• Title/Summary/Keyword: Manual Muscle Test

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A Case Report of Central Post-stroke Pain and Hemiparesis due to Anterior Cerebral Artery and Middle Cerebral Artery Infarction That Improved Following Treatment with Korean Medicine, Including Moxibustion (간접구 중심의 한의복합치료로 전대뇌동맥 및 중대뇌동맥 경색 환자의 중추성 통증과 하지마비에 개선을 보인 증례보고 1례)

  • Seong-hyeon Jeon;Da-dam Kim;Yu-bin Kim;Han-song Park
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.246-258
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    • 2024
  • This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

Infusion Methods for Continuous Interscalene Brachial Plexus Block for Postoperative Pain Control after Arthroscopic Rotator Cuff Repair

  • Byeon, Gyeong Jo;Shin, Sang Wook;Yoon, Ji Uk;Kim, Eun Jung;Baek, Seung Hoon;Ri, Hyun Su
    • The Korean Journal of Pain
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    • v.28 no.3
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    • pp.210-216
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    • 2015
  • Background: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

The Effects of Dynamic Functional Electrical Stimulation With Treadmill Gait Training on Functional Ability, Balance Confidence and Gait in Chronic Stroke Patients

  • Cho, Young-Ki;Ahn, Jun-Su;Park, Yong-Wan;Do, Jung-Wha;Lee, Nam-Hyun;Kwon, Oh-Yun
    • Physical Therapy Korea
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    • v.21 no.4
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    • pp.23-33
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    • 2014
  • The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

Case Report of Multiple Cerebral Infarction in Middle Cerebral Artery with Gait Disturbance Treated by Korean Medicine (중대뇌동맥 영역에 발생한 다발성 뇌경색 환자의 보행장애에 대한 한의 복합 치료: 증례보고 1례)

  • Chae, In-cheol;Choi, In-woo;Yang, Ji-hae;Kang, Jie-yoon;Ryu, Ju-young;Jung, Eun-sun;Kim, Yoon-sik;Seol, In-chan;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.75-85
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    • 2021
  • Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report (척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고)

  • Hyunjin Choi;Seung Ho Yu;Sangjoon An;Seyun Kim;Woochul Shin;Jae-Heung Cho;Won-Seok Chung;Mi-Yeon Song;Hyungsuk Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.243-249
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    • 2023
  • This case study showed improvement both in pain and gait disturbance caused by SCH. KM can be a positive treatment for reducing pain or improving gait disturbance caused by SCH, and it can be considered a treatment option for SCH. Future studies with a larger number of cases and longer period of follow-up in SCH with gait disturbance and rigidity are needed.

Reliability of Muscle Evaluation with a Tactile Sensor System (촉각센서를 이용한 근육평가의 신뢰도 조사)

  • Oh, Young-Rak;Lee, Dong-Ju;Kim, Sung-Hwan;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.337-344
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    • 2005
  • A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.

A Case Report of a Chronic Intracerebral Hemorrhage Patient with Obstinate Gait Disturbance Treated with Korean Medicine and Rehabilitation Exercise (완고한 보행장애를 주소로 하는 만성기 뇌출혈 환자의 한의 치료 및 재활 운동 증례보고 1례 : GAITRite®를 이용하여)

  • Chae, In-cheol;Choi, In-woo;Kim, Chan-young;Park, Mi-so;Park, Sang-soo;Jung, Eun-sun;Cha, Ji-yun;Jo, Hyun-kyung;Kim, Yoon-sik;Seol, In-chan;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.40 no.4
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    • pp.730-741
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    • 2019
  • Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment with rehabilitation exercise on a chronic intracerebral hemorrhage patient with a severe gait disturbance. Method: The patient was treated with Korean herbal medicine (Gami-sibjeondaebo-tang) along with acupuncture, moxibustion, and rehabilitation exercise. The treatment effect was evaluated through the Manual Muscle Test (MMT) and the Korean version of the Modified Barthel Index (K-MBI). The gait of the patient was evaluated by Functional Ambulatory Category (FAC) and the Timed Up and Go (TUG) test. The spatiotemporal parameters were evaluated by a walkway system (GAITRite(R) system) and gait symmetry was evaluated by Symmetry Criterion (SC). Results: After 111 days of traditional Korean medicine treatment, the spatiotemporal parameters and symmetry of the patient's gait improved. Conclusion: This study suggested that traditional Korean medicine treatment with rehabilitation exercise could be effective for gait disturbance in patients with chronic intracerebral hemorrhage.

