• 제목/요약/키워드: Functional impairment

검색결과 309건 처리시간 0.025초

월경전 불쾌기분장애에 관한 전향적인 연구 (A Prospective Study of Premenstrual Dysphoric Disorder)

  • 김지연;조숙행;곽동일;박용균
    • 정신신체의학
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    • 제5권1호
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    • pp.52-62
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    • 1997
  • This study was designed to determine the frequency of premenstrual dysphoric disorder in gynecological outpatients, and also attempted to compare premenstrual change characteristics, functional impairment due to premenstrual changes and frequency of risk factors reported by women with confirmed premenstrual changes$(PMC^+)$(n=17) and those without confirmed premenstrual changes$(PMC^-)$(n=23). Forty gynecological outpatients who complained of premenstrual discomforts were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and premenstrual change and functional impairment. The women were also asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle. Absolute severity method, effect size method and percent change method were used to assess changes between follicular phase and luteal phase. The results of the study were as follows: 1) The frequency of premenstrual dysphoric disorder according to each of the three methods was 5% for the absolute severity method, 15% for the effect size method, and 27.5% for the percent change method. 2) The frequently reported symptoms were as follow: physical symptoms(64.7%) : lethargy, easy fatigability, or marked lack of energy(41.2%) : decreased interest in usual activities(29.4%) ; and marked affective lability(23.5%). 3) There were no significant differences in onset ages of premenstrual changes, regularities of premenstrual changes and changes of severity and duration of premenstrual symptoms over time between women with and without confirmed premenstrual changes. However, women with confirmed premenstrual changes reported both physical and emotional symptoms as earliest symptoms most frequently, while women without confirmed premenstrual changes reported only physical symptoms most frequently. 4) functional impairment was significantly higher in women with confirmed premenstrual changes than those without confirmed premenstrual changes, but impairment was not severe. 5) No differences were found between women with and without confirmed premenstrual changes in risk factors including demographic data, menstrual and obstetric and gynecological history. These results suggest that the prevalence of premenstrual dysphoric disorder varies with scoring methods. The women with confirmed premenstrual changes reported physical symptoms most frequently(64.7%). functional impairment was significantly higher in women with confirmed premenstrual changes, but impairment was not severe.

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사회공포증 환자의 기능장애에 관한 연구 (A Study of Functional Impairment in Social Phobia)

  • 오강섭;오명신;이시형
    • 정신신체의학
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    • 제7권1호
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    • pp.72-78
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    • 1999
  • 본 연구는 1996년 10월에서 1997년 7월까지 강북 삼성병원 신경정신과를 처음 방문하여 사회공포증으로 진단 받은 66명의 환자들을 대상으로 사회공포증의 증상정도, 기능장애의 정도, 이환 기간, 아형간의 연관성을 살펴보았다. 대상환자들에게 SPS(Social phobia scale), SDS(Social disability scale), LSRDS(Liebowitz self-rated disability scale)을 시행하여 다음과 같은 결과들을 얻었다. 1) 상당수의 사회공포증 환자들은 일, 여가, 가정, 사회생활 등 여러 영역에서의 중등도 이상의 기능장애를 보이고 있다. 2) 사회공포증 환자들의 기능장애는 여가, 일, 가정 순으로 높게 나타났다. 3) 사회공포증 환자들의 기능장애의 정도는 이환 기간보다는 현재의 증상 정도와 관련성이 높았다. 4) 비가해형 보다는 가해형 사회공포증 환자에서 타인에 의해 주시될 상황에 대한 주관적 두려움의 정도가 의미 있게 높았다. 5) 비가해형 보다는 가해형 사회공포증 환자에서 전반적인 기능장애의 정도가 심각하였으며 현재의 증상이 심할수록 기능장애의 정도가 심해지는 양상이다. 결론적으로 사회공포증 환자들은 교육, 직업, 가족관계, 애정관계, 사회적 관계 등 전반적 생활영역에서의 기능장애가 있음을 확인할 수 있었으며 특히 가해형 사회공포증 환자에서 그 정도가 심각하였다.

