• 제목/요약/키워드: Movement impairment

검색결과 104건 처리시간 0.025초

뇌졸중 환자의 건측억제유도와 자기효능에 대한 이해 (Understanding the constraint induced movement and Self-efficacy in Stroke Patients)

  • 신형수;김중선
    • PNF and Movement
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    • 제3권1호
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    • pp.35-45
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    • 2005
  • Objectives : The purpose of this study was to understanding the constraint induced movement and Self-efficacy with arm training on upper motor function in Stroke Patients. Methods : Stroke, the leading cause of functional disability, causes a variety of impairments that compromise quality of life. Upper limb hemiparesis, a commonly seen impairment, is particularly problematic given its impact on activities of daily living. Because stroke was a disease to correspond to the first during domestic cause of death, and was accompanied by a lot of side aftereffects after a survival, stroke rehabilitation bought a patient and a family and a physical therapist, and it was main concern of. Results : Looks into upper extremity excrise of a subacute stroke patient estranged a acute convalescence later by a rehabilitation treatment in this consideration, and evaluates an effect to wind up constraint induced movement for an early treatment of stroke and Self efficacy, and help is one to an early rehabilitation of an stroke patient. Conclusions : Overuse sound tends after the stroke occurrence in the early stage in order to recompense for stroke, and at the time of a new aspect called learned nonuse syndrome by a movement of a paralysis part dusting off wealth with this step thing later. Constraint induced movement using self efficacy could be an effective for improving function of stroke.

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매선요법을 병행한 특발성 동안신경마비 한방치험 1례 (A Case of Idiopathic Oculomotor Nerve Palsy Treated with Korean Medicine Including Needle-embedding Therapy)

  • 송지훈;최정화;김종한;정민영;박수연
    • 한방안이비인후피부과학회지
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    • 제33권3호
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    • pp.138-152
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    • 2020
  • Objectives : The aim of this study is to report a case of idiopathic oculomotor nerve palsy improved by Korean Medicine therapy including needle-embedding therapy. Methods : We treated a 69-year old male patient who has Rt. ptosis, Rt. eye movement impairment, and dizziness with various Korean medical therapy including acupuncture, Bojungikgitanggami, and Hominis Placenta pharmacopuncture. To promote recovery, we additionally performed needle-embedding therapy to periocular acupoints. Results : Ptosis started to remarkably improve after performing needle-embedding therapy. After 54 days of treatment, ptosis and eye movement impairment of Rt. eye were significantly improved similar to the normal eye. Dizziness was cured in a few days after administration. Conclusions : This case suggests Korean medicine including needle-embedding therapy is effective against oculomotor nerve palsy symptoms especially for ptosis.

상지 근골격계 기능장애 평가 도구 DASH의 고찰 (Disability Measurement Tool for Upper Extremity Disorders: The DASH (Disabilities of the Arm, Shoulder, and Hand))

  • 김규상
    • 한국산업보건학회지
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    • 제19권2호
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    • pp.156-169
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    • 2009
  • In this study, the authors introduced DASH (Disabilities of the arm, shoulder, and hand), which had been developed for evaluating the functional impairment in the movement of upper extremities in regular daily activities, work ability and sports/performing arts ability. It is an ergonomic risk assessment tool used for industrial workers and also a disability measurement tool for upper extremity disorders arising from musculoskeletal disorders and symptom. This study intended to examine the applicability of DASH in occupational health field. Firstly, DASH development process and composition were reviewed through The DASH outcome measure user's manual and early articles. Secondly, reliability, validity, and responsiveness of the DASH in various languages at the application stage as well as its reliability and validity at the early stage of development were investigated. Thirdly, focusing on the application of DASH to clinical cases, workers with musculoskeletal symptoms, healthy workers, workers with other diseases, and general population were discussed besides workers with major musculoskeletal disorders. Lastly, DASH questionnaire was examined for its potential as a reference for assessing the functional impairment in the movement of upper extremities of workers with musculoskeletal symptoms in industrial workers in Korea.

Reliability of the Korean Version of the Trunk Impairment Scale in Patients With Stroke

  • Seo, Hyun-Du;Kim, Nam-Joe;Chung, Yi-Jung
    • 한국전문물리치료학회지
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    • 제15권4호
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    • pp.87-96
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    • 2008
  • The purpose of this study was to establish the reliability of the Trunk Impairment Scale (TIS) translated into Korea in patients with stroke. It also aims to score the quality of trunk movement and to be a tool for the treatment. The TIS consists of three subscales that static sitting balance, dynamic sitting balance and co-ordination. The TIS score ranges from a minimum of 0 to a maximum of 23. Twenty-five stroke patients (13 males, 12 females) were examined by two physiotherapists. Interrater and test-retest reliability were assessed. Kappa and weighted kappa values for the items of the trunk assessment of the TIS ranged from .67 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .95 and .97. Cronbach alpha coefficients for internal consistency range from .87 to .97. The TIS provide reliable assessments for the trunk and are valid scales for measuring trunk performance in patients with stroke. TIS can be used as a guideline for treatment and the assessment of quality of trunk activity.

