• The Korean Journal of Pain
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• v.32 no.2
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• The Journal of the Korea Contents Association
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• v.11 no.6
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• pp.270-278
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• 2011

The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.394-404
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• 2021

Background: We aimed to investigate the effect of epidural polydeoxyribonucleotide (PDRN) on mechanical allodynia and motor dysfunction in a rat model of lumbar foraminal stenosis (LFS). Methods: This study was conducted in two stages, using male Sprague-Dawley rats. The rats were randomly divided into eight groups. In the first stage, the groups were as follows: vehicle (V), sham (S), and epidural PDRN at 5 (P5), 8 (P8), and 10 (P10) mg/kg; and in the second stage, they were as follows: intraperitoneal PDRN 8 mg/kg, epidural 3,7-dimethyl-1-propargilxanthine (DMPX) (0.1 mg/kg), and DMPX (0.1 mg/kg). The LFS model was established, except for the S group. After an epidural injection of the test solutions, von Frey and treadmill tests were conducted for 3 weeks. Subsequently, histopathologic examinations were conducted in the V, S, P5, and P10 groups. Results: A total of 65 rats were included. The P8 and P10 groups showed significant recovery from mechanical allodynia and motor dysfunction at all time points after drug administration compared to the V group. These effects were abolished by concomitant administration of DMPX. On histopathological examination, no epineurial inflammation or fibrosis was observed in the epidural PDRN groups. Conclusions: Epidural injection of PDRN significantly improves mechanical allodynia and motor dysfunction in a rat model of LFS, which is mediated by the spinal adenosine A_2A receptor. The present data support the need for further research to determine the role of epidural PDRN in spinal stenosis treatment.

• Physical Therapy Korea
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• v.11 no.3
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• pp.19-24
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• 2004

The purposes of this study were to analyze gait patterns of patients with chronic lumboscaral radiculopathy and to investigate gait parameters which can reflect a functional deficit in relation to the level of lumbosacral radiculopathy. The study population consisted of 25 patients of chronic lumbosacral radiculopathy and 25 healthy control subjects. Conventional physical examinations and three-dimensional gait analyses were performed on all participants. The data were analyzed using an independent sample t-test. The results were as follows: (1) In the patients' group, cadence, walking velocity, stride length and double support time were less than in the control group (p<.05). (2) In the patients' group, maximum flexion of hip, maximum flexion of loading response, maximum flexion of swing phase on the knee and maximum plantar flexion of pre-swing were less than the control group (p<.05). Using three-dimensional gait analysis, we could identify specific gait parameters to reflect a functional deficit related to the level of lumbosacral radiculopathy.

• Journal of Korean Academy of Nursing
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• v.31 no.5
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• pp.749-758
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• 2001

The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease. Method: Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn. Results: 9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia. Conclusion: The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.174-202
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• 2002

Twenty five patients, 14 males and 11 females with an average age of 75years with chronic Low Back Pain were tested before, during, and after 10minutes transcutaneous electrical nerve stimulation. It is important to consider the effect of TENS on the autonomic function because the pain pathway and the ANS pathway are somehow correlated to each other. There is still controversy among researchers who have reported the effect of TENS on autonomic function. So the purpose of this study is to measure the effect of TENS on the ANS and to see the relation of the pain control mechanism and the change in the ANS. The results were as follows : 1) Systolic blood pressure between before and during the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 2) Systolic blood pressure between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 3) Systolic blood pressure between before and after 10 minutes experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 4) Diastolic blood pressure between before and during experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 5) Diastolic blood pressure between during and after 10 minutes experiment was significantly decreased(P<.05). 6) Diastolic blood pressure between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 7) Heart rate between before and during the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 8) Heart rate between during and after 10 minutes the experiment was significantly decreased(P<.05). 9) Heart rate between before and after 10 minutes the experiment was significantly decreased(P<.05). 10) Skin temperature between before and during the experiment was significantly increased(P<.05). 11) Skin temperature between during and after 10 minutes the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 12) Skin temperature between before and after 10 minutes the experiment was significantly increased(P>.05). 13) Respiratory rate between before and during the experiment was apt to be a little increased, but statistically there was no significant change(Pgt;.05). 14) Respiratory rate between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(Pgt;.05). 15) Respiratory rate between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05).

• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.583-593
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• 2019

The purpose of this study was to investigate the relation between and subjective instability pain behavior (SIPB) and physical instability test(PIT) according to the presence of characteristic past histories(CPH) in people with chronic low back pain(CLBP). Forty CLBP subjects participated in this study. The presence of four characteristics past histories(long term history, traumatic experience, sports activities, neurologic sign) were examined. According to presence number(PN) of CPH, subjects were divided into 5 groups[group 1(PN:0): n=8, group 2(PN:1): n=8, group 3(PN:2): n=8, group 4(PN:3): n=8, group 5(PN:4): n=8]. After 16 items were examined for the SIPBs, then Seven PITs were conducted, and the results were scored. The SIPBs and PITs were compared according to the presence numbers of CPH, and the relation between them was analyzed. There was a significant difference(p<.05) in both SIPB scores and PIT scores in the comparison of groups according to the presence number of CPH. There was high positive correlation between the presence numbers of CPH and SIPB score(r=.819, p=.000) and PIT score(r=.606, p=.000). Also, there was a correlation between SIPB score and PIT score(r=.571, p=.000). Based on the findings in the present study, the presence of three or more CPH in people with CLBP may be a useful variable in the diagnosis of lumbar instability. The combined findings of the three variables such as CPH, SIPB, and PIT can improve the accuracy of lumbar instability diagnosis.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.370-374
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• 2014

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.218-222
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• 2003

Purpose: The objective of this study was to define the Os submalleolare as an any ossicles below medial malleolus of tibia and to determine the characteristics of clinical and radiological characteristics and to evaluate results of surgical treatment of Os submalleolare in sports player group. Materials and Methods: Twenty-two patients with Os submalleolare were identified between November, 1, 1998 and June, 30, 2002. Results: The mean age was 18.3 years. All patient were male and soccer players comprised 71%(20 cases). Associated disease were 8 cases(29%) of chronic ankle instabilities, one case(4%) of anterior impingement syndrome and one (4%) of plantar fascitis. The most common clinical symptom was pain during walking and sports activity and sign was tenderness around medial malleolus. Only simple radiograph could reveal presence of ossicle and differentiate with acute fracture. If symptom and sign obscured, Bone scan(7 cases) and MRI(3 cases) identify causes of pain and tenderness. As a surgical treatment, all bony fragment caused symptom and sign were eliminated and medial collateral ligament was reattached meticulously. Associated chronic ankle instability were present, modified Brostrom procedure was done simultaneously. On follow-up, The symptomatic pain were wholly disappeared at average 2.2 months (1-6months) after operation. On one year follow-up, all patients have been daily life without any complaints and have gone back to the game within three months. Conclusion: as submalleolare have relatively rare incidence in sports players and most common clinical symptom and sign is tenderness on medial malleolar area of ankle, can be diagnosed both physical examination and plain X-ray film. As a treatment, Removal of ossicle and reattachment of MCL could obtain excellent or good results.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.13 no.2
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• pp.129-139
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• 2009

Sagittal spinal balance means standing postural balance at sagittal plane. Postural imbalance with displacement of the patient's center of gravity can cause chronic back pain and ambulatory difficulty. The sagittal spinal balance is determined based on the deviation of the C7 plumb line, originating at the middle of the C7 vertebral body, from the posterior superior endplate of S1. The line is called as sagittal vertical axis (SVA). In the traditional Korean medicine, the meridian sinews, which are the most superficial pathways of the meridian system, associated with movement, muscle balance and defense. They too are separate from the main meridians, though they intersect the main meridians. Some creative and pioneer researchers in Korea thought that the anatomy trains, which suggested by Myers is a concept familiar to the meridian sinews. A reciprocal relationship between the superficial back line and the superficial front line used to be compared to the rigging of a sailboat. Therefore, We suggest that spine may be compared to a mast of the sailboat and that the sagittal spinal balance can be maintained with systemic reciprocal interacts between the front line muscles and the back.