• 제목/요약/키워드: functional disability

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수부(手部)의 표재성 2도(度) 화상(火傷)의 침치료(針治療) 1례에 관한 임상적(臨床的) 고찰(考察) (A clinical case study of Acupuncture treatment for burned hand)

  • 원승환;위종성;최은주;권기록
    • Journal of Acupuncture Research
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    • 제22권1호
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    • pp.13-17
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    • 2005
  • 1. 우측(右側) 수지(手指) 3-4지에 $2.0{\times}2.0cm$의 수포와 $6.0{\times}4.0cm$의 발적(發赤)이 형성된 2도 화상의 환자를 5회의 환부자침(患部刺鍼)만으로(총 11일) 흉터 없이 완치되는 효과를 얻었다. 2. 피부 손상의 경우, 환부주위(患部周圍)에 자침(刺鍼)하여 십이피부(十二皮膚)의 기혈(氣血)소통을 원활히 해주면 우수한 치료효과가 있음을 알 수 있었다. 따라서 욕창(褥瘡)이나 창상(創傷)등에서도 훌륭한 치료 효과가 기대된다. 2. 화상의 정도가 심한 경우는 사순청양음(四順淸凉飮) 같은 청열해독작용(淸熱解毒作用)과 통리대소편(通利大小便)하는 처방을 사용 하여 내외동치(內外同治)하면 효과가 극대화되리라고 사료된다.

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Comparison of treatment outcomes in lumbar central stenosis patients treated with epidural steroid injections: interlaminar versus bilateral transforaminal approach

  • Sencan, Savas;Edipoglu, Ipek Saadet;Celenlioglu, Alp Eren;Yolcu, Gunay;Gunduz, Osman Hakan
    • The Korean Journal of Pain
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    • 제33권3호
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    • pp.226-233
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    • 2020
  • Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure. Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020). Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.

뇌졸중 노인의 기능장애 정도, 일상생활 수행능력, 우울과 삶의 질 간의 관계 (The Relationship of Dysfunctions Degree, Daily Living Activity, Depressiveness and Quality of Life among the Elderly Suffering from Stroke)

  • 박인숙;김도연;강창렬
    • 보건의료산업학회지
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    • 제5권2호
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    • pp.173-186
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    • 2011
  • The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • 제56권3호
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    • pp.224-229
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    • 2014
  • Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

The Effects of Sling Bridging Exercise to Pain Scale and Trunk Muscle Activity in Low Back Pain Patients

  • Jeong, Eun Dong;Chae, Chang Woo;Yun, Hong Kyu;Woo, Kwang Seog;Kim, Dong Hyun;Kim, Seung Min
    • 국제물리치료학회지
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    • 제4권1호
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    • pp.523-531
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    • 2013
  • Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.

견갑골 골절 환자의 기능회복에 대한 추나 요법을 포함한 한방재활치료: 증례 보고 (The Clinical Effects of Korean Medicine Rehabilitation Including Chuna Manual Therapy on Scapular Fracture Patient's Functional Recovery: A Case Report)

  • 배준형;고준혁;김세윤;이한솔;장호경;안종현;김형석;정원석
    • 한방재활의학과학회지
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    • 제29권4호
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    • pp.117-126
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    • 2019
  • To evaluate the effects of Korean medicine and Chuna treatment on patient with pain and limited range of motion (ROM) after scapular fracture. Patient was treated with Chuna manual therapy, acupuncture, herbal medicine, pharmacoacpuncture, cupping therapy and measured by ROM, visual analog scale (VAS), shoulder pain and disability index (SPADI), American shoulder elbow surgery scale (ASES), Korean shoulder score for instability (KSS). After the 3 weeks treatment, the patient's ROM, VAS, SPADI, ASES, KSS scores were improved. Rehabilitation program including Chuna manual therapy can be effectively used to improve scapular fracture patient's pain and symptom during rehabilitation period. Therefore it is recommended to use Chuna manual therapy for the improvement of movement and pain from fracture.

The Effects of Online Home Learning in Connection with Extracurricular Activities for Lifelong Education for the Disabled at University on Cafeterias Cooking Assistance Skills of Job Search Persons with Developmental Disabilities

  • Kim, Young-Jun;Park, Jae-Kook;Kwon, Ryang-Hee
    • International Journal of Advanced Culture Technology
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    • 제9권3호
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    • pp.188-201
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    • 2021
  • The purpose of this study is to analyze the effects of online home learning in connection with extracurricular activities for lifelong education for the disabled in university on the cooking aids skills of cafeterias for the job search persons with developmental disabilities. Three people with job search developmental disabilities who have been in a state of unemployment for three years after graduating from a special high school course participated in the experiment. In order to verify the meaningful functional relationship between independent variables and dependent variables, multiple probe design across subjects, one of the main techniques of a single object study, was used. The experimental conditions according to the research design consisted of the steps of baseline, intervention, maintenance, and generalization. The dependent variable of this study is the restaurant cooking aid skills in the cafeteria, and three subskills such as side dish arrangement, sink arrangement, and dish washing were combined by task analysis. And the independent variable of this study was composed of procedures and methods to teach the environment, tools and materials related to the performance of dependent variables to the developmental disabled people at home by using real-time image technique through zoom service, and the contents of the performance by stages of task analysis. In addition, independent variables were applied to the subjects in the course of the extracurricular activities with the theme and contents of lifelong education for the disabled at university. Students who completed the above extracurricular activities practiced the intervention scene of the researcher through the screen sharing of zoom service. As a result, the subjects with developmental disabilities effectively acquired and maintained the positive response performance of dependent variables through independent variables. The subjects also showed high positive responses to generalization tests conducted in kitchens in cafeterias located elsewhere in the same university.

