• 제목/요약/키워드: Knee function score

검색결과 79건 처리시간 0.031초

근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가 (Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia)

  • 박원종;손종민;정양국;강용구
    • 대한골관절종양학회지
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    • 제7권4호
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    • pp.139-143
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    • 2001
  • 목적 : 근위 경골 종양의 광범위 절제술에 따른 재건술은 적절한 연부 조직의 피복(cover age), 슬관절 신전 장치(knee extensor apparatus), 특히 슬개건의 견고한 재부착이 어려워 슬관절의 기능적 결과가 만족스럽지 않은 것으로 알려져 있는바, 근위 경골의 골육종으로 광범위 절제 후 종양 대치물 삽입으로 사지 구제술을 시행 받은 환자에서 기능을 평가하고 문제점을 분석하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 1992년 4월부터 1998년 10월까지 경골 근위부의 골육종으로 확진된 후 종양 대치물을 이용한 사지 구제술을 시술 받은 11명을 대상으로 하였다. 남자가 6명, 여자가 5명이었으며, 환자의 나이는 15세에서 65세로 평균 23.7세였다. 추시 기간은 최단 1년에서 최장 4년 6개월로, 평균 2년 5개월이었다. 최종 기능평가는 1993년 국제 사지 보존 회의(International Symposium On Limb Salvage; ISOLS)에서 수정 보완한 방법을 이용하여 동통, 기능(functional activity), 환자의 정서적 만족도(emotional acceptance), 보조기 사용여부(use of external support), 보행 능력(walking ability), 그리고 보행 상태(gait)등 여섯 가지로 나누어 평가하였다. 각각의 요소를 최하 0점에서 최고 5점으로 하고 그 중간을 정도에 따라 1, 2, 3, 4점으로 점수화하여 정상 기능에 대한 백분율(% )로 표시하여 분석하였다. 결과 : 기능 평가 성적은 정상 기능에 대해 최고 86.7%에서 최저 53.3%로 평균 68.3%를 나타냈으며, 세부적으로 보면 동통이 82.5%, 기능이 62.5%, 정서적 만족도가 67.5%, 보조기 사용여부는 77.5%, 보행능력은 62.5%, 보행상태는 57.5%였다. 슬관절의 평균 운동범위는 신전 5도, 굴곡 85도였으며, 5례에서 최소 5도, 최고 15도, 평균 10도의 신전 제한(extension lag)을 보였다. 합병증으로는 2명에서 수술 후 감염 소견을 보였으며 1명은 항생제 치료로 호전되었으나 다른 1명은 종양 구조물 제거 후 관절고정술로 전환이 필요하였다. 결론 : 경골 근위부의 골육종 환자에서 광범위 절제 후 종양 대치물 삽입에 의한 사지구제술의 기능 평가 성적은 감염이 합병되지 않은 경우에는 전반적으로 양호하였으나, 동통 소실, 보조기 사용여부에 비해 슬관절의 부분 강직 및 extension lag로 인해 기능, 정서적 만족도, 보행등에서 덜 만족스러웠다. 임상적으로 더 만족스러운 결과를 얻기 위해 수술 후 대퇴사두근 강화 운동 및 굴곡 운동 등의 적극적인 재활 치료가 필요한 것으로 생각된다.

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Effects of glenohumeral corticosteroid injection on stiffness following arthroscopic rotator cuff repair: a prospective, multicentric, case-control study with 18-month follow-up

  • Amyn M. Rajani;Urvil A Shah;Anmol RS Mittal;Sheetal Gupta;Rajesh Garg;Alisha A. Rajani;Gautam Shetty;Meenakshi Punamiya;Richa Singhal
    • Clinics in Shoulder and Elbow
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    • 제26권1호
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    • pp.64-70
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    • 2023
  • Background: This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods: In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results: A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions: Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence: III.

부자(附子)의 경구투여(經口投與)가 RAT의 척수손상(脊髓損傷)에 미치는 영향(影響) 및 비교(比較) (The Effects of Radix aconiti on the Contraction of Rat's Spinal Cord Injury)

