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The Relationship Between Balance and Gait Outcome in Patients With Stroke (뇌졸중환자의 균형과 보행능력과의 관계)

  • Kim, Myoung-Jin;Yi, Chung-Hwi;Chung, Bo-In;Lee, Young-Hee
    • Physical Therapy Korea
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    • v.5 no.1
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    • pp.17-29
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    • 1998
  • The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.89 and $r_s$=0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were $r_s$=0.82 and $r_s$=0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

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A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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Role of Posterior Intralaminar Thalamic Nuclei in Acupuncture Analgesia in Rats (침진통(鍼鎭痛) 작용에 있어서 시상 후방 층판내핵(속방핵)의 역할)

  • Roh, Sik;Min, Byung-Il;Yoon, Sang-Hyub
    • The Journal of Korean Medicine
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    • v.20 no.3 s.39
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    • pp.36-44
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    • 1999
  • Objectives: It has been well known that electroacupuncture(EA) has an analgesic effect and there is a pain control system in the central nervous system(CNS). The pain control system is composed of three major nuclei, which are periaqueductal gray(PAG), raphe nuclei, and the pain inhibitory complex located in the spinal cord. It has been suggested that the analgesic effect of EA might be the result of activation of the pain control system in the CNS. However, there may be a possibility that other nuclei are also involved in this pain modulation. Thus, we investigated whether the posterior intralaminar thalamic nuclei (PTIN) are involved in the pain modulation. Methods: To measure the level of pain, the jaw opening reflex (JOR) was used as a pain index. The magnitude of JOR is estimated by averaging the area of 10 successive responses. JOR was evoked by tooth-pulp stimulation with bipolar electrode carrying stimulus with the following parameters: intensity ranging from 420uA to 680ulA, 0.3ms duration of square pulse, and 0.5 Hz. Hapkog($LI_4$) and Taechung ($LR_3$) were the chosen acupoints. The Hapkog point was stimulated ipsilaterally at 5V, 3 Hz, for 15min in total, and the Taechung was stimulated at 2-3 V, 3 Hz, and for a total of 15 or 30 minutes. Different intensities of stimulation were given the PITN; one was given at $300{\mu}A$ and the other was at 500uA. The position stimulated in these nuclei by Paxinos Atlas was AP; from bregma $-4.0{\sim}-4.3mm,\;L; 0.5{\sim}1.8mm,\;D;\;4.8{\sim}6.3mm$. Results: The Hapkog point had a significant analgesic effect (P<0.05). However, the Taechung point had no effect. Both types of stimulation in the PITN did not reveal any analgesic effects. Conclusions: From these results, it was suggested that the posterior intralaminar thalamic nuclei are not involved in the modulation of pain.

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Effect of Hwanggumgung, a Natural Product, on Hair Growth Promotion in C57BL6 Mice (C57BL6 마우스에서 복합생약제인 황금궁의 육모 효과)

  • Hue Jin-Joo;Li Lan;Lyu Sul-Hye;Baek In-Jeoung;Yon Jung-Min;Nam Sang-Yoon;Yun Young Won;Hwang Seock-Yeon;Hong Jin Tae;Lee Beom Jun
    • YAKHAK HOEJI
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    • v.49 no.6
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    • pp.518-526
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    • 2005
  • Hwanggumgung (HGG) is a hair-care product which is composed of several plant extracts used in oriental medicine. This study was carried out to investigate effect of HGG on hair regrowth in a shaving model of C57BL6 mice. Five-week-old mice were acclimated for 1 week under 23$\pm$3$^{\circ}C$, 50$\pm10\%$ relative humidity and 12 h of a light/dark cycle before beginning experiment. There were four experimental groups including distilled water (D.W., control), 10$\%$ ethanol (EtOH, vehicle control), a positive control of 3$\%$ minoxidil (MXD), and HGG for female and male mice, respectively; Six-weeks old mice were trimmed by electric clippers so as not to damage the skin. The next day; mice without visible scraches were selected, randomized and separated in groups of 11 mice. The test compounds were topically treated with 0.15ml per mouse per day for 21 days. The hair regrowth was photographically and histologically determined during the experimental period of 21 days. Enzyme activities of $\gamma$-glutamyl transpeptidase and alkaline phosphatase were also determined using a rate assay method. There were no clinical signs in all experimental groups. The topical application of 3$\%$ MXD and HGG in female mice promoted hair regrowth earlier and faster than the control groups. In male mice, the topical application of 3$\%$ MXD and HGG also accelerated hair growth compared with the controls. Ten percent ethanol also promoted hair growth faster than D.W group. The histology of hair growth in experimental groups was strongly associated with the hair regrowth. 3$\%$ MXD and HGG promoted elongation of hair follicles compared with the controls in both female and male mice. Activities of alkaline phosphatase and $\gamma$-glutamyl transpeptidase, enzymes related to hair growth, significantly increased after treatments of 3$\%$ MXD and HGG for 2 weeks in both female and male mice (p < 0.05). These results suggest that HGG has hair growth promoting activities and it can be for treatment for alopecia.