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Can Angular Deformity Due to Sacrococcygeal Fracture Cause Permanent Impairment? : Current State and Problems in Korea

  • Cho, Dosang
    • Journal of Korean Neurosurgical Society
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    • 제65권2호
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    • pp.173-179
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    • 2022
  • Disabilities can emerge due to traumatic spinal fractures. In terms of sacrococcygeal spine, because of its unique anatomic structure with minimal movement, the possibility for it to have a disability is relatively low. In Korea, unlike most disability criteria, private insurance companies acknowledge angular deformities caused by vertebral fractures as disabilities according to their degree, so there were several cases where patients required compensation, arguing angular deformity caused by sacrococcygeal fracture, which in some cases led to legal conflicts. Except the Act Welfare of Persons with Disabilities which recognizes only severe angular deformity affecting internal organs as disability and the industrial accident disability evaluation which does not recognize coccygeal fracture as disability but rarely recognizes sacral vertebra deformity equivalent to compressive deformation, there is little or no case where angular deformity is recognized as disability. Given the impairment evaluation standards in social insurance, McBride system, American Medical Association (AMA) guides, and newly proposed standards by the Korean Academy of Medical Sciences (KAMS), the most contentious point in the general terms and conditions of private insurance is spinal deformity. To overcome controversy over disability evaluation, the private insurance sector is now applying criteria for axial skeleton to sacrococcygeal vertebrae through revision of standards. Under these circumstances, it is fair to recognize sacrococcygeal fracture as impairment in terms of the pelvis only when the fracture leaves serious deformity and neurological symptoms with clear relevancy. Though it may not be easy to develop accurate disability evaluation standards, improvement is necessary to remove any irrationalities and make the standards as objective as possible.

MBSImP에 따른 뇌졸중 환자의 삼킴 장애 양상 분석 (Characteristics of the Oropharyngeal Swallowing Impairment in Stroke Patient using the Modified Barium Swallowing Impairment Profile)

  • 임익재
    • 한국산학기술학회논문지
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    • 제20권7호
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    • pp.36-44
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    • 2019
  • 본 연구는 뇌졸중 환자들의 대표적인 후유증인 삼킴 장애의 양상을 14개의 하위 항목으로 분류하고 그 특징을 조사하는데 그 목적이 있다. 연구 대상자는 소뇌 천막을 기준으로 천막상 병변의 소견을 보이는 아급성 뇌졸중 환자 49명 이었다. 삼킴 문제의 양상을 조사하고 그에 따른 생리학적 근거를 조사하기 위해 모든 피검자에게 비디오투시조영 삼킴 검사를 시행하였으며 삼킴 장애 평가에는 삼킴 장애 프로파일(The Modified Barium Swallowing Impairment Profile, MBSImP)이 사용되었다. 조사 결과, 뇌졸중 환자의 95.9%는 입술 조절기능에서 문제가 있었고 98%는 혀 조절 기능에서 문제가 있었다. 또한 환자의 57.1%는 음식물을 인두쪽으로 이동시키는데 문제가 있었으며 51%는 구강에 음식물의 일부를 남기는 증상을 나타내었다. 음식물이 인두족으로 유입됨과 동시에 일어나는 인두 삼킴 반사의 경우에는 89.8%의 환자가 지연된 삼킴 반사 증상을 보였으며 후두와 설골의 운동은 각각 42.9 %와 87.8% 환자가 문제가 있는 것으로 조사되었다. 또한 연구개는 환자의 18.4%가 이상 소견을 보였고 후두개의 경우에는 단지 4.1%만이 이상 소견을 보여 대체로 후두개 기능은 잘 보전되어 있는 것으로 조사되었다. 뇌졸중 환자의 30.6%는 후두 폐쇄 기능에 문제가 있었고, 식도 근육의 경우에는 모든 환자(100%)가 이 근육의 상부를 적절히 조절하지 못하는 것으로 조사되었다. 혀 기저부 움직임 또한 환자의 91.8%에게서 문제가 있는 것으로 나타났으며 인두에 음식물을 남기는 증상도 91.8%의 환자에게서 관찰되었다. 본 연구의 결과로부터 뇌졸중 환자의 삼킴 문제의 구체적 양상들에 대해 살펴보았으며 이는 삼킴 장애 중재 및 치료 개발을 위한 기초 자료로 활용 될 수 있을 것이다.

