• 제목/요약/키워드: Musculoskeletal intervention

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초음파 조영제 (Ultrasound Contrast Agent)

  • 김기욱
    • Clinical Pain
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    • 제20권2호
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    • pp.86-92
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    • 2021
  • Ultrasound imaging in clinical practice is one of the widely used diagnostic methods because there is no radiation risk, more cost- effective compared to MRI or CT, and possible to perform an intervention through fast real-time imaging. In order to increase the diagnostic value, the studies of contrast-enhanced ultrasound (CEUS) using an ultrasound contrast agent have been actively conducted since about 50 years ago and are being used clinically in vascularity and microcirculation of internal organs. Although ultrasound is actively used for the diagnosis and treatment of various diseases in musculoskeletal disorders, there are some limitations in diagnosing mild or small lesions, inflammatory reactions, or abnormalities at the molecular level. In this review, the principles, types, and research, and clinical applications of ultrasound contrast agents have been summarized and introduced. If we understand the characteristics of the ultrasound contrast agents and anatomical knowledge, as well as molecular changes, the ultrasound contrast agents are widely applied in musculoskeletal disorders and have tremendous potential for diagnosis and treatment.

경부운동훈련이 외상 후 스트레스 장애 환자의 경부통증 수준, 우울 요인에 미치는 영향 (The Impact of The Cervical Exercise Training on Post-traumatic Stress Disorder Patient's Cervical Pain Levels and Depression Factor)

  • 박성두;신영일;김명준
    • 대한정형도수물리치료학회지
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    • 제21권1호
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    • pp.37-42
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    • 2015
  • Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

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VDT 증후군 환자에 물리치료와 인간공학적 개입: 사례 연구 (Physical Therapy and Ergonomic Interventions in Patients with VDT Syndrome: 4 Cases Study)

  • 이인희;박상영
    • The Journal of Korean Physical Therapy
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    • 제22권4호
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    • pp.91-96
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    • 2010
  • Purpose: Among computer users, the awkward posture and workstation setups of workers contribute to work-related upper limb musculoskeletal disorders. The purpose of this study was to evaluate the efficacy of a traditional physical therapy and ergonomic intervention by physical therapists in 4 computer users. Methods: After checking Visual Analogue Scores (VAS), four subjects who were treated by physical therapy for neck and shoulder problems related to VDT syndrome were enrolled in the study. All subjects spent at least 40 hours per week at a computer workstation. All subjects had pain and ergonomic states evaluated using methods such as VAS, Neck Disability Index (NDI), Workstyle short form, Rapid Upper Limb Assessment (RULA), and OSHA VDT checklist (Occupational Safety and Health Administration video display terminal) before a physical therapy + ergonomic intervention. Participants were re-evaluated 1 month later. Results: Participants showed more improvement of their neck pain after being treated with a physical therapy plus ergonomic intervention than when treatment consisted only of physical therapy. Improvements in RULA, Workstyle short form, and OSHA VDT checklist also were achieved. Conclusion: This case study suggests the importance of examining the work habits and work-related postures of subjects who complain of neck and shoulder pain that is exacerbated by computer use. Personalized ergonomic interventions and physical therapy can lead to improvement of patients with VDT syndrome.

Occupational Diseases Among Office Workers and Prevention Strategies

  • Lee, Jongin;Koo, Jung-Wan
    • 대한인간공학회지
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    • 제34권2호
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    • pp.125-134
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    • 2015
  • Objective: In this review we discuss the health effects among office workers. Background: Even if office workers are not exposed hazardous or harmful environment frequently, some problems could be happened to the office workers. Although serious occupational diseases rarely occur to the office workers, it is important to consider occupational risk factors for the office worker because the portion of the office workers is relatively high in all industries. Method: We divided possible health effects for the office workers into three categories; musculoskeletal disorders, indoor environment, and cerebro-cardiovascular diseases. We reviewed related articles, textbooks, and statistical materials non-systematically and described risk factors, related illnesses, and prevention strategies on each category. Results: Office workers have various musculoskeletal disorders to be intervened. By medical treatment, improving working environment, and ergonomic intervention, office workers can be prevented from musculoskeletal injuries. Poor indoor environment can cause many building-related illnesses or sick building syndrome. Although the etiology of some problems by poor indoor environment is not clear, it helps to maintain adequate humidity, temperature, and clarity of indoor air. Cerebro-cardiovascular diseases are a rising issue because office workers in Korea tend to work for a lot of time. To prevent the diseases, it is needed to work for adequate time, lengthen activity level, and manage other medical risk factors for the diseases. Conclusion: There is no distinct occupational disease for office workers. However, there are some aspects to consider the health effects of office workers and it is important to prevent the possible health problems. Application: A strategy against occupational diseases among office workers can be established by reviewing this article.

Vibration and Ergonomic Exposures Associated With Musculoskeletal Disorders of the Shoulder and Neck

  • Charles, Luenda E.;Ma, Claudia C.;Burchfiel, Cecil M.;Dong, Renguang G.
    • Safety and Health at Work
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    • 제9권2호
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    • pp.125-132
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    • 2018
  • Background: According to the US Bureau of Labor Statistics, musculoskeletal disorders (MSDs) accounted for 32% of all nonfatal injury and illness cases in 2014 among full-time workers. Our objective was to review and summarize the evidence linking occupational exposures to vibration and awkward posture with MSDs of the shoulder and neck. Methods: A literature search was conducted using the terms musculoskeletal disorders, vibration, and awkward posture. All types of observational epidemiologic studies, with the exception of case reports, published during 1998-2015 were included. Databases searched were MEDLINE (Ovid), Embase (Ovid), Scopus, Ergonomic Abstracts, NIOSHTIC-2, and Health and Safety Science Abstracts. Results: Occupational exposures to whole-body or hand-arm vibration were significantly associated with or resulted in MSDs of the shoulder and neck. Awkward postures while working were also associated with MSDs in these locations. These findings were consistent across study designs, populations, and countries. Conclusion: Occupational exposure to vibration and awkward posture are associated with shoulder and neck MSDs. Longitudinal studies are required to elucidate the mechanisms responsible for these associations, and intervention studies are warranted.

