• 제목/요약/키워드: disability evaluation

검색결과 291건 처리시간 0.021초

요골 신경 손상의 수술적 치료 (Surgical Treatment of Radial Nerve Injury)

  • 이광석;박상원;위대곤
    • Archives of Reconstructive Microsurgery
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    • 제5권1호
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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치료적 운동이 허리통증을 가진 여자 청소년 골프선수의 통증, 근기능 및 방사선학적 평가에 미치는 영향: 증례보고 (The Effect of Exercise Therapy on Pain, Muscle Function and Radiological Evaluation in a Female Youth Golf Player with Low Back Pain: Case Report)

  • 이호성
    • 대한물리의학회지
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    • 제13권3호
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    • pp.1-9
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    • 2018
  • PURPOSE: The purpose of this study was to determine the effect of exercise therapy on low back pain (LBP), the function of paraspinal and abdominis muscles, and the sacrohorizontal angle as seen on the radiographs of the lumbar spine in a young female golf player with LBP. METHODS: This case report describes an 11-year-old female golfer who presented with LBP. The exercise therapy program comprised lumbar joint mobilization, lumbar spine flexion distraction, abdominal bridge, plank, side plank, and single-leg extensions from a 4-point kneeling position for 40 min/day; this was done twice a week for 8-weeks. LBP [visual analog scale (VAS) and Oswestry disability index (ODI)] and function of paraspinal and abdominis muscles [Ito test, curl-up test, $90^{\circ}$ stop test, squat test, opened eye one leg stance test (OEOL), and closed eye one leg stance test (CEOL)] were measured before and after 4 and 8 weeks of exercise therapy. The radiographs were analyzed for the lumbar Cobb's angle and sacrohorizontal angle before and after 8 weeks of exercise therapy. RESULTS: After 4 and/or 8 weeks of exercise therapy, VAS and ODI scores decreased; results for the Ito test, curl-up test, $90^{\circ}$ stop test, squat test, and OEOL and CEOL of muscle function improved; and the lumbar Cobb's angle and sacrohorizontal angle improved. CONCLUSION: These results suggest that exercise therapy improves LBP, muscle function, and radiographic parameters associated with LBP in young golf players. These findings have clinical implications for exercise therapy in young female golf players who have LBP.

회전근개 파열 환자의 옷입고 벗기 향상을 위해 ICF Tool을 적용한 PNF 중재전략 : 증례보고 (A PNF Intervention Strategy with ICF Tool Applied for Improvement of Dressing in a Patient with Rotator Cuff Syndrome : A Case Report)

  • 김진철;이정아
    • 대한물리의학회지
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    • 제13권3호
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    • pp.49-60
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    • 2018
  • PURPOSE: This study was conducted to investigate the intervention effect obtained by applying an ICF tool to improve the dressing in a patient with rotator cuff syndrome to schematize the problems and approaching with PNF to solve the problems. METHODS: The subject of this study was a 44-year-old patient who underwent surgery after complete right rotator cuff tear. To treat his symptoms, the processes of clinical practice were implemented in the order of examination, assessment, diagnosis, prognosis, intervention, and outcome. During examination, patient information was collected using the ICF core set. In the assessment, the problems were schematized, and an ICF assessment sheet was used to identify the interaction of the problems. The diagnosis was made by clearly describing the causal relationship derived from the assessment in ICF terms. To solve the problems, the intervention was given in the order of indirect, direct, and task based on the philosophy of PNF. To evaluate the outcome, the differences before and after the intervention were compared. Additionally, the comparison for the ICF qualifier is presented with the ICF evaluation display. RESULTS: The results of the study showed clinical advantages in shoulder strength, eccentric control, range of motion, scapular stability, and shoulder pain. Overall, our patient with rotator cuff syndrome showed improvement in dressing and undressing activity in response to the PNF strategy. CONCLUSION: Application of the PNF intervention strategy after complete rotator cuff tear would have a positive effect on patient upper extremity function.

The Relationship between Increased Intervertebral Disc Height and Development of Postoperative Axial Neck Pain after Anterior Cervical Fusion

  • Chang, Han;Baek, Dong-Hoon;Choi, Byung-Wan
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.343-347
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    • 2014
  • Objective : To evaluate the relationship between postoperative increase in intervertebral disc space height (IVH) and posterior axial neck in cases of degenerative cervical disease treated with anterior cervical discectomy and fusion (ACDF). Methods : A total of 155 patients who underwent ACDF with more than 1 year follow up were included. Radiologically, IVH and interfacet distance (IFD) of the operated segment were measured preoperatively and postoperatively. We clinically evaluated neck and arm pains according to visual analogue scale (VAS) scores and assessed neck disability index (NDI) scores preoperatively, postoperatively, at 3 months, 6 months, and 1 year postoperatively. The relationship between radiological parameters, and clinical scores were analyzed using a regression analysis. Results : The mean increase in IVH was 2.62 mm, and the mean increase in IFD was 0.67 mm. The VAS scores for neck pain preoperatively, postoperatively, and at 3 months, 6 months, 1 year postoperatively were 4.46, 2.11, 2.07, 1.95, and 1.29; those for arm pain were 5.89, 3.24, 3.20, 3.03, and 2.18. The NDI scores were improved from 18.52 to 7.47. No significant relationship was observed between the radiological evaluation results regarding the increase in intervertebral height or interfacet distance and clinical changes in VAS or NDI scores. Conclusion : The increase in intervertebral space or interfacet distance by the insertion of a large graft material while performing ACDF for the treatment of degenerative cervical disease was not related with the change in VAS scores for neck and arm pains and NDI scores postoperatively and during the follow-up period.

