• Title/Summary/Keyword: Orthostatic

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The Effect of Seat Incline Angle in Hemiplegic Patients' Standing up Training

  • Sim, Woo Sang;Jung, Kwang Tae;Won, Byeong Hee
    • Journal of the Ergonomics Society of Korea
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    • v.35 no.6
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    • pp.493-501
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    • 2016
  • Objective: This study analyzes the effect of angle conditions of rehabilitation equipment used for supporting hemiplegic patients on their rehabilitation training for standing action. The study was performed by adjusting the rear angle of seat inclination through a motion analysis. Background: Owing to a loss of muscle rigidity and degradation of muscle control ability, hemiplegic stroke patients suffer from asymmetrical posture, abnormal body balance, and degraded balance abilities due to poor weight-shifting capacity. The ability to shift and maintain one's weight is extremely essential for mobility, which plays an important role in our daily life. Thus, to improve patients' ability to maintain weight evenly and move normally, they need to undergo orthostatic and ambulatory training. Method: Using a motion analysis system, knee movements on both hemiplegic side and non-hemiplegic side were measured and analyzed in five angles ($0^{\circ}$, $10^{\circ}$, $30^{\circ}$, $50^{\circ}$, $70^{\circ}$) while supported by the sit-to-stand rehabilitation equipment. Results: The knee movements on both sides increased as the angle increased in angle support interval to support a hemiplegic patient's standing up position. In standing up interval, a hemiplegic patient's knee movement deviations on both sides decreased, and the movement differences between hemiplegic and non-hemiplegic legs also decreased as the angle increased. Conclusion: The results of this study showed that the rehabilitation effectiveness increases as the angle increases, leading to a balanced standing posture through the decrease of movement difference between hemiplegic and non-hemiplegic sides and an improved standing up ability through the increase of knee movement on both sides. However, angles higher than $50^{\circ}$ didn't provide a significant effect. Therefore, a support angle under $50^{\circ}$ was proposed in this study. Application: The results of this study are expected to be applicable to the design of sit-to-stand support equipment to improve the effectiveness of the rehabilitation process of hemiplegic patients.

Clinical and autonomic characteristics in patients with postural tachycardia syndrome (기립빈맥증후군 환자의 임상적 및 자율신경 특성)

  • Kim, Duk Ju;Kang, Sa-Yoon;Kim, Joong Goo
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.96-100
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    • 2019
  • Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

Cervical Dural Tear induced by Cervical Chuna Manipulation Treatment : A Case Report (경추추나치료 후 발생한 경막파열 환자 1례 보고)

  • Kong, Jae-Cheol;Park, Tae-Yong;Ko, Youn-Seok;Won, Jae-Kyun;Park, Darn-Seo;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.45-50
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    • 2006
  • Objectives : A rare case of dural tear ensuing after a cervical Chuna Manipulation Treatment leading to cerebrospinal fluid (CSF) leakage in the lower cervical and upper thoracic spine was found, so we report it. Methods : A 32-year-old woman presented with back and neck pain in 1 days earlier. The patient undertook a cervical Chuna Manipulation Treatment. After this maneuver, the patient complained of an orthostatic headache with nausea. The patient's headache worsened, and lying down gave the only measure of limited relief. In Brain CT and MRI study, nonspecific finding was detected. In Cistemography study, CSF leakage at lower cervical or upper thoracic area was detected. Results and Conclusions : It is supposed that this patient suffered a dural tear and CSF leakage secondarily due to a cervical Chuna Manipulation Treatment. From this case, we can understand the etiology of dural tear to some extent and consider the complication of Chuna Manipulation Treatment. In the future, more study, research and prospective trial for complications of a cervical Chuna Manipulation Treatment is needed.

