• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.199-203
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• 2018

The number of reported cases with dual disability is increasing for the past few decades. Currently, dual disability of lower limb amputation and motor weakness after stroke became a strong issue in public concern. The functional levels of patients have shown in the wide range from independent community ambulation to non-ambulation. Thus, it indicates that favorable outcomes for dual disability may depend upon adopted rehabilitative strategies. We present the case of a man with left below-knee amputation and severe right-sided weakness following a huge putaminal hemorrhage. He had suffered from extreme pain and misfit of the prosthetic socket and the complicated residual limb for three years prior to the stroke. Forty days post-stroke, we performed a revision surgery to resolve the complications of bony overgrowth, verrucous hyperplasia, and neuroma and applied an ankle foot orthosis (AFO). Two years post-stroke, he was able to ambulate outside his home and negotiate stairs using a cane. This is the first case with the dual disability of lower limb amputation and contralateral hemiplegia to undergo revision surgery. The results suggest that an early revision surgery and use of an AFO are crucial for achieving a higher level of mobility in such cases.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.133-137
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• 2022

A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.47-55
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• 2021

Background: Plantar fasciitis is one of the most common conditions of the lower limbs. The present study aimed to compare the effect of hip muscle strengthening exercise and stretching of lower extremity in plantar fasciitis, with regard to pain, navicular drop and foot and ankle functional ability. Methods: A total of 42 patients diagnosed with plantar fasciitis were randomly assigned to the experimental group (n=21) that applied the hip muscle strengthening exercise and the control group(n=21) that applied the general lower limb stretching. The intervention period was 6 weeks. Results: The results of the experiment showed that the exercises for strengthening the hip muscle had significant effects on pain, navicular drop and foot and ankle functional ability In addition, lower extremity stretching showed improvement effects in pain, navicular drop and foot and ankle functional ability, however, the difference between the groups except navicular drop did not reach statistical significance Conclusion: Both interventions tested in this study were confirmed to be effective treatment options for patients with plantar fasciitis.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.77-88
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• 2019

Objectives : The purpose of this study was to show the effectiveness of Chuna Manual Therapy applied to a osteoporosis patient with gait disturbance due to lower limb fracture surgery. Method : We focused on Chuna therapy accompanied with acupuncture, herbal medicine, moxibustion, cupping treatment and rehabilitation exercise. This case was assessed using the Visual Analogue Scale (VAS), Pain Free Walking Distance (PFWD), Berg Balance Scale (BBS), and Modified Barthel Index (MBI). Result : This patient showed improvement on the VAS from 6 to 3, PFWD from 0 m to 2000 m using a walker and 50 m by self-walking, BBS from 2 to 28, and MBI from 56 to 89. Moreover the walking state improved from gait disturbance to self-walking. Conclusion : This study suggests that Chuna therapy could be used to improve gait disturbance in patients with osteoporosis and lower limb fracture surgery.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.104-113
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• 2021

Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.235-243
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• 2014

Purpose: The purpose of this study was to identify the effects of Ankle Pump Exercise on lower limb edema and pain of operating room nurses. Methods: This research was arranged on the basis of the nonequivalent control group pre-post test design. The participants were 41 nurses working in the operating room in 'S' hospital in Seoul and 'H' hospital in Guri City, Korea. Data were collected from August 20 to September 30, 2012. Edema of the lower extremities was measured in terms of the girths of ankles and calves. Pain of the lower extremities was measured in terms of VAS (Visual Analogue Scale) for pain. The data were analyzed by frequency, percentage mean, and standard deviation, using the chi2(p) and t-test, repeated measures ANOVA, and a paired t-test. The SPSS Win 20.0 program was used for analysis. Results: Hypothesis 1 - "There are significant differences in lower extremity edema between the experimental group and the control group." - was partially supported. Hypothesis 2 - "There are significant differences in lower extremity pain between the experimental group and the control group." - was supported. Conclusion: The results of this study demonstrate positive practical effects of the Ankle Pump Exercise in reducing the circumference of both ankles, reducing the circumferential edema of both calves, and alleviating the pain of nurses in the operating room. Based on these findings, application of the Ankle Pump Exercise can be considered as an effective method to prevent nurses' health problems in the lower extremities that can be induced by their work during surgical operations.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.134-137
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• 2016

Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.792-797
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• 2000

Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2096-2101
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• 2020

Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I² ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient's data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.