• Title/Summary/Keyword: Pain Term

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The Effect of Lumbar Stabilization Exercise For Caregivers With Chronic Low Back Pain (요부안정화 운동프로그램이 요양보호사의 만성요통에 미치는 영향)

  • Lee, Jae-Moon;Yi, Chung-Hwi;Kwon, Oh-Yun;Jeon, Hye-Seon
    • Physical Therapy Korea
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    • v.18 no.2
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    • pp.9-17
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    • 2011
  • The objective of this research was to examine the effects of lumber stabilization exercise and a general physiotherapy program for caregivers with chronic low back pain. Sixteen people participated in this study and were randomly assigned to two groups for either lumbar stabilization exercise or for general physiotherapy, respectively. The experiment was performed for eight weeks. To examine the general as well as the medical characteristics of the participants, the following measurements were used: Visual Analogue Scale (VAS); Oswestry Disability Index (ODI); Back Performance Scale (BPS); Roland - Morris Disability Questionnaire (RMDQ); and Beck Depression Index (BDI). To compare the general and medical characteristics of the participants in the two groups, an independent t test were used. During the experiment, a paired t test was conducted to determine whether there was a significant difference in the values of VAS, ODI, BPS, RMDQ, and BDI before and after the experiment. To examine the difference in the VAS, ODI, BPS, RMDQ, and BDI values in the two groups, ANCOVA was used with pre test values as a covariate. According to the test results, in the lumbar stabilization exercise group, the VAS, ODI, BPS, RMDQ, and BDI values showed a statistically significant difference before and after the test (p<.05). In comparison, in the general physiotherapy program group, only the ODI and BPS values showed a statistically significant level of improvement. Regarding the degree of improvement, participants in the lumbar stabilization exercise group showed statistically significant progress compared to those in the general physiotherapy group. In summary, lumbar stabilization exercise is regarded as more effective than general physiotherapy for treating caregivers with chronic low back pain. In future studies, it will be useful to expand the research and to examine the long term effects of lumbar stabilization exercise on workers.

Traumatic Disc Injuries and the Iatrogenic Spinal Disability (외상성 추간판 손상과 의원성 척추장애인 만들기)

  • Lee, Kyeong-Seok;Doh, Jae-Won;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.935-939
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    • 2000
  • Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

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A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage($Tyche^{(R)}$ Cage) for Degenerative Lumbar Spinal Disorders

  • Kim, Jin-Wook;Park, Hyung-Chun;Yoon, Seung-Hwan;Oh, Seong-Hoon;Roh, Sung-Woo;Rim, Dae-Cheol;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.251-257
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    • 2007
  • Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

Study of General Public's Knowledge of TMD : how predominantly is TMD understood by people (일반인에 있어서 측두하악장애의 인지도 조사에 대한 연구)

  • Kim, Sun-Hee
    • Journal of Oral Medicine and Pain
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    • v.25 no.4
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    • pp.371-382
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    • 2000
  • This study was performed to research how predominantly TMD is known among people and how exactly it is understood. The data set up by this study could be used as beneficial references. Based on this data, people can be more knowledgeable of TMD so that they can recognize the signs and symptoms of TMD. Then, the patients can visit eligible clinician, TMD professionals. Nine hundred thirty six people (426 men and 510 women, ranging from 18 to 69 years old) were selected for the subjects of this study and were investigated by use of self-administered questionnaire. The obtained results were as follows : 1. 10.68% of the subjects were reported to have heard of the term, "Temporomandibular disorders". Females occupied significantly higher percentage than males and 18-29 age group occupied higher percentage than 30-49 age and 50-69 age groups. On the other hand, even more people (52.24%) were reported to have heard of the tenn, "Jaw joint disease". It also had same sex and age prevalences, too. 2. As for the route through which people have heard of TMD, more than half (58.38%) of the people mentioned mass media of communication (T.V. radio 40.36%, newspapers magazines 15.86%, internet 2.16%). Other people who had already heard of TMD (25.05%), dentist (7.75%), and other sources (8.83%) such as physicians, physicians of Chinese medicine, pharmacists were also mentioned. There were not significant differences among sex and age groups. 3. When it comes to the cause and concept of TMD, 32.59% of the subjects considered" an inappropriate overuse of the mandible" as the cause of TMD. There were not significant differences among sex and age groups. 4. The most frequently reported presumable TMD signs and symptoms were jaw pain (61.00%), jaw joint sound (57.80%), and difficulty with mouth opening (50.11%). 5. In answer to the question who is the eligible person to treat jaw joint disease, 35.26% answered the dentists are and 41.99%, orthopedicians. Of the people who chose dentist, 30-49 age group occupied the largest part. In the case of orthopedicians, 18-29 age group was the largest. 6. Of the 7.69% of subjects who had been treated of TMD, only 5.02% of them visited the dentist for the treatment of TMD. There were not significant differences among sex and age groups. 7. In answer to the question of how to prevent development of TMD, 58.87% selected "Avoid eating hard food", 58.65%, "Avoid opening the mouth wide", and 51.07%, "Avoid chewing gum frequently".

