• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.6-11
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• 2023

Spinal cord injury (SCI) has a significant negative effect on the quality of life due to permanent neurologic damage and economic burden by continuous treatment and rehabilitation. However, determining the correct approach to ensure optimal clinical outcomes can be challenging and remains highly controversial. In particular, with the introduction of the concept of early decompression in brain pathology, the discussion of the timing of decompression in SCI has emerged. In addition to that, the concept of "time is spine" has been added recently, and the mortality and complications caused by SCI have been reduced by providing timely and professional treatment to patients. However, there are many difficulties in establishing international clinical guidelines for the timing of early decompression in SCI because policies for each country and medical institution differ according to the circumstances of medical infrastructure and economic conditions in the surgical treatment of SCI. Therefore, we aim to provide a current review of timing of early decompression in patient with SCI.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.105-116
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• 1998

Purpose In this study, We observed the recovery process in the ability to move in the hind limbs of the rats whose spinal cord injuries were treated by Radix acouniti(RA). The purpose of this study is to see the effects of Radix acouniti(RA) water extract on the contraction of rat's spinal cord injury. Procedure First, the rats were subjected to hemisectional spinal cord injuries by a scalpel blade. Those rats, then, were divided into three groups: Sham operated rats group and the experimental group, which received the Radix acouniti(RA) water extract, and the control group, which had no treatment. Their recovery in the ability to walk was observed by the Open Field Test (OFT) for 14 days after the injuries. Method The OFT was applied at four points: the hip, knee, ankle joint, and the tail. Each joint was given a movement rating of from 0 to 3, depending on the amount of movement. A movement rating of 0 designates no movement, a 1 designates slight movement, a 2 designates increased movement, and a 3 designates active movement. Slight movement is defined as a joint displaying less than or equal to 30% of that joint range, increased movement is displaying less than or equal to 60% of that joint's range, and active movement is greater than or equal to 90% of that joint's range. Tail movement is also graded on a scale of 0 to 3. A rating of 0 indicates that the tail is down 100% of the time, one of 1 indicates that the tail is down more than 10%, one of 2 shows that the tail is down less than 50% but more than 10% of the time, and one of 3 shows that the tail is down less than 10% of the time. All four ratings were added together and then averaged to arrive at a single score. Results The sham group which did not go through spinal cord injuries showed near normal results on all 3 joints and tail from right after the operation, which one would expect. The RA oral application group showed more effective recovery of movememt function than the control group around 4 days after the spinal cord injuries. However, after 14 days, both groups displayed almost the same degree of movement recovery. The results of this study are summarized as follows: 1. After 14days the spinal cord injuries, movement was recovered in sham operated group, control group, and experimented group in the hip, the knee, the tail and then the ankle of rats, in that order. 2. Around 7 days after the spinal cord injuries, the experimental group proved the effectiveness of the therapy in terms of movement recovery. 3. The level of ALT, ALP, AST in RA treated group was slightly increased. 4. The level of BUN and creatinine in RA treated group was slightly increased. The above results indicate that RA therapy at an early stage can bring about better movement recovery in patients with spinal cord injuries from traffic accidents or industrial disasters. But there is apparent side effect of RA on clinical, therefore the study on this should be continued.

• Clinical and Experimental Reproductive Medicine
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• 제19권1호
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• pp.87-94
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• 1992

From December 1991 to March 1992, 34 anejacuratory patients with spinal cord injury underwent 90 of electric stimulations with Seager NRH model 12. The average patient age was 43.5 years with a range of 23 to 48 years. The level of cord injury was cervical in 7, thoracic in 6, lumbar in 11, lumbosacral in 7 and conus medullaris in 3. The average number of electric stimulation per a patient was 2.65 with a range of 1 to 4. The average voltage and amplitude per a stimulation were 17.72 volts and 309. 89 mAmp with ranges of 5 to 25 volts and 50 to 500 mAmp. The total and motile sperm number were evaluated microscopically and analyzed statistically by paired t-test according to the frequency of electroejaculation, level of cord injury and voiding pattern. The results were obtained as follows. 1. An overall success rate of electroejaculation was 85.3% among 34 patients and 82.2% among 90 electric stimulations. 2. The total and motile sperm number per a stimulation were not correlated the frequency of electric stimulation, level of cord injury and voiding pattern. 3. Complications occured in 10 cases; severe low abdominal pain in 5, hypertension in 2, sweating in 1, headache in 1 and neck stiffness in 1. All the copmlications subsided spontaneously within 5 to 10 minutes after transient interruption of the electric stimulation. In summary, rectal probe electroejaculation is an accepted safe means of procuring sperm from spinal cord injury patients with ejaculatory incompetence. However very poor sperm motility was found and it was not related with the frequency of electroejaculation, level of cord injury and voiding pattern. Further investigation would be needed to conclude and to identify the reasons for impaired sperm motility.