  • 이건목;김경식;이강창
    • Journal of Acupuncture Research
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    • 제15권2호
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    • pp.105-116
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    • 1998
  • Purpose In this study, We observed the recovery process in the ability to move in the hind limbs of the rats whose spinal cord injuries were treated by Radix acouniti(RA). The purpose of this study is to see the effects of Radix acouniti(RA) water extract on the contraction of rat's spinal cord injury. Procedure First, the rats were subjected to hemisectional spinal cord injuries by a scalpel blade. Those rats, then, were divided into three groups: Sham operated rats group and the experimental group, which received the Radix acouniti(RA) water extract, and the control group, which had no treatment. Their recovery in the ability to walk was observed by the Open Field Test (OFT) for 14 days after the injuries. Method The OFT was applied at four points: the hip, knee, ankle joint, and the tail. Each joint was given a movement rating of from 0 to 3, depending on the amount of movement. A movement rating of 0 designates no movement, a 1 designates slight movement, a 2 designates increased movement, and a 3 designates active movement. Slight movement is defined as a joint displaying less than or equal to 30% of that joint range, increased movement is displaying less than or equal to 60% of that joint's range, and active movement is greater than or equal to 90% of that joint's range. Tail movement is also graded on a scale of 0 to 3. A rating of 0 indicates that the tail is down 100% of the time, one of 1 indicates that the tail is down more than 10%, one of 2 shows that the tail is down less than 50% but more than 10% of the time, and one of 3 shows that the tail is down less than 10% of the time. All four ratings were added together and then averaged to arrive at a single score. Results The sham group which did not go through spinal cord injuries showed near normal results on all 3 joints and tail from right after the operation, which one would expect. The RA oral application group showed more effective recovery of movememt function than the control group around 4 days after the spinal cord injuries. However, after 14 days, both groups displayed almost the same degree of movement recovery. The results of this study are summarized as follows: 1. After 14days the spinal cord injuries, movement was recovered in sham operated group, control group, and experimented group in the hip, the knee, the tail and then the ankle of rats, in that order. 2. Around 7 days after the spinal cord injuries, the experimental group proved the effectiveness of the therapy in terms of movement recovery. 3. The level of ALT, ALP, AST in RA treated group was slightly increased. 4. The level of BUN and creatinine in RA treated group was slightly increased. The above results indicate that RA therapy at an early stage can bring about better movement recovery in patients with spinal cord injuries from traffic accidents or industrial disasters. But there is apparent side effect of RA on clinical, therefore the study on this should be continued.

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유아(幼兒)의 특성을 고려한 기능적 실내복 디자인 개발 - 만 3-6세 남아를 중심으로 - (Development of Functional Indoor Apparel Considering Toddlers' Behavioral Characteristics - Focus on 3-6-Year Old Boys -)

  • 남영란;최혜선
    • 복식
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    • 제63권1호
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    • pp.81-96
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    • 2013
  • We interviewed and surveyed parents of 3 to 6-year-old boys in order to determine designs for indoor apparel that appealed to toddlers. In addition, on the basis of the behavioral characteristics of such boys, improvements in the development of indoor apparels were suggested. Parents preferred indoor apparels because it could be worn as underwear when the kid is outdoors and as outerwear when indoors. These apparels were popular with toddlers. Therefore, indoor apparel that gives the impression of outerwear while performing the function of underwear was designed. Underwear fabric was used, but outerwear apparel design was partially adopted. In order to improve the activity, fabric that could be stretched in any direction was used for the sleeves and pant legs, while organic fabric with soft texture was used for the trunk part of the apparel. Dark-colored material was used for the chest and elbow parts of the clothes in order to prevent contamination in these parts. In particular, a bib was used to prevent contamination in the chest part. Given that toddlers engage in many activities, the fabric needed to be durable, so this led to thick materials being used for the knee part. As certain parents complained about the short length for tops, we increased the length of the tops by 5cm. In the survey items that investigated overall wearability, ease, and suitability for toddlers' activities, the test apparel obtained a higher score than existing apparel did. This indicates that the overall suitability of the newly designed apparel was improved.

골관절염 노인의 건강 관련 삶의 질 영향요인: 국민건강영양조사 자료를 이용하여 (Factors influencing Health-related Quality of Life in Older Adults with Osteoarthritis: Based on the 2010-2011 Korea National Health and Nutrition Examination Survey)

  • 김민주;배선형
    • 근관절건강학회지
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    • 제21권3호
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    • pp.195-205
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    • 2014
  • Purpose: This study was conducted to identify factors that influence health-related quality of life in older adults with osteoarthritis. Methods: This study used a cross-sectional design with secondary analysis of the Korean National Health and Nutrition Examination Survey 2011. A total of 362 participants aged 65 years and older who had osteoarthritis were selected. Health-related quality of life using EQ-5D, perceived health status, body mass index, numbers of chronic illness, smoking and alcohol use, exercise, activity limitation, joint pain and stiffness, depression, and perceived stress were measured. Descriptive statistics, $x^2$-test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression were conducted with SPSS/WIN 21.0. Results: The mean score of EQ-5D was 0.77 in older adults with osteoarthritis. The results of multiple regression analysis showed that age, income, subjective health status, restriction of activity, knee joint stiffness, depressive mood, and perceived stress significantly predicted health-related quality of life in older adults with osteoarthritis, explaining 42% of the variance. Conclusion: Older adults with osteoarthritis have low health-related quality of life. In oder to improve health-related quality of life in older adults with osteoarthritis, it is important not only to enhance physical function but also to provide emotional support.

