• 제목/요약/키워드: Conservative Physical Therapy

검색결과 182건 처리시간 0.027초

Early versus Delayed Surgery for Spinal Epidural Abscess : Clinical Outcome and Health-Related Quality of Life

  • Behmanesh, Bedjan;Gessler, Florian;Quick-Weller, Johanna;Dubinski, Daniel;Konczalla, Juergen;Seifert, Volker;Setzer, Matthias;Weise, Lutz
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.757-766
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    • 2020
  • Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.

비뇨기 암으로 인한 남성 외성기 림프부종의 물리치료 -사례연구- (Physical Therapy of Male External Genitalia Lymphedema from Urological Cancer -Case Report-)

  • 소운영;김성중
    • The Journal of Korean Physical Therapy
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    • 제21권4호
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    • pp.103-109
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    • 2009
  • Purpose: Cases of male external genitalia lymphedema are relatively uncommon in the clinical physical therapy field. Of more than two thousand clinical cases treated by the author in the lymphedema treatment center, only 4~5 cases of male external genitalia lymphedema were encountered. The present case report presents the experience and treatment results of male external genitalia lymphedema from urological cancer. Method: This case was a 47-year-old man, who was treated with complex decongestive physical therapy consisting of manual lymph drainage, compression bandage (including the external genitalia), remedial exercise, skin care. Result: The results were relatively good. The clinical experience would suggest that early treatment and education can reduce the external genitalia lymphedema. However, the treatment efficacy remains limited. Therefore, early treatment is vital for more successful outcomes. Conclusion: The relief of symptoms and a decrease in male external genitalia lymphedema may be the best result from long-term conservative management.

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환축추 회전 아탈구 환자에 대한 도수치료 효과 (Effect of Manual Therapy on a Patient With Atlantoaxial Rotatory Subluxation)

  • 전재국;양성화;신의주
    • 대한정형도수물리치료학회지
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    • 제25권1호
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    • pp.71-76
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    • 2019
  • Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.

자기장 치료법이 무릎 뼈관절염 환자의 통증 역치, 혈류량 및 균형능력에 미치는 영향 (Effects of Magnetic Therapy to Improve on Pain Threshold, Blood Flow, and Balance in Patient with Knee Osteoarthritis)

  • 김경훈;김동훈
    • 대한통합의학회지
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    • 제11권3호
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    • pp.127-135
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    • 2023
  • Purpose : This study was performed to evaluate the effects of magnetic therapy (MT) on pain threshold, blood flow, and balance in patients with knee osteoarthritis. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 30 patient with knee osteoarthritis. They were randomly allocated 2 groups; magnetic therapy group (MTG; n=15) and placebo magnetic therapy group (PG; n=15). The MTG group received 30 minutes magnetic therapy and 20 minute conservative physical therapy (Hotpack, ICT), magnetic therapy was conducted in magnetic therapy device (OM-100, NUGA, Korea). In the placebo magnetic group received 30 minutes placebo magnetic therapy and 20 minute conservative physical therapy. Each group performed 50 minutes a day 3 times a week for 8 weeks. The primary outcome pressure pain threshold test, blood flow, balance ability were measured by a pressure threshold meter (Commander algometer, JTECH medical, USA), laser dofler image (Moor LDI2-IR, Moor instruments, USA), balance measurement system (BioRescue, Marseille, France). The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in pain threshold, blood flow, and balance ability during intervention period. magnetic therapy group revealed significant differences in pain threshold, blood flow, and balance as compared to the placebo magnetic therapy group groups (p<.05). Our results showed that magnetic therapy was more effective than placebo therapy on pain threshold, blood flow, and balance in patients with knee osteoarthritis. Conclusion : Our findings indicate that magnetic therapy can improve pain threshold, blood flow, and Balance, highlight the benefits of magnetic therapy. This study will be able to be used as an intervention data for recovering pain threshold, blood flow, and balance in patients with knee osteoarthritis.