An Evaluation of the Quality of Sleep Before and After Surgical Treatment of Patients with Cervical Disc Herniation

  • Ogden, Mustafa;Akgul, Mehmet Huseyin;Yuksel, Ulas;Bakar, Bulent;Kamasak, Kagan;Ozveren, Mehmet Faik
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.600-607
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    • 2018
  • Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

장애인 이용자의 요구분석을 통한 대학도서관 서비스 개선방안에 관한 연구 (Improvement Plan for Library Services Through the Disabled Users' Needs Analysis in University Library)

  • 정재영;정혜미
    • 한국도서관정보학회지
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    • 제41권2호
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    • pp.189-207
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    • 2010
  • 대학도서관은 장애인 이용자의 정보이용 및 학습의 기회를 보장하기 위해 적절한 시설과 장비를 구비하고 서비스를 제공해야 한다. 본 연구는 국내 외 현황 조사와 장애인 이용자와의 심층면접을 기초로 대학도서관에 서 제공하고 있는 장애인 서비스에 대한 개선 방안을 제시하고자 하였다. 조사 결과 도서관에서 제공하고 있는 장애인 서비스를 개선하고 장애인 이용자의 이용을 높이기 위해서는 장비 도입과 서비스 제공 시 요구분석과 의견 수렴과정을 통해 장애인 이용자들의 의견이 반영될 수 있도록 해야 하며, 시설과 서비스를 효과적으로 결합할 수 있는 전용공간을 제공할 필요가 있는 것으로 나타났다. 또한, 도서관 직원에 대한 지속적이고 정기적인 장애인 서비스 교육과 함께 장애인 전담사서를 지정해 One-stop 서비스를 제공할 필요가 있다. 이와 함께 장애인 지원을 위한 교내 외 기관, 단체 등과의 협력 및 연계와 함께 서비스 개선을 위한 정기적인 실태조사와 평가가 이루어질 필요가 있는 것으로 분석되었다.

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한양방 협진치료가 안면마비환자의 삶의 질 변화에 미친 영향 (Changes in Facial palsy Patient's Quality of life based upon Oriental-Western Medicine Treatment)

  • 김동현;정달림;조창건;홍승욱
    • 한방안이비인후피부과학회지
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    • 제23권2호
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    • pp.174-185
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    • 2010
  • Objective : In period of convalescence and aftereffect, facial palsy patients suffer from social and psychological problems, besides experiencing physical inconvenience. So Quality of life is important Evaluation in treatment or facial palsy. Nevertheless the aims of recent study were only trying to explain about objective symptoms. Therefore, Oriental-Western Medicine was performed, effectiveness of treatment were measured in Quality of life. Methods : Acute facial palsy patients who visiting whin 5days completed questionnaire about Quality of life, if he(or she) participated voluntarily. Questionnaire are comprised of general characteristics, Facial Disability Index(FDI), WHOQOL-BREF, VAS and House-Brackmann grade. Questionnaire used two times, the first medical examination and 4weeks later after starting Oriental-Western Medicine. The statistical analysis was performed by GraphPad Prism 4.0. T-test was used to verify effectiveness between the two groups. Results : 1. When we compared the first medical examination with 4weeks later, score of FDI-Physical function and FDI-Social/Well-bieng function increased but they were not valid statistically. 2. When we compared the first medical examination with 4weeks later, in WHOQOL-Brefoverall domain and physical domain, score increased. In WHOQOL-Bref-psychological, Social, Environment domain, score decreased. but, they were not valid statistically. 3. VAS, House-Brackmann grade decreased, but, they were not valid statistically. Conclusion : The number of subjects with facial palsy in our study(N=5) was too small, and the period of study(4 weeks) was short, too. For this reason, our data were not valid statistically. But Facial palsy Patient's Quality of life has risen.

Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms

  • Seong, Ji-Hoon;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Hur, Jin-Woo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.363-369
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    • 2011
  • Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Filum Terminale Lipoma with Herniated Intervertebral Disc Treated with Traditional Korean Medicine: A Case Report

  • Kim, Sang-Gyun;Park, Ju-Hun;Park, Han-Bin;Yoo, Dong-Hwi;Jang, Won-Suk;Shin, Won-Bin;Choi, Kang-Eah;Cho, Hyun-Woo
    • Journal of Acupuncture Research
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    • 제37권4호
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    • pp.281-284
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    • 2020
  • Filum terminale lipoma is an inherited lumbosacral abnormality that can cause tethered cord syndrome. This report describes an unusual case of lumbago and sciatica, pain suspected to be caused by a filum terminale lipoma where a herniated intervertebral disc had occurred. The patient was hospitalized for 43 days and received integrative Korean medicine treatment, including acupuncture, pharmacopuncture, Chuna therapy, cupping therapy, physiotherapy and herbal medicine. Treatment effectiveness was assessed using the numerical rating scale, Oswestry Disability Index, European Quality of Life 5-Dimensions, and patient symptoms. After inpatient treatment, the pain the patient suffered was significantly reduced, and the evaluation indices scores reflected this. Integrative Korean remedies may be an effective option for lower back pain and lower extremity symptoms which are caused by filum terminale lipoma where a herniated intervertebral disc has occurred. Additional clinical research is required to support this observation.

A case of McKusick-Kaufman syndrome

  • Son, Se-Hyung;Kim, Yoon-Joo;Kim, Eun-Sun;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • 제54권5호
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    • pp.219-223
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    • 2011
  • McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.