• Title/Summary/Keyword: 척수 손상

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An Explanatory Model for Patient Adherence of Rehabilitation in patients with Spinal Cord Injury (척수손상 환자의 재활 치료 지속이행 설명모형)

  • Kim, Aee-Lee
    • Korean Journal of Adult Nursing
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    • v.22 no.1
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    • pp.90-102
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    • 2010
  • Purpose: The purpose of this study was to identity factors affecting patient adherence and to develop an explanatory model for patient adherence in patients with spinal cord injury. 8 Variables that were based on the previous research and a review of literature were used to construct hypothetical model. Social support, economic status, perceived barrier, patient provider relationship and rehabilitation related knowledge were the exogenous variables, depression, self-efficacy and patient adherence were the endogenous variables. Methods: Data form 117 patients with SCI were analysed to test the hypothetical model, using SAS and LISREL 8.53 program. Results: The overall fitness of the model was good (GFI=.991, AGFI=.915, NNFI=1.299, NFI=.953, p=.632) Depression, powerlessness, economic status were the strong factors influencing patient adherence. Powerlessness was significant factors for self-efficacy. Conclusion: To improve of patient adherence should focus on nursing intervention for depression, powerlessness and economic status.

Electromyographic features of upper body during wheelchair cycle ramps ascent for disabled with spinal cord injury (휠체어 사이클 경사로 주행 시 척수손상 장애인의 상체 근전도 특성 분석)

  • Kim, S.B.;Ko, C.Y.;Kang, S.J.;Choi, H.J.;Rue, J.C.;Mun, M.S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.1
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    • pp.13-19
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    • 2013
  • The aim of this study was to investigate difference of the muscle activation patterns of the upper body during wheelchair cycle ramps ascent of different slopes for disabled with spinal cord injury. Three subjects who is disabled with spinal cord injury participated in this study. Surface electromyography (EMG) data (reaction time [RT], onset-offset time, and peak value of muscle activation) were collected biceps, triceps, upper trapezius, anterior deltoid, latissimus dorsi, and upper rectus abdominal muscles during wheelchair cycle ramps ascent ($0^{\circ}$, $3^{\circ}$, and $6^{\circ}$). For latissimus dorsi muscle, RT and peak value of muscle activation was were increased and offset time was delayed as the slope increased (p < 0.05). These results indicate that wheelchair cycle ramps ascent might cause excessive overuse of latissimus dorsi muscle.

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The expression of c-fos and HSP70 by the Capsaicin injection in the spinal cord(dorsal horn) (Capsaicin 적용 후 손상된 흰쥐 척수내 c-fos와 HSP70의 발현)

  • Kim, Dong-Hyun;Kim, Souk-Boum;Baek, Su-Jeong;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.131-137
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    • 2002
  • C-fos는 원종양유전자(proto-oncogene)인 v-fos의 세포 동족체로써, 성장인자나 신경전달 물질에 의해 수분 내에 다양한 형태의 세포에서 활성화된다. Fos단백질은 스트레스와 통증 과정의 신호전달기전에서 세포활동을 조절하는 3차전령으로 활동한다. 열충격 단백질(Heat shock protein : 이하 HSP)은 계통발생학적으로 초기 척추 동물에서부터 발현되며 생체방어체계의 중요한 인자로 세포가 고열, 외상, 허혈 등의 스트레스에 직면했을 때 발현이 증가하는 단백질로 알려져 있다. 본 연구에서는 캡사이신(capsaicin)으로 말초 신경병변을 유발시킨 후 통각신경활성의 지표로 이용되는 원종양 유전자인 c-fos의 발현과 열 또는 스트레스로 야기되는 손상에 대한 조직의 방어작용으로 발현되는 HSP 70의 발현을 동시에 관찰함으로서, 급성으로 유발된 말초 신경병변의 확인과 동시에 실험동물 체내에서 방어적인 역할을 밝히는 일환으로 이 실험을 실시하였다. 본 실험의 결과는 다음과 같다; 1. 척수 등쪽뿔 천층(Laminae I and II)에서 각각 c-fos와 HSP70을 항원으로 하는 면역조직화학적 방법으로 염색한 표본에서 0.9% NaCI 투여 2시간 후 c-fos와 HSP70의 양성을 나타내는 세포는 전혀 없음을 알 수 있었다. 2. 척수 등쪽뿔 천층에서 c-fos 단백질을 항원으로 하는 면역조직화학적 방법으로 염색한 표본에서 Capsaicin 투여 2시간 후 c-fos 단백질에 양성을 나타내는 세포가 많이 발현됨을 육안적 관찰로서 알 수 있었다. 3. 척수 등쪽뿔 천층에서 HSP70을 항원으로 하는 면역조직화확적 방법으로 염색한 표본에서 Capsaicin 투여 2시간 후 HSP7O의 양성을 나타내는 세포가 보통수준으로 발현됨을 육안적 관찰로서 알 수 있었다. 이 실험의 결과로 볼 때, 화학적인 신경병변 유발물질에 의한 손상을 방어하기 위해서 체내에는 내인성 물질이 형성될 것이라는 추측과 c-fos 가 다른 유전자의 발현을 유도한다는 점을 함께 고려 하였을때, Capsaicin에 의한 말초 신경병변에서 c-fos 발현이 많이 나타나는 것은 손상을 방어하는 물질의 생성에 관여하기 때문이며, 방어물질 중 이 실험에서 본 HSP70도 증가한 내인성 방어물질의 하나라고 할 수 있을 것이다.