A Study on the Utilization of a Rural Health Subcenter for Primary Health Care (일개 농촌지역주민의 면보건지소 이용실태에 관한 고찰 -경기도 남양주군 수동면-)

  • Kim, Young-Bok;Wie, Cha-Hyung
    • Journal of agricultural medicine and community health
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    • v.19 no.1
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    • pp.31-39
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    • 1994
  • We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

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The Effects of Education According to Constitution & Character of Patients Who have Stroke (뇌졸중 환자의 체질별 건강통제위 성격별 자가간호에 대한 교육의 효과)

  • Kang Hyun-Sook;Lee Jung-Min;Choi Eun-Sun;Jeon Eun-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.7-18
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    • 1995
  • This study was designed to explore the effectiveness of education to improve self-care of stroke patients with three types of charactor health locus of control and constitution. A total of 56 patients were selected by convenience sampling at one oriental hospital. The teaching of self-care was conducted by the researcher. The self-care performance was measured for 10 days. The data were analyzed using t-test, ANOVA and Scheffe method as post hoc test. The results of this study are as follows : 1. The self-care performance by patients' characteristics : Age and education had impact on the self-care performance. The level of self-care performance of young and high educated patients was high, gender, religion, occupation, monthly income, and the paralyzed side, however, didn't have influence on the self-care performance. 2. The self-care performance of patients with three types of constitution : There was no statistical significance on the self-care performance of patients group by constitution. However, average score of self-care performance of patients with So-Um was high. 3. The self-care performance of patients with three types of health locus of control : There was no statistical significance on self-care performance of patient group by health locus of control. 4. The correlation between the constitution and the health locus of control : There was no statistical significance on the introverted and chance health locus of control of patients with three types of constitution. However, there was a statistically significant relationship between the powerful others health locus of control and So-Yang. Even though there was no statistically significant self-care performance of patients with So-Um, there was a clinical significance on the high score of self-care performance of patients with So-Um as compared with the self-care performance of the patients. The health locus of control didn't have influence on the self-care performance of patients. There was a statistically significant relationship between the powerful others health locus of control and So-Yang. Therefore, this study suggest the need to develop the nursing intervention to improve the self-care of stroke patients with the powerful others health locus of control and So-Yang, Furthermore, the longitudinal research is needed to determine the effectiveness of training to imp

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A Study on the Sasang Constitution and Type A/B Personality in Kangwon Province (사상체질과 A/B형 성격에 관한 연구)

  • Lee Kyu-Eun;Kim Nam-Sun;Ryu Jae-Gyu
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.201-212
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    • 2002
  • Purpose: The purpose of this study was to identify the association between Sasang constitution and type A/B personality. Method: The subjects for this study were 113 Korean adults living in Kangwon Province, the northeastern part of Korea. The data were collected from March 10 to April 13. 2002 using a structured questionnaire. The instrument for this study were QCSSII (Questionnaire for Sasang Constitution Clsssification II) by Kim et al.(1996), and the Revised Type A/B personality by Eysenck & Fulker(1983). The data were analyzed through the SPSS 10.0 for Windows program using frequency, percentage, $x^2$-test, ANOVA, and Pearson correlation coefficient. Results: The results of the study are as follows : 1. Of 113 Korean adults, the portion who were Taieum-in, Soeum-in, Soyang-in was 39.8%, 34.5%, 25.7% respectively. 2. For type A/B personality, mixed type was most common, 19.4% of the participants were of type B and 8.0%., type A. 3. For type A/B behavior, mixed type was most common at 47.8% and type A was 2.7%. 4. There were statistically significant differences in the Sasang constitutional type according to BMI (F=14.542, P<.001), and alcohol consumption (F=4.256, p<.018). 5. There were significant difference between type A/B Personality and BMI (F=3.592, P<.032). 6. The data shows correlations between BMI and amount smoked per day (r=2.74, P<.004), between BMI and alcohol consumption (r=-.303, p<.008), between BMI and Sasang constitutional type (r= -.592, p<.0001), between BMI and type A/B personality (r=285, p<.011), between amount smoked per day and alcohol consumption (r= .-361, p<.001). between alcohol consumption and Sasang constitutional type (r=-.306, p<.019). between perceived health state and type A/A personality (r= .246, p<.011). Conclusion: According to the above findings, it can be concluded that further research is need to understand the Sasang constitution for the discipline of Nursing and for nurses to prepare nursing protocols relevant to Sasang constitutional care. Also, Sasang constitution has to be considered in research and practice in the health care delivery system.

