• Title/Summary/Keyword: Early rehabilitation

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Clinical Outcomes of Anterior Open Reduction and Posterior Percutaneous Screw Fixation for Displaced Talar neck Fractures (전방 정복술 및 경피적 후방 압박나사 내고정술을 이용한 전위성 거골 경부 골절의 치료 결과)

  • Park, Ji-Kang;Kim, Yong-Min;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Cha, Jung-Kwan
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.106-114
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    • 2013
  • Purpose: Posteroanterior screw fixation is biomechanically stronger than anteroposterior screw fixation. However, there are few literature about the correlation between clinical results and more strength by posteroanterior fixation. This study was performed to evaluate the clinical outcomes of the accelerated rehabilitation following anterior open reduction and posterior percutaneous screw fixation for displaced talar neck fractures. Materials and Methods: Eighteen cases were followed up for more than 1 year after posteroanterior fixation using headless compression screw for talar neck fractures. The clinical evaluation was performed according to American Orthopaedic Foot and Ankle Society (AOFAS) score and Hawkins criteria. As radiographic evaluation, the degree of fracture displacement, period to union, and occurrence rate of complications such as avascular necrosis through MRI were measured. Results: The AOFAS score was average 90.4 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the Hawkins criteria. Therefore, 16 cases(88.8%) achieved satisfactory results. The degree of fracture displacement had improved significantly from preoperative average 5.6 mm to 1.2 mm immediate postoperatively, and maintained to 1.1mm at the last follow-up. All cases achieved bone union, and the period to union was average 12.4 weeks. There were 3 cases of avascular necrosis of talar body and 2 cases of post-traumatic arthritis. Conclusion: Anterior open reduction and posterior percutaneous headless screw fixation seems to be an effective surgical method for displaced talar neck fractures, because of the possibility of accurate restoration of articular surface, fixation strength enough to early rehabilitation, and needlessness of hardware removal.

Effect of Neonatal Developmental Intervention Program (NDT) on Motor Development and Growth in Premature Infants

  • Park, Geun-Hwa;Choi, Sang-Youn;Kim, Sung-Mi;Kim, Mi-Ae;Lee, Eun-Ju
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.207-216
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    • 2010
  • Purpose: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. Methods: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. Results: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA $\geq$34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. Conclusion: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.

An Experimental Study for the Prevention of CT Contrast Media Extravasation with Extravasation Detection Accessory System in Femoral Vein of Rabbit (가토 정맥에서 CT 조영제의 혈관외유출 예방을 위한 EDA 시스템의 실험적 연구)

  • Kweon, Dae-Cheol;Jeong, Seok-Hee;Yang, Sung-Hwan;Cho, Mun-Son;Jang, Keun-Jo;Kim, Sun-Geun;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.238-245
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    • 2006
  • To assess the ability of an extravasation defection accessory (EDA) to detect the clinically important extravascular Injection of iodinated contrast material that was delivered with an automated mechanical power injector. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The EDA system was composed of a strain gage, an amplifier and a computer-based system. In the rabbit experimental cases, there were seven true-positive cases (range of the extravasation volumes: $14{\sim}23 ml$). The algorithm results showed seven true-positive cases (range of the extravasation volumes: $7{\sim}16ml$), nineteen true-negative cases, two false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 90% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors.

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Effect of Korean Medicine Combined with Electric Moxibustion in Patients with Traffic Accident-Induced Lumbago

  • Jeong, Hui-Gyeong;Kwon, Oh-Hoon;Park, Ju-Hun;Kim, Sang-Gyun;Kim, Yong-Hyeon;Lee, Ju-Young;Kim, Eun-Ji;Kim, Tae-Ju;Jeong, Sang-Jun
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.193-199
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    • 2018
  • Background: The purpose of this study was to investigate electric moxibustion on patients with back pain caused by road traffic accidents. Methods: This was a retrospective study (n = 112) comparing treatment with Korean medicine combined with electric moxibustion (n = 56), and Korean medicine alone (n = 56). Patient gender, age, Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EuroQol-5 Dimension (EQ-5D) was recorded for each group at the time of hospital admission. Mean NRS measured weekly, mean ODI and EQ-5D scores were measured 2 weeks post-treatment, and evaluated by paired sample t test. using the Statistical Program for Social Science v. 25.0 for Windows. An independent, two-sample t test was used to test for a significant difference in the decrement of NRS, ODI and increment EQ-5D scores between groups. Results: NRS scores decreased in both groups after 1 week of treatment (electric moxibustion, from $5.13{\pm}0.79$ to $3.86{\pm}0.67$; Korean medicine alone, from $5.18{\pm}0.92$ to $4.30{\pm}0.94$; both p < 0.001). There was a significantly greater reduction in NRS score in the electric moxibustion group ($1.27{\pm}0.59$) than in the Korean medicine alone group ($0.88{\pm}0.61$; p = 0.001). After 2 weeks of treatment, EQ-5D scores increased significantly in the moxibustion group ($0.19{\pm}0.12$) compared with the Korean medicine alone group ($0.13{\pm}0.20$; p = 0.043). After 2 weeks of treatment, NRS and ODI scores decreased in both groups. EQ-5D increased in both groups. Conclusion: We suggest that electric moxibustion treatment may be effective for reducing early-stage back pain in patients with road traffic accident injuries.

