• 제목/요약/키워드: Paraplegic patient

검색결과 20건 처리시간 0.031초

척수손상으로 인한 하지마비 환자 1례에 대한 임상증례 (Clinical Study on the Case of Paraplegic Patient Caused by Spinal Cord Injury)

  • 이지은;천혜선;조명래;류충열
    • 동의생리병리학회지
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    • 제23권4호
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    • pp.898-902
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    • 2009
  • The aim of this study is to report the improvement after the Oriental medical treatment about a paraplegic patient caused by spinal cord injury. The paraplegia caused by spinal cord injury was the result of falling down. So we diagnosed it as Eohyeol(瘀血), Wei symptom(痿證), Urinary retention(癃閉) in Oriental medical system and applied herbal medicine, acupuncture, moxibustion, physical exercise to the patient for 42days. We evaluate the clinical effect of the treatment with VAS and motor/sensory function score of the body and lower extremities. After the Oriental medical treatment, we achieved the effective result on impairment in motor and sensory function of the paraplegic patient. And also we got the improvement of urinary disorder and pain. The more clinical study about paraplegic patient caused by spinal cord injury may be needed.

척수손상환자의 배설장애에 대한 학습요구 : 환자 대 간호사 지각 비교 (A study on learning needs about altered elimination of spinal cord injury patients : A comparison patients에 and nurses에 perceptions)

  • 김인자
    • 대한간호학회지
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    • 제24권1호
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    • pp.129-142
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    • 1994
  • The purpose of this study determine and compare spinal cord injured(SCI) patients’ and nurses’ perceptions of SCI patients’ learning needs about altered elimination and then provide nursing data for more effective SCI patients’ learning process. Data collection was done from September 3 to October 2, 1993. For this study, 36 SCI Patients(12 paraplegia, 24 quadriplegia) and 20 nurses who were working neurosurgery or rehabilitation unit in 3 general hospitals in C and I city were selected. Data collection was accomplished by Questionnaire method and the instrument developed by the investigator, elicited information about learning needs about altered elimination of SCI patients from SCI patient, nurse, rehabilitation doctor, nursing professor, nursing graduate students. The questionnaire composed altered urinary elimination part with 10 categories and altered bowel elimination part with 10 categories. The results of this study were as follows : 1. There was no significant difference in learning needs about altered urinary elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered urinary elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=2.48, p=.017). 2. There was no significant difference in learning needs about altered bowel elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered bowel elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=-3.00. p=.005). 3. Degree of paraplegic SCI patients’ perceived learning needs about altered urinary elimination was 2.4083 and quadriplegic SCI patients’ perceptions were 2.0750. Degree of paraplegic SCI patients’ perceived learning needs about altered bowel elimination was 2.3972 and quadriplegic SCI patients' perceptions were 2.181.

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하지 부분마비 장애인을 위한 착용형 로봇의 보행 보조 방법 (Gait Assist Method by Wearable Robot for Incomplete Paraplegic Patients)

  • 우한승;이장목;공경철
    • 로봇학회논문지
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    • 제12권2호
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    • pp.144-151
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    • 2017
  • An important characteristic of people with partially impaired walking ability, such as incomplete paraplegics, is that they are able to generate voluntary motion of lower-limbs. Therefore, wearable robots for the incomplete paraplegic patients require a different assistance method compared to those of complete paraplegics. First, the wearable robot should be controlled to not resist wearer's motion. Second, it should be able to generate assistive torque accurately when needed. In this paper, a wearable robot, called EROWA, for the incomplete paraplegic patients is introduced. EROWA utilizes compact rotary series elastic actuators (cRSEAs) and a control method called the zero impedance control to reduce the mechanical resistance. An assistive torque trajectory is proposed to assist gait in this paper. The proposed method is verified by simulation and experimental studies.

척수신경 장애자의 성적기능 조사 및 성 재활

  • 박지환
    • 대한물리치료사협회지
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    • 통권3호
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    • pp.27-37
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    • 1981
  • The Sexual Function Study and Its Rehabilitation Of the Patients With Spinal Cord Injuries Park Ji Whan, R.P.T. Dept. of Rehabilitation Medicine, nanyang University Hospital The patient with complete spinal cord injuries cannot expect normal intercourse. In spite of these ultimate limitations. coitus is practied with gratification by about a third of paraplegic men. and probably a higher percentage of paraplegic women. Th-is is possible since a significant percentage of paraplegic men can have erections .In patients with upper motor neurone lesions at any spinal level, reflex erections can be produced by local stimulation , in. patients with lesions at higher levels, the probability of success is greater. The ability to have erections, psychic or reflex or both, usually appears within six months after injury .

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표면 전극용 기능적 전기자극 시스템의 개발 및 하반신 마비환자의 보행 (Development of a Transcutaneous FES System and Its Application to Paraplegic Walking)

