• Title/Summary/Keyword: Pain Disability

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Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.224-229
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    • 2014
  • Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

Effects of Myofascial Release and Posture Correction Exercise on the Neck Movement and the Quality of Sleep in Patients with Chronic Tension-Type Headaches

  • Cho, Sunghak
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1897-1902
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    • 2019
  • Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

Body composition and hemodynamic changes in patients with special needs

  • Tsukamoto, Masanori;Hitosugi, Takashi;Esaki, Kanako;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.193-197
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    • 2016
  • Background: Some patients with special needs exhibit intellectual disability, including deficits in cognitive skills and decreased quality of life. The purpose of this study was to retrospectively compare changes in body composition and hemodynamics during general anesthesia in patients with and without special needs. Methods: The backgrounds of patients who underwent oral maxillofacial surgery under general anesthesia were recorded from medical records. Intracellular water (ICW), extracellular water (ECW), stroke volume variation (SVV), and heart rate (HR) were recorded for 3 h after the start of anesthesia. Categorical data were compared using an unpaired t-test, and a P-value of less than 0.05 was regarded as significant. Numerical data were compared using the Bonferroni correction, and a P-value of less than 0.0125 was regarded as significant. Results: A total of 21 patients were included in the study: 10 patients without special needs (non-S-group) and 11 patients with special needs (S-group). There were no significant differences in patients' backgrounds, except with regard to height (P = 0.03). In both groups, ICW and ECW were maintained, although they were lower in the S-group compared to the non-S-group. SVV was maintained in both groups, although it was higher in the S-group than the non-S-group. HR was significantly lower in the S-group 1 h after induction of anesthesia (P < 0.003). Conclusions: Changes in hemodynamics due to body fluid imbalance should be monitored during general anesthesia, especially for patients with special needs.

A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic

  • Shin, Bisol;Yoo, Seunghoon;Kim, Jongsoo;Kim, Seungoh;Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.203-208
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    • 2016
  • Background: In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods: This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results: Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was $132.7{\pm}77.6min$, and the mean duration of treatment was $101.9{\pm}71.2min$. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions: Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

A Case Report on Korean Medical Treatment for a Patient Hospitalized with Acute Compression Fracture (한방병원에 입원한 압박 골절 환자에 대한 한방 치료 1례)

  • Lee, Yu-jin;Choi, Ki-won;Kwon, Min-jin;Jang, Won-suk;Youn, Jun-heum;Bae, In-su;Hwang, Dong-wook;Yoon, Kyung-young
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1027-1034
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    • 2021
  • Objectives: This study aimed to determine the effects of Korean medical treatment on a patient with compression fractures. Methods: The patient was treated with herbal medicine and acupuncture for 51 days. Symptom changes were measured using the Numerical Rating Scale (NRS), Range of Motion (ROM), Oswestry Disability Index (ODI), and European Quality of Life Five Dimensions (EQ-5D) Scale. Results: The NRS score for lower back pain decreased from 7 to 3, and the ODI score decreased from 51.11 to 22.22. Range of motion (ROM) increased meaningfully in flexion(from 30 to 60), Left/Right lateral bending(from 10/30 to 30/45), Left/Right rotation (from 10/30 to 30/45), and the EQ-5D score also increased from 0.506 to 0.677. Conclusion: The results indicate that Korean medical treatment may be effective for managing patients' acute compression fractures.

A Case Report of Korean Medicine Rehabilitation Treatment after Sauve-Kapandji Procedure (Sauve-Kapandji 수술 후 한방재활치료에 대한 증례보고)

  • Cho, Eun-Byul;Geum, Ji-Hye;Baek, Dong-Gi;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.1
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    • pp.49-59
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    • 2019
  • Objectives : The purpose of this study was to report the clinical progress of a patient exposed to a Sauve-Kapandji procedure after being diagnosed with dislocation of distal radioulnar joint and was treated using Korean medicine rehabilitation treatment. Methods : During the admission period, the patient was treated with acupuncture, cupping, herbal medicine, and Chuna therapy. The clinical progress was assessed by using range of motion(ROM), manual muscle test(MMT), numeric rating scale(NRS), and pain disability index(PDI). Results : After receiving the above treatments, the active ROM and motor grade of the elbow, wrist, and finger joints were improved; the NRS and PDI were decreased. Conclusions : Although this is a single case report, Korean medicine rehabilitation treatment, including Chuna manual therapy, might be an effective intervention for a patient after being exposed to a Sauve-Kapandji procedure.

The Case Report on Twelve Patients of Lateral Epicondylitis Treated with Muscle Contraction/Relaxation Strengthen Technique, Instrument Assisted Soft Tissue Mobilization Treatment and Acupuncture (근육 수축/이완 강화 기법과 Instrument Assisted Soft Tissue Mobilization 및 침 치료를 병행하여 치료한 주관절 외상과염 환자 치험 12예)

  • Jeong, Seung-Hyun;Kim, Chang-gon;Yun, Yeong-Ung;Ryu, Won-Hyung;Jeon, Yong-hyun;Choi, Young-jun;Chung, Jae-hyun
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.2
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    • pp.195-201
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    • 2019
  • The purpose of this study is to report the treatment effects of Korean medicine for patients with lateral epicondylitis. This study was done on 12 cases of patients with lateral epicondylitis who visited in Korean Medicine Clinic of Ganghwa-gun Public Health Care Center. We used muscle contraction/relaxation strengthen technique, Instrument assisted soft tissue mobilization (IASTM), acupuncture on patients and mesured numerical rating scale (NRS), pain disability index (PDI), and grip strength test to evaluate treatment effects. Among twelve patients, eleven cases showed decreasing in NRS and all cases showed decreasing in PDI. Ten cases showed increasing in grip strength test. Korean medical treatments including muscle contraction/relaxation strengthen technique and IASTM are thought to be one of the effective treatment for patients with lateral epicondylitis.