• 재활치료과학
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• 제9권4호
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• pp.107-120
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• 2020

목적 : 척수손상환자를 대상으로 한 무작위 대조군 연구의 체계적 고찰과 메타분석을 통해 척수손상환자의 재활 중재의 효과성과 근거를 알아보고자 한다. 연구방법 : 국외 논문데이터베이스에서 검색어를 사용하여 학술지에 게재된 연구를 2명의 연구자가 독립적으로 검색하여 선정하였다. 선정기준에 부합한 연구는 총 21편이었고, PEDro Scale을 사용하여 연구의 질적 평가를 실시하였다. 메타분석은 Comprehensive Meta-Analysis 3.0 프로그램을 사용하였다. 결과 : 분석된 연구에 참여한 연구대상자는 총 713명이었고, 메타분석을 실시한 결과 신체활동을 이용한 중재는 0.406(95.0% 신뢰구간: 0.221~0.591), 전기 자극 치료중재는 0.505(95.0% 신뢰구간: 0.449~1.528)로 중간크기(Medium)의 효과를 보이는 것으로 나타났고 교육적 방법 중재는 0.248(95.0% 신뢰구간: 0.033~0.464), 복합 중재는 0.280(95.0% 신뢰구간: 0.122~0.438)로 작은 크기(Small)의 효과를 보이는 것으로 나타났다. 통계적 이질성 검정에서 유의미한 이질성이 있어 연구결과 통합 시 랜덤효과 모형을 선택하여 분석하였고, 출판편견은 유의미하지 않아 신뢰할만한 연구결과였다. 결론 : 분석된 결과 척수손상환자를 대상으로한 재활 중재는 효과적임을 알 수 있었다. 척수손상환자를 대상으로한 재활분야에서 임상가들이 대상자의 라이프 스타일을 개선하기 위한 프로그램을 구성할 때 기여할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.153-162
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• 2020

Spinal cord injury (SCI) is one of the most devastating conditions and many SCI patients suffer neurological sequelae. Stem cell therapies are expected to be beneficial for many patients with central nervous system injuries, including SCI. Adult stem cells (ASCs) are not associated with the risks which embryonic stem cells have such as malignant transformation, or ethical problems, and can be obtained relatively easily. Consequently, many researchers are currently studying the effects of ASCs in clinical trials. The environment of transplanted cells applied in the injured spinal cord differs between the phases of SCI; therefore, many researchers have investigated these phases to determine the optimal time window for stem cell therapy in animals. In addition, the results of clinical trials should be evaluated according to the phase in which stem cells are transplanted. In general, the subacute phase is considered to be optimal for stem cell transplantation. Among various candidates of transplantable ASCs, mesenchymal stem cells (MSCs) are most widely studied due to their clinical safety. MSCs are also less immunogenic than neural stem/progenitor cells and consequently immunosuppressants are rarely required. Attempts have been made to enhance the effects of stem cells using scaffolds, trophic factors, cytokines, and other drugs in animal and/or human clinical studies. Over the past decade, several clinical trials have suggested that transplantation of MSCs into the injured spinal cord elicits therapeutic effects on SCI and is safe; however, the clinical effects are limited at present. Therefore, new therapeutic agents, such as genetically enhanced stem cells which effectively secrete neurotrophic factors or cytokines, must be developed based on the safety of pure MSCs.

• 한방재활의학과학회지
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• 제32권2호
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• pp.37-54
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• 2022

Objectives This review investigates the effectiveness of electroacupuncture for impairment of motor and sensory functions after spinal cord injury. Methods The databases used for the search were PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), KMBASE, and Oriental Medicine Advanced Searching Integrated System (OASIS). The literature were searched using a total of 9 domestic and foreign databases. Randomized controlled trials (RCTs) using electroacupuncture as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk-of-bias tool, and meta-analysis was perfomed using RevMan version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results A total of 14 RCT studies were selected through 9 domestic and foreign databases, and analyzed. As a result of meta-analysis, when electroacupuncture was performed together with rehabilitation treatment or western drug treatment, it was effective in the recovery of motor and sensory functions of spinal cord injury patients. Conclusions This review suggests that electroacupuncture can be applied as an effective treatment for the recovery of motor and sensory functions of spinal cord injuries. However, there are several limitations, including the small number and heterogeneity of the included studies, as well as their poor methodological quality. Therefore, further, higher-quality studies should be required.

