• 제목/요약/키워드: therapy protocol

검색결과 396건 처리시간 0.03초

The Effect of Whole Body Vibration Exercise on Ankle Joint Spasticity Patients with Chronic Stroke

  • Jo, Yeo-Reum;Jeong, Mo-Beom;Lee, Dong-Woo
    • The Journal of Korean Physical Therapy
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    • 제30권4호
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    • pp.135-140
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    • 2018
  • Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.

측두하악관절 환자의 전방재위치장치 치료 전후의 임상증상 및 자기공명영상을 이용한 관절원판 변화의 분석 (ANALYSIS OF THE CLINICAL SYMPTOMS AND THE TEMPOROMANDIBULAR JOINT DISK BY MAGNETIC RESONANCE IMAGING AFTER CONSERVATIVE TREATMENT WITH ANTERIOR REPOSITIONING SPLINT)

  • 명신원;박재억
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권2호
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    • pp.136-142
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    • 2006
  • Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

동료멘토(peer mentor) 프로그램이 뇌졸중 환자의 회복에 미치는 영향: 연구 프로토콜 (A Effect of Peer Mentor Program on Recovery after Stroke)

  • 이창대;박지혁
    • 재활치료과학
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    • 제4권2호
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    • pp.84-91
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    • 2015
  • 본 연구는 해외 많은 분야의 재활에서 적용되고 있는 peer mentor 프로그램을 국내에 연구적, 임상적으로 도입하여 뇌졸중 환자의 정신적, 신체적 회복을 돕는 방법을 소개하고자 하였다. 두 집단 실험 설계로 뇌졸중이 발생한지 3-6개월인 환자들을 대상으로 설계하였다. 동료멘토는 뇌졸중이 발생한지 2년이 지난 외래 환자로 서로 다른 회복수준을 보이는 환자들로 구성하고, 프로그램을 운영하기에 앞서 참가자들에게 심리적, 평가적, 정보적인 도움을 주는 방법과 프로그램 운영 방법에 대해 교육한다. 한국판 노인 우울 척도 단축형 (Geriatric Depression Scale Short Form-Korea Version; GDSSF-K)을 사용하여 프로그램 참가자들의 심리적 요인을 측정하고, 뇌졸중 영향척도(Stroke Impact Scale; SIS)를 통해 회복수준을, 노인 상지 기능평가도구(Upper Extremity Function Test for the Elderly; TEMPA)을 사용하여 신체적 요인을 측정한다. 본 연구를 토대로 연구를 진행하고자 하는 연구자는 본 연구에서 제안한 방법과 더불어 뇌졸중 환자의 회복에 더 효과적인 프로그램 적용 방법에 대한 모색이 필요할 것이다.

Efficacy of Korean Red Ginseng Supplementation on Eradication Rate and Gastric Volatile Sulfur Compound Levels after Helicobacter pylori Eradication Therapy

  • Lee, So-Jung;Park, Ji-Young;Choi, Ki-Seok;Ock, Chan-Young;Hong, Kyung-Sook;Kim, Yoon-Jae;Chung, Jun-Won;Hahm, Ki-Baik
    • Journal of Ginseng Research
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    • 제34권2호
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    • pp.122-131
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    • 2010
  • This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. $^{13}C$-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p<0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p<0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.

Bright Light Therapy in the Morning or at Mid-Day in the Treatment of Non-Seasonal Bipolar Depressive Episodes (LuBi): Study Protocol for a Dose Research Phase I / II Trial

  • Geoffroy, Pierre Alexis;El Abbassi, El Mountacer Billah;Maruani, Julia;Etain, Bruno;Lejoyeux, Michel;Amad, Ali;Courtet, Philippe;Dubertret, Caroline;Gorwood, Philip;Vaiva, Guillaume;Bellivier, Frank;Chevret, Sylvie
    • Psychiatry investigation
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    • 제15권12호
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    • pp.1188-1202
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    • 2018
  • Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

수면장애에 대한 인지행동 치료 효과에 대한 체계적 문헌 고찰 개관 (Effectiveness of Cognitive Behavioral Therapy for Sleep Disorder: An overview of Systematic Review)

  • 이장원;여진주;김경식;현민경
    • 대한한의학회지
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    • 제43권2호
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    • pp.75-91
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    • 2022
  • Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.

Effectiveness and Safety of Pharmacopuncture Therapy for Chronic Low Back Pain: A Study Protocol for a Pragmatic Randomized Controlled Trial

  • Youn Young Choi;Hwa Yeon Ryu;Jae Hui Kang;Hyun Lee
    • Journal of Acupuncture Research
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    • 제41권2호
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    • pp.107-114
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    • 2024
  • Background: Low back pain (LBP) is a common musculoskeletal disorder worldwide, with a lifetime prevalence of up to 80%. Among nonsurgical treatments for chronic LBP, Korean medicine treatments are highly preferred, and pharmacopuncture therapy combining acupuncture and herbal medicine is widely used. However, no evidence-based study has focused on the use of various types of pharmacopuncture. Methods: The pragmatic randomized controlled clinical trial will include 44 participants; recruitment will start in July 2023. All participants will receive integrated Korean medicine treatment including acupuncture, cupping, and infrared therapy, and the intervention group will also receive pharmacopuncture. After 16 treatment sessions, twice a week for 8 weeks, follow-up assessments will be performed at week 9. As a pragmatic randomized controlled clinical protocol, the type, dose, and acupoints of acupuncture and pharmacopuncture are not determined in advance but are selected and recorded according to the clinical judgment of the Korean medicine doctor. Results: The primary outcome will be measured using a visual analog scale score, and the secondary outcomes include the Oswestry disability index, patient global impression of change, no worse than mild pain, and range of motion. Safety will be assessed by examining participants' self-reported adverse events and vital signs and conducting blood tests before and after the test. Conclusion: This study aims to provide clinical evidence of the effectiveness and safety of pharmacopuncture for chronic LBP.