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THE EXPERIMENTAL STUDY ON THE CHANGES OF CONDYLAR HEAD FOLLOWING UNILATERAL DISCECTOMY IN RABBIT (가토 편측 악관절원판 제거 후 하악 과두 변화에 관한 실험적 연구)

  • Park, Kwang-Jin;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.758-770
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    • 1996
  • Discectomy is the oldest and most commonly performed operation for the painful temporomandibular joint with internal derangement. It is the one operation for which there are longest follow-up study, with Eriksson, Silver, and Tolvanen et al reporting good results in patients about 30 years after discectomy. About 80% to 90% of patients clinically experience relief from pain and dysfunction after discectomy, and interestingly, the results may improve with time. However such as Myrhaug found headache and Poswillo supposed pain and limitation of movement as postoperative complications, even though this operation had the longest follow-up term, several aspects of discectomy remain unclear. The controversies to discectomy for TMJ with pain and dysfunction have laid emphasis only upon clinical results, and then the histomorphological study was planned to evaluate the morphologic change of TMJ after discectomy. To clarify the nature of the change through an observation on the morphologic changes of articular cartilage and subchondral bone of the condyle resulting from experimental unilateral discectomy in rabbit, the author excised the left articular discs of 12 male rabbits(control 4 rabbits), weighing about 3kg, and at 1, 3, 6, 9 weeks following surgery, harvested both(left surgical site and right nonsurgical sits) TMJ. The specimens were examined with light microscope after H-E and MT stain and the obtained results were as follows. 1. Histopathological features showed thickening of articular zone and active proliferation of fibrocartilaginous zone associated with slight proliferative zone in surgical site than control group. Also replacement of chondrocytes in calcified cartilaginous zone into bone cells was observed. 2. There were thinning of thickness of each zone of articular cartilage except calcified cartilagnous zone was observed in nonsurgical site. 3. In MT stain of condylar trabeculae, there was increased calcification in nonsurgical site than control and surgical site and the degree of calcification was similar in surgical site and control group. 4. In both site of experimental group no features of degenerative changes were observed. From the above results, it is presumed that the morphologic changes of surgical site discectomy are compensatory remodeling process characterized by an hyperplastic reaction of the articular zone and fibrocartilaginous zone filling the void created by removing the disc, and the bone changes are secondary to changes in the cartilage. Increased degree of calcification seen in condylar trabeculae of nonsurgical site results from the excessive use of condyle of that site.