요통환자의 물리치료에 관한 임상적 연구

  • 이재학;장수경;한동직
    • 대한물리치료사협회지
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    • 통권3호
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    • pp.11-18
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    • 1981
  • A Clinical Study of physical Therapy on the Low Back Conditions J. B. Rhee, S. K. fang, D. J, Han Low back pain usually is due primarily to a faulty mechanics, ,dis'c disease and other contributing factors .Conservative treatment of low back pain is considered to be useful with applicationes physical therapeutic measures including elimination of gravity, but surgical treatment is alternative to conservative .This study 1s conducted to analyse and evaluate efficiency of physical therapy on the low back pain on 452 cases who were treated at the Korea University Hospital, from January 1, 1978 to December 31. 1978.The results obtained in this study are summarized as follows :1. Sex distribution of total rationㄷs surveyed showed that 5l.3% in male and 487% in female.2 . In the age distrbution. the mest Liedominant age group was 25-54 years with7O.8 % .3 . The most proportion of the cases by occupation was housewife 27.7%, clerical and office workers 2l.7% , students 12.8% and labours 12.2 % respectively .4 . The most common causes of low back conditions classified, the Strain or Trau-rla revealed the highest frequency with 58.4% and thc Herniated Nucleus Pulpe-sus with 29.2 % of the total.5 . The modalities of physical therapy suitable to each cases were applied : 94.0%of all cases were treated with deep thermotherapy, 91.4 % hydrocollator steampack, 86.7% strengthening exercise of the weak muscles, pelvic traction 34.1%.6 . In regard to the duration required for the physical therapy. Herniated Nucleus Pulposus were approximately 4 weeks and strain or trauma were 2 weeks.7 . The improvement by physical therapy on lcw back conditions was classified in-to 41grades and showed following reaulits , excellent 42.5%, good 37.8%, fair 13.7% and poor 6.0% respectively.

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요통(腰痛) 및 요각통(腰脚痛) 환자에 있어 약침치료(藥鍼治療)의 호전도에 대한 임상적 고찰 (The Clinical Studies about improvement rate in managering patients who had lumbago and pain in loin & feet with herbal-acupunture therapy)

  • 이동현;김효수;위통순
    • 대한약침학회지
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    • 제7권2호
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    • pp.97-105
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    • 2004
  • Objectives : The purpose of this study is to compare the improvement rate in managering patients who had lumbago and pain in loin & feet by herbal-acupunture therapy with conservative treatment. Methods : 40patients who invited from March. 2003 to May. 2004 with lumbago and pain in loin & feet inve, were divided into two classes. A class was managed with conservative treatment(acupuncture, herb med, negative therapy, bed rest and physical therapy) and herbal-acupuncture therapy, the other class was managed with conservative treatment only. Two classes were distributed by sex and age, therapeutic periods, radiolographic results and therapeutic results that checked with VAS(visual analog scale) and ODI(Oswestry disability index). Results : According to VAS and OBI results, A class was managed with conservative treatment and herbal-acupuncture therapy shows the improvement in controling the pain of lumbago etc. comparing with the other class.

복부 기능적전기자극이 목척수손상환자의 최대기침유량과 노력성폐활량에 미치는 효과 (Effects of Abdominal Functional Electrical Stimulation on Peak Cough Flow and Forced Vital Capacity in Patients with Cervical Spinal Cord Injury)

  • 안혜인;고영범;윤선화;차수환;전용진
    • 대한통합의학회지
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    • 제7권2호
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    • pp.85-93
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    • 2019
  • Purpose : The purpose of this study was to investigate the effects of abdominal functional electrical stimulation on peak cough flow and forced vital capacity in patients with cervical spinal cord injury. Methods : The study examined 20 patients with cervical spinal cord injury. The subjects were randomly divided into two groups. All subjects performed conservative physical therapy for 30 minutes. The experimental group also underwent abdominal functional electrical stimulation for at least 20 minutes per day. Abdominal functional electrical stimulation was applied to the rectus abdominis muscle twice each day, three times a week, for four weeks. In all subjects, the peak cough flow was measured using a peak flow meter and forced vital capacity was assessed using a spirometer. Results : The experimental group showed a significant increase in peak cough flow and forced vital capacity in pre-post measurements (p<.05), while the control group showed a significant increase only in peak cough flow. Conclusion : These findings suggest that conservative physical therapy in combination with the abdominal functional electrical stimulation can improve peak cough flow and forced vital capacity in patients with cervical spinal cord injury.

