Purpose: Gamma knife radiosurgery (GKR) requires frame positioning because the treatment target should be as close as possible to the center of the frame. The purpose of this study was to identify the level of pin-fixing (PFP) and removal pain (PRP), and the associated factors with the pain undergoing GKR. Methods: A total of 116 patients who underwent GKR for their brain tumor were recruited from C University hospital located in H city, J province. The level of pain was measured by the 10 cm VAS. Results: The level of PFP and PRP were 6.36 and 3.26 points, respectively. Step-wise multiple regressions found that the group who have not perceived numbness after applying 5% EMLA cream was the highest associated factor with PFP, following the time from lidocaine injection to pin-fixation, which explained 21% of total variance of the level of PFP. On the other hand, a group who did not perceive numbness after applying 10% lidocaine spray was the highest factor with PRP, among female patients, which explained 27% of total variance of the level of PRP. Conclusion: Both of PFP and PRP of the stereotactic frame were moderate so that nurses should consider diverse strategies to reduce pain among patients undergoing gamma knife radiosurgery.
The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.25
no.2
/
pp.31-38
/
2019
Background: The purpose of this study was to investigate the effects of Progressive muscle relaxation training on pain, Korean version of Oswestry disability index (ODI) and psychological level in chronic low back pain patients with somatization. Methods: A total of 30 subjects were treated with the experimental group (n=15) and conservative physical therapy (n=15). The experimental group was trained with progressive muscle relaxation (PMR), and the control group was treated with conservative physical therapy. Physical factor treatment was applied for 60 minutes by hot pack, electrotherapy and ultrasound. Both groups performed three times a week for six weeks. VAS, ODI, psychological level measurements were taken before and after intervention. Results: There was a significant difference in VAS (p<.05) and ODI (p<.01) between experimental and control group. At the psychological level, there were significant differences in somatization (p<0.01) and depression scales (p<.01), but not in anxiety. Conclusion: As a result of this study, the degree of pain was decreased, the level of back pain dysfunction was improved, and the somatization scale and depression scale were decreased by gradual muscle relaxation therapy.
The purposes of this study were; 1) to gather data relevant to demographic features. major main management practices, and the level of impairment of the activities of daily living (ADL) of patients with back pain, 2) to test the sensitivity of the Korean Pain Rating Scale and the Graphic Rating Scales, and 3) to identify indirect indicators of back pain by analysing pain related-behaviors. The level of pain was measured by Korean Pain Rating Scale(KPRS) and Graphic Rating Scales(GRS) developed by the reserchers. The GRS consists of two dimensions; the pain intensity (sensory) and unpleasantness (affective) measures. Of the 1,650 diagnosed back pain patients, from January 4 through June 30, 1987 by visiting outpatients' clinics of orthopedic and neurosurgical departments at 11 university hospitals in different districts of Korea, 330 men and women patients were self-selected by responding to the mailed questionnaires. The results were summarised as follows: Male exceeded female patients in number and onset of back pain were more prevalent in the age groups of 20s and the 30s. The average duration of suffering from the pain were 11 months, sixty three (19.1%) of the subjects retired from their jobs, one third(36.7%) have teen hospitalized for the treatment of back pain. In two thirds(64.8%) of the cases pain was characterized as lower back pain. The average sleep hour was 6.8 hours per 24 hours and the average rest hour during the day was 3.3 hours. The mean percentage of pain measured by GRS was higher than that of KPRS. The level of sensory intensity as well as the affective level of pain measured by KPRS and GRS were not highly correlated (sensory intensity r=0.4986, affective r=0.5029) which indicated low discriminative power. On the other hand, intercorrelation between sensory and affective dimension measured by KPRS and GRS showed moderate interrelation(r=0.7247; r=0.7899). One-third(32.5%) of the subjects complied with the hospital prescribed treatment while the other one-third(31.5%) depended on self-remedy and traditional practices, and the last one-third did not imply any pain management practices. The following 6 pain-related behaviors such as length of hospitalization, rest hour during day hours, varieties of pain management practice implied, number of pain sites, need for ADL and discomfort accompanied by ADL revealed to be important indicators of back pain. An investigation of sociodemographic features of patients with back pain in a larger context, i.e. with bigger number of respondents is recommended. Tests for construct validity of KPRS, i.e. factor analysis is further recommended.