Efficacy of a Novel Annular Closure Device after Lumbar Discectomy in Korean Patients : A 24-Month Follow-Up of a Randomized Controlled Trial

  • Cho, Pyung Goo;Shin, Dong Ah;Park, Sang Hyuk;Ji, Gyu Yeul
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.691-699
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    • 2019
  • Objective : Lumbar discectomy is an effective treatment for lumbar disc herniation (LDH); however, up to 2-18% of patients with LDH have experienced recurrent disc herniation. The purpose of this study was to evaluate the efficacy of a novel annular closure device (ACD) for preventing LDH recurrence and re-operation compared with that of conventional lumbar discectomy (CLD). Methods : In this prospective randomized controlled trial, we compared CLD with discectomy utilizing the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) ACD. Primary radiologic outcomes included disc height, percentage of preoperative disc height maintained, and re-herniation rates. Additional clinical outcomes included visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and 12-item short-form health survey (SF-12) quality of life scores. Outcomes were measured at preoperation and at 1 week, 1, 3, 6, 12, and 24 months postoperation. Results : Sixty patients (30 CLD, 30 ACD) were enrolled in this study. At 24-month follow-up, the disc height in the ACD group was significantly greater than that in the CLD group ($11.4{\pm}1.5$ vs. $10.2{\pm}1.2mm$, p=0.006). Re-herniation occurred in one patient in the ACD group versus six patients in the CLD group (${\chi}^2=4.04$, p=0.044). Back and leg VAS scores, ODI scores, and SF-12 scores improved significantly in both groups compared with preoperative scores in the first 7 days following surgery and remained at significantly improved levels at a 24-month follow-up. However, no statistical difference was found between the two groups. Conclusion : Lumbar discectomy with the $Barricaid^{(R)}$ (Intrinsic Therapeutics, Inc.) ACD is more effective at maintaining disc height and preventing re-herniation compared with conventional discectomy. Our results suggest that adoption of ACD in lumbar discectomy can help improve the treatment outcome.

Case Report on Headache (Suspected CPSP) Treated with Korean Medicine in a Hospitalized Patient with a History of Cerebral Infarction (두통(중추성뇌졸중후통증 의증)을 호소하는 뇌경색 과거력이 있는 한방병원 입원 환자에 대한 한방 치료 1례)

  • Park, Jin-hun;Kong, Geon-sik;Song, Jin-young;Kim, So-won;Wang, Yen-min;Kim, Sang-yoon;Kang, Man-ho;Park, Sung-hwan;Eom, Guk-hyeon;Lee, Hyung-chul;Lee, Jee-young
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.893-903
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    • 2021
  • Objectives: This study investigated the efficacy of Korean medical treatment for a headache (suspected CPSP) patient with a history of cerebral infarction. Methods: We treated the patient using Korean medical treatments (herbal medicines-Kamiseokyong-tang, acupuncture, pharmacopuncture, and chuna). The treatments were measured using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) for headache and post neck pain. General health status was evaluated using the European Quality of Life Five Dimensions (EQ-5d) Scale. Results: We observed improvements in the NRS, NDI, and EQ-5d scores after the treatments. Conclusions: This study suggests that Korean medicine may effectively treat headaches (suspected CPSP) with accompanying cerebral infarction.

4 Case Reports On Patients with Acute Lower Limb Muscle Weakness Treated by Spinal Mobilization With Leg Movement(SMWLM) Combined with Korean Medicine Treatment (다리움직임을 동반한 척추 가동술(SMWLM)과 통합한방치료를 활용하여 호전된 급성 하지 근력저하 4례: 증례보고)

  • Moon, Young-Joo;Shin, Won-Bin;Ryu, Gwang-Hyun;Lee, Ji-Yun;Jeon, Hyun-A;Lim, Su-Yeon;Kim, Seong-Hyun;Koo, Seng-Hyuk;Moon, Hyun-Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.2
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    • pp.63-73
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    • 2020
  • Objectives The purpose of this study was to investigate the possibility of spinal mobilization with leg movement (SMWLM) using Korean Medicine treatment on acute lower limb muscle weakness through four case studies. Methods SMWLM, with other Korean Medicine treatments, was performed on four patients who underwent treatment at OOOO Korean Medicine Hospital from August 2017 to July 2018. Additionally, results of the Numerical Rate Scale(NRS), EuroQol-FiveDimensions(EQ-5D),Oswestry lowback pain disability questionnaire(ODI), Straight Leg Raise(SLR) test, and Manual Muscle Test(MMT) were evaluated. Results There was a significant increase in NRS, ODI, and EQ-5D scales with im-rovements of SLR angle and MMT figures to a normal range. Conclusions This study suggested that Korean Medicine treatment combined with SMWLM may affect treating acute lower limb muscle weakness. Further clinical studies are needed to establish a definite conclusion.