Development of Management Guidelines and Procedure for Anthropometric Suitability Assessment: Control Room Design Factors in Nuclear Power Plants

  • Lee, Kyung-Sun;Lee, Yong-Hee
    • Journal of the Ergonomics Society of Korea
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    • v.34 no.1
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    • pp.29-43
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    • 2015
  • Objective: The aim of this study is to develop management guidelines and a procedure for an anthropometric suitability assessment of the main control room (MCR) in nuclear power plants (NPPs). Background: The condition of the MCR should be suitable for the work crews in NPPs. The suitability of the MCR depends closely on the anthropometric dimensions and ergonomic factors of the users. In particular, the MCR workspace design in NPPs is important due to the close relationship with operating crews and their work failures. Many documents and criteria have recommended that anthropometry dimensions and their studies are one of the foremost processes of the MCR design in NPPs. If these factors are not properly considered, users can feel burdened about their work and the human errors that might occur. Method: The procedure for the anthropometric suitability assessment consists of 5 phases: 1) selection of the anthropometric suitability evaluation dimensions, 2) establishment of a measurement method according to the evaluation dimensions, 3) establishment of criteria for suitability evaluation dimensions, 4) establishment of rating scale and improvement methods according to the evaluation dimensions, and 5) assessment of the final grade for evaluation dimensions. The management guidelines for an anthropometric suitability assessment were completed using 10 factors: 1) director, 2) subject, 3) evaluation period, 4) measurement method and criteria, 5) selection of equipment, 6) measurement and evaluation, 7) suitability evaluation, 8) data sharing, 9) data storage, and 10) management according to the suitability grade. Results: We propose a set of 17 anthropometric dimensions for the size, cognition/perception action/behavior, and their relationships with human errors regarding the MCR design variables through a case study. The 17 selected dimensions are height, sitting height, eye height from floor, eye height above seat, arm length, functional reach, extended functional reach, radius reach, visual field, peripheral perception, hyperopia/myopia/astigmatism, color blindness, auditory acuity, finger dexterity, hand function, body angle, and manual muscle test. We proposed criteria on these 17 anthropometric dimensions for a suitability evaluation and suggested an improvement method according to the evaluation dimensions. Conclusion: The results of this study can improve the human performance of the crew in an MCR. These management guidelines and a procedure for an anthropometric suitability assessment will be able to prevent human errors due to inadequate anthropometric dimensions. Application: The proposed set of anthropometric dimensions can be integrated into a managerial index for the anthropometric suitability of the operating crews for more careful countermeasures to human errors in NPPs.

The Effect of Korean Medicine Treatment on Cerebral Infarction with Hemiplegia: A Case Report (아급성기 뇌경색 환자의 좌측 편마비에 대한 한의 치료 1례)

  • Oh, Ju-hyun;Sung, Jae-yeon;Seo, Hye-jin;Lee, Yu-ra;Song, Jin-young;Kong, Geon-sik;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.990-998
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    • 2019
  • Introduction: Stroke refers to a sudden brain disease that results in disorders in the anatomy of the brain. The cause is a sudden circulatory disorder of the cerebrovascular system that creates a consciousness disorder and hemiplegia. Despite aggressive treatment after the onset, stroke is a social problem because the patient has difficulty in recovering from sequelae that can include limb movement disorders, language disorders, and emotional disorders. In this study, we describe the effect of traditional Korean medicine treatment on the sequelae in a subacute cerebral infarction patient admitted to a Korean medical hospital. Case presentation: A 67-year-old male patient was diagnosed with cerebral infarction circa 2005, and his condition had not improved. Around March 15, 2018, he experienced the sudden onset of a cerebral infarction in his daily life. This was confirmed by a brain MRI, and he was hospitalized at other hospitals, but he showed no improvement. We conducted a manual muscle test (MMT) to evaluate the patient's exercise and strength. His gait level was measured to evaluate his degree of walking. He was treated with Bojungikgi-tang and acupuncture twice a day. After 34 days of inpatient treatment, the patient's exercise strength improved from Grade 2+~Grade 3 to Grade 3+ determined by the MMT, and his walking ability improved from Gait Level 3 to Gait Level 4. Conclusion: The findings of this study indicate that acupuncture and herbal medicine treatment can help treat patients with hemiplegia due to cerebral infarction.

Evolution of Exercise Performance and Medical Assessments in U-12 Youth Football Players (U-12 유소년 축구선수의 운동수행력 및 의학적 평가)

  • Seo, Sang-Won;Lee, Ho-Seong
    • 한국체육학회지인문사회과학편
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    • v.56 no.5
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    • pp.665-677
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    • 2017
  • This study aimed to examine the evolution of exercise performance and medical assessments in U-12 youth football players. Participants were recruited from an youth football players (YFG, n=15; $11.2{\pm}0.9yrs$) and normal youth (CON, n=15; $11.5{\pm}0.6yrs$). Both groups were tested for exercise performance (health related physical fitness, skill related physical fitness, functional movement screen; FMS and Y-balance) and medical assessments (lower extremity alignment, range of motion; ROM and manual muscle test; MMT). YFG showed a positive effects on pacer in health related physical fitness, 50-m run and Single-leg standing with eyes closed in skill related physical fitness, active straight leg raise and rotary stability in FMS, non-dominant composite score in Y-balance, respectively compared to CON. However, YFG showed a negative effects on Q-angle of dominant and non-dominant in lower extremity alignment, dorsiflexion of non-dominant, plantarflexion of dominant and non-dominan in ROM, hip extension and abduction, knee flexion and extension of dominant, knee flexion and extension of non-dominant in MMT, respectively compared to CON. These results indicated that U-12 youth football players have shown excellent exercise performance, but medical assessments has proved negative effects.