• 제목/요약/키워드: functional disability

검색결과 395건 처리시간 0.027초

전이성 척추 종양으로 인한 압박 골절 환자의 척추 후굴 풍선 복원술의 임상 효과 (The Clinical Outcomes of Kyphoplasty for the Treatment of Malignant Vertebral Compression Fractures)

  • 김다미;서경수;박은정;한경림;김찬
    • The Korean Journal of Pain
    • /
    • 제21권3호
    • /
    • pp.197-201
    • /
    • 2008
  • Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

산업재해로 인한 수부손상환자의 물리치료에 관한 연구 (A Study on the Physical Therapy and Rehabilitation Service to the Hand Injury Patients of Industrial Accidents)

  • 김희라;김명준
    • 대한물리치료과학회지
    • /
    • 제10권2호
    • /
    • pp.246-257
    • /
    • 2003
  • Even though the automation of industrial machinery has dramatically increased, most industries still require human hands for the production of goods. Our hands are essential to our existence. For this reason, hand injuries caused by industrial accidents have become an important issue lately. Most hand injuries are external wounds and constitute 38.6% of disabling industrial accidents. This significant statistic cannot be ignored by rehabilitation programs. The rate of success in operations of finger and hand injuries has increased, but relatively less consideration has been given to physical therapy, rehabilitation, research, or systematic installment in terms of welfare, which would help the injured carry on the nominal life they lived before their injury. Therefore, it is necessary to study systematically all related aspects to provide patients with physical therapy, rehabilitation, and social welfare, in order to restore their social, professional, and economical capabilities. Physical considerations, functional usability, and cosmetic restoration, as well as the patients' mental state must be addressed. The results of the study shows several problems. Medical appliances, manpower, and the environment of the treatment rooms are very poor. The patients cannot receive treatment early enough nor enough treatment because of too many patients for too few physical therapists. Close cooperation between physical therapists and doctors, nurses, or related departments is lacking. Furthermore, it is irrational that industrial accident premiums for the exert; e treatment of hand injury patients are not itemized. Lack of recognition of the importance of specialty in hand injury therapists leads to the lack of professionalization of systematic hand injury treatment In order to solve these problems, the professonalism of physical therapy should be acknowledged and particular treatment courses should be available and/or required. Based on the understanding of the hand injury patients' needs, new theories of physical therapy should be developed and modem medical appliances and facilities should be available, in order to provide the patients with qualitative medical treatment, which then will facilitate the patients' recovery.

  • PDF

Percutaneous Endoscopic Thoracic Discectomy : Posterolateral Transforaminal Approach

  • Lee, Ho-Yeon;Lee, Sang-Ho;Kim, Dong-Yun;Kong, Byoung-Joon;Ahn, Yong;Shin, Song-Woo
    • Journal of Korean Neurosurgical Society
    • /
    • 제40권1호
    • /
    • pp.58-62
    • /
    • 2006
  • Objective : Development of diagnostic tools has resulted in early detection of thoracic disc herniations[TDH] even when the herniated disc is soft in consistency. In some of the cases, it is considered better not to opt for surgical treatment due to the unduly high morbidity and potential complications associated with conventional approaches. The authors have applied percutaneous endoscopic thoracic discectomy[PETD] technique to soft TDHs in order to avoid the morbidity associated with conventional approaches. Methods : Eight consecutive patients [range, 31 to 75 years] with soft lateral or central TDH [from T2-3 to T11-12] underwent PETD between May 2001 and June 2004. The patient was positioned in a prone position with intravenous sedation and local anesthetic infiltration. The authors introduced a cannula into the thoracic intervertebral foramen using endoscopic foraminoplasty technique. Discectomy was performed with mechanical tools and a laser under continuous endoscopic visualization and flu oroscopic guidance. Functional status was assessed preoperatively and postoperatively using the Oswestry Disability Index[ODI]. Results : The mean ODI scores improved from 52.8 before the surgery to 25.8 at the final follow-up. In cases of myelopathy, long tract signs showed improvement. The mean operative time was 55 minutes, and no patient required conversion to open surgery. Conclusion : The technique allows a smaller incision and less morbidity. Soft TDH is amenable to this minimally invasive approach in selected patients with myeloradiculopathy.

