• Title/Summary/Keyword: clinical pattern

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Acupuncture: How Might the Mechanisms of Treatment Have Contributed to the Diagnosis of "Patterns" and Pattern-based Treatments - Speculations on the Evolution of Acupuncture as a Therapy. Implications for Researchers

  • Birch, Stephen
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.47-51
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    • 2018
  • Acupuncture is a complex intervention that manifests varied theories, treatment methods, diagnostic methods and diagnostic patterns. Traditionally based systems of acupuncture (TBSAs) often have their own diagnostic approaches and patterns. Despite the wide variety that can be found amongst TBSAs, is it possible that they share a common background in clinical observation and practice? Research has shown that multiple physiological pathways and mechanisms can be triggered by different acupuncture techniques and methods. It is highly likely that clinicians will have observed some of the effects of these responses and used those observations as feedback to help construct the patterns of diagnosis and their associated treatments. This review briefly examines this possibility. Pattern identification will have developed out of a complex interaction of factors that include; theories current at the time of their development, historical theories, personal choices and beliefs, training, practice methods, clinical observations and the natural feedback that comes from observing how things change once the treatment is applied. Researchers investigating TBSAs and pattern identification need to be more explicit about the systems they have investigated in order to understand the biological basis of pattern identification and their treatments.

A clinical study about painful manifestation on lumbar with regard to movement change of trunk (체간의 움직임 변화에 따른 요추부 근육의 통증 발현에 대한 임상적 고찰)

  • Kim, Sung-Ryul;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.86-96
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    • 2004
  • A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

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Clinical statistics: five key statistical concepts for clinicians

  • Choi, Yong-Geun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.203-206
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    • 2013
  • Statistics is the science of data. As the foundation of scientific knowledge, data refers to evidentiary facts from the nature of reality by human action, observation, or experiment. Clinicians should be aware of the conditions of good data to support the validity of clinical modalities in reading scientific articles, one of the resources to revise or update their clinical knowledge and skills. The cause-effect link between clinical modality and outcome is ascertained as pattern statistic. The uniformity of nature guarantees the recurrence of data as the basic scientific evidence. Variation statistics are examined for patterns of recurrence. This provides information on the probability of recurrence of the cause-effect phenomenon. Multiple causal factors of natural phenomenon need a counterproof of absence in terms of the control group. A pattern of relation between a causal factor and an effect becomes recognizable, and thus, should be estimated as relation statistic. The type and meaning of each relation statistic should be well-understood. A study regarding a sample from the population of wide variations require clinicians to be aware of error statistics due to random chance. Incomplete human sense, coarse measurement instrument, and preconceived idea as a hypothesis that tends to bias the research, which gives rise to the necessity of keen critical independent mind with regard to the reported data.

Central Core Disease : Clinical Characteristics of Family Members Manifested by Autosomal Dominant Pattern through Three Generations (중심핵병 : 삼대에 걸쳐 상염색체 우성 양식으로 발현된 가계 환자들의 임상적 특징)

  • Park, Kee Hyung;Shin, Dong Jin;Kim, Seung Hyun
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.23-28
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    • 2006
  • Background: central core disease is one of the non-progressive benign congenital myopathies characterized by the presence of cores in muscle fibers, which was originally described by Shy and Magee (1956). We describe clinical charcteristics of central core disease in a Korean family manifested by autosomal dominant pattern through three generations. Methods: Clinical, serologic, and electrophysiologic profiles were evaluated in eleven members among 22 family members through three generations. Results: Six family members were symptomatic and five were non-symptomatic. Instead of proximal muscle weakness, musculoskeletal manifestations including non-specific joint pain and stiff sense were the most frequent symptoms. Muscle biopsy performed in two symptomatic patients revealed that type I fiber showed central halo, which is charactreristics of central core disease. No remarkable findings were present in serologic study including CPK level and electromyographic findings suggesting myopathic pattern were only present in two patients among 11 symptomatic group. Conclusions: In evaluating non-specific musculoskeletal complaints from the familial members showing genetic trait, central core disease should be considered to one of the possible diagnosis.

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Study on the Revision and Clinical Validation of the Sasang Digestive Function Inventory (사상소화기능검사의 개정 및 임상 타당화 연구)

  • Lee, Yong-jae;Lee, Seul;Kim, So-hyung;Lee, Jeongyun;Chae, Han
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.54-71
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    • 2021
  • Objectives The purpose of this study was to revise Sasang Digestive Function Inventory (SDFI) and improve its validity and reliability using clinical data. Methods The Sasang type and Cold-Heat pattern differentiation by certified clinical specialist and responses to SDFI items were acquired from 419 hospital patients. The revision of SDFI was performed using item analysis and Explorative Factor Analysis (EFA). Furthermore, the validity and reliability of the revised SDFI (rSDFI) were investigated using Confirmatory Factor Analysis (CFA), Internal Consistency and Item Response Theory (IRT). And, clinical significance of the rSDFI was examined for the differentiation of Sasang types and Cold-Heat patterns. Results The number of the SDFI items were modified from 21 to 15. And, the validity and reliability of the rSDFI subscale structure were found to be acceptable. The scores of rSDFI-total and rSDFI-E significantly decreased in the order of Tae-Eum (TE), So-Yang (SY), So-Eum (SE) types, and the rSDFI score of SE type was significantly lower than that of TE and SY types. The rSDFI-total score could differentiate Cold-Heat pattern in both SY and SE types. And the difference of digestive function between Cold and Heat pattern of SE type could be explained with the rSDFI-D score. The rSDFI-total score in Cold pattern significantly decreased in the order of TE, SY, and SE types, and the rSDFI-total score of TE type is significantly higher than that of SE type in Heat pattern. Conclusions Current results demonstrated the reliability, validity and clinical usefulness of the rSDFI in clinical patients. Therefore, rSDFI can be utilized as an objective clinical measure supporting the differential diagnosis of Sasang typology.

