• The Journal of Korean Physical Therapy
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• 제21권2호
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• pp.31-38
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• 2009

Purpose: This study was examined the effect of training using a Virtual Reality System on the sitting balance and Activities of Daily Living for patients with a spinal cord injury. Methods: The subjects were divided into an experimental (6 persons) and control group (5 persons). The experimental group trained the 5 programs, three times per week for 6 weeks using the Virtual Reality System and five days for week using conventional physical therapy. The control group trained five days for a week using conventional physical therapy. Results: The difference in the mean Spinal Cord Independence Measurement (SCIM) score in the experimental and control groups was increased to 8.33 and 6.60 (p=0.79), respectively. The difference in the mean functional reaching test in experimental and control group increased to 4.21 and 1.09 (p=0.25), respectively. The difference in the mean sitting time in experimental and control group increased to 41.05 and 10.33 (p=0.66), respectively. There was a difference in the mean of all variances but these differences were not statistically significant. Conclusion: These results suggest that training using the Virtual Reality System increased the SCIM, functional reaching test and sitting time in people with a spinal cord injury.

• The Korean Journal of Pain
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• 제12권1호
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• pp.123-127
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• 1999

Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

• 대한물리치료사협회지
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• 제13권1호
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• pp.5-17
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• 1992

Depression in Spinal Cord Injury Patients Kang, Soon Hee, M.Ed., R.P.T. Dept. of Rehabilitation Medicine, Kyung-Hee University Medical Center Depressions have the potential to affect adversely the rehabilitation of patients with spi-nal cord iniury. The present study examined depression, functional independence, and demographic and medical characteristics for 49 spinal cord injury(SCI) patients. This investigation involved the administration of the Beck Depression Inventory, the Modified Barthel Index, and aquestionnaire consisted of 14 items, The results were as follows .1. Compared to normal subjects, SCI patients had significantly higher BDI scores.2. When the cut-off point of HDI scores was assumed 21, 26.1% of normal subjeets and 75.5% of SCI patients appeared to be depressed. Depression in SCT patients were not related with age, sex, marital status, injury evel, severity, duration, pain, functional independence and medical charge. Depression in SCI patients were related with education level, economic level, age at injury, motivation. Depression in normal subjects were related with age, education level, economic level, but not related with sex, marital status. There were significant differences at 30 items of BDI between normal subjects and SCI patients. The items were as fellows . 1 sadness, 2 pessimism, 3 failure, 4 dissat-isfaction, 5 guilt, 6 punishment. 7 self-dislike 9 suicidal, 10 crying, 11 irritability, 12withdrawl, 13 indecisive, 14 self-image, IS work inhibition, 16 insomnia, 17 fatigue,18 anorexia, 19 weight loss, 20 hypochondria, 21 libido loss.

• 대한임상전기생리학회지
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• 제2권1호
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• pp.83-92
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• 2004

This study aims to the influenced factor analysis of spinal cord independence measure(SCIM), on walking velocity, walking endurance, time up & go(TUG), and subject characteristics. The subject of this study were 12 persons with incomplete spinal cord injury(ASIA C, D). All subject ambulatory with or without an assistive device. All participants were assessed on SCIM(score), walking velocity(m/s), walking endurance(m) and TUG(s). The data were analyzed using independent t-test and stepwise multiple regression. The results revealed that no statistical difference was noted in subject characteristics among SCIM, walking velocity, walking endurance, TUG(p>0.5). The independence score, breathing-sphincter control and ambulation were important factors in TUG(31.4%). The results suggest that SCIM may be an inappropriate assessment tool to predict gait ability of patient with incomplete spinal cord injury. Further study about gait speed, gait endurance and TUG by change of SCIM is needed using to patient of incomplete spinal cord injury.