Effects of Root of Cibotii Rhizoma on Neuronal Damage of Spinal Cord Contusion Injury in Rats (구척(狗脊)이 흰쥐의 척수압박에 의한 신경세포 손상에 미치는 영향)

  • Park, Won-Sang;Kim, Eun-Seok;Shin, Jung-Won;Kim, Bum-Hoi;Kim, Seong-Joon;Kang, Hee;Sohn, Nak-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.1-15
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    • 2010
  • Objectives : This study was performed to evaluate the effects of root of Cibotii rhizoma(CR) ethanol extract on the tissue and neuronal damage of the spinal cord injury(SCI). Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rats. CR was orally given once a day for 7 days after SCI. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue(LFS) histochemistry. HSP72(as neuronal damage marker), MAP2(as nerve fiber degeneration marker), c-Fos(immediate early gene), and Bax(pro-apoptotic molecule) expressions were examined using immuno-histochemistry. Individual immuno-positive cells expressing HSP72, MAP2, c-Fos and Bax were observed on the damaged level and the upper thoracic and lower lumbar spinal segments. Results : 1. CR reduced degeneration of nerve fibers and motor neuron shrinkage in the ventral horn of the lower lumbar spinal segment, but generally it did not seem to ameliorate the tissue injury following SCI. 2. CR reduced demyelination in the ventral and lateral funiculus of the lower lumbar spinal segment. 3. CR reduced HSP72 expression on the neurons in the peri-central canal gray matter adjacent to the damaged region. 4. CR strengthened MAP2 expression on the motor neurons in the ventral horn and on nerve fibers in the lateral funiculus of the lower lumbar spinal segment. 5. CR reduced c-Fos positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. 6. CR reduced Bax positive cells in the peri-lesion and the dorsal horn of the damaged level and in the ventral horn of the lower lumbar spinal segment. Conclusions : These results suggest that CR plays an inhibitory role against secondary neuronal damage and nerve fiber degeneration. following SCI.

An Experimental Study for Performance Evaluation in Dogs of Preventive Contrast Media Extravasation with a Strain Gage Based Prototype Extravasation Detection Accessory System (잡견에서 조영제 혈관외유출 예방을 위한 스트레인 게이지 기반의 EDA 시스템 성능 평가를 위한 실험적 연구)

  • Kweon, D.C.;Yoo, B.G.;Lee, J.S.;Cho, M.S.;Yang, S.H.
    • Journal of Biomedical Engineering Research
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    • v.29 no.1
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    • pp.66-72
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    • 2008
  • The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of computed tomography (CT) contrast media can produce the compartment syndrome. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The extravasation detection accessory (EDA) system was composed of a strain gage, an amplifier and a computer based system. A strain gage pliable adhesive patch was applied to the skin aver the intravenous catheter and the catheter was connected to the power injector with a cable to monitor the resolution data. If the programmed monitoring, which was developed with MS Visual C++, at the extravasation occurred, then the injection was interrupted the auto injector. CT was used to demonstrate the clinically important extravasation. This study was a prospective, observational study in which the EDA system was used to monitor the automated mechanical injection of contrast material in 7 dogs. There were two true-positive cases (range of extravasation volumes: $18{\sim}22ml$), twenty three true-negative cases, three false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 88% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors. The EDA system is easy to use safe and accurate for the monitoring extravasation of the intravenous injections, and this system may prove especially useful in CT applications.

Changes in the Concept of Disability and its Implications for Social Work Practice (장애개념의 변화와 사회복지실천 현장 함의)

