The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.20
no.1
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pp.47-52
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2014
Background: This case study is to describe the manual therapy for the patient with posttraumatic stress (PTSD), sleep disturbance, and pain such as chronic low back pain (CLBP). Methods: The patient who participated in this study was a 60 year-old male PTSD patient with CLBP. His CLBP is not from any genetic or family history but a sequelae of torture that he had gone through about 30 years ago. Prior to the intervention, it was assessed that the PDS-K score was 16, PQSI-K was 12, SLR-90-R was low, VAS score was 10, and KODI socre was 25. The intervention was conducted through manual therapy (myofascial release, muscle energy technique, lumbar stabilization) twice a week for eight weeks in total. Results: After eight week-intervention, the PDS-K, SLR-90-R, VAS, and KODI score were improved whereas PQSI-K was not sufficiently fast improved. Conclusions: The manual therapy is substantially effective in dealing with PTSD and CLBP.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.23
no.2
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pp.75-81
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2017
Background: The purpose of this study is to examine the effects of myofascial release technique (MFR) on psychological and physical symptom in somatization with post traumatic stress disorder (PTSD). Based on this, proceed to present an effective physical treatments. Methods: In this study, three subjects were applied ABA design for a total of 12 weeks. Intervention was performed three times per week, and only MFR for 6 weeks was applied to the patient for 60 minutes. General physical therapy consisted of a total of 60 minutes including hot pack, electric therapy, and ultrasound. In this study, we measured three times in the second baseline stage at the initial evaluation before the commencement of intervention, somatization, depression, anxiety, sleep disorder, and pain after 6 weeks and 12 weeks. Results: In this study, the application of MFR showed significant differences in somatization symptoms, sleep disturbance, and headache. There was no significant difference in depression and anxiety. Conclusions: As a result, the application of MFR in PTSD patients with somatization can be suggested as a useful intervention to resolve the psychosomatic problem.
The Journal of Korean Academy of Sensory Integration
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v.15
no.1
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pp.33-45
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2017
Objective : This study was to investigate the relationship between sensory processing patterns and sleep quality for poor sleepers enrolled in universities. Methods : The participants are 191 students, aged 18 to 25, at the 6 universities located in Busan, Daegu, and other Gyeongsang Provinces. These participants completed the Korean version of Adolescent/Adults Sensory Profile (AASP) and the Pittsburgh Sleep Quality Index (PSQI). Results : The group with lower sleep quality of this study participants suggested low but positive correlation with sleep disturbance which is one of sleep quality components of the PSQI. Low sensory registration suggested high positive correlation and Sensory sensitivity suggested low positive correlation with daytime dysfunction. Conclusion : We identified that sensory processing patterns and sleep quality may influence each other and sleep quality can be more significantly influenced by specific sensory processing pattern. More studies requires on sleep quality and sensory processing patterns in children, adults, and elders.
Background: No studies have reported on the effects of loess beddings on insomnia patients. Purpose: It studied the change in quality of life and quality of sleep after having 15 insomnia subjects use the bedding that emits far-infrared rays. Methods: After using loess bedding for the test group and general yellow bedding for the control group, the study was conducted in the form of a questionnaire on the WHO quality of life of the subjects. Results: In the overall quality of life evaluation, the pre-and post-changes significantly improved in the test group. Using loess bedding was greatly enhanced the physical change, the actual sleep time, and the quality of sleep of the test group. The period of sleep was significantly longer post-treating, and the habitual sleep efficiency was considerably higher, and sleep disturbance was significantly lower than before in the test group. Sleep drug use and daytime dysfunction after treating in the test group significantly improved the sleep effect. Changes in the Sociality Scale, Environmental Change Scale, and Quality of Life Scale significantly improved in the test group. The quality of life for 14 items in the test group was significantly correlated. Daytime drowsiness, depression, and anxiety scale changes were significantly improved in the test group. According to the predictive survey, the subjects felt warmth in their body and comfort in mind during and after using loess bedding and evaluated that sleep quality was good. Conclusions: The overall quality of life in the test group increased using loess bedding.
This case report describes a patient with olivopontocerebellar atrophy accompanied by sleep disorder and gait disturbance whose condition was improved by treatment with Korean medicine. The 61-year-old woman, who was diagnosed with olivopontocerebellar atrophy (Multiple Systemic Atrophy-Cerebellum), was admitted to hospital twice and treated with Korean medicine (acupuncture and herbal medicine) and rehabilitation. The Korean medicine was Gwibiondam-tang-gami and Jaeumgeonbi-tang-gami. Clinical symptoms were assessed by the Modified Bathel index, functional independent measurement, Berg balance scale, and Unified Multiple System Atrophy rating scale. A brain MRI at the one-year follow up after onset showed similar progress but clinical symptoms were improved after treatment, and the evaluation index score increased. Multiple system atrophy, a type of degenerative neurological disease, has no targeted treatment. In this situation, although this report describes a single case, Korean medicine treatment could provide a meaningful improvement in the sleep disturbance and gait disorder symptoms of patients with olivopontocerebellar atrophy.
