• 제목/요약/키워드: functional disability

검색결과 399건 처리시간 0.026초

도침치료가 급성 요추 염좌 환자의 통증 및 기능개선에 미치는 영향: 후향적 연구 (Effects of Acupotomy on Pain and Functional Improvement in Acute Low Back Pain Patients: A Retrospective Study)

  • 김연희;오민석
    • 한방재활의학과학회지
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    • 제28권2호
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    • pp.91-104
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    • 2018
  • Objectives The aim of this study is to investigate the effect of Acupotomy on the pain reduction and functional improvement of patients with Acute low back pain. Methods We studied 60 patients with Acute low back pain with Numeric Rating Scale (NRS) 5 or higher in admission and had admitted to Department of Korean Medicine Rehabilitation of Daejeon University from March 1, 2017 to October 31, 2017. 30 patients had received Acupotomy combined Korean Medicine treatment(such as acupuncture, moxabustion, herbal medicine, etc) and the other 30 had received Korean Medicine treatment only. The analysis was conducted as a retrospective study which analyzes the patient's medical records. Statistical analysis was performed using the IBM SPSS Statistics 24 program. We used NRS to evaluate pain reduction, used Range of Motion (ROM) and Roland Morris Disability Questionnaire (RMDQ) to evaluate function improvement, and used EuroQol-5 Dimension (EQ-5D) and EuroQoL-Visual Analogue Scale (EQ-VAS) to assess quality of life. Finally, a five-point Likert scale was used to assess treatment satisfaction. Results The analysis revealed that patients who were treated with Acupotomy showed statistically significant NRS reduction, improvement of ROM and RMDQ, improvement of EQ-5D and EQ-VAS and satisfaction compared to those who just recevied Korean Medicine treatment. Conclusions In conclusion, we found that the Acupotomy showed a positive effect on pain resolving, functional rehabilitation and quality of life in patients with Acute low back pain.

ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례 (A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient)

  • 윤태원;김태윤
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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천장관절융합술 후 기능 회복에 대한 추나요법을 포함한 한의복합치료 증례보고 1례 (A Case Report of Complex Korean Medicine Treatment Application Including Chuna Manual Therapy for Functional Recovery After Sacroiliac Joint Fusion)

  • 한윤희;박신혁;우현준;하원배;이정한
    • 척추신경추나의학회지
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    • 제17권2호
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    • pp.63-72
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    • 2022
  • Objectives This case study aimed to investigate the effect of complex Korean medicine treatment including Chuna manual therapy on sacroiliac joint (SIJ) pain status post SIJ fusion with sacroiliac screw fixation. Methods Complex Korean medicine treatments including Chuna manual therapy were provided to patients with SIJ widening due to a traffic accident trauma. Measurement of range of motion and manual muscle test to evaluate functional activities of daily living was conducted before and after treatment. Moreover, outcome estimates were performed using the numeric rating scale, pain disability index, and EuroQol 5-dimension five-level questionnaire. Results After complex treatment, functional activities of daily living improved. Sacroiliac joint pain decreased and the quality-of-life score improved. Conclusions This study suggests that treatment with complex Korean medicine treatment including Chuna manual therapy may improve traumatic SIJ widening status post SIJ fusion. A postoperative rehabilitation protocol based on accumulated research results considering a multidisciplinary approach should be prepared to ensure holistic treatment.

중등도 이상의 목 통증을 동반한 앞쪽 머리 자세를 가진 중·고등학교 교사들을 위한 물리치료적 프로그램: 머리-목뼈 굽힘근 훈련과 일반적 훈련의 효과 비교 (A Physiotherapy Program for Secondary School Teachers with Forward Head Posture Accompanied by Moderate to Severe Neck Pain: Comparison of the effects of cranio-cervical flexor training and general training)

  • 김현수;추연기
    • 대한통합의학회지
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    • 제11권3호
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    • pp.195-204
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    • 2023
  • Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.