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The Effects of Thoracic Spine Self-mobilization Exercise Using a Tool on Pain, Range of Motion, and Dysfunction of Chronic Neck Pain Patients (소도구를 이용한 등뼈 자가 관절 가동성 운동이 만성 목통증 환자의 통증, 관절가동범위, 기능장애에 미치는 영향)

  • Kim, Su-jin;Kim, Suhn-yeop;Lee, Min-ji
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.1-10
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    • 2020
  • Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

The degree of burden and depression in family caregivers of patients with stroke (뇌졸중 환자의 자가간호 수행수준에 따른 환자가족의 부담감과 우울정도에 관한 연구)

  • Lee, Kang Yi;Song, Young Shin
    • Journal of Haehwa Medicine
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    • v.6 no.1
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    • pp.555-566
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    • 1997
  • This study was undertaken to identify the degree of burden and depression according to level of self-care activity and variables to which affect that in family caregivers of patients with stroke. The data were collected from October 23th to November 20th, 1995 The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital in D city. The questionnaires consisted of questions regarding burden(13 items, 6 point scale), depression(20 items, 4 point scale), and self-care activity(15 items, 5 point sacle) Data were analyzed using percentages, means, t-test and ANOVA with the SAS program. The results of this study are as follows: 1) The mean score for client's self-care activity was 2.58. The highest score of the self-care activity item was 'returning'(M=3.604), and the lowest score of the self-care activity item was 'shower or tubbathing'(M=1.925). 2) the degrees of self-care activity according to the general characteristics of patients were tested. It was significantly different by sex(P<0.01), occupation(P<0.05), and relationships with patients(P<0.05). That is, the degree of self-care activity was higher in men than that of women, and caregiver with job than caregiver without that. In the case that caregiver was a patient's spouse, the degree of self-care activity was higher than other case. 3) The score for family caregiver's burden was higher than the mid level for the 13 items and caregiver's depression was relatively low. 4) According to the degree of self-care activity, the group was divided to 3, that is, A( 15-33), B(34-56), and C(57-75). The score of total burden was the highest in group A(M=55.257) and the lowest in group C(M=51.928), but there were no statistically significant differences between groups. The score of objective burden was the highest in group A(M=30.400), and the lowest in group C(M=25.214), and there were statistically significant differences between groups. The score of subjective burden was the highest in group B(M=26.000) and the lowest in group A(M=24.783), but there were no statistically significant differences between groups. The degree of depression was the highest in group A(M=44.750) and the lowest in group C(M=40.751), but there were no statistically significant differences between groups.

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A Research on the Health State According to Each of the Korean Constitution's Perceptual Level of Stress (한국인의 체질별 스트레스 인지정도에 따른 건강상태에 대한 연구)

  • Jeon, Eun-Young;Ko, Byung-Hee;Kim, Kwuy-Bun
    • Journal of Sasang Constitutional Medicine
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    • v.4 no.1
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    • pp.81-106
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    • 1992
  • The purpose of this study was to find out the causal relationship between perceptual level of stress and health state according to Korean constitutions and to analyze that effect on the Korean constitution's health state. Subjects of this study were 87 out patient department of constitution at Kyung-Hee Oriental Medicine Hospital. Data were collected by using interview with Questionaire during 6 months from Feb. 2 to June 31, 1991. The Measurement tools used by this researcher were Go's The Questionaire of Identify about constitution, Lee's stress scale and Go's modified Cornell Medical Index which were approved it's reliability and validity. All of the questionaires of were used after pre- test. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and Pearson correlation. And then this research's issue was tested by SAS program's ANCOVA. The findings of this study was summarized as follow. 1. There was significantly differences in stress perceptual level in Korean constitution. (F=9.68, P=.000). The So Em In (小陰人) were higher than the other constitution on stress perceptional level. 2. In health state, there was significantly difference among Korean constitution. (F=6.654, P=.002). Also the So Em In (小陰人) was lower than the other constitution at health state. Therefore, it was considerate that So Em In (小陰人) was higher perceptual level of stress than the other constitution and the resulting poor health state. 3. Stressful perception was effected on the health state, as a result inverted correlation was constructed between stress perception and health state. (r=-.6034, P=.0001) 4. After exclusion of stress perceptual level, each of the Korean Constitution's health state was not difference (F=1.01, P=.37). It was mean that differences of the Korean Constitution's perceptual level of stress effected on the health state. Bacause So Em In (小陰人) had higher perceptual level of stress than other constitution (F=9.687, P=.000), in proportion to that one's health state was poor. From the results of this study, it could be concluded that the higher stress perceptual level according to Korean constitution, the poorer health state. Further study in this area needs to be consideration that in order to coping with stress, researcher grope for quality nursing intervention with more accurative assessment about Korean constitution.

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