다리 움직임을 동반한 복부 드로우-인 기법이 뇌졸중 환자의 배가로근 두께와 몸통 조절에 미치는 영향 (The Effect of Abdominal Draw-in Maneuver with Leg Movements on Transversus Abdominis Thickness and Trunk Control in Stroke Patients)

  • 강정일;문영준;정대근
    • 한국엔터테인먼트산업학회논문지
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    • 제14권8호
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    • pp.287-294
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    • 2020
  • 다리 움직임이 몸통 주위 근육에 효과적인 변화를 줄 수 있다는 근거를 바탕으로 다리 움직임을 동반한 복부 드로우-인 방법이 뇌졸중 환자들의 배가로근 두께와 몸통 조절 능력에 변화를 알아보고, 효율적인 복부 드로우-인 기법에 있어서 임상적 기초 자료를 제공하기 위해 시행하였다. 본 연구는 뇌졸중 환자 18명을 표본 추출하여, 기존의 복부 드로우-인 기법을 적용한 집단을 실험군I(n=9)로, 다리 움직임을 동반한 복부 드로우-인 기법을 적용한 집단은 실험군II(n=9)로 무작위 배치한 후 사전 검사로 초음파를 활용하여 마비측 배가로근의 두께를 측정하였고, 몸통 조절 능력은 몸통 손상 정도 평가지를 이용하여 측정하였다. 총 4주 간, 주 4일, 1일 1회, 30분씩 중재 프로그램을 시행한 후 사후검사를 사전검사와 동일하게 재 측정하여 분석하였다. 그 결과 두 집단 내 배가로근 두께 변화 비교에서는 두 집단 모두 복부 드로우-인 동작 시 유의한 차이가 있었으며(p<0.01), 몸통 조절 능력에서도 두 집단 모두 유의한 차이가 있었다(p<0.001). 그러나 두 집단 간 배가로근 두께와 몸통 조절 능력 변화 비교에서는 몸통 조절 능력에서만 유의한 차이가 있었다(p<0.05). 따라서 집단 간 배가로근의 두께는 차이가 없었지만, 다리의 움직임을 통해 자동 반사적인 골반 움직임이 나타나 복부 주위의 근육들에게도 효율적인 수축 반응이 나타나 더 효과적으로 몸통 조절 능력을 향상시킬 수 있는 중재방법임을 알 수 있었다.

경근추나 치료 후 호전된 발음성 고관절 환자 치험례 (A Case Report on Snapping Hip Patient Treated by Chuna Manual Therapy for Meridian Sinew System)

  • 김우영;이재영;한상엽;공덕현;박재영;이현종
    • 척추신경추나의학회지
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    • 제5권2호
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    • pp.43-48
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    • 2010
  • 단순 방사선검사와 이학적 검사에서 특이 소견을 발견할 수 없는 발음성 고관절 환자에서 대전자의 움직임을 통해 고관절의 움직임 이상을 발견하고 경근추나를 시행하였다. 1. 환자분이 복와위에서 능동적 신전운동, 앙와위에서 능동적 굴곡운동을 하는 동안 환자의 대전자를 통해 고관절이 전내측 방향으로 움직임을 관찰하였다. 2. 고관절의 전내측 방향으로 움직임의 과도를 유발할 수 있는 대퇴근막장근과 슬괵근의 단축을 평가하고 경근이완기법을 적용하였다. 3. 슬곽근에 대항작용을 하고 고관절이 관골구내에서 안정성을 유지하기 위해 필요한 대둔근, 대퇴근막장근에 대항작용을 할 수 있는 후중둔근과 장요근의 약화를 관찰하고 경근강화기법을 시행하였다. 4. 13회의 치료 후 발음성고관절의 주증상인 통증과 탄발음이 거의 소실되는 양호한 결과를 얻었다. 5. 고관절의 움직임 이상이 발견된 발음성 고관절 환자에서 해당 경근의 단축과 약화가 발견될 경우 경근추나수기법을 이용해 볼 수 있을 것으로 판단된다.

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Action observation training enhances upper extremity function in subacute stroke survivor with moderate impairment: a double-blind, randomized controlled pilot trial

  • Kim, Chang-Heon;Bang, Dae-Hyouk
    • 대한물리의학회지
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    • 제11권1호
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    • pp.133-140
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    • 2016
  • PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

가미반하백출천마탕과 침치료를 통한 한의치료로 호전된 뇌경색 후 시야장애 환자 치험 1례 (A Case Report on Treating Post-stroke Visual Impairment with Gami-banhabakchulchunma-tang and Acupuncture)

  • 김정희;김해융;원서영;유주영;정은선;유호룡;설인찬;김윤식
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.1045-1053
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    • 2021
  • Objectives: This study investigated the effectiveness of acupuncture and herbal medicine (Gami-banhabakchulchunma-tang) for post-stroke visual impairment. Methods: A 79-year-old male with headache, dizziness, visual field defects, and blurred vision caused by a posterior cerebral infarction was treated with acupuncture and Gami-banhabakchulchunma-tang for three months. We used the Numerical Rating Scale (NRS) for each symptom and measured the patient's eye-movement range. Results: Following treatment, the NRS score for headache decreased from 5 to 0, and for dizziness and blurred vision, it decreased from 5 to 1. The NRS score for visual field defects decreased from 5 to 2. The range of the patient's left and right eye movements both improved, and no adverse side effects were observed during the admission period. Conclusions: Korean medical treatment with acupuncture and herbal medicine (Gami-banhabakchulchunma-tang) could effectively treat post-stoke visual impairment.