Objectives: A number of studies have shown that sleep deprivation results in reduced vigilance and increased negative affects such as tension, depression and anger. However there are few studies about effects of sleep deprivation on anxiety. The purpose of this study was to investigate the effects of 40 hour sleep deprivation on state anxiety, affects, sleepiness and fatigue. The authors also intended to study the effect of trait-anxiety on these psychological variables after sleep deprivation. Methods: Twenty nine subjects(22 men, 7 women, $24.59{\pm}1.35$ years of age) participated in this study. Subjects had no past history of psychiatric disorders and physical illnesses, and had normal sleep-waking cycle without current sleep disturbances. All of the subjects completed sleep dairy for two weeks to exclude some who suffered from chronic sleep deprivation or sleep disturbances. Subjects were instructed to get a normal sleep as usual at night before the study. After awakening, subjects remained awake for 40 hours under continuous surveillance. They completed State-Trait Anxiety Inventory, Index of General Affect, Stanford Sleepiness Scale and Fatigue Questionnaire every three hours, therefore they completed the scales 14 times totally. Subjects were dictated not to take caffeine, alcohol, or any medications on the day of the study. Heavy exercises and naps were restricted too. Results: Sleep deprivation resulted in increased state anxiety, negative general affects, and increased sleepiness and fatigue(p<.001). Dividing into high trait-anxiety group and low trait-anxiety group, there was significant sleep deprivation x traitanxiety interaction effect on general affect(p<.05). But, there was no significant sleep deprivation x trait-anxiety interaction effect on state-anxiety, sleepiness and fatigue. During sleep deprivation, the highest ratings of scales on anxiety, negative affect, sleepiness and fatigue occurred between 4 : 00AM and 7 : 00AM. Conclusions: These results show that sleep deprivation results in increased anxiety, mood state disturbance and increment of sleepiness and fatigue. These findings also suggest that trait-anxiety is a factor that influences the degree of worsening in general affect caused by sleep deprivation. During sleep deprivation, the rating curves of anxiety, affect, sleepiness and fatigue show rhythmicity that may be related to circadian rhythm.
Background: Actigraphy is a reliable and valid method for assessing sleep in normal, healthy populations, but it may be less reliable and valid for detecting disturbed sleep in patients. In this study, we attempted to assess the utility of actigraphy in the estimation of sleep quality in patients with obstructive sleep apnea syndrome (OSAS), a major sleep disorder. Method: We analyzed the data of patients who underwent polysomnography (PSG) and actigraphy simultaneously for one night at the Center for Sleep and Chronobiology, Seoul National University Hospital from November 2004 to March 2006. Eighty-nine subjects with OSAS alone and 21 subjects with OSAS and periodic limb movement disorder (PLMD) were included for final data analyses between groups. Polysomnographic and actigraphic data were also compared. Results: In subjects with mild OSAS (RDI<15), modretae ($15{\leq}RDI$<30), and OSAS with PLMD, PSG and actigraphy did not show significant difference in total sleep time and sleep efficiency. However in severe ($30{\leq}RDI$) OSAS subjects, PSG and actigraphy showed significant difference in total sleep time and sleep efficiency. In all patients, no correlations were found between sleep parameters from PSG and from those using actigraphy. Conclusions: We suggest that in severe OSAS patients, PSG is the diagnostic tool. In mild and moderate cases, actigraphy might be used as a screening tool.
Park, Kyung Won;Kim, Hyeong Wook;Choi, Mal Rye;Kim, Byung Jo;Kim, Tae Hyung;Song, Ok Sun;Eun, Hun Jeong
Sleep Medicine and Psychophysiology
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v.24
no.2
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pp.86-96
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2017
Objectives: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. Methods: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. Results: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. Conclusion: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.
Objectives : The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. Methods : Epidemiological survey was performed at home by means of semi structured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. Results : (1) The mean retiring time was 10.28 h (SD 1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h). The mean sleep onset time was 44.51 min. The mean frequency of daytime napping was 2.49 (SD 3.23). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. Conclusions : The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.
Lee, Mi Hyun;Choi, Jae-Won;Oh, Seong Min;Lee, Yu Jin
Sleep Medicine and Psychophysiology
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v.25
no.2
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pp.51-57
/
2018
Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.
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