• Title/Summary/Keyword: 재활 치료

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Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Comparison of Rotational Strength in Shoulders with Anterior Instability and Normal Shoulders Using Isokinetic Testing (등속성 검사를 통한 견관절 전방 불안정 환자와 정상인의 회전력 비교)

  • Lee, Dong-Ki;Kim, Tae-Kwon;Lee, Jin-Hyuck;Lee, Dae-Hee;Jung, Woong-Kyo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.79-85
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    • 2012
  • Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.

Ultrasonographic Assessment for Rotator Cuff Repair According to the Tear Sizes and the Repair Method (회전근 개 파열의 크기 및 봉합 방법에 따른 초음파를 이용한 추적검사의 유용성)

  • Choi, Chang-Hyuk;Park, Jae-Hyun;Shin, Dong-Young;Lee, Jae-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.53-61
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    • 2009
  • Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.

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A Comparison of Outcomes after Early and Delayed Reconstruction in the Acute Posterior Cruciate Ligament Injuries (급성 후방십자인대 손상 환자에서 조기 재건군과 지연 재건군의 결과 비교)

  • Lee, Yong Sik;Lee, Soo Won;Seo, Byung Ho;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.31-37
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    • 2013
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute posterior cruciate ligament (PCL) injuries. Materials and Methods: Thirty-two Patients who underwent PCL reconstruction between March 2008 and October 2011 enrolled this study. We performed transtibial single bundle reconstruction using the allo-achilles tendon in all cases. We divided the patient into two groups, early reconstruction group underwent surgery before a week, delayed reconstruction group underwent surgery after 3 weeks, before 6 weeks. All the patients underwent aggressive joint motion exercise till surgery and enrolled post operative rehabilitation program. We checked posterior drawer stress radiography, range of motion, the Lysholm score, the International Knee Documentation Committee (IKDC) score and the Tegner score to evaluate the results. Results: At the final follow up the Lysholm score was 92.1 in the early group and 93.8 in the delayed group. All the cases were rated above B (near normal) on IKDC score (p=0.808, p=0.722). The Tegner score was 6.6 in the early reconstruction group and 6.2 in the delayed group (p=0.480), The average of maximum flexion and extension angle was $133.9^{\circ}$, $1.4^{\circ}$ in the early group and $133.6^{\circ}$, $1.1^{\circ}$ in the delayed group (p=0.560, p=0.581), no complication such as deep vein thrombosis or infection, no difference in posterior drawer stress radiography (p=0.750). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute PCL injuries. Therefore, the early reconstruction of PCL performed before a week could be one of the treatment options for acute PCL injury.

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Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.139-143
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    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

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Usefulness of the Salivagram for the Diagnosis of Brain Lesions in Patients with Aspiration Pneumonia (뇌병변 환자에서 흡인성 폐렴 진단을 위한 Salivagram의 유용성)

  • Oh, Shin Hyun;Choi, Yung Sook;Ro, Dong Wook;Nam-Koong, Hyuk;Kim, Jae Sam;Leee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.48-52
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    • 2013
  • Purpose: Bed, living a long time is required in adult patients with brain lesions such as stroke, traumatic brain injury, and Parkinson's disease, causing pneumonia and respiratory diseases may be due to aspiration of food or saliva. In patients with recurrent pneumonia or pulmonary symptoms, there is a need to determine the possibility of pulmonary aspiration due to aspiration of saliva. Materials and Methods: Saliva due to aspiration pneumonia diagnosis in patients with brain lesions request for inspection to the Department of Nuclear Medicine, 10 patients (male 6, female 4) were included in this study. Patients were fasted before the test, $^{99m}Tc_{O4}$ 185 MBq (5 mCi) of less than 1 mL of solution was administered in the oral cavity. Administration and 20 minutes of dynamic imaging acquisition, and immediately after that the static images were acquired. Delayed scan after 2-4 hours if necessary. Results: Positivity rate of all 10 patients was 60%. In 4 patients showed positive reactions after the administration of oral cavity in a 20-minute dynamic imaging were able to confirm whether the aspiration. In the remaining 2 patients, four hours of additional delay tests were able to confirm whether the aspiration. Conclusion: Does not require changes in patient posture compared to the other checks that can be diagnosed with aspiration pneumonia. A simple test and takes less time. Therefore be useful in providing information for the diagnosis and treatment modality.

