• Title/Summary/Keyword: General Walking

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Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

Arthroscopic Shaving Cystectomy of Popliteal Cyst by using Posteromedial Portal (관절경적 후내측 도달법을 이용한 슬와 낭종의 절삭 절제술)

  • Kwak, Kyoung-Duck;Ahn, Sang-Min;Baek, Seung-Il;Jung, Chan-Jong;Roh, Jae-Su
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.153-158
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    • 2006
  • Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

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A Study on the Level of ADL in Community Dwelling Elderly Registered in a Public Health Center (일개 시 보건소에 등록된 재가노인의 일상생활 동작수행 정도에 대한 조사연구)

  • Kim, Keum-Ja;Jang, Hyo-Soon;Yoon, Jin;Ko, Sun-Hwa;Lee, Eun-Hui
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.332-342
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    • 2002
  • Purpose: The purpose of this study was to assess the level of activities of daily living (ADL) in a group of community dwelling elderly. Methods: The subjects were 100 low-income elderly registered in a public health center. The data were analyzed using the SPSS/PC program. Results: The results were as follows: 1. The basic ADLs of the subjects were scored at 7 levels, and the mean score was 6.24 out of 7 points. The subjects did not necessarily require help from others, but might have needed more times or instrumental assists to perform ADLs. The lowest ADL score was reported on walking up to the stairs (5.05), for which the subjects did not need physical assistance, but needed a certain degree of supervision. The highest score was reported on self eating (6.74), followed by bowel management (6.60). 2. The mean IADL score of the subjects was 1.77 out of 4 points. indicating that the subjects were very independent in performing IADLs, without help from others. 3. In relation to general characteristics, the level of ADLs of the subjects was significantly different by age (F=6.65, P=.000), main activities (F=6.36, P=.001), perceived health status (P=4.66, P=.012), educational background (F=4.64, P=.03), marital status(F=4.62, P=.005), and major household income (F=4.15, P=.002). 4. The subjects' level of IADLs in relation to their general characteristics was significantly different by perceived health status (F=8.08, P=.001), major activities (F=7.33, P=.000), age (F=6.18, P=.000), family context (F=3.53, P=.018), religion (F=3.10, P=.019), marital status(F=2.62, P=.055), and major household income (F=2.31, P=.049).

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A Study on the Guidance Signage System of Outpatient in General Hospital using Spatial Configuration Theory - View from G.D.Weisman's Way-finding Influence Factors (공간구조론을 적용한 종합병원 외래부 유도사인 배치 및 평가에 관한 연구 - G.D.Weisman의 길찾기 요소를 중심으로)

  • Kim, Suktae;Paik, Jinkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.3
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    • pp.25-35
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    • 2015
  • Purpose: Signs that are installed at unnoticeable places or that disconnect before the destination can bring errors of location information delivery. Therefore, this study aims to find out the spatial relation between structure of space and signs in the perspective of visual exposure possibility, operating arrangement and assesment by applying spatial structure theory. Methods: Effectiveness of organization of guidance signs was evaluated after the four way-finding factors(Plan Configuration, Sign System, Perceptual Access, Architectural Difference) that G.D.Weisman suggested were interpreted by spatial structure theory(J-Graph analysis, Space Syntax, Visual Graph Analysis) under the premise that it is closely related to the structure of space. Results: 1) Because the south corridor that connects each department of outpatient division is located in the hierarchy center of the space, and walking density is expected to be high, guidance signs need to be organized at the place with high integration value. 2) The depth to the destination space can be estimated through J-Graph analysis. The depth means a switch of direction, and the guidance signs are needed according to the number. 3) According to visibility graph analysis, visual exposure can be different in the same hierarchy unit space according to the shape of the flat surface. Based on these data, location adjustment of signs is possible, and the improvement effect can be estimated quantitatively. Implications: Spatial structure theory can be utilized to design and evaluate sign systems, and it helps to clearly understand the improvement effect. It is desirable to specify design and estimation of sign systems in the order of J-Graph analysis${\rightarrow}$Space Syntax Theory${\rightarrow}$visibility graph analysis.

Proposed surface modeling for slip resistance of the shoe-floor interface

  • Kim, In-Ju
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 1995.04a
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    • pp.515-528
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    • 1995
  • Slips and falls are the major causes of the pedestrian injuries in the industry and the general community throughout the world. With the awareness of these problems, the friction coefficients of the interface between floorings and footwear have been measured for the evaluation of slip resistant properties. During this measurement process, the surface texture has been shown to be substantially effective to the friction mechanism between shoe heels and floor surfaces under various types of walking environment. Roughness, either of the floor surface or shoe heels, provides the necessary drainage spaces. This roughness can be designed into the shoe heel but this is inadequate in some cases, especially a wear. Therefore, it is essential that the proper roughness for the floor surface coverings should be provided. The phenomena that observed at the interface between a sliding elastomer and a rigid contaminated floor surface are very diverse and combined mechanisms. Besides, the real surface geometry is quite complicate and the characteristics of both mating surfaces are continuously changing in the process of running-in so that a finite number of surface parameters can not provide a proper description of the complex and peculiar shoe - floor contact sliding mechanism. It is hypothesised that the interface topography changes are mainly occurred in the shoe heel surfaces, because the general property of the shoe is soft in the face of hardness compared with the floor materials This point can be idealized as sliding of a soft shoe heel over an array of wedge-shaped hard asperities of floor surface. Therefore, it is considered that a modelling for shoe - floor contact sliding mechanism is mainly depended upon the surface topography of the floor counterforce. With the model development, several surface parameters were measured and tested to choose the best describing surface parameters. As the result, the asperity peak density (APD) of the floor surface was developed as one of the best describing parameters to explain the ambiguous shoe - floor interface friction mechanism. It is concluded that the floor surface should be continuously monitored with the suitable surface parameters and kept the proper level of roughness to maintain the footwear slip resistance. This result can be applied to the initial stage of design for the floor coverings.