Preliminary Study to Develop the Instrument on Pattern Identifications for Insomnia (불면증 변증도구 개발을 위한 기초 연구)

  • Lee, Hun-Soo;Kim, Hwan;Yun, Yong-Gi;Lee, Sujin;Jeon, Ju-Hyun;Kim, Bo-Kyung;Lee, Eun Jung;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.223-234
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    • 2016
  • Objectives: This study was carried out to develop a standard tool of pattern identifications for insomnia in Korean Medicine. Methods: The advisory committee for this study was organized by 17 Korean Medicine neuropsychiatry professors who were faculty members of different Korean Medicine colleges. The pattern identifications and symptoms for this tool were extracted from published Korean and Chinese literature. The Instrument on Pattern Identifications for Insomnia was developed following discussions among internal experts and after consultations with members of the advisory committee. Results: 1) Five pattern identifications were set for the tool. 2) The mean weights which represent the importance of each symptom and scored on a hundred-point scale were obtained. 3) The Instrument on Pattern Identifications for insomnia was designed in the self-reporting format composed of 47 questions. Conclusions: An Instrument on Pattern Identifications for Insomnia was created in this study. However, owing to any clinical trials has not been set yet. Therefore its validity and reliability were not confirmed. To make up for this limitation, the further clinical study would be performed in the near future.

Assessment of Concordance Rate in Pattern Analysis between Pattern Diagnosis of KiFDA on Allergic Rhinitis in 2008 and Doctor of Korean Medicine (알레르기 비염의 한의학적 분류를 위한 진단 평가지와 한의사 변증의 일치도 평가)

  • Lee, Kyu-Jin;Kim, Hee-Taek;Jang, Bo-Hyeong;Choi, In-Hwa;Ko, Seong-Gyu
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.1
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    • pp.91-98
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    • 2014
  • Objective : This study aimed to assessment for concordance rate in pattern analysis between pattern diagnosis of KiFDA on allergic rhinitis in 2008 and doctor of Korean medicine. Methods : Data were obtained from 35 patients with allergic rhinitis(AR). They were asked to perform the questionnaires and had been interviewed by specialist of Korean Medicine. For correlation analysis, we used Cohen's Kappa. Results : The pattern diagnosis was done only 15 patients(42.9%). Correlation between pattern diagnosis of questionnaires and specialist showed 0.2105 in Kappa and 0.1993 in weighed Kappa. Conclusions : The result may provide the basis of modification in Pattern Diagnosis of KiFDA on allergic rhinitis in 2008.

Clinical Application and Limitations of the Capsular Pattern (관절낭 패턴의 임상적 적용과 한계)

  • Lim, Wootaek
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.13-17
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    • 2021
  • A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

Clinical features of COVID-19 as presented in journal articles : A Korean Medical Approach (COVID-19 임상표현에 대한 한의학적 접근 -국내외 논문을 중심으로-)

  • Kim, Jong-hyun;Ahn, Jinhee;Kim, Sanghyun
    • Journal of Korean Medical classics
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    • v.35 no.1
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    • pp.1-32
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    • 2022
  • Objectives : This paper examines major symptoms representation in COVID-19 patients as groundwork for development of an effective clinical data collection format in Korean Medicine. Methods : Major symptoms representation in COVID-19 related papers published worldwide were collected. Corresponding symptoms in Korean Medicine were then examined, followed by discussion of symptomatic features that require further consideration in regards to a more systematic clinical data collection. Results : Of 256 papers, most papers listed fever and cough while symptoms such as difficulty breathing, diarrhea, muscle pain, headache, nausea, fatigue, chest pain, phlegm, nasal discharge were also mostly listed. Clinical representations could be categorized into general symptoms, throat symptoms, chest symptoms, head and facial symptoms, gastrointestinal symptoms, musculo-skeletal and cutaneous symptoms, psychiatric symptoms and sensory problems. Conclusions : Although each clinical representation could be likened to certain clinical representations of Korean Medicine, the variety of symptoms were too limiting and lacking in detail to be applied in the pattern identification[辨證] of Korean Medicine. For effective clinical data collection and analysis in the future, symptom change according to time, comparison between location, climate and ethnicity, existence of interior symptoms when diagnosing exterior symptoms, deficiency-excessiveness of blood patterns, consciousness levels, etc., need to be considered in establishing criteria for symptom evaluation.

Phonological Error Patterns: Clinical Aspects on Coronal Feature (음운 오류 패턴: 설정성 자질의 임상적 고찰)

  • Kim, Min-Jung;Lee, Sung-Eun
    • Phonetics and Speech Sciences
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    • v.2 no.4
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    • pp.239-244
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    • 2010
  • The purpose of this study is to investigate two phonological error patterns on coronal feature of children with functional articulation disorders and to compare them with those of general children. We tested 120 children with functional articulation disorders and 100 general children from 2~4 years of age with 'Assessment of Phonology & Articulation for Chidren(APAC)'. The results were as follows: (1) 37 disordered children substituted [+coronal] consonants for [-coronal] consonants (fronting of velars) and 9 disordered children substituted [-coronal] consonants for [+coronal] consonants (backing to velars). (2) Theses two phonological patterns were affected by the articulatory place of following phoneme. (3) The fronting pattern of children with articulation disorders was similar with that of general children, but their backing pattern was different with that of general children. These results show the clinical usefulness of coronal feature in phonological pattern analysis, the need of articulatory assessment with various phonetic context, and the importance of error contexts in clinical judgment.

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