Lee, Cho In;Kim, Sung Jin;Choi, Yi Jeong;Lee, Bong Hyo;Lee, Hyun Jong;Lim, Seong Chul;Lee, Yun Kyu;Jung, Tae Young;Kim, Jae Su
Journal of Acupuncture Research
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v.30
no.4
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pp.211-218
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2013
Objectives : The purpose of this study is to show the clinical effects of integrative oriental medical treatments for femur pain and disfunction after hip fracture surgery. Methods : Two patients were treated using acupuncture, pharmacopuncture, herbal medication and other oriental medical treatments include moxibustion, cupping therapy, physical rehabilitation for 2~3 months. And the effects of these integrative treatments were measured with numeric rating scale(NRS) and functional recovery score(FRS). Results : NRS of femur pain was decreased from 8 to 4~5 in case 1 and from 6 to 4 in case 2. FRS was improved in both cases. Conclusions : Integrative oriental medical treatments maybe effective to the patients complaining pain and functional limitations after hip fracture surgery.
Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.
Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.
The study was to provide basic data and to examine the effect of combined exercise for 12 months on functional fitness and bone mineral density (BMD) in breast cancer survivors. The subjects of this study were 40 to 60-year-old married women (N=24) who finished their treatments chemotherapy and radiation therapy. They were divided into two groups that exercise group and exercise with alendronate group. Eighteen (T-score=$-2.2{\pm}0.8$) of the 24 women who were diagnosed osteopenia (N=15) and osteoporosis (N=3), participated in combined exercise (EG). The other six (T-score=$-4.6{\pm}0.9$) women who were diagnosed as osteoporosis (EDG), participated in the combined exercise program with osteoporosis drug (Alendronate 70 mg/w). The result of the analysis was as follows: Twelve months after, the participants (N=24) had a significant increase of the items such as sit and reach ups, grip strength (R and L) and sit ups test of functional fitness in the periods. In body composition, FM (fat mass) had significant decrease in periods. In the comparison of BMD, EG (N=18) had no change, while EDG (N=6) had significant improvement in L1, T12 and T-score after 12months. Consequently, complex exercise program (Hatha yoga, elastic band, gym ball) had positive effect on functional fitness and bone mineral density. We suggest that complex exercise program can be applied as recovery program after breast cancer surgery. Further research needs various and repetitive studies from more different targets or methods in the exercise program for its improvement.
Journal of The Korean Society of Integrative Medicine
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v.7
no.2
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pp.153-163
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2019
Purpose : This study was to identify the effects of Mobilization with Movement combined with exercise (EMWM) on acromio-humeral distance (AHD), range of motion (ROM), pain intensity, and functional performance in patients with impingement syndrome of the shoulder. Methods : The subjects were 40 patients diagnosed with impingement syndrome of the shoulder. Twenty subjects are randomly assigned to each 2 different groups; Group 1. (exercise group), Group 2. (EMWM group). Three weekly interventions were given for 4 weeks. The main outcome measures were ultrasound, goniometer, visual analogue scale (VAS), and Korean Constant shoulder score (K-CSS). The ultrasound (AHD), ROM (flexion, abduction), pain intensity (for shoulder flexion) and functional performance (K-CSS) were compared between the groups. Results : The AHD was significantly increased in Group 2 compared to Groups 1. No significant difference was observed between the groups in the range of abduction of the shoulder, but the range of flexion was significantly increased in Group 2 compared to Groups 1. Pain intensity was significantly lower in Group 2 than in Group 1, and functional performance was significantly increased in Group 2 compared to Group 1. Conclusion : An intervention that combined mobilization with movement with exercise was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance.