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The effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in persons with stroke: a pilot study

  • Park, Jae Ho;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.3
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    • pp.125-131
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    • 2016
  • Objective: The purpose of this study was to investigate the effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in stroke patients. Design: Randomized controlled pilot trial. Methods: Fifteen subjects were randomly divided into three groups where five subjects were in the visual feedback robotic device assist gait training (VRGT) group, five subjects in the auditory stimulation robotic device assist gait training (ARGT) group, and five subjects in the control group. Subjects received visual feedback and auditory stimulation while undergoing robotic gait training for 45 minutes, three times a week for 2 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 2 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test (10MWT) pre- and post-intervention. Results: All subjects showed that BBS, TUG test, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved post-treatment (p<0.05). The VRGT and the ARGT showed significant improvements in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). The VRGT group showed a significant improvement in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). In addition, it has been confirmed that VRGT had significantly improved in BBS, TUG test, and 10MWT scores compared with the auditory stimulation and control group (p<0.05). Conclusions: The results of this study showed improved balance and gait abilities after VRGT and ARGT groups compared with general physical therapy and was found to be effective in enhancing the functional activity of persons affected with stroke.

Thoracic Epidural Anesthesia and Analgesia (TEA) in Patients with Rib Fractures

  • 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 Effects of the Balancing Training on the Unstable Surface for the CVA Patients (불안정한 지지면에서의 평형 훈련이 편마비 환자의 균형 능력에 미치는 영향)

  • Bae, Soo-Chan;Kim, Keun-Jo;Yoon, Hong-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.2
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    • pp.5-22
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    • 2001
  • The purpose of this study was to investigate the balancing training effect on weight bearing ratio and postural sway on the unstable surface for the CVA patients with balance disability. The inclusion criteria were walking independently 20m distances. Eighteen subjects, 4 with right and 14 with left hemiplegic patients were participated in this study. The range of age was from 35 to 75 and the duration from onset time was from 1 to 38 months. The intervention program including balancing training that they were introduced for 10 minutes every other day during 12 weeks to experimental group, and general therapeutic exercise to control group. The result of this study were as following; 1. The balancing training on the unstable surface showed that the postural sway of left/right distribution would appear more effective on sitting with eyes opened. 2. The balancing training on the unstable surface showed that the postural sway of forward/rear distribution, left/right distribution and distance would appear more effective on standing with eyes opened. 3. The balancing training on unstable surface would increase more effective on the weight-bearing ratio of left/right difference and frequency. 4. The balancing training on unstable surface was statistical significant on the postural sway of left/right distribution and area in experimental group. and it was statistical significant on the postural sway of forward/rear distribution, left/right distribution and distance in control group, too.

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RETT SYNDROME : CASE REPORT (Rett syndrome 환자의 증례보고)

  • Kong, Eun-Kyung;Hong, So-Yi;Mah, Yon-Joo;Ahn, Byung-Duk;Jung, Young-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.1
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    • pp.68-74
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    • 2011
  • Rett syndrome is a X-linked genetic neurological disorder characterized by developmental regression, particularly in relation to expressive language and use of the hands, together with profound mental retardation, that almost exclusively affects females. Oral manifestations of the disease are commonly associated with the clinical conditions such as convulsion activity, difficulties for oral hygiene behavior, walking problems and oral/digitalmanual habits. Bruxism is the most frequently observed oral habit in patients with Rett syndrome. Two cases with the Rett syndrome were reported. Both patients had the typical manifestations like stereotypic hand movement, bruxism and digit-hand sucking. Caries control for the patients was perfomed under general anesthesia.

A clinical case study of chronic inflammatory anemia in post-symptom period resulting Stroke of Soeumin patient (소음인환자(少陰人患者)의 중풍후유기(中風後遺期)에 병발(倂發)한 만성(慢性) 염증성(炎症性) 빈혈(貧血)에 대한 증례(症例))

  • Park, Eun-kyung;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.377-383
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    • 1999
  • The anemia which is accompanied with chronic primary diseases has been showed most frequently in the clinic. The purpose of this study is to give an account of the effects of the Korean herbal medicine therapy which is based on the constitutional medicine for the patient who has suffered from mild anemia, pneumonia and general depressed condition in the chronic stage of post-cerebellar hemorrhage. The subject is a 75-year-old woman who has had the symptoms caused by hemorrhage, which are headache, dizziness, walking disturbance, dysphasia, and general weakness and so forth. Therefore, she has normocytic normochromic anemia in the hematomancy. We have diagnosed her as Soeumin(少陰人) Ulkwangjeung(鬱狂症) and have prescribed Palmulgunjatang(八物君子湯) in accordance with the principle of Seungyangikgi(升陽益氣). The consequence is that the accompanied anemia and genseal depressed condition have improved.

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