요추간판 탈출증의 보존적 치료효과 분석 (The Effect Analysis of Conservative Treatment In Lumbar Intervertebral Disc)

  • 강점덕;박흥덕
    • 대한정형도수물리치료학회지
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    • 제7권2호
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    • pp.41-49
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    • 2001
  • This study was undertaken to find out the effect analysis of conservative treatment in of lumbar intervertebral disc. The data was performed to evaluate the effect of conservative treatment in 50 patients aging from 20 to 67 with lumbar intervertebral disc patients. Changes in low back pain score were evaluated by age, occupation, duration of symptoms, marital status, education period, self assessment. Duration of symptoms in over 7 months was 62.0%. 8.6 scores of complete recovery was changes in low back pain score of self assessment patients. In the multiple regression of risk factors to changes in low back pain score were correlated with age, education period, marital status, duration of symptoms(p<0.05). All patients were assessed by the low back pain protocol which was composed of symptom, clinical sign and activities of daily living scales before and after the treatment. Poor result could be predicted after the nonoperative treatment in the patient groups of changes low back pain score decreased with aging, duration of symptom over 7 months.

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무릎관절 통증 환자에서 멀리건 관절가동술과 맥켄지 운동이 통증과, 균형, 관절가동범위에 미치는 영향 (The Effects of Mulligan Mobilization with Movement and McKenize Exercise on Pain, Balance, Range of Motion in Patients with Knee Pain)

  • 이호종;김진영;신영일
    • 대한정형도수물리치료학회지
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    • 제28권2호
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    • pp.35-44
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    • 2022
  • Background: This study aimed to compare the effects of the Mulligan mobilization with movement and McKenzie exercise after applying conservative physical therapy to patients with knee pain. Methods: Patients were randomly allocatied into two groups: the Mulligan mobilization with movement (10 subjects) and the McKenzie technique (10 subjects). Each group was givenr conservative physical therapy and manual therapy sessions, three times week, for four weeks. The pain intensity was measured using the visual analogue scale (VAS). The cervical range of motion (ROM) was measured with a goniometer. Balance was measured using the modified Berg balance scale (BBS). Results: After four weeks of therapy, VAS (p<.05) decreased significantly, and ROM and balance increased siginficantly in both groups(p<.05). There was a significant improvement in knee extension (p<.05) in the McKenzie group compared to the Mulligan group. No intergroup differences were found with respect to the knee flex, VAS, and BBS (p>.05). Conclusion: The McKenzie exercises are more effective than Mulligan mobilization with movement for improving knee extension. Both interventions have the same effects on pain relief, in increasing knee flexion ROM and improving balance in patients with knee pain.

측두하악장애의 치료 (Management of Temporomandibular disorder)

  • 정다운;정아영;김성택
    • 구강회복응용과학지
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    • 제28권4호
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    • pp.441-452
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    • 2012
  • 다른 근골격성 질환에서와 같이, 측두하악장애의 징후와 증상은 일시적이거나 자기 한정적(self-limiting)인 경우가 많다. 따라서 복잡한 교합 치료나 수술과 같은 비보존적, 비가역적 치료를 초기치료로 선택하는 것은 가급적 피해야 한다. 또한 자가요법, 행동 수정, 물리치료, 약물요법, 장치치료 등과 같은 보존적, 가역적 치료가 측두하악장애의 초기치료로 추천된다.