• Journal of Korean Biological Nursing Science
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• 제15권2호
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• pp.65-73
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• 2013

Purpose: The purpose of this study was to review the literature on music intervention for neurological patients in Korea and to explore the effect of music intervention on functional rehabilitation of neurological patients. Methods: This systematic review examined literature from 2005 to 2010. The existing literature was searched in the electronic databases of RISS and KISS using the following keywords: music, rhythmic movement, stroke, brain injury, dementia, Parkinson, spinal cord injury. Seventy-seven studies were founded through the database. After The exclusion of duplicates, case studies, literature review, and irrelevant studies, nine studies were included for analysis. Results: They included nine quasi-experimental studies. The medical diagnoses of the study participants were stroke, dementia, brain injury, and spinal cord injury. Among nine studies, only two studies were conducted in the nursing area. Eight studies used comprehensive music programs composed of health education, gait training, vocal training, or relaxation therapy, and these comprehensive programs were effective in the areas of physical and psychosocial treatment. Seventeen sessions were provided on average throughout intervention, and the average duration of each session was 49.4 minutes. Conclusion: Comprehensive music intervention can be implemented in nursing care for patients with neurological problem.

• The Journal of Korean Physical Therapy
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• 제14권4호
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• pp.131-146
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• 2002

In the last years, it has become possible to regain some locomotor activity in patients with incomplete spinal cord injury (SCI) through intense training on a treadmill. The ideas behind this approach owe much to insights derived from animal studies. Many studies showed that cats with complete spinal cord transection(spinalized animals) can recover locomotor function. These observations were at the basis of the concept of the central pattern generator located at spinal level. The neural system responsible for the locomotor restoration in both cats and humans is thought to be located at spinal level and is referred to as the central pattern generator(CPG). The evidence for such a spinal CPG in human is emphasis on some recent developments which support the view that there is a human spinal CPG for locomotion. An important element in afferent inputs for both spinal injured cats and humans is the provision of adequate sensory input related locomotor, which can possibly activate and/or regulate the spinal locomotor circuitry This review article deals with the afferent control of the central pattern generator. Furthermore, the application of adequate afferent inputs related locomotor for stroke patients will be able to facilitate locomotion ability, which is automatic, cyclic, rhythmic. These insights can possibly contribute to a better therapeutic approach for the rehabilitation of gait in patients with stroke.

• 대한간호학회지
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• 제31권1호
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• pp.126-138
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• 2001

The purpose of this study is to act nursing intervention strategies to promote quality of life (QOL) in Spinal Cord Injury patients. Therefore, the study is designed to evaluate religion, marital status, educational background economic status, level of injury, voiding pattern, transportation by driving, rehabilitation education, self-concept, sexual status, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL, perceived hopelessness, personality and pain for QOL at the same time. It was gathered empirical data was collected using a self report questionnaire from 61 patients during a six month period after SCI at 5 general hospitals, at 2 rehabilitation centers and at 2 rehabilitation schools province from Jun. 18, 1999 through Sep. 28, 1999. The reliability of the 19 instruments was tested with Cronbach's alpha which ranged from .6319 to .9769. For the data analysis a SAS program was used for Pearson correlation coefficients, and stepwise multiple regression. The results were as follows; 1. The mean of total item score in the QOL scale was 2.814, which showed a much lower score than the cancer points. 2. There was a significant correlation between self concept, transportation by driving, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL and QOL.(${\gamma}$= .27~-.79, p< .05) 3. Stepwise multiple regression analysis showed that; a) Depression was the main predictor of QOL and account for 53.7% of the variance in QOL. b) Hope, ecomic status and body satisfaction accounted for 8%, 4%, 3.4% respectively and these variables combined accounted for 69.2% of the variance in QOL. In conclusion, to begin with, it is important to reduce depression and to help for SCI points to inspire hope, economic status and body satisfaction. That will be short cut for nursing strategies to enhance QOL.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.152-160
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• 2004

The purpose of this study was to investigate the effect of elastic band based of PNF pattern on the U/E function in the spinal cord injury patient. 11 subjects with spinal cord injury participated in this study. They took elastic band excercise 5 times per week for 8 weeks. One time excercise spent 35minutes. The therapeutic effect was evaluated by Cybex 6000, BTE Work Simulator, how many seconds they needed to walk 100 meters. 11 cases were examined before, after 8 week, elastic band excercise. The results of this study are as follows; 1. Isokinetic power by Cybex 6000 : The elbow flexion, shoulder flexion and extension were significant difference between test-retest(p<.05). but elbow extension were not significant difference between test-retest. 2. BTE Work Simulator : Wheelchair Propulsion and Steering Torque were significant difference between test-retest(p<.05). 3. Wheelchair Propulsion velocity : There were significant difference between test-retest(p<.05). The findings suggest that SCI patients can improve their Isokinetic power on shoulder and elbow joint, wheelchair propulsion and Steering Torque by BTE Work Simulator, Wheelchair Propulsion velocity through elastic band based of PNF pattern.