The purpose of the present study was to the investigate the effect of sports massage, kaltenborn-evjenth orthopedic manipulative therapy and electrical therapy, general exercise on the limitation of range of motion(ROM) and on the pain(VAS) in patients with frozen shoulder. Fiftheen frozen shoulder patients between 50 and 60 years of age(females) were selected and were divided equally by random distribution into A group(sports massage, kaltenborn-evjenth orthopedic manipulative therapy, N=7)and B(electrical therapy, general exercise therapy, N=7) group. The results obtained were as follows : 1) The range of motion between two groups are significantly different in the treatment times, the ROM of A group increase in after-treatment(2 week 4 week) in comparison with ROM in before-treatment, it is significant increase. And it is significant difference in B group. 2) The pain level between two groups are not significantly different in the treatment times, the pain level of A group decrease in after-treatment(2 week, 4 week) in comparison with before-treatment, it is significant decrease. And it is significant difference in B group. Although the pain level of the A group decrease in after 2 week treatment in comparison with before-treatment but it is not significant decrease. Although the pain level of the B group decrease in after 4 week treatment in comparison with after 2 week treatment, but it is not significant decrease. 3) The A group is more effective in increasing the ROM and decreasing the pain level than B group during treatment times. The results showed that both A group method and B group method are effective ROM increase and pain reduce, but A group method is superior to B group method in ROM increase and pain reduce.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.29
no.3
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pp.43-53
/
2023
Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.
Journal of Korean Academic Society of Home Health Care Nursing
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v.17
no.1
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pp.55-62
/
2010
Purpose: This study investigated the sought to identify the pain management knowledge and attitude of nurses in internal medicine and surgery stream wards and intensive care units to obtain basic information needed for improved pain control. Method: Data was collected through self-reported questionnaires and analyzed by descriptive statistics, t-test and ANOVA using SPSS Win 12.0. Results: Pain management knowledge score averaged 51.1 out of 100, with significant differences evident depending on age, marital status, educational level, position, total work career, working department and cancer care-giving experience. Pain management attitude score averaged 2.9 out of 4, and significant differences were evident depending on age, marital status, educational level, position, total work career, working department, cancer care-giving experience, education experience and number of patients treated. Conclusion: Further studies are necessary to develop effective nursing knowledge and attitude education programs and evaluation such as discussion by cases, workshops, system of expert help for uncontrollable pain or a multi-disciplinary pain management task force. In addition, patient satisfaction level with pain management should be assessed and the responses reflected practically.
Objectives : The aim of the study is to offer basic data that help to reduce dental fear by measuring adult dental fear level with DFS scale. Methods : The subjects were 300 persons including college students in W University and their parents in Jeollabuk-do Province. Data were collected by convenience sampling from May 1 to May 30, 2013. Results : 1. Dental clinic visit provoked pain in 99 people(47.4%). Oral examination and preventive treatment evoked pain in 13 people(6.2%). 2. Women tended to feel much pain than men. Both women and men felt the thrilling fear when a needle pricks the flesh. 3. Respondents having dental caries, gum bleeding, halitosis, shaking tooth, and painful tooth had a higher dental fear level. 4. The direct pain experience(p<0.001) had the greatest influence. The next influencing factor was the insufficient anesthesia(p<0.05). 5. The explanatory power that the pain experience has influence upon dental fear is $R^2$=0.151. Conclusions : The direct pain experience and the insufficient anesthesia experience have the great influence upon patients' dental fear level. Anesthetics and analgesics can be considered as one of the positive methods for pain control.
Jeong, Eun Dong;Chae, Chang Woo;Yun, Hong Kyu;Woo, Kwang Seog;Kim, Dong Hyun;Kim, Seung Min
Journal of International Academy of Physical Therapy Research
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v.4
no.1
/
pp.523-531
/
2013
Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.
Cutaneous stimulation and distraction are independent nursing interventions used in various painful conditions, which is explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation, distraction and combination of cutaneous stimulation and distraction on the reduction of intravenous injection pain levels of chemotherapy patients. Repeated measurement post test research design was used for one group. Fifty-three cancer patients who received intravenous chemotherapy regulary in outpatient injection rooms of D medical center and Y medical center in Taegu were studied from June 23, 1997 to July 12, 1997. First the intravenous injection pain level of the control period was measured. Second, the intravenous injection pain level of the experimental period using cutaneous stimulation was measured. Third, the intravenous injection pain level of the experimental period using distraction was messured. Fourth, the intravenous injection pain level of the experimental period using a combination of cutaneous stimulation and distraction was measured. The instruments used for this study were a visual analogue pain scale as subjective pain measurement and an objective pain behavior checklist. Analysis of data was done by use of repeated measure ANOVA, bonferni, t-test, and F-test. The results of this study were summerized as follows : 1) The first hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was rejected. 2) The second hypothesis that the objective pain behavior score of intravenous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 3) The third hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with distraction will be lower than in the control period was rejected. 4) The fourth hypothesis that the objective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 5) The fifth hypothesis that the subjective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=3.04, p=0.031, Bonferni p<.05). 6) The sixth hypothesis that the objective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bonferni p<.05).
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