• Title/Summary/Keyword: 통증 척도

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A Study on the Changes in Motor Unit Action Potential, EMG Power Spectrum, and Pressure Pain Threshold of Masticatory Muscles during Sustained Fatiguing Contraction (피로를 유발하는 지속적인 근수축 동안 저작근의 운동단위전위, 근전도 power spectrum, 압력통각역치 변화에 대한 연구)

  • Kim, Cheol;Kim, Young-Jun;Kim, Kyung-Nyun
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.261-276
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    • 2001
  • 본 연구는 구강안면동통 중에서 빈번히 나타나는 근육성 동통의 주 원인인 저작근의 과활성으로 유발된 근육의 피로 시에 운동단위전위, 압력통각역치, 근전도 power spectrum의 변화 양상과 이들 척도간의 연관성을 조사하기 위해 시행되었다. 두개하악장애의 병력 및 현증이 없고 정상적인 구치부 교합관계를 가진 평균연령 25.8세인 36명의 정상 성인(남자 26명, 여자 10명)을 대상으로 교근과 전측두근의 지속적인 등길이 수축 전후의 압력통각역치 및 운동단위전위를 측정하였고 인내시간까지의 근수축 동안 근전도 power spectrum을 분석하여 다음과 같은 결론을 얻었다. 1. 지속적인 등길이 수축 후 교근과 전측두근의 압력통각역치는 수축 전에 비해 유의하게 감소하였다. 2. 압력통각역치는 수축 전과 수축 후 모두에서 전측두근이 교근보다 유의하게 높게 나타났으며, 전체적으로 남성이 여성보다 높게 나타나는 양상을 보였으나 성별간의 차이는 전측두근의 수축 후 압력통각역치에서만 통계적으로 유의하게 나타났다. 3. 지속적인 등길이 수축말기의 중간주파수는 수축초기에 비하여 유의하게 감소하였고, 전측두근의 수축초기 중간주파수와 수축말기 중간주파수 모두 교근보다 유의하게 높게 나타났다. 4. 교근은 지속적인 등길이 수축 전에 비하여 수축 후의 운동단위전위의 지속시간,진폭, 면적, 상의 4가지 척도에서 유의한 증가를 보였고 전측두근은 진폭을 제외한 나머지 3가지 척도, 즉 지속시간, 면적, 상의 유의한 증가를 보였다. 5. 교근과 전측두근의 지속적인 등길이 수축 전의 압력통각역치와 운동단위전위 척도 사이에는 통계적으로 유의한 상관관계가 없었고 교근에서는 수축 후의 압력통각역치와 운동단위전위의 지속시간, 진폭, 면적, 상 사이에 유의한 상관관계가 존재하였다. 위의 실험결과를 통해 근육피로 검사에 압력통각역치, 근전도 power spectrum 검사 외에 근육수축의 기능적 최소 단위인 운동단위전위의 분석 또한 유용할 수 있고 추후 만성으로 진행된 근막동통환자와 정상 대조군간의 운동단위 수준에서의 비교연구와 근피로에 더욱 민감한 운동단위전위의 다른 척도에 대한 개발과 연구가 필요하다고 사료된다.

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The Effect of Psychological Factors on Postoperative Pain in Gastric Tumor Patients after Endoscopic Submucosal Dissection (내시경 점막하 박리법을 시술 받은 위종양 환자에서 심리적 요인이 시술 후 통증에 미치는 영향)

  • Lee, Joon-Hyub;Jeon, Han Ho;Lee, San;Lee, Hyeok;Oh, Seung-Taek;Chang, Jhin Goo;Im, Woo Young;Park, Jaesub;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.68-75
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    • 2018
  • Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

Acupuncture Stimulation on LR3 Reduced Shoulder Pain Caused by Upper Trapezius Rigidity. A Case Report (상부 승모근 경직으로 유발된 견비통에 대한 태충혈 자침의 효과 1례)