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Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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Representation of Child Sexual Abuse in TV Documentary -Focused on KBS 'Current Topics Ssam'- (TV다큐멘터리의 아동성폭력 재현 방식 -'KBS시사기획 쌈'을 중심으로-)

  • Hong, Sook-Yeong
    • The Journal of the Korea Contents Association
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    • v.11 no.1
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    • pp.102-112
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    • 2011
  • The purpose of the study was to analyze narrative structure and spoken contents of two TV documentaries televised in KBS 1TV 'Current Topics Ssam' to examine how child sexual abuse was represented on TV. As a result, the study could see that child sexual abuse attackers were stressed by a system to monitor and punish them and TV documentary took a neutral attitude between their human rights and pain of the victims. And it emphasizes 'abnormal' sides such as attackers' drinking or history of mental illness, and men's social authority individualizes a woman's damage into private pain by imposing a light punishment on child sexual abuse attackers and letting them not punished. Child sexual abuse victims treated to be a sexual object as a 'small, easy and weak' woman are represented as a lethargic human who is afraid of revenge and lives in pain. The representation of child sexual abuse through 'Current Topics Ssam' has its limit in the fact that it neglected understanding social context of child sexual abuse by forming an event-centered immediate and fragmentary narration and didn't play a right role in making an efficient and long-term plan considering actual conditions of Korean society and leading the people's participation.

A Convergence Study of Insole Inserted Indoor Sandal Effectiveness in School Aged Flexible Flat-foot Patients (학령기 유연성 편평족 환아에서 치료용 깔창이 삽입된 실내화의 효과에 관한 융합 연구)

  • Lee, Jun Young;Moon, Jeong Eun;Cho, Yong Jin
    • Journal of the Korea Convergence Society
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    • v.10 no.11
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    • pp.199-207
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    • 2019
  • This study was a convergence study of pre- and post-treatment clinical outcomes and radiologic results of school aged flexible flat foot using insole inserted indoor sandal. Thirty five subjects were asked to wear insole inserted indoor sandals at least five times a week and at least four hours a day. Before and after the $4^{th}$ and $8^{th}$ week of the treatment, foot radiography and FAOS questionnaire were performed. Statistical analysis was performed using repeated measure ANOVA. The clinical results showed statistically significant improvement in FAOS symptom and pain category. Radiological results showed a tendency of improvement in the Anterioposterior Talo-$1^{st}$ Metatarsal angle, the Lateral Talo-$1^{st}$ Metatarsal angle, and the Talo-Horizontal angle, but no statistical significance was found. In this study, the use of insole inserted indoor sandal during the majority of the indoor life in school aged flexible flat foot patients is effective in alleviating symptoms and pain relief in the short term.

Effects of Audio-visual Entertainment and Soft Tissue Mobilization on Pressure Pain Thresholds, Psychophysiological parameters, and Brain waves in University Students with Tension-type Headache (긴장성 두통이 있는 대학생들에게 시청각적 엔터테인먼트와 연부조직 가동술이 압력통각역치, 바이오피드백, 뇌파에 미치는 영향)

  • Jung, Dae-In;Lee, Eun-Sang;Kim, Hyun-Joong
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.539-548
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    • 2020
  • TTH(tension-type headache) is the most common primary headache among adults. Long-term headaches cause chronic headaches and have a better impact on daily life. The purpose of this study is to compare the contributions to TTH through AVE(audio-visual entertainment) and STM(soft tissue mobilization) suitable for management of pathogenic and psychogenic factors of TTH. The participants of this study were from 30 people who complained of intermittent or persistent headaches for more than 6 months, and 10 participants each in the AVE group, STM group, and AVE plus STM group. In the assigned group, a total of 12 sessions were performed three times a week for 4 weeks after the baseline, followed by post-test. Outcome measures measured PPTs(pressure pain thresholds), psychophysiological parameters, and EEG(electroencephalogram). The measured results were analyzed for interaction between time and group through a two way rmANOVA(repeated measurement variance analysis). As a result of the PPTs, interaction was found in the results of the right trapezius (p<.05), and the more improvement was observed in the AVE group. Therefore, through AVE based on psychological factors rather than direct access to the muscles of pathogenic factors, a positive impact on the PPTs was shown, but the average value of the psychophysiological parameters and brain waves that were not statistically significant. The amount of change was observed. Through this, it is suggested that audio-visual stimulation could be considered in the management of TTH.

TRAUMATIC TMJ INJURY (외상성 악관절 손상)

  • Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.191-199
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    • 1997
  • Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

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