Comparison between Instrumented Mini-TLIF and Instrumented Circumferential Fusion in Adult Low-Grade Lytic Spondylolisthesis : Can Mini-TLIF with PPF Replace Circumferential Fusion?

  • Kim, Jin-Sung;Kim, Dong-Hyun;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
    • /
    • 제45권2호
    • /
    • pp.74-80
    • /
    • 2009
  • Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

A Comparison of Anterior Cervical Discectomy and Fusion versus Fusion Combined with Artificial Disc Replacement for Treating 3-Level Cervical Spondylotic Disease

  • Jang, Seo-Ryang;Lee, Sang-Bok;Cho, Kyoung-Suok
    • Journal of Korean Neurosurgical Society
    • /
    • 제60권6호
    • /
    • pp.676-683
    • /
    • 2017
  • Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

손잡이/발판 컨트롤러를 이용한 걷기게임 '팔도강산2' 개발 및 효과성 연구 (Development and Analysis of Walking Game Using Controllers of Hand Buttons and Footboards (Title: Paldokangsan2))

  • 김경식;오성석;안준희;안진호
    • 한국게임학회 논문지
    • /
    • 제13권3호
    • /
    • pp.95-104
    • /
    • 2013
  • 본 연구진에서 이번에 개발한 '팔도강산2'는 노인용 기능성게임으로서 2011년에 개발한 '팔도강산1'(팔걸이와 발판을 이용하여 2인이 걷는 PC 운동게임)의 후속 작이며 걷기운동에 노인들의 인지, 신체, 심리 기능을 추가한 게임이다. 현대생활에서의 장보기(몰워킹)를 게임 속에서 구현하였으며, 70년대의 재래시장을 배경으로 기억한 물품을 사오는 장보기 걷기 운동 게임이다. 유사한 맥락으로 걷기가 어려운 노인과 장애인용으로 미니게임도 2종 개발하였다. 아산 노인종합복지관에서 65세이상 고령자 219명을 대상으로 실험하여 효과성을 테스트한 결과 게임 플레이가 기억력, 집중력, 활력도에 긍정적인 효과가 있다고 평가되었다.

주관적으로 인지한 구강건강상태가 삶의 질에 미치는 영향 : PRECEDE 모형 적용 (Impact of Subjectively Reported Oral Health Status on the Quality of Life among Adults: Applying the PRECEDE Model)

  • 이미라;한경순;한수진;최준선
    • 보건교육건강증진학회지
    • /
    • 제28권1호
    • /
    • pp.23-35
    • /
    • 2011
  • Objectives: This study aims to identify the impact of subjectively reported oral health status on the quality of life by applying the PRECEDE model. Methods: This study was conducted on a total of 450 people who had dental visit experience among persons above 35 and under 65 years living in Seoul and Gyeonggi provinces. Oral health-related quality of life was measured using the OHIP-14. The relationship between subjectively reported oral health status and the quality of life was evaluated by the chi-square test, t-test, one-way ANOVA and multiple linear regression analysis. Results: OHIP-14 scores were significantly associated with self-reported oral health problem. Especially the strongest correlations were found between functional limitation, physical psychological social disability on the OHIP-14 7 sub-factor and self-reported periodontitis and dry mouth symptoms. Conclusion: Subjectively reported oral health status is associated with oral heath related quality of life. In order to improve people's the quality of life, taking care of their oral heath is indispensable factor. Therefore, it is required to revitalize regular oral health check system and the development of effective oral health education programs by the government to prevent periodontitis and dry mouth as well.