골-슬개건-골 및 슬괵건을 이용한 전방 십자 인대 재건술의 비교 - 술후 슬관절의 기능, 안정성 및 대퇴, 경골터널 확장정도에 대하여 - (A Comparison of the Results of BPTB and Hamstring ACL Autograft - Function, Stability & Tunnel Expansion -)

  • 정영복;태석기;임정일
    • 대한관절경학회지
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    • 제4권1호
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    • pp.1-6
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    • 2000
  • 목적 : 자가이식건을 이용한 전십자인대 재건술에 있어서 골-슬개건-골과 슬괵건을 사용하고 그 결과를 서로 비교하고자 함에 있다. 대상 및 방법 : 1996년 1월부터 1999년 7월까지 골-슬개건-골을 이용한 군 32례, 슬괵건을 이용한 군 18례를 대상으로 하였고 평균 추시기간은 각 각 18 개월, 15 개월이었으며 기능, 안 정성 경골과 대퇴골 터널의 확장정도를 평가하였다. 결과 : 기능적인 평가에서 OAK(Orthopadishe Arbeitsguppe Knie) 점수는 슬개건을 사용한 군에서 술 전평균 71.6점$({\pm}10.0)$, 최종 추시점에서 88.5점$({\pm}7.9)$이었고 슬괵건을 사용한 군에서는 술 전 평균 73.9점$({\pm}11.5)$, 최종 추시점에서 82.5점$({\pm}12.9)$이었으며 IKDC(international Knee Documentation Committee)상 B군 이상의 결과를 보인 군은 슬개건을 사용한 경우 28례$(87\%)$, 슬괵건을 사용한 경우가 10례$(55\%)$였다. 안정성은 $KT-1000^{TM}$을 사용한 최대 도수 변이 검사에서 건측과 환측의 차이가 슬개건을 사용한 경우 술 전 평균6.5$({\pm}4.0)$mm, 최종 추시점에서 2.4$({\pm}1.8)$mm를, 슬괵건을 사용한 경우는 6.6$({\pm}2.9)$mm에서 2.3$({\pm}2.4)$mm를 보였다. 부하 방사선 사진상 전위는 각각 술 전 평균 8.0$({\pm}4.8)$mm, 7.0$({\pm}4.3)$mm에서 최종 추시점에서 2.8$({\pm}3.4)$mm, 2.8$({\pm}2.5)$mm의 차이를 나타냈다. 터널의 확장 정도는 대퇴골 터널의 경우에서 슬괵건을 사용한 군이 술 전 평균 9.6$({\pm}1.4)$mm, 최종 추시점에서 10.8$({\pm}1.0)$mm를 나타내어 슬개건을 사용한 경우보다 더 유의하게 확장되었다(p=0.03). 결론 : 두 군간에 술 후 안정성에서는 차이를 보이지 않아 슬개-대퇴 관절 동통, 골연령 및 미용상의 문제 등을 종합적으로 고려하여 이식건은 선택되어야하고, 터널확장을 줄이면 두 군의 안정성을 보다 향상시킬 수 있을 지는 대조군을 이용한 더 많은 연구가 필요할 것으로 보인다.

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일지역 노인의 관절 건강 상태 (A Study on Health Status of Joints in Elderly People)

  • 은영;김은심;강영실;권인수;오현숙;구미옥
    • 기본간호학회지
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    • 제11권2호
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    • pp.186-194
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    • 2004
  • Purpose: The purpose of this study was to describe the subjective health status of joints, flexibility of joints, muscle strength and state of Joint exercise in elderly people living in the community. Method: The participants were 74 elderly people in a health program of the Gerontological Health Research Center at G University. The data were collected from March to July, 2003. The instrument for the study included items on general characteristics (5 items), subjective health status of joints (10 items), flexibility of Joints and strength of muscle (8 items), and state of joint exercise (7 items). Results: The score for subjective health status of joints was 3.70 (range 1-5). Knee and waist joints were in the worst state. Neck extension and flexion were $17.38{\pm}1.80$ and $.60{\pm}1.08(cm)$ respectively. Trunk extension and flexion were $68.24{\pm}4.47$ and $58.00{\pm}4.91(cm)$ respectively. Flexibility of the Rt./Lt. shoulder joints was $14.63{\pm}12.51/18.82{\pm}13.80(cm)$. Muscle strength of the Rt./Lt. leg was $30.47{\pm}19.68/29.67{\pm}21.22$ (sec.). Shoulder joints were more flexible for men and people in their sixties compared to women and people in their seventies. Hand grip was stronger for men compared to women. The score for state of joint exercise was 2.83(range 1-4). The state of handgrip correlated with the state of joint exercise [r=.423 (Rt.)/r=.273(Lt.)]. Conclusion: To prevent falls and disorders in neuromuscular function, it is important to develop systemic joint exercise programs for elderly people.

