly decreased in the control group(p>.05). In the comparison of difference of the latency of SSEP between groups, there was not significant difference between the experimental group and the control group(p>.05). 6. In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was not significant difference in the experimental group and the control group(p>.05). In the comparison of difference of the FAP between groups, there was not significant difference between the experimental group and the control group(p>.05).
The rhizomes of the Acorus gramineus Soland have been used as sedatives, analgesics, stomachics and anthelmintics in chinese medicine. It is known that the rhizomes of the Acorus gramineus Soland contains the essential oil about 0.5~0.8% and this essential oil contains asarone about 86%. The asarone possess many pharmacological properties similar to those of reserpine and chlorpromazine. Sedative and analgesic effects of essential oil of Acorus gramineus Solaad in mouse was observed. The essential oil of Acorus gramineus Soland decreased the frequency of ambulation on mouse in proportion of concentration. ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride) were markedly decreased in frequency of ambulation. The essential oil of Acorus gramineus Soland decreased writhing syndrome in mouse and ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride), opioids receptor antagonist(naloxone hydrochloride) were not increased above effects. In conclusion, these experimental results show that the essential oil of Acorus gramineus Soland have sedative and analgesic effects, but it did not antagonized ${\alpha}_2$ receptor antagonist(yohimbine hydrochloride) and opioids receptor antagonist(naloxone hydrochloride).
The purpose of this study was to investigate the effects of the increasing ankle range motion program on ambulation and balance for the elderly with balance disorder. Eighteen elderly subjects were administered with a timed test twice; approximately 4 weeks apart. The exercise group participated in a fall prevention exercise class at the Y.S. Senior Welfare Center of the Seoul Metropolitan Government. The session consisted of a stationary cycle, static stretching ankle joints, balance boards, and progressive resistive exercises using the Thera-band. The results were as follows: Firstly, the increasing ankle range of motion program was effective on the exercise group. Gait-speed was improved (p<.005). Secondly, balance was significantly improved (p<.000). Thirdly, increasing ankle range of motion program was effective in ankle dorsiflexion which was the major risk factor for falls among the elderly. Differences in gait and balance between the groups were examined using a paired t-test (p<.05). The exercise group demonstrated significantly higher values of gait-speed, ankle range of motion, and balance when compared with the non-exercise group. The results of this study suggest that the increasing ankle range of motion program is an effective intervention for the elderly with balance disorder.
Objectives: This study aims to evaluate the clinical effectiveness of a Korean medicine treatment on a traumatic spinal cord injury. Metohds : A 44-year-old male patient who had suffered a traumatic spinal cord injury was treated for two months. The effectiveness of complex Korean medicine treatments was measured using the Numeric Rating Scale (NRS) and the Manual Muscle Test (MMT). Result : We found that the NRS of pain caused by numbness was decreased from 7 to 0-1, and the overall motor measured by the MMT was also improved. The patient's walking state was changed from wheelchair ambulation to walker ambulation. Conclusion : Based on this finding, complex Korean medicine treatments may be effective in treating patients' pain, controlling paresthesia, and aiding the recovery function of activities in daily living. However, because of the limitation of our study, further high-quality research should be conducted.
The purpose of this study was to investigate the effect of Treadmill Training on WISCI level, walking velocity, walking endurance, motor score and gait cycle of spinal cord injury patient with incomplete. Four subjects with spinal cord injury participated in this study. They took walking excercise 5 times per week for 8 weeks. One time excercise spent 30minutes. The theraputic effect was evaluated by WISCI level, walk 10 meters test, walk for 12 minutes test, motor score and gait cycle. Four subjects were examined before, after 8 week, walking training. Collected data were statistically analyzed by SPSS PC for Wilcoxon signed rank test. The results of this study are as follows; 1) In WISCI level, walking velocity, walking endurance and motor score, post - treatment score were higher compared to pre-treatment score with statistical significance(p<0.05). 2) In Rt SLS, DLSII and Lt SLS, post-treatment percentage were higher compared to pre-treatment percentage with statistical significance(p<0.05). but DLSI were not statistical significance(p>0.05). The findings suggest that spinal cord injury patients with incomplete can improve their WISCI level, walking velocity, walking endurance, motor score and gait cycle through Treadmill gait training.
Rahman, Mahbubur;Choudhuri, M Shahabuddin Kabir;Khan, Mahmud Tareq Hassan;Jabbar, Shaila;Alamgir, Mahiuddin
Advances in Traditional Medicine
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v.6
no.1
/
pp.34-38
/
2006
The hot water extract of the seeds of Vernonia anthelmintica Kuntze (Compositae) in a dose of 10 ml/kg body weight of mice, showed significant analgesic activity on the hot plate analgesic method throughout the 4 h experimental period. The hole cross scores and the climbing out scores are of lower than the control animals. The hot water extract reduced the defecation in hole board study and significantly reduces the exploratory ambulation and head dipping behaviour. The seed also showed significant depressant activity on the exploratory ambulation of the open field scores. The drug decreased the spontaneous locomotion activity on brick-chip displacement method up to 45 min and also showed the ability to lessen the amphetamine induced hyperactivity up to 20 min. But it didn't show any effect on pentobarbital induced sleeping time test. The extract reduced gastrointestinal motility.
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