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Functional Implications of Transporters Under Nitrosative Stress Conditions

  • Yu, Kyung-Ha;Maeng, Han-Joo;Chung, Suk-Jae
    • Journal of Pharmaceutical Investigation
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    • 제40권3호
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    • pp.139-153
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    • 2010
  • Nitrosative stress is defined as pathophysiological conditions that are related to covalent modifications of proteins by nitration/nitrosylation by forms of nitrogen oxide ($NO_x$), leading to DNA damage, ultimately, cell death. This type of stress condition appears to be associated with a number of disease states, including diabetes, inflammation and neurodegenerative diseases. Since these pathological conditions are frequently chronic in nature and, thus, require long-term treatment, changes in pharmacokinetics are likely to affect the therapy. Transporters are membrane proteins that facilitate the movement of substrates, including drugs, across plasma membranes of epithelial / endothelial cells. Since it is now increasingly evident that transporters are pharmacokinetically significant, functional alteration of transporters by this stress condition may have therapeutic relevance. In this review, experimental techniques that are used to study both in vivo and in vitro nitrosative stress are summarized and discussed, along with available literature information on the functional implication of transporters under conditions of nitrosative stress conditions. In the literature, both functional induction and impa irment were apparently present for both drug transporter families [i.e., ATP-binding cassette (ABC) and solute carrier families (SLC)]. Furthermore, a change in the function of a certain transporter appears to have temporal dependency by impairment in the early phase of nitrosative stress and induction thereafter, suggesting that the role of nitrosative stress is complex in terms of functional implications of the transporters. Although the underlying mechanisms for these alterations are not fully understood, protein nitration/nitrosylation appears to be involved in the functional impairment whereas transcript factor(s) activated by nitrosative stress may play a role, at least in part, in functional induction. Interestingly, functional induction under conditions of nitrosative stress has not been observed for SLC transporters while such impairment has been documented for both ABC and SLC transporters. Further investigations appear to be necessary to fully delineate the underlying reasons for these differences on the impact and importance of nitrosative stress conditions.

Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes

  • Kim, Eun-Hee;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • 제59권4호
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    • pp.155-164
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    • 2016
  • Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered important. In recent studies, antecedent cognitive impairment before the first recognized seizure and microstructural and functional alteration of the brain at onset of epilepsy suggest the presence of a common neurobiological mechanism between epilepsy and cognitive comorbidity. However, the overall impact of cognitive comorbidity in children with epilepsy and the independent contribution of each of these factors to cognitive impairment have not been clearly delineated. This review article focuses on the significant contributors to cognitive impairment in children with epilepsy.

한의 복합 치료를 통해 보행 장애, 인지 장애, 배뇨 장애, 연하 장애에 개선을 보인 중대뇌동맥 폐색에 의한 뇌경색증 환자 1례에 대한 증례보고 (A Case Report of Gait Disturbance, Cognitive Impairment, Dysuria, and Dysphagia in a Stroke Patient Treated with Traditional Korean Medical Treatment)

  • 김광호;이영웅;추홍민;임현서;김철현;이정연;이상관;성강경
    • 대한한방내과학회지
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    • 제41권2호
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    • pp.204-212
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    • 2020
  • This study aimed to investigate the effect of traditional Korean medical treatments on a stroke patient with gait disturbance, cognitive impairment, dysuria, and dysphagia. A 78-year-old female with chronic middle cerebral artery infarction had symptoms of gait disturbance, cognitive impairment, dysuria, and dysphagia. After being treated with Korean medicine therapies, including acupuncture and herbal medicine, the patient's symptoms were significantly improved. During all the treatments, Indices including manual muscle test, functional ambulation category, functional independence measuring, mini-mental state examination-K, global deterioration scale, pelvic symmetry, functional ambulation profile used to evaluate her symptoms indicated improvement in her symptoms, without any side effects. Traditional Korean medical treatments, such as acupuncture and herbal medicine, can be considered to be effective therapies for a stoke patient who has symptoms of gait disturbance, cognitive impairment, dysuria, and dysphagia.

The Effect of Prism Adaptation Following Traumatic Brain Injury: A case report

  • 정은화
    • 재활치료과학
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    • 제6권2호
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    • pp.37-45
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    • 2017
  • Background: The presence of visuospatial impairment can make patients slow functional recovery and impede the rehabilitation process in TBI patients. Objective: The aim of this study is to investigate effects of prism adaptation treatment for functional outcomes in patients following traumatic brain injury. Methods: The subject received prism adaptation treatment for 2 weeks additionally during traditional rehabilitation for 4 weeks. The Patient has prism adaptation treatment while wearing wedge prisms that shift the external environment about $12^{\circ}$ leftward. The patient received 10 sessions, 15-20min each session. Outcome measures were visuospatial deficit(line bisection, latter cancellation), Visual and spatial perception(LOTCA-visual perception and spatial perception), motor function of upper extremity(FMA U/E; Fugl-Meyer motor assessment upper extremity, ARAT; Action research arm test), balance(BBS; Berg Balance Scale), mobility(FAC; Functional ambulation classification) and functional level(FIM; Functional independent measure). All Assessments took place on study entry and post-treatment assessments were performed at discharge from the hospital. Results: After prism adaptation, the visuospatial impairment scores improved as indicated in the line bisection(-15.2 to -6.02), latter cancellation(2 to 0) and LOTCA- spatial perception scores(7 to 9). The upper motor function improved as indicated in the scores of affected FMA U/E(21 to 40) and ARAT(4 to 22). Ambulation and balance improved as indicated in the BBS scores(25 to 38) and FAC scores(0 to 4). ADL function improved as indicated in the FIM total scores 54 to 70(motor 34 to 61, cognition 20 to 29). Conclusion: Prism adaptation did improve functional level such as motor functions and ADL abilities in TBI patient. Further research is recommended.