Individualized Traditional Korean Acupuncture for Knee Osteoarthritis : a Protocol for a Randomized Controlled Trial

  • Byun, Hyuk;Baek, Seung-Tae;Park, In-Shik;Kim, Kap-Sung;Kim, Sun-Woong;Choi, Sun-Mi;Lee, Seung-Deok
    • 대한한의학회지
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    • 제27권4호
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    • pp.225-232
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    • 2006
  • Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

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Risk Factors Predicting Unfavorable Neurological Outcome during the Early Period after Traumatic Brain Injury

  • Park, Jung-Eon;Kim, Sang-Hyun;Yoon, Soo-Han;Cho, Kyung-Gi;Kim, Se-Hyuk
    • Journal of Korean Neurosurgical Society
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    • 제45권2호
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    • pp.90-95
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    • 2009
  • Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

중추 신경계 혈관질환(C. V. A)환자 중 퇴원환자의 신체기능장애정도와 그 특성에 관한 고찰 (Selected Characteristics and Degree of Physical Disability of Stroke Survivors at Discharge from Five General Hospitals in Seoul, 1975)

  • 이선옥
    • 대한간호학회지
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    • 제6권1호
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    • pp.23-28
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    • 1976
  • This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

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요추부 불안정성을 가진 요통환자의 복부 드로우-인 기법과 복부 확장 기법을 이용한 체간안정화운동의 효과 비교 (Comparison of the Effects of Abdominal Draw-In and Expansion Maneuvers on Trunk Stabilization in Patients With Low Back Pain and Lumbar Spine Instability)

  • 이호준;김선엽
    • 한국전문물리치료학회지
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    • 제22권1호
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    • pp.37-48
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    • 2015
  • This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

교합이 붕괴된 지적장애 환자의 국소의치 수복증례 (Full mouth rehabilitation of the intellectually disabled patient with collapsed bite using partial removable dental prosthesis: a case report)

  • 김민지;양홍서;박상원;임현필;윤귀덕;박찬
    • 구강회복응용과학지
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    • 제33권3호
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    • pp.216-222
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    • 2017
  • 지적장애는 정신 발육이 항구적으로 지체 되어 지적 능력의 발달이 불충분하고 불완전한 장애이며, 지적장애를 가지면 자신의 일을 처리하는 것과 사회생활에의 적응이 상당히 곤란하다. 그렇기 때문에 환자 스스로 구강상태를 위생적으로 관리하는 것이 쉽지 않아 다발적 우식이 쉽게 관찰되며 치주질환 이환율이 높다. 본 증례의 환자는 지적장애 1급을 판정받은 33세 여환으로 치아 및 치주 건강이 좋지 않아 식사에 어려움이 있다는 주소로 내원하였다. 초진 구내 검사 시 환자는 치주염과 다발성 우식으로 수직고경이 감소되고 구치부 교합이 붕괴되어 있었다. 이를 가철성 국소의치 이용하여 교합을 재구성함으로써 심미적, 기능적으로 만족할 만한 결과를 얻었기에 보고하는 바이다.

Shell teeth 환자의 전신마취 하 치과치료 : 증례보고 (DENTAL TREATMENT OF SHELL TEETH UNDER GENERAL ANESTHESIA: A CASE REPORT)

  • 장은정;이형직;김지연;정태성
    • 대한장애인치과학회지
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    • 제14권1호
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    • pp.31-35
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    • 2018
  • 부산대학교 치과병원 소아치과에 내원한 Shell teeth에 이환된 소아 환자를 전신마취 하에 치료하였다. 임상검사시 다수 치아의 치관 파괴와 치수 노출 및 상악 유전치 잔존치근이 관찰되었다. 방사선검사상 전반적인 유치열에서 정상보다 큰 크기의 치수강과 넓은 치근관 및 얇은 경조직 층이 존재했으며 발생중인 영구치 치배의 형태이상이 관찰되었다. 환자의 언니와 아버지를 포함한 부계 가족 구성원 일부에서 상아질형성부전증 병력이 조사되었다. 치료시 수복이 불가능한 치아는 발거하였고 보존 가능한 치아는 치수치료 및 기성금속관, 복합레진 수복치료를 시행하였다. 치료 결과 환자의 통증이 감소하였고 저작능력이 회복되었다. 주기적인 내원 및 경과관찰이 요구된다.