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Report on the Guillain-Barre Syndrome with Autonomic Dysfunction(1 Case) (자율신경 기능 이상을 동반한 Guillain-Barre 증후군 1례)

  • Kim, Dong-Ung;Shin, Sun-Ho;Cho, Gwon-Il;Shin, Hak-Su;Han, Myung-A;Choi, Jin-Young;Choi, Woo-Jung;Yang, Jae-Hun;Chung, Yong-Jun;Kim, Kwan-Sick
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.453-458
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    • 2001
  • Guillain-Barre syndrome, or acute inflammatory demyelinating Polyradiculoneuropathy, is frequently accompanied by cardiac and autonomic dysfunction. We report a patient who had tachycardia, orthostatic hypotension, hypertension, pronounced blood pressure fluctuations, abnormal sweating, constipation and urinary frequency as well as qudriparesis. We thought that the GBS was incurred by Damp-Heat, used Heat-Clearing and Dampness-Transforming decoction(Chongjoo-tang) in the early stage. In the later stage, fortifying the Spleen and Boosting Qi plus Supplementing the Kidney decoction(Palmultang+chongawon) was used to remove low back pain and boost recovery. The patient reached the nadir 14 days after onset. He became bed-bound and autonomic dysfunction was very severe. From 3rd week, abnormalities of autonomic function and paresis impoved gradually and he could walk above 5m without walker or equivalent support at the 5th week after onset.

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One case treated Tremor(mouth, chin and hand) (수(手), 구순(口脣), 신 진전증(振顫症) 환자(患者)의 치험(治驗) 1례(例))

  • Seong, Gang-Gyeong;Lee, Sang-Gwan;Lee, So-Young;Cheong, Sang-Su;Cheon, Young-Sae;Lee, Si-Woo;Kim, Yo-Han
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.477-482
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    • 2001
  • Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Because Dansambohyul-tang has been used to treat patients differentiated with an insufficiency of the heart and the spleen(心脾兩虛) in oriental medicine, we treated a 78 year-old female patient who suffered from tremor in mouth, chin and hand and insomnia, with improvement of general condition, who was differentiated with an insufficiency of the heart and the spleen(心脾兩虛) with Dansambohyul-tang, herb complex. After 78 days of treatment with Dansambohyul-tang and some other herb complex, we observed improvement of tremor, insomnia and general condition So Dansambohyul-tang shows therapeutic effects on tremor.

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Influence of Clinical and Demographical Variables on Depression, Instrumental Activities of Daily Living, and Cognitive Function in Patients with Parkinson's Disease (파킨슨병 환자의 인구학적.임상적 특성에 따른 우울, 일상생활 수행능력 및 인지기능)

  • Sohng, Kyeong-Yae;Choi, Dong-Won;Park, Hea-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.249-256
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    • 2006
  • Purpose: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. Method: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. Results: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. Conclusion: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

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Differences in Heart Rate Variability Depending on Sex, Level of Stress, Anxiety, and Depression among College Students: on the Basis of Neurovisceral Integration Model (대학생의 성별, 스트레스, 불안 및 우울 정도에 따른 심박변이도 차이: Neurovisceral integration model에 기반하여)

  • Suh, Min Hee
    • Journal of Korean Biological Nursing Science
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    • v.23 no.1
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    • pp.22-30
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    • 2021
  • Purpose: This descriptive study aimed to investigate heart rate variability (HRV) according to sex and to elucidate the influence of negative emotion such as levels of stress, anxiety and depression on HRV among Korean college students based on a neurovisceral integration model. Methods: A descriptive study design was used. Eighty-six healthy college students participated in the study. Resting HRV and standing HRV on orthostatic stimulation were measured for 5 minutes during 4-6 p.m. in the afternoon. Levels of stress, anxiety and depression were assessed using the Global assessment of recent stress, State-Trait Anxiety Inventory and Beck Depression Index, respectively. Results: Out of the 86 students, 47 (54.7%) were men and 39 (45.3%) were women. Root mean square of the differences between adjacent RR intervals (RMSSD) and normalized high frequency (nHF) on standing HRV were significantly lower in men than in women (p= .005, p= .019, respectively). Male gender (β= 0.30, p= .013), higher level of stress (β= -0.36, p= .009) and lower level of depression (β = 0.30, p= .044) exerted a significant influence on decreased nHF in the multiple regression analysis. Conclusion: We suggest that men are more vulnerable to having reduced vagal activity on HRV than women. Since male gender, higher level of stress and lower level of depression level influenced decreased vagal activity, strategies are needed to improve stress and depression rather than anxiety especially for men, which contribute to promoting HRV to prevent cardiac health diseases.