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The Effect of Shoulder Pain on the Quality of Life of Manual Wheelchair Users With Spinal Cord Injuries (수동휠체어를 사용하는 척수손상자의 어깨통증이 삶의 질에 미치는 영향)

  • Lee, Jung Kyu;Kang, Mo Yeol;Jeon, Eun Mi
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.33-44
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    • 2023
  • Objective : The purpose of this study was to identify the risk factors for shoulder pain in manual wheelchair users with spinal cord injuries and to explore the correlation between shoulder pain and quality of life. Methods : Out of 182 participants initially included, 168 were selected for analysis. The questionnaire had 41 questions, with 15 on the Wheelchair User's Shoulder Pain Index (WUSPI) and 26 on the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Results : It was found that participants' scored 50.75 in the WUSPI, whereas they scored higher in mobility and overhead activity. In addition, participants' WHOQOL-BREF scored 70.48, with a mean score of 2.71, which was lower than ordinary adults' WHOQOL-BREF (mean: 3.11) and that of older people suffering from chronic musculoskeletal system pain (total score: 77.92). Conclusion : The participants' WUSPI showed negative correlations with all items, including the total scores on the WHOQOL-BREF. This suggests that the participants' shoulder pain had a negative impact on their quality of life. Therefore, clinical experts, including occupational therapists, should provide manual wheelchair users with spinal cord injuries with programs aimed at preventing and managing shoulder pain, thereby contributing to improving their quality of life.

Studies of the Effects of Acupuncture Stimulation at Huatuo Jiaji(EX B2) Points on Axonal Regeneration of Injured Sciatic Nerve in the Rats (화타협척혈 침자극에 의한 손상 말초신경의 재생효과에 관한 연구)

  • Kim, Dae-Feel;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.39-61
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    • 2008
  • Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods: Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, Dil fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and Dil-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increase in regeneration-associated protein levels appeared to be related with increase cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased Dil-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of Dil labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.

반복측정된 실험자료 분석에 관한 고찰

  • Ha, Il-Do;No, Gyu-Jeong;Go, Jeong-Hwan
    • Journal of the Korean Data and Information Science Society
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    • v.7 no.1
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    • pp.129-135
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    • 1996
  • 본 논문은 의뢰인의 Pilot Study를 상담한 것으로서 당뇨병 및 암 환자에게 효능이 있는 약으로 밝혀진 Steroid계통의 Methyl Prednisolone이 척수손상 환자에게 효능이 있는지를 알아보기 위해, 토끼를 실험대상으로 하여 얻은 반복측정자료를 분석하였다.

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A Ground Theory Approach to the Adaptation Process of the Spinal Cord Injured Persons (척수손상인의 적응과정에 관한 근거이론적 접근)

  • Song, Chung Sook
    • Journal of East-West Nursing Research
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    • v.22 no.2
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    • pp.158-169
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    • 2016
  • Purpose: This study is a qualitative research on the adaptation of the spinal cord injury after fortuitous the accident. Methods: The subjects are fifteen spinal cord injuries. As a study method, this author employed Grounded theory, one of the qualitative research methods. For data analysis, the procedures of Grounded theory methodology was adopted, and then the data collection were collected for six months from March to September 2009. Concerning the frequence of interviewing, each participants went through individual interviewing twice at least and up to four times if necessary. Results: As a result of open coding, total thirty six concepts and twenty categories were drawn. To synthesize these categories, they came to choose 'Going into the new self-made spinal cord injury' as a nuclear category. Typological analysis based on the result of the paradigm model divided them into a reality-avoiding, passive coping, reality-maintaining, reality-overcoming, and self-fulfillment type. Conclusion: As a result of this study, family support to those with spinal cord disability is an important factor for their motive for rehabilitation and adjustment, spinal disabilities were accepted to mostly the disabilities in relations with colleagues. Thus it is necessary to give them a nursing intervention through disability group for successful adjustment to life with disability.