• 한방재활의학과학회지
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• 제26권3호
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• pp.143-151
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• 2016

A 57-year-old male patient was diagnosed as Incomplete cervical spinal cord injury and Neurogenic bladder after falling accident and suffered from tetraplegia and urinary retention. The patient was hospitalized and treated with Complex Korean Medical treatment such as acupuncture, electro-acupuncture, bee venom pharmacopuncture and herbal medication for 13 weeks. International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) was adopted to evaluate the functional recovery and Korean version of Modified Barthel Index (K-MBI) was adopted to evaluate the recovery of activities of daily living (ADL). After treatment, Total scores of ISNCSCI and K-MBI were improved. Also patient's micturition reflex was recovered and symptoms of neurogenic bladder were improved. This result shows that Korean Medical treatment may be an effective treatment option for spinal cord injury and neurogenic bladder patients. Further clinical studies are needed to clarify the effect of Korean Medical treatment on spinal cord injury.

• 척추신경추나의학회지
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• 제5권1호
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• pp.81-89
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• 2010

Objects : This study was to report a clinical effect of Chuna Treatment for a patient diagnosed by Magnetic Resonance Imaging(MRI) as Cervical Myelopathy. Methods: In order to alleviate shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, phamacopucture, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results: VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions: Korean Treatment can be effectively used for a patient with Cervical Myelopathy. Further clinical studies are needed to verify the findings.

• PNF and Movement
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• 제11권2호
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• pp.103-110
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• 2013

Purpose : The aim of study was to assess the effect of backward walking combined with body weight supported treadmill training for patients with spinal cord injury. Methods : Forced vital capacity(FVC), forced expiratory volume at one second(FEV1), peak expiratory flow(PEF) and FEV1/FVC ratio(FER) were measured with a spirometer for on subject of T12 spinal cord injury. 10 meter walking test(10MWT), timed up & go test(TUG) and 6-Minute walking test(6MWT) were the measured. Intervention consisted of backward walking combined with body weight supported treadmill training five times a week for 12 weeks. Results : The date of 10MWT, TUG, 6MWT were improved. Furthermore, the date of PEF, FEV1, FVC, FER showed a improvement. Conclusion : Backward walking combined with body weight supported treadmill training may be a better and more effective method for gait performance and respiratory on incomplete spinal cord injury.

• Clinical Pain
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• 제20권2호
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• pp.145-149
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• 2021

Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.

• 재활치료과학
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• 제5권2호
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• pp.35-47
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• 2016

목적: 본 연구의 목적은 도로 주행 능력을 향상시키기 위한 운전재활의 방법과 효과에 대해 체계적 고찰을 통하여 추후에 있을 운전재활 연구의 방향을 제시하고자 한다. 연구방법: 2014년 12월부터 2015년 1월까지 운전재활에 관한 연구를 CINAHL, Embase, Pubmed, PsycINFO, Riss를 통하여 검색하였다. 선정기준에 따라 최종적으로 15편의 연구를 분석하였으며 주요검색용어로는 "On-road" OR "Driving" AND "Driving rehabilitation"AND "Intervention"을 사용하였다. 결과: 고찰한 연구는 총 15개로 근거 수준은 I, III, V이었다. 연구대상은 뇌졸중 환자(40.0%), 고령 운전자(20.0%), 외상성 뇌손상 환자(20.0%), 후천적 뇌손상 환자(13.3%), 척수환자(6.7%)였으며, 실제 도로 주행 능력을 향상시키기 위한 중재 방법은 시뮬레이터를 이용한 훈련(53.3%), 인지 기술을 훈련(26.6%), 운전을 위한 교육(6.7%), 보조 기기의 적용(6.7%), 운전 연수(6.7%)이었다. 중재 효과는 방법에 따라 차이가 있었지만 시뮬레이터를 이용한 모든 연구에서 중재 후 도로 주행 능력의 유의한 향상을 보고하였다. 결론: 도로 주행 능력을 향상시키기 위한 운전재활은 다양한 방법으로 적용되고 있었다. 특히 시뮬레이터를 이용한 중재는 많은 연구를 통해 효과가 입증되고 있었다. 추후 다양한 연구 대상자와 중재 방법을 통해 도로 주행 능력 향상을 위한 운전재활 연구가 지속적으로 이루어져야 할 것이다.