  • Kim, Yong-Deug
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.157-182
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    • 2002
  • This study attempts to identify the changes in social reactions to disabilities in general, and to research the contextual implication of these changes in social work practice in Korea. In the early years after the Industrial Revolution, disability was conceived as social unfitness and it was assumed that the cause and responsibility could be attributed to people with disabilities. But, in the midst and late 20th century, social responsibility for people with disabilities was argued and generally accepted. As the results of these changes, conceptual models explaining disabilities have changed gradually; there has been a transition, so called, from individual model to social model. In a similar vein, WHO has refined the definition and classification of disability. Related to these changes, social welfare service paradigm for people with disabilities has shifted. This paradigm shift can be explained with the perspective of strength approach, empowerment approach, case management and independent living model. In Korea, 1998 Act on welfare for people with disabilities meant that social service for the disabled were categorized with, namely, residential service, community rehabilitation service and vocational rehabilitation service. Recently, the extent of these services has been rapidly broadened. In these situation, this study researched to identify the implications on social work practice in the context of changes in social response, conceptual model, definition and also service paradigm. Such as the followings are enumerated for the implications: disabled person's participation in assessment process, development of assessment tools focusing on social and environmental perspectives, reinforcement of information service helping self-determination, supporting on formal and informal helping network, expanding self-help programs and, finally, a shift from displacement model to support model.

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Feeding Disorders in Autistic Spectrum Disorders (자폐 스펙트럼 장애 아동의 섭식장애: 문헌 고찰)

  • Min, Kyoung-chul;Shin, Jin-yong;Kim, Eun-hye
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.3
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    • pp.79-102
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    • 2023
  • Objective : Autistic Spectrum Disorders(ASD) is a developmental disorder characterized by atypical sensory adaptation, communication problem, stereotyped behavior, and feeding disorders. The reasons for ASD feeding disorders are oral sensory motor, cognitive, behavioral, and social problems. Major symptoms include picky eating, selective eating, food refusal, food neophobia, limited food variety, and food aversion. ASD feeding disorders could be accompanied by various problems such as health and nutrition intake problems, feeding development, eating-related sociability, and family and caregiver stress. Feeding problems and disorders in ASD can present from birth. However, ASD is diagnosed by the age of 3, and there might be an appropriate treatment gap. Usually, symptoms of feeding disorders tend to decrease with age. However, the symptoms often remain, so early evaluation, intervention, and periodic checking are necessary. In this study, the general information about the feeding disorder characteristics of ASD, influencing factors, and intervention were described through a literature review. Conclusion : Sensory-based therapy and behavior-based therapies are generally used for feeding disorders in ASD. Sensory-based therapy is effective for food sensitivity and behavior-based therapy for food selection. As the symptoms of feeding disorders in ASD are diverse, a comprehensive approach includes play and participation, oral motor exercise, diet, and daily life. However, appropriate evaluation, intervention protocol, and guidelines for the treatment of feeding disorders in ASD are limited. Therefore, a complex approach based on a more systematic understanding is needed. Feeding rehabilitation specialists, such as occupational therapists, should provide appropriate evaluation and intervention.

Comparison of Kinematics and Myoelectrical Activity during Deadlift, with and without Variable Banded Resistance, in Healthy, Trained Athletes

  • Everett B. Lohman;Mansoor Alameri;Fulden Cakir;Chih Chieh Chia;Maxine Shih;Owee Mulay;Kezia Marceline;Simran Jaisinghani;Gurinder Bains;Michael DeLeon;Noha Daher
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.53-70
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    • 2024
  • Background: The conventional deadlift is a popular exercise for enhancing trunk, core, and lower extremity strength. However, its use in sports medicine is constrained by concerns of lumbar injuries, despite evidence supporting its safety and rehabilitative benefits. To optimize muscle activation using resistive bands in variable resistance therapy, we explored their feasibility in the deadlift. Design: Comparative experimental design Methods: Surface electromyography recorded muscle activity in the trunk and lower extremities during lifting, with normalization to the isometric Floor Lift using Maximal Voluntary Contraction. Kinematics were measured using inclinometer sensors to track hip and trunk sagittal plane angles. To prevent fatigue, each subject only used one of the three pairs of bands employed in the study. Results: Our study involved 45 healthy subjects (mean age: 30.4 ± 6.3 years) with similar baseline characteristics, except for years of lifting and strength-to-years-of-lifting ratio. Various resistance band groups exhibited significantly higher muscle activity than conventional deadlifts during different phases. The minimal resistance band group had notably higher muscle activity in the trunk, core, and lower extremity muscles, particularly in the end phase. The moderate resistance band group showed increased muscle activity in the mid-and end-phases. The maximum resistance band group demonstrated greater muscle activity in specific muscles during the early phase and overall higher activity in all trunk and lower extremity muscles in the mid and end phases of the deadlift (p<0.05). Conclusion: Our findings provide valuable insights into muscle activation with various resistance bands during deadlift exercise in clinical and gym settings. There appears to be a dose-response relationship between increased resistance bandwidth, external load, myoelectric activation, and range.

The Analysis of Free Flap (유리 조직 이식의 분석)

  • Choi, Sang-Mook;Hong, Sung-Bum;Chung, Chan-Min;Suh, In-Seock
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.35-45
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    • 1996
  • After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

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