경도의 지적장애를 가진 20대 대학생의 다양한 누운 자세별 복합적 폐활량에 대한 비교 (Analysis of the Convergence Pulmonary Function in the 20s Men of Mild Intellectual Disabilities according to Multiple Lying Positions)

  • 김옥기;박승환;서교철;조미숙
    • 한국융합학회논문지
    • /
    • 제10권12호
    • /
    • pp.169-175
    • /
    • 2019
  • 본 연구는 경도의 지적장애를 가진 20대 대학생이 다양하게 누운 자세변화 따른 복합적 폐활량에 미치는 영향을 알아보고자 하였다. 경도의 지적장애를 가진 20대 남자 대학생 20명을 대상으로 실험에 참여하였다. 실험 대상자들은 누운 자세, 오른쪽 옆으로 누운 자세, 원쪽 옆으로 누운 자세, 엎드러 누운 자세에 따라 폐기능 측정기를 이용하여 폐활량을 평가해 보았다. 자료분석은 SPSS 18.0 버전을 이용하여 실험 대상자의 자세변화에 따란 호흡변화를 분석하기 위해 일요인 반복측정 분산분석으로 검증하였다. 결과는 오른쪽 옆으로 누운 자세에서 폐활량이 가장 크게 나타났고 엎드러 누운 자세에서 가장 낮게 나타났다. 이 연구를 통해 경도의 지적장애인이 일상이나 임상에서 침상생활을 할 때 취침에서 가장 안정된 호흡능력을 확보할 수 있는 이상적인 누운 자세를 제시하고 효율적 환기능력에도 긍정적인 효과를 나타날 것으로 생각된다.

DASH로 평가한 상지 근골격계 질환자의 기능 제한 (Determining the Degree of Disability in Workers with Upper Limb Musculoskeletal Disorders using DASH)

  • 김규상;장기언
    • 대한인간공학회지
    • /
    • 제29권3호
    • /
    • pp.311-320
    • /
    • 2010
  • This study aimed to examine the development and characteristics of the workers with upper limb musculoskeletal symptoms and disorders and to analyze the upper limb musculoskeletal symptoms and disorders for its relationship with the individual socio-demographic characteristics. This study investigated the effect on the limitations of physical activities using standardized surveillance tool and clinical diagnosis. Musculoskeletal symptoms and the limitations of physical activities were examined. The clinical diagnosis of musculoskeletal disorders were carried out by physical examination, radiological examination and electromyography-electroneuronography for 22 workers in kitchen hood assembly process and 50 workers in toggle process of leather product manufacturing. The proportion of workers with musculoskeletal disorders was higher and the DASH score was also statistically higher in female and aged workers with longer working hours, longer household working hours, less leisure/hobby activity and higher physical load. Physical activities component score increased in the following order: workers in normal health, workers with musculoskeletal symptoms, and workers with musculoskeletal disorders as clinically diagnosed. Score for each DASH component increased in the following order: sports/performing arts ability, social activities, specific physical functional activities, work or other regular daily activities, work ability, psychological activities, insomnia and upper limb symptoms. The overall and each component DASH scores were higher in workers with symptoms of status praesens and of more severity, and receiving medical intervention. Musculoskeletal symptoms and disorders are associated with individual socio-demographic characteristics, and DASH score for physical activities of upper limb was higher in workers with musculoskeletal disorders. Musculoskeletal symptoms and disorders have a remarkable epidemiological significance for physical activities, social activities, work or other regular daily activities, upper limb symptoms and insomnia, where work ability, sports/performing arts ability and preventive measure is needed.

식중독의 사회경제적 비용추정: 삶의 질 개념을 적용한 질병비용추정법을 이용하여 (Socioeconomic Costs of Food-Borne Disease Using the Cost-of-Illness Model: Applying the QALY Method)

  • 신호성;이수형;김종수;김진숙;한규홍
    • Journal of Preventive Medicine and Public Health
    • /
    • 제43권4호
    • /
    • pp.352-361
    • /
    • 2010
  • Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.