• Radiation Oncology Journal
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• 제19권1호
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• pp.53-65
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• 2001

목적 : 비인강암 환자의 국소제어율을 향상시키기 위한 목적으로 보상 여과판을 이용한 전방위 강도변조 방사선치료방법(intensity modulated radiation therapy : IMRT)을 계획하고 기존 3차원 입체조형치료방법과 비교하여 최적의 방사선치료방법을 모색하고자 한다. 대상 및 방법 : 3-차원 입체조형치료계획으로 치료받았던 비강암환자(T4N0M0) 1예를 선택하여 치료면의 굴곡과 뼈, 공동 등 불균질 조직으로 인하여 발생되는 표적체적의 선량분포를 균일하게 만들고 주변 정상장기의 손상을 최소화하기 위한 일차 입사선량의 강도 조절을 보상여과판으로 시행 하였다. 환자는 열변성 plastic mask로 고정시킨 후 치료조준용 CT Scan (PQ5000)을 이용하여 3 mm 간격으로 scan 하고 가상조준장치(virtual simulator)와 3차원 방사선치료계획 컴퓨터$(ADAC-Pinnacle^3)$를 이용하여 보상여과판을 제작하였다. 각 조사면을 세분한 소조사선(beamlet)의 강도 가중치(weighting)를 계산하고 가중치에 따른 선량 감약을 보상여과판의 두께로 환산하여 판별이 쉽도록 도표화하였다. 방사선 치료성과의 기준은 정량적으로 평가할 수 있는 선량체적표(dose volume histogram : DVH)와 종양억제확율(tumor control probability : TCP)및 정상조직 손상확율(normal tissue complication probability : NTCP)의 수학적 관계식을 이용하여 치료효과를 평가하였다. 결과 : 전방위 IMRT에서 계획용표적체적(planning target volume: PTV)내의 최소선량과 최대선량의 차이가 입체조형치료계획보다 약간 증가하였으며 평균선량은 강도조절치료계획에서 약 $10\%$, 더 높았고 전체 방사선량의 $95\%$가 포함되는 체적(V95)은 비교적 양쪽 설계방법에서 비슷한 양상을 보이고 있었다. 주위 건강장기들의 DVH에서 방사선에 민감한 장기인 시신경, 측두엽, 이하선, 뇌간, 척수, 측두하악골관절 등은 강도조절치료계획에서 많이 보호되었다. PTV의 종양제어확율은 입체조형치료계획과 강도변조치료계획에서 모두 비교적 균일하였으며 계획선량이 50 Gy에서 80 Gy로 증가함에 따라 TCP가 0.45에서 0.56으로 완만하게 증가하였다. 척수, 측두하악골 관절, 뇌간, 측두엽, 이하선, 시신경교차, 시신경 등 정상장기의 손상확율은 입체조형치료계획보다 강도조절치료계획에서 월등히 감소되었으며 특히 뇌간(brain stem)의 NTCP는 입체조형치료계획에서 보다 강도조절치료계획에서 훨씬 적은 값(0.3에서 0.15)으로 감소되었다. 계획선량의 증가에 따른 TCP와 NTCP를 입체조형치료계획과 강도조절치료계획에서 TCP는 공히 완만한 증가를 보였으나 NTCP값은 선량증가에 비례적으로 증가하였고 입체조형치료계획이 강도조절치료계획보다 월등히 증가하였다. 결론 : 보상여과판을 이용한 전방위 강도변조 방사선치료에서 PTV내의 선량 균일도의 개선은 없었지만 뇌간, 척수강 등 정상장기의 피폭을 줄일 수 있었다. 특히 인체표면의 굴곡이 심하거나 뼈, 동공 등으로 종양에 도달하는 방사선량분포가 균일하지 않을 경우 매우 유리한 치료방법이였다. 방사선치료성적을 평가함에 있어 DVH와 TCP, NTCP 등 수학적 척도를 이용함으로서 치료성과의 예측, 종양선량의 증가(dose escalation), 방사선수술의 지표 및 방사선치료의 질적 상황을 정량적 수치로 평가할 수 있어 방사선치료성과 향상에 기여할 수 있다고 생각한다.