A Case of Multiple System Atrophy(MSA-C) Patient with Autonomic Dysfunction Improved by Korean Medicine Treatment Including DokhwalJihwang-tang Gami-bang (독활지황탕가미방을 포함한 한의치료로 자율신경장애가 호전된 MSA-C 환자에 대한 치험 1례)

  • Kyeong-Hwa Heo;Dong-Joo Kim;Hye-Min Heo;Ye-Chae Hwang;Seung-Yeon Cho;Jung-Mi Park;Chang-Nam Ko;Seong-Uk Park
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.24 no.1
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    • pp.41-54
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    • 2023
  • ■Objectives This study is to report the effectiveness of Korean medicine on the treatment for multiple system atropy(MSA-C) patient complaining of autonomic dysfunction. ■Methods The patient was treated with Korean medicine(mainly DokhwalJihwang-tang Gami-bang) for 39 days. The evaluations were performed using UMSARS(Unified Multiple System Atrophy Rating Scale), SCOPA-AUT(The Scale for Outcomes in Parkinson's disease-Autonomic), K-OGS(Korean version of the Orthostatic Grading Scale). ■Results After treatment, the UMSARS score decreased from 25 to 18, the SCOPA-AUT score decreased from 21 to 14, K-OGS score decrease from 15 to 8. ■Conclusion This case suggests that Korean medicine treatment may be effective for MSA-C patients with autonomic dysfuction.

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Spontaneous Intracranial Hypotension (자발성 두개강내압 저하증)

  • Kong, Doo Sik;Kim, Jong Soo;Park, Kwan;Nam, Do Hyun;Eoh, Whan;Shin, Hyung-Jin;Hong, Seung-Chyul;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.240-248
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    • 2000
  • Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

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Effect of Terazosin on Posttraumatic Nightmares : A Pilot Study (외상 후 스트레스장애 환자의 악몽치료에서 Terazosin의 효과 : 예비 연구)

  • Chung, Moon-Yong;Jung, Ji-Young;Lee, Tae-Young;Kang, Suk-Hoon;Kim, Tae-Yong;Choi, Jin-Hee;Chung, Ha- Kyoung
    • Anxiety and mood
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    • v.2 no.1
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    • pp.39-44
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    • 2006
  • Objective : Chronic posttraumatic stress disorder (PTSD) is defined by the coexistence of symptoms (reexperiencing, avoidance and hyperarousal), persisting for more than months or years that causes significant impairment in social occupational functioning. This study was conducted to evaluate the effects of terazosin on posttraumatic nightmares which is one of chronic PTSD symptoms. Methods : Twenty patients with chronic PTSD and severe trauma-related nightmares were treated with terazosin (3-7 mg/day) for 8 weeks. Recurrent distressing dreams item of the Clinician administered PTSD Scale (CAPS), Total CAPS score, Clinical Global Impressions-Severity Scale (CGI-S) and Clinical Global Impressions-Change Scale (CGI-C) were performed at baseline, 4-week and 8-week. Mississippi Scale for Combat-Related PTSD and Combat Exposure Scale (CES) were used to evaluate PTSD symptom pattern and degree of exposure. Results : Significant decrease in recurrent distressing dreams item, reexperiencing, avoidance and hyperarousal symptom score and total CAPS score were at 4-week and 8-week treatment compared to baseline (recurrent distressing dreams item : $2.70{\pm}1.88$ and $1.25{\pm}1.49$ ; reexperiencing, avoidance and hyperarousal symptom score : $2.30{\pm}2.49$, $1.20{\pm}1.05$, $3.10{\pm}1.68$ and $4.00{\pm}3.59$, $1.55{\pm}1.50$, $5.60{\pm}3.23$ ; total CAPS score : $8.20{\pm}6.26$ and $5.40{\pm}5.89$). There were significant correlation between dosage of terazosin and improvement of PTSD symptoms. Adverse effects such as fatigue and orthostatic hypotension were showed, which were mild and self-limited. Conclusion : These results suggest that terazosin may improve severe trauma-related nightmares and overall PTSD symptoms. Randomized controlled study with more subjects would be necessary in the future.

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