서울시 학교급식시설 조리종사자의 직무 스트레스와 근골격계질환 (Job Stress and Musculoskeletal Disorder in Seoul City's School Foodservice Employees)

  • 이새롬;김규상;김은아;김지혜;김도형
    • 한국직업건강간호학회지
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    • 제23권4호
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    • pp.245-253
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    • 2014
  • Purpose: School foodservice employees (SFEs) could be exposed to the risk of musculoskeletal disease and of job stress due to their job characteristics. This study was to evaluate the level of job stress and the prevalence of work-related musculoskeletal symptoms (WRMS) in Seoul city's SFEs, and to determine associations between job stress and WRMS. Methods: The study design was cross-sectional, and 975 SFEs were recruited. Self-administered questionnaire included the 'Korean occupational stress scale-short form' and the 'KOSHA GUIDE H-9-2012' instrument to evaluate the job stress and WRMS, respectively. SFEs' medians of job stress were compared to the reference values of published study in Korean workers. Results: The participants reported greater levels of job demand and physical environment than the general Korean population. WRMS were reported in 89.0% of participants at any body part, and 41.1% were presumed to need for medical intervention. High levels of job demand and of physical environment were significantly associated with WRMS. Conclusion: Subscales of job demand and physical environment were relatively high in SFEs and those were related to the occurrence of WRMS. To reduce the WRMS prevalence, a job stress management program focused on job demand and physical environment may be required.

요양병원 요양보호사의 작업환경, 심리적 업무요구, 피로가 근골격계 증상에 미치는 영향 (Factors Influencing on Musculoskeletal Symptoms of Care Workers in Long-Term Care Hospitals for Job Environment, Psychological Work Demand, Fatigue)

  • 오진영;하영미
    • 디지털융복합연구
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    • 제18권11호
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    • pp.559-569
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    • 2020
  • 본 연구는 요양병원 요양보호사의 작업환경, 심리적 업무요구, 피로도, 근골격계 증상의 관계를 파악하고 근골격계 증상에 미치는 영향요인을 규명하기 위해 시도되었다. 연구방법은 S시에 소재한 3곳의 요양병원에 근무하는 요양보호사 128명을 대상으로 2020년 4~5월까지 설문 조사하였다. 연구결과 요양병원 요양보호사의 근골격계 증상은 어깨, 손/손목/손가락, 허리 세 부분에 대한 증상발생빈도, 증상지속기간, 통증의 강도를 합한 값으로 42점 만점에 평균 11.41±9.50점으로 나타났다. 요양병원 요양보호사의 근골격계 증상에 미치는 영향요인을 규명하기 위해 회귀분석을 실시한 결과 근무병동(β=.18, p=.034)과 심리적 업무요구(β=.21, p=.013), 피로도(β=.25, p=.003)가 근골격계 증상에 유의한 영향을 미치는 것으로 나타났으며, 이들 3개 변수는 근골격계 증상에 대하여 21.6%의 설명력을 보였다(F=6.87, p<.001). 본 연구결과를 바탕으로 요양병원 요양보호사들의 근골격계 증상을 감소시키기 위해서는 담당하는 환자의 중증도를 고려하여 심리적 업무요구와 피로도를 줄일 수 있는 중재프로그램 개발 및 적용이 필요하다.

근육뼈대계 질환에 대한 도수치료의 효과: 메타분석 (Effects of Manual Therapy on Musculoskeletal Diseases : A Meta-Analysis)

  • 이정우;공광식;김동연;고운
    • 대한통합의학회지
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    • 제9권1호
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    • pp.203-217
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    • 2021
  • Purpose: The purpose of this meta-analysis was to examine the high-level evidence of the effects of manual therapy on musculoskeletal diseases. Methods: Domestic databases were searched for studies that conducted clinical trials associated with manual therapy on chronic musculoskeletal diseases. A total of 591 studies published between 2005 and 2018 were identified, with 18 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with pain and physical function. The 18 studies included in the study were evaluated by using the R meta-analysis (version 4.0). The quality of 18 randomized control trials was evaluated by using the Cochrane risk of bias (ROB). The effect sizes were computed as the corrected standardized mean difference (SMD). Subgroup and meta-regression analyses were also used. Egger's regression test was carried out in order to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were also conducted in order to analyze the data error. Results: The following factors showed the large effect size of manual therapy on chronic musculoskeletal diseases: pain (Hedges's g = 2.66; 95% CI = 1.47 ~ 3.85), and physical function (Hedges's g = 2.15; 95% CI: 1.22 ~ 3.08). The subgroup analysis only showed a statistical difference in the type of manual therapy (pain) and outcome (physical function). No statistically significant difference was found in the meta-regression analysis. Publication bias was found in the data, but the results of the trim-and-fill method showed that such bias did not largely affect the obtained data. Furthermore, there were no data errors in the cumulative meta-analysis and sensitivity analysis. Conclusion: This study provides evidence for the effectiveness of manual therapy on chronic musculoskeletal diseases in pain and physical function. Subgroup analysis suggests that only the type of manual therapy for pain and the type of outcome for physical function differed in effect size.

Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • 국제물리치료학회지
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    • 제4권2호
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.