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Comparison of Play Perception and Play Participation of Parents of Disabled Children and Non-disabled Children in Preschool Age (학령전기 장애 아동 부모와 비장애 아동 부모의 놀이 인식과 놀이 참여 비교 연구)

  • Park, DaSol;Lee, EunYoung;Lee, SunHee;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.69-78
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    • 2020
  • Objective : The purpose of this study was to conduct a comprehensive survey of children's play in parents of disabled and non-disabled children prior to commencing school. This study aimed to further understanding play recognition and to present a specific direction of play necessary to each parent. Methods : A questionnaire based on prior studies was sent to 700 people who had previously agreed to the take part. A total of 596 questionnaires were analyzed. Uncollected and insincere surveys, of which 106 were questionnaires for parents of disabled children, were exclused from analysis. The SPSS Window 23 program was used for data analysis and frequency analysis and the independent sample T test were performed. Results : Disabled children's parents perceived playing with their children as more important than that of non-disabled children's parents(p<0.01). There was no statistical difference between disabled children and non-disabled children's parents, but there were some differences(p=0,053). Both disabled and non-disabled children had more time to participate with their mothers than with their fathers. Mothers with disabilities had more time to play however, fathers with no disabilities had more time. Both disabled and non-disabled children's parents had the most "ordinary" frequency of buying toys and there was very littele difference between the 2 groups. Both disabled and non-disabled children's parents primarily used the internet to acquire play information, and consideration when buying fun was followed by interest inducement, development level and safety. Conclusion : Through this study, it was possible to compare the status of play recognition and participation by parents of children with or without disabilities. Based on this study, parents will be able to find out what they really need to play and will be provided as a basis for future play studies for children.

The clinical utility of K-CBCL 6-18 in diagnosing ADHD -focused on children with psychological disorders in child welfare institution- (ADHD 진단에서 K-CBCL 6-18의 임상적 유용성 -아동복지시설 심리장애 아동에의 적용-)

  • Kim, Sang A;Ha, Eun Hye
    • Journal of the Korean Society of Child Welfare
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    • no.56
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    • pp.253-281
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    • 2016
  • The purpose of this study was to verify the clinical utility of th Korea Child Behavior Checklist 16-18(K-CBCL 6-18) in diagnosing ADHD among children with psychological disorders in child welfare institutions. The participants were 509 elementary school children(309 boys and 200 girls) who lived in child welfare institutions. They were assessed using the Korean ADHD Rating Scale(K-ARS) and K-CBCL 6-18. Only five scales of the K-CBCL 6-18 related with attention were used for analysis: syndrom total, externalizing total, aggressive behavior, attention problems and DSM-oriented ADHD scales. The results were as follows. First, K-ARS and K-CBCL 6-18 had significantly positive correlations with all five scales. Second, as a result of a t-test on the ADHD and the non-ADHD groups, which were divided using K-ARS, the mean scores of ADHD group were significantly higher than the non-ADHD group for all five scales of the K-CBCL 6-18. The hit rate of all five scales of the K-CBCL 6-18 was 60 to 70 percent. The syndrom total and externalizing total scales had high sensitivity, whereas the aggressive behavior, attention problems, and the DSM-oriented ADHD scales had high specificity. In addition, all scales had high positive predictive values. Third, as the result of a t-test on the ADHD group and the emotional disorder group, there were significant difference in the mean scores of the attention problems and the DSM-oriented ADHD scales. The attention problems and the DSM-oriented ADHD scales had a similar percentage of hit rate, high specificity and low sensitivity. Especially, the DSM-oriented ADHD scale revealed higher specificity than the attention problems scale. The results of this study suggested that the five scales related to attention of the K-CBCL 6-18 are useful in diagnosing ADHD in child welfare institutions.

A Study on the Problems of Eating Habits of Mordern People and Suggesting Alternatives to Overcome Diseases: A Review of the Five Blue Zones, Based on the Roma Linda Region in the USA (현대인의 식습관 문제점 인지와 발생 질병극복을 위한 대안 제시: 5대 블루존 중 미국 로마린다 지역을 중심으로)

  • Shin, Kyung-Ok;Je, Haejong
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.53-62
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    • 2018
  • The purpose of this study was to propose an alternative for the eating habits of modern people and coping with the diseases. The purpose of this study was to apply the principles of eating habits of people living in Roma Linda to modern dietary life and to help healthy life and prevent disease. The period of this study was from May 1, 2016 to February 28, 2018. Literature search was conducted using Pubmed and Korean academic web sites. Based on the recognition of wrong eating habits, we classify and classify diseases according to eating habits. A total of more than 100 papers were selected and 60 papers and a database were prepared. People living in Roma Linda have eight health principles. The Roma Linda practiced balanced nutritional intake, sufficient exercise, adequate water intake, sunlight, temperance (abstinence from alcohol etc.), fresh air, adequate rest, and trust in eating habits. People living in Roma Linda have a high intake of vegetables, fruits and nuts. People living in Roma Linda are educated about nutrition, and among them, there is a low prevalence of coronary heart disease and cancer, because they mostly do not smoke or drink alcohol. Unhealthy eating habits and dietary behavior are associated with many diseases. Many chronic, degenerative diseases are due to bad eating habits and stress. If you take good food habits of people living in the Roma Linda area and practice it steadily, it will have a great effect on disease prevention.

Needs and Related Factors for Return-to-Work Support in Cancer Survivors (암 경험자의 직장복귀지원에 대한 요구도 및 관련 요인)

  • Lee, Sungwon;Lee, Kwang-Min;Oh, Gyu-Han;Yeom, Chan-Woo;Jung, Sanghyup;Hahm, Bong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.126-134
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    • 2020
  • Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.