Speech Outcomes in 5-Year-Old Korean Children with Bilateral Cleft Lip and Palate

  • Kyung S. Koh;Seungeun Jung;Bo Ra Park;Tae-Suk Oh;Young Chul Kim;Seunghee Ha
    • Archives of Plastic Surgery
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    • 제51권1호
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    • pp.80-86
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    • 2024
  • Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

Report of the AAPM Radiation Therapy Committee의 Task Group No.66에 의한 전산화 단층촬영 모의치료기의 정도 관리 (Quality assurance for computed-tomography simulator : Report of the AAPM Radiation Therapy Committee Task Group No.66)

  • 이윤석
    • 대한방사선치료학회지
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    • 제17권1호
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    • pp.41-43
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    • 2005
  • 목적 : 자체 제작한 Q.A tool을 이용하여 AAPM Task Group Report No.66 에서 제시하는 CT simulator의 Q.A 항목을 확인하여 보다 안전하고 정확한 CT-simulation 과정을 확보하기 위해 효율적이고 편리성을 갖춘 정도관리 과정을 제시하고자 한다. 대상 및 방법 : 본원에 CT simulator의 Q.A tool을 제작하여 Report of the AAPM Task Group No.66에서 제시하는 wall laser system, patient table, CT scanner의 imaging plane의 isocenter간의 정렬을 일간 단위로 확인한다. 결과 : Report of the AAPM Task Group No.66에서 제시하고 있는 정도관리 항목의 확인으로 wall laser의 ${\pm}\;2mm$, table의 ${\pm}\;2mm$, imaging plane의 ${\pm}\;2mm$ 허용 오차 범위내의 측정치를 확인하였다. 결론 : 방사선 치료을 위한 CT-simulation 과정에서 기존의 진단 영역의 CT Q.A protocol로는 확인되지 않는 항목이 있는데, Report of the AAPM Task Group No.66에서 제시하고 있는 Q.A 항목을 확인하여 방사선 치료전용 CT-simulator 장비의 적절한 정도 관리를 기하여 안전하고 정확한 CT-simulation 과정을 보장받을 수 있었다.

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다양한 adeno-associated virus (AAV) 혈청형의 효율성 높은 생산법과 새로운 공통적 정량법 개발 (Improved Production Efficiencies of Various Adeno-Associated Virus (AAV) Serotypes and a Novel Universal AAV Titration Method)

  • 조영화;최예진;윤정희;김남희;최미라;최영국;김경희;이영일;이범준;박기랑
    • 생명과학회지
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    • 제22권6호
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    • pp.703-712
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    • 2012
  • AAV는 매우 안전하고 효율적인 유전자전달방법으로 인정되어 왔다. 그러나, AAV가 가진 생물의약품으로서 단점은 효율적이고 재현성 높은 생산법이 취약하고, 또한 다양한 혈청형을 간단한 한 가지 공통적 방법으로 신뢰성 있게 정량하는 방법이 개발되어야 하는 것이다. 따라서, 본 연구에서는 AAV2와 아데노바이러스를 동시에 감염하는 종래의 생산법에 의한 효율성과 새로운 생산법, 즉 AAV2 감염 후 pHelper 플라스미드를 transfection 하는 방법을 통한 생산효율성을 비교하였고, HEK293과 293T를 생산세포주로 하여 시간에 따른 생산효율성도 분석하였다. 그 결과 AAV2와 pHelper DNA를 포함한 새로운 생산법은 기존의 방법에 비해 10배 이상 높은 생산효율성을 보였고, 293T에서 AAV2를 10 MOI로 감염한 후 5일째에 가장 높은 생산효율성을 보였는데, 생산세포 한 개 당 $1.61{\times}10^5$ virus genomes (v.g.)을 생산하는 결과였다. 따라서 이 생산조건을 다른 혈청형 생산에 적용한 결과, 모든 혈청형에서 생산세포주 한 개 당 $10^5$ v.g. 이상을 생산하는 효율성을 보였다. 한편, 다양한 AAV 혈청형을 한 가지 공통적인 방법으로 정량하기 위해 the universal PCR 프라이머를 제작하였고, 그것을 이용하여 신뢰성 높고 10개 분자까지도 증폭이 가능한 결과를 모든 혈청형에서 얻었다. 그러므로 이 한 쌍의 정량용 the universal 프라이머는 임상시험용 아데노바이러스벡터에 존재하는 AAV오염을 검출하는 것에도 사용 가능하다.