Journal of the Korean Society of Physical Medicine
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v.12
no.3
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pp.33-42
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2017
PURPOSE: To compare postural vertical training with and without visual feedback for improving functional recovery in post-stroke hemiparesis patients with pusher syndrome. METHODS: This study used a single-subject research with alternating design with multiple baselines. Three patients with hemiparetic post-stroke diagnosed with pusher syndrome were selected from the inpatients at the department of physical therapy of a local rehabilitation hospital. For subjective postural vertical (SPV) training with and without visual feedback, an alternating treatment was used. The subjects were randomly selected using the sequence of the two training methods upon starting the intervention, and then the training was alternated. SPV training was performed twice a day, once in the morning and again in the afternoon. Scale for contraversive pushing (SCP), postural assessment scale for stroke, and Barthel index score were used to determine the intervention-related changes. RESULTS: Compared to the average score at baseline, the average SCP score for the SPV training without visual feedback decreased from 5.3 to 2.8, from 4.6 to 3, and from 3.5 to 2.7 for subjects 1, 2, and 3, respectively. However, the average score for the SPV training with visual feedback decreased from 5.3 to 3.1, from 4.6 to 3.5, and from 3.5 to 3.3 for subjects 1, 2, and 3, respectively. CONCLUSION: Postural vertical training without visual feedback may be more beneficial than postural vertical training with visual feedback for improving pushing behavior and functional activity in stroke patients with pusher syndrome.
Purpose: The purpose of this study was to determine the effects of group exercise, manual therapy, and a home exercise program on VAS (visual analogue scale), ROM (range of motion) of shoulder, and functional outcome in adhesive capsulitis. Methods: The study was conducted with 45 patients. All subjects were randomly assigned to 3 groups: group exercise (n=15), manual therapy (n=15), home exercise (n=15). The subjects performed an intervention program 3 times a week for 4 weeks a total of 12 times. Outcome measurements were VAS, ROM, and Constant-Murley score outcome measures. Measurements were taken four times, at baseline, 4 weeks later, 8 weeks later, and 12 weeks later. Results: VAS, ROM of the shoulder, and functional outcomes showed improvement in all groups at the final follow-up (p<0.05). VAS and ROM showed greater improvement with group exercise and manual therapy than home exercise, however, there were no significant differences between the two groups (p>0.05). Functional outcomes showed the greatest improvement in group exercise at the final follow-up. This improvement was greater than with manual therapy or home exercise (p<0.05). Conclusion: Group exercise and manual therapy were more effective for improving pain, ROM, and function than home exercise in adhesive capsulitis. In particular, group exercise is more effective in functional recovery than other physiotherapy interventions.
Kim, Jung-Goan;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
Journal of Korean Neurosurgical Society
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v.39
no.3
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pp.188-191
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2006
Objective : The purpose of this study is to evaluate the efficacy and necessity of combined anterior approach [discectomy and fusion] and posterior approach[open-door laminoplasty] in the treatment of cervical spondylotic myelopathy. Methods : The authors reviewed 14 cases in whom combined anterior and posterior approach performed for cervical myelopathy due to simultaneous anterior and posterior pathology such as huge central disc herniation with narrow spinal canal between January 2000 and December 2002. Clinical symptoms were evaluated by Japanese Orthopaedic Association [JOA] score and then the cervical curvature, change of spinal canal to vertebral body[SC/VB] ratio and canal widening were measured and compared to the clinical symptoms. Results : The mean JOA score increased from $10.4{\pm}3.1$ preoperatively to $14.8{\pm}1.2$ at the final follow up with a mean recovery rate 66.4%. In all cases, there were not neurologic deterioration. Mild postoperative complications developed in two cases. One patient had a limitation of range of neck motion and the other one showed kyphotic change. Postoperative radiography showed an improvement of body to canal ratios [average $0.70{\pm}0.08$ before surgery to $1.05{\pm}0.12$ after surgery and mainte nance or recovery of cervical lordosis. Canal widening of antero-posterior diameter and dimension after operation is 6.8mm. $116.61mm^2$. Conclusion : Combined anterior and posterior procedure could be helpful in decompression of the spinal cord and good functional recovery in spondylotic myelopathy patients with combined anterior and posterior pathology such as huge disc herniation accompanying narrow spinal canal.
Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95% showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.
Jeon, Seung Bae;Ahn, Hee Chang;Ahn, Yong Su;Choi, Matthew Seung Suk
Archives of Plastic Surgery
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v.42
no.6
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pp.761-768
/
2015
Background Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. Methods A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. Results The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). Conclusions Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.
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