  • 송동진;이정한;강곤
    • 대한의용생체공학회:의공학회지
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    • 제24권6호
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    • pp.523-531
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    • 2003
  • 본 연구에서는 표면 전극을 사용하는 8채널 전기자극 시스템을 개발하였고. 이 시스템을 이용하여 하반신 마비한자의 근력강화를 위한 전기자극 엑서사이즈와 FES 보행을 하였다. 본 연구에서 개발한 전기자극 시스템은 컴퓨터 프로그램, 전기자극기, 그리고 컴퓨터 프로그램과 전기자극기를 연결하는 통신부분으로 구성되어 있다. 컴퓨터 프로그램에서는 마우스를 이용하여 임의의 자극 패턴을 손쉽게 구성하고 편집학 수 있으며 이렇게 구성/편집된 자극 패턴은 동원곡선(recruitment curve)을 통하여 자극 파라미터로 변환된다. 자극 파라미터는 직렬통신을 이용하여 전기자극기에 전달된다. 전기자극기는 주제어부에 1개, 각 채널에 1개씩 총 9개의 마이크로프로세서로 구성되어 있다. 주제어부의 마이크로프로세서가 컴퓨터 프로그램과 통신을 하고 각 채널의 마이크로프로세서를 제어한다. 본 연구에서 개발한 기능적 전기자극 시스템으로 하반신 마비환자에게 100주 동안 전기자극 엑서사이즈를 실시한 결과 근력, 다리둘레, 그리고 피로저항성의 증가를 볼 수 있었다. 전기자극 엑서사이즈로 무릎신근(knee extensor muscle)이 체중을 지지한 수 있을 정도로 증가한 후에 FES 보행을 시작하였고, 현재 2분 동안 50m 이상 보행할 수 있다.

말기 압박궤양에 있어서 일측성 골반제거술의 임상례 (Clinical experience of a Hemipelvectomy in the End-Stage of the Pressure Sore)

  • 이성수;홍종원;정윤규;오진록;홍준표
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.47-52
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    • 2002
  • One of the most common problems in cord injury is pressure sores. In the early stage of pressure sores, the wound can be covered by advancing or transpositioning a local myocutaneous flap. However, it can be a great challenge to treat end-stage paraplegic patient who underwent multiple prior flaps, where continuous treatment is needed to prevent recurrent pressure sore due to infection and metabolic drain. In these patients, a local myocutaneous flap may be very difficult for coverage of the wounds. Therefore, hemipelvectomy may be considered. The authors performed a hemipelvectomy on a 33 year-old male paraplegic patient who presented with multiple, large wounds seen in end-stage pressure sores. He had a compression fracture of the lumber spine 9 years ago during a motor vehicle accident. After a wide exicision of the wound, the anterior flap was used as a fillet-flap for reconstruction. On the sixth day postoperatively, secondary repair was done due to wound dehiscence and the postoperative results have been satisfactory thus far.

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하반신 마비환자의 FES 독립보행을 위한 근육 강화 프로그램 (FES Exercise Program for Independent Paraplegic Walking)

  • 강선화;강곤;최현주;김종문;정순열;정진상
    • 대한의용생체공학회:의공학회지
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    • 제19권1호
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    • pp.69-80
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    • 1998
  • 본 연구에서는 엑서사이즈 프로그램이 FES를 이용한 하반신 마비환자의 일어서기 및 보행에 미치는 영향을 고찰하였으며, 또한 주요 다리근육들의 전기자극에 대한 수축특성과 피로특성에 주안점을 두었다. 정상인 10명과 완전 하반신 마비환자 4명의 대퇴사두근에 연속적 혹은 간헐적으로 전기자극을 가하였고, 자극주파수는 20Hz와 80Hz로 하였다. 또 근육의 길이에 따른 피로현상을 살펴보기 위하여 무릎의 각도를 90$^{\circ}$와 150$^{\circ}$로 각각 고정한 뒤 무릎신근 토크를 측정하였다. 그 결과를 바탕으로 남자 하반신 마비환자의 대퇴사두근과 장딴지근에 지난 2년간 FES엑서사이즈를 시행하였다. 무릎신근의 근력이 체중을 지지하기에 충분하다고 판단되었을 때 FES 일어서기를 시작하였으며, 자세교환 연습을 거친 뒤 평행봉 혹은 워커를 잡고 정전압 자극기와 표면전극을 사용한 4 또는 6채널 자극으로 보행하도록 하였다. 마비된 근육은 정상인과는 반대로 최적길이 부근에서 상대적으로 급격한 피로를 나타내었고, 저주와 자극과 간헐 자극이 피로를 지연시키는 것을 확인할 수 있었다. 본 실험에 참가한 환자는 FES 엑서사이즈 프로그램을 실시한 결과, 근력이 초기의 10배 정도로 증가하였고, 피로지수는 초기의 절반 정도로 감소하였으며, 엑서사이즈 횟수를 매주 6일에서 7일로 바꾼 후 근력이 눈에 띄게 향상되었다. 환자 자신의 잔존능력도 향상되어 양쪽 무릎을 10cm정도 들어올릴 수 있게 됨으로써 보행시 스윙 단계에서 이 능력을 최대한 활용할 수 있었다. 현재 환자는 워커를 잡고 스스로 자극기의 스위치를 조작하면서 4채널 자극에 의하여 10m/min의 속도로 최대 약 2분 40초의 보행이 가능하다.

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척수손상인의 기능적 전기자극을 이용한 보행 (A Case Study of Functional Electrical Stimulation(FES) for Paraplegic Patients)

  • 이재호;김택훈
    • 한국전문물리치료학회지
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    • 제3권3호
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    • pp.32-43
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    • 1996
  • The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

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전기자극에 의한 마비 근육의 훈련 프로그램 (An Exercise Program for Paralyzed Muscles Employing Electrical Stimulation)

  • 강선화;강곤
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 춘계학술대회
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    • pp.179-183
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    • 1997
  • The objective of this study was to develop an FES exercise protocol that can enhance muscle force and fatigue resistance and to evaluate the resulting effects. We investigated contraction and fatigue properties of vasti of 10 normal subjects and 4 paraplegics by applying different types of electrical stimulation. Based on the results, we have been training quadriceps of a male paraplegic patient. The results suggested that the exercise be applied 7 days a week, and confirmed that low frequency and intermittent stimulation delays fatigue. After the two-year FES exercise, the patient's knee extensor torque increased by about ten folds and the fatigue index decreased to half of the preFES value.

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