Posterior Floating Laminotomy as a New Decompression Technique for Posterior Cervical Spinal Fusion Surgery

  • Shin, Hong Kyung;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.901-912
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    • 2021
  • Objective : In the cervical spine, many surgical procedures have been developed to achieve optimal results for various disorders, including degenerative diseases, traumatic injury, and tumor. In this study, we report our experience and follow-up results with a new surgical technique for cervical spine entitled posterior floating laminotomy (PFL) in comparison with conventional laminectomy and fusion (LF). Methods : Data for 85 patients who underwent conventional LF (n=66) or PFL (n=19) for cervical spine disorders between 2012 and 2019 were analyzed. Radiological parameters, including cervical lordosis (CL), T1 slope (T1S), segmental lordosis (SL), and C2-7 sagittal vertical axis (SVA), were measured with lateral spine X-rays. Functional outcomes, comprising the modified Japanese Orthopaedic Association (mJOA), neck disability index (NDI), and visual analog scale (VAS) scores, were also measured. For the patients who underwent PFL, postoperative magnetic resonance image (MRI) was performed in a month after the surgery, and the degree of decompression was evaluated at the T2-weighted axial image, and postoperative computed tomography (CT) was conducted immediately and 1 year after the operation to evaluate the gutter fusion. Results : There was no difference in CL, T1S, SL, and C2-7 SVA between the groups but there was a difference in the preoperative and postoperative SL angles. The mean difference in the preoperative SL angle compared with that at the last follow-up was -0.3° after conventional LF and 4.7° after PFL (p=0.04), respectively. mJOA, NDI, and VAS scores showed significant improvements (p<0.05) during follow-up in both groups. In the PFL group, postoperative MRI showed sufficient decompression and postoperative CT revealed gutter fusion at 1 year after the operation. Conclusion : PFL is a safe surgical method which can preserve postoperative CL and achieve good clinical outcomes.

Gait Analysis and Functional Outcomes Following Pan Tarsal Arthrodesis of Tarsal Joint in a Toy Poodle

  • Song, Jaeyong;Kim, Jun-Hyung;Woo, Heung-Myoung;Kang, Byung-Jae
    • 한국임상수의학회지
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    • 제36권2호
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    • pp.123-125
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    • 2019
  • A 12-year-old castrated Toy Poodle was referred with a continuous non-weight bearing lameness of right hind limb due to a traffic accident 9 years ago. Physical examination and radiographs revealed partial loss of right calcaneal bone, loss of Achilles tendon and disused muscular atrophy. Arthrodesis was performed to preserve the function of the right hind limb. Pan tarsal arthrodesis plate was applied medially with 2.7 mm cortical screws and 2.0 mm cortical screws. During fixation, cancellous bone chip was transplanted into the arthrodesis site. A bone union was confirmed 9 weeks after surgery. Furthermore, on the gait analysis, the weight-bearing of right hind limb was restored to 70% of the opposite hind limb. Arthrodesis can be used to treat more difficult and serious problems affecting the joints. In particular, arthrodesis is indicated in cases such as comminuted intraarticular fractures and irreparable injury of the calcaneal tendon apparatus in the hock joint. In this case, the pan tarsal arthrodesis provided stability to the hock joint and improved the gait by restoring severe chronic damage. In conclusion, we successfully treated a challenging disability of hock joint using pan tarsal arthrodesis to restore the legs that were non-weight bearing due to chronic injury by traffic accident and objectively ascertained the increased weight bearing by gait analysis.

Clinical Features and Treatment Outcomes of Acute Multiple Thoracic and Lumbar Spinal Fractures : A Comparison of Continuous and Noncontinuous Fractures

  • Cho, Yongjae;Kim, Young Goo
    • Journal of Korean Neurosurgical Society
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    • 제62권6호
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    • pp.700-711
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    • 2019
  • Objective : The treatment of multiple thoracolumbar spine fractures according to fracture continuity has rarely been reported. Herein we evaluate the clinical features and outcomes of multiple thoracolumbar fractures depending on continuous or noncontinuous status. Methods : From January 2010 to January 2016, 48 patients with acute thoracic and lumbar multiple fractures who underwent posterior fusion surgery were evaluated. Patients were divided into two groups (group A : continuous; group B : noncontinuous). We investigated the causes of the injuries, the locations of the injuries, the range of fusion levels, and the functional outcomes based on the patients' general characteristics. Results : A total of 48 patients were enrolled (group A : 25 patients; group B : 23 patients). Both groups had similar pre-surgical clinical and radiologic features. The fusion level included three segments (group A : 4; group B : 5) or four segments (group A : 19; group B : 5). Group B required more instrumented segments than did group A. Group A scored 23.5 and group B scored 33.4 on the Korean Oswestry Disability Index (KODI) at the time of last follow-up. In both groups, longer fusion was associated with worse KODI score. Conclusion : In this study, due to the assumption of similar initial clinical and radiologic features in both group, the mechanism of multiple fractures is presumed to be the same between continuous and noncontinuous fractures. The noncontinuous fracture group had worse KODI scores in long-term follow-up, thought to be due to long fusion level. Therefore, we recommend minimizing the number of segments that are fused in multiple thoracolumbar and lumbar fractures when decompression is not necessary.