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골관절염 환자에서의 건강관련 삶의 질 도구(EQ-5D)의 타당도 검증 (A Validation Study of EQ-5D in the Patients with Osteoarthritis)

  • 임난영;이인옥;이은남;이경숙;조경숙;이선자;강현숙;김금순;김종임;박원숙;이윤경;전미영
    • 근관절건강학회지
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    • 제17권2호
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    • pp.203-211
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    • 2010
  • Purpose: We aimed to test the validity of the EQ-5D (Euro-Quality of Life-5 Dimension), a brief and simple instrument, in measuring health related quality of life in the patients with osteoarthritis. Methods: 183 participants attending the education programs for osteoarthritis patients at the Health Centers located in Seoul and Gyunggi province area during the periods of June to December in 2009 were interviewed with the EQ-5D and KWOMAC (Korean version of Western Ontario and McMaster Scale). The data were analysed with Spearman correlation coefficents and t-test by using of SPSS/WIN 12.0 version. Results: There was a negative correlation between knee pain, stiffness and difficulty in usual activity of sub category items of KWOMAC and EQ-5Dindex, while there was no correlation between these categories and EQ-VAS. Moreover, as a result of comparing the score of physical function measured by KWOMAC according to the severity degree of the EQ-5Dindex, the group of advanced stage having moderate and severe symptoms reported significantly higher scores of physical function than those of groups having no health problems. Conclusion: The EQ-5D is an acceptable and valid instrument for measuring health-related quality of life in patients with osteoarthritis.

이중 다발 자가 슬괵건을 이용한 전방십자인대 재건술 (Double-bundle Anterior Cruciate Ligament Reconstruction using Autogenous Hamstring Grafts)

  • 최남용;남원식;양영준;한창환;문찬웅;권재영;송현석
    • 대한관절경학회지
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    • 제12권2호
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    • pp.112-117
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    • 2008
  • 목적: 이중 다발을 이용한 전방십자인대 재건술은 등장성과 해부학적 기능을 회복할 수 있다는 장점이 있다. 본 연구는 전방십자인대 손상 환자에서 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 재건술의 임상적 결과를 평가하고자 한다. 대상 및 방법: 2005년 1월부터 2006년 7월까지 자가 슬괵건(hamstring tendon)을 이용하여 이중 다발 전방십자인대 재건술을 시행한 60예(남자: 52예, 여자: 8예)를 대상으로 하였다. 평균 나이는 31.7세($20{\sim}51$세)였다. 평균 추시 기간은 13.4개월($12{\sim}16$개월)이었다. 슬관절의 경골 조면 부위에서 수평 사위(horizontal-oblique)의 피부 절개를 시행하여 반건양건(semitendinosus tendon)과 박건(gracilis tendon)을 얻었다. 후외측 다발을 위한 경골 터널은 해부학적인 위치에 만들었다. Yasuda 등이 보고한 방법을 변형하여, 후외측 다발을 위한 대퇴골 터널은 부가적인 전내측 입구를 통하여 만들었다. 전내측 다발에 대하여는 통상적인 방법으로 터널을 만들었다. 후외측 다발은 박건을, 전내측 다발은 반건양건을 사용하였다. 최종 추시시 관절 운동범위, 전방 전위 정도(KT-1000 관절계), pivot-shift 검사로 임상 결과를 평가하였다. 슬관절의 기능적 평가는 Lysholm score와 modified Feagin Scoring System를 측정하였다. 결과: 최종 추시시 관절 운동 범위 제한은 없었다. KT-1000 관절계를 이용한 정상측과의 비교에서 경골 전방 전위가 술전 평균 8.4 mm에서 술후 평균 1.7 mm로 향상되었다(p<0.05). Lysholm score는 술전 평균 64.1점에서 술후 평균 92.2점으로 향상되었다(p<0.05). Modified Feagin Scoring System에 의한 기능 평가에서는 90%에서 우수 이상의 결과를 보였다. 결론: 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 전방십자인대 재건술은 우수한 임상 결과를 보였다.

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