뇌졸중 환자의 체간 조절 수준이 균형과 보행 및 기능적 수행 능력에 미치는 영향 (The Effects of Trunk Control Ability on Balance, Gait, and Functional Performance Ability in Patients With Stroke)

  • 안승헌;정이정;박세연
    • 한국전문물리치료학회지
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    • 제17권2호
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    • pp.33-42
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    • 2010
  • The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

Effect of Bridge Exercise Combined with Functional Electrical Stimulation on Trunk Muscle Activity and Balance in Stroke Patients

  • Kang, Jeongil;Jeong, Daekeun;Heo, Sinhaeng
    • 국제물리치료학회지
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    • 제12권2호
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    • pp.2323-2330
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    • 2021
  • Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupII. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn't show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

스텝을 활용한 인지-운동프로그램이 경도인지장애 노인의 인지기능, 보행, 우울에 미치는 효과 (The Effects of Cognition-Exercise Program Using Step on Cognitive Function, Gait, and Depression in Elderly with Mild Cognitive Impairment)

  • 주은솔;방요순;오은주
    • 대한통합의학회지
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    • 제8권3호
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    • pp.21-31
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    • 2020
  • Purpose : The purpose of this study was to determine the effects of a cognitive-exercise program using step on the cognitive function, gait, and depression of elderly with mild cognitive impairment. Methods : The subjects comprised 30 elderly people with mild cognitive impairment who used elderly welfare centers in the provinces A, B, and C between March 21 and June 7, 2019. They were divided into an experimental group (n=15) and a control group (n=15) before undergoing an experiment based on a pretest-posttest control group design. The lowenstein occupational therapy cognitive assessment-geriatric population was used to assess the subjects' cognitive function, while the 4-stage balance test, 30-second chair-stand test, timed up & go test, and functional reach test were employed to evaluate their gait. In addition, the beck depression inventory was used to measure their levels of depression. Results : The cognitive-exercise program using step enhanced the subjects' cognitive function and gait and reduced their levels of depression. Furthermore, statistically significant differences were found between the experimental group and the control group. Conclusion : The cognitive-exercise program using step promoted the process of sensorimotor and cognition through the learning process of various steps taking left and right steps and cognitive activities. It improves gait by activating the coordination of the musculoskeletal and nervous systems of the body and positively affecting posture control, balance, flexibility, and lower extremity muscles. It also relieved depression by performing successful step learning and cognitive activities with forward-looking (doing) that leads to pleasure and achievement. The present study confirmed the value of a cognitive-exercise program using step to treat multiple domains of functional decline in elderly patients with mild cognitive impairment. This is therefore proposed as an intervention program for this patient group.

뇌졸중 재활 환자의 기능적 의존도와 스트레스가 건강 관련 삶의 질에 미치는 영향 (The Effect of Functional Dependency and Stress on Health-related Quality of Life in Patients under Rehabilitation after Stroke)

  • 조옥희;최수영;송지현
    • 근관절건강학회지
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    • 제20권2호
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    • pp.81-90
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    • 2013
  • Purpose: The purpose of this study was to identify factors contributing to health-related quality of life in patients under rehabilitation after stroke. Methods: A descriptive correlational study design was used. Ninety-two stroke patients under rehabilitation from a university hospital were included. Data were collected on March and April, 2013 using structured questionnaires. Hierarchial multiple regression analysis was used to identify factors influencing health-related quality of life. Results: There were significant differences in health-related quality of life according to type of impairment. The health-related quality of life had significant correlations with age, functional dependency, and stress. Factors influencing health-related quality of life for stroke patients under rehabilitation were stress, functional dependency, type of impairment, and age, which explained about 34.5% of total variance. Conclusion: To promote health-related quality of life for stroke patients under rehabilitation, stress and functional dependency should be managed in this population, especially for older adults. Also these results can be utilized in the development of program for helping rehabilitation of stroke patients. The effect of depression and anxiety on health-related quality of life should also be addressed in future research.