  • Lee, Hey-Jin;Lee, Nam-Heon;Son, Chang-Gue;Cho, Jung-Hyo
    • Journal of Haehwa Medicine
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    • v.25 no.1
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    • pp.63-69
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    • 2016
  • 이 임상례는 근육 경직으로 인한 견비통에 태충혈이 유효함을 제시하고 있다. 환자의 주관적인 만족도를 평가하기 위해 점수식 평점 척도(Numerical rating scale;NRs)를 측정하였고 어깨 경직의 객관적인 호전 정도를 평가하기 위하여 양측 견정혈의 통증 통각 역치(Pressure pain threshold;PPT)와 어깨 외전력, 어깨관절의 외전시 가동범위(Range of motion;ROM)을 측정하였다. 양측 태충혈에 15분간 유침 후 NRS는 5에서 2로 감소하였다. 치료 전 왼쪽 견정혈의 PPT는 19N이었고 오른쪽은 22N이었다. 치료 후 왼쪽 견정혈의 PPT는 22N이었고 오른쪽은 27N이었다. 치료 전 견관절의 외전력은 왼쪽에서 29N, 오른쪽에서 22N으로 측정되었다. 치료후 견관절의 외전력은 왼쪽에서 33N, 오른쪽에서 22N으로 측정되었다. 견관절 ROM은 치료 전과 후 동일하게 왼쪽 관절 170도, 오른쪽 관절 165도로 나타났다. 결론적으로, 태충혈 자극은 어깨의 경직을 해소하고 어깨 근력을 강화하는 것으로 나타났다. 또한 그것은 상부 승모근의 압통을 감소시킬 수 있다. 이러한 측면에서, 태충혈의 효과에 대해서 보다 추가적인 연구가 필요할 것으로 보인다.

Clinical Study on 16 Conservatively Treated Acute Compression Fracture Patients with Focus on Compression Ratio (급성 흉요추부 압박골절 환자 16례의 보존 치료에 따른 Compression Ratio에 중점을 둔 임상 고찰)

  • Joh, Byung-Jin;Koh, Pil-Seong;Yi, Won-Il;Baek, Yong-Hyeon;Nam, Tong-Hyun;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.1-9
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    • 2009
  • 목적 : 한양방 협진을 통한 보존적 입원 치료를 받은 급성 흉요추 압박골절 환자군에서의 압박골절 compression ratio의 급성기 내의 변화를 기록 분석하여 차후 환자군의 예후를 예측하고자 하였다. 방법 : 한양방 협진병원 척추센터에 입원하여 보존치료를 시행한 발병 2주 내의 압박골절 환자 중 2회 이상의 시점에서 압박골절 부위의 측면 X-ray 영상이 있는 환자 16명의 기록을 수집하였다. X-ray상 급성 압박골절이 발생한 추체(n=19)의 anterior wall과 posterior wall의 높이를 입원 1주차, 입원 2주차, 입원 3주차와 최종 영상 확보 시점의 X-ray에서 측정해 wedge fracture에 해당하는 anterior column fracture가 있는 추체(n=14)에 한해 anterior height/posterior height의 공식을 통해 compression ratio를 산출하였다. 2차적 지표로 입원 1주차에서 입원 3주차까지 환자의 VAS(visual analog scale) 통증 척도 점수를 분석하였다. 그 외 연령, 성별, 입원 기간, 총 치료기간, 당뇨, 골다공증, 골밀도, 압박골절 기왕력, 압박골절의 형태의 빈도와 비율을 분석하였다. 결과 : 1. 전방 골주 단독 골절에서의 compression ratio는 입원 1주차에서 3주차, 그리고 최종 영상 확보시점까지 각각 20.92${\pm}$10.42, 25.22${\pm}$10.90, 25.57${\pm}$11.04, 25.07${\pm}$11.94로 기록되었다. 시점간에는 통계적으로 유의한 compression ratio의 차이가 나타나지 않았다. 2. 통증 VAS 점수 평균은 입원 1주차부터 3주차까지 각각 7.44${\pm}$2.07, 4.67${\pm}$1.63, 3.00${\pm}$1.80으로 기록되었다. 시점간 모두 통계적으로 유의한 감소가 있었다(1주차-2주차 p=.003, 1주차-3주차 p<.000 2주차-3주차 p=0.021). 결론 : 본 연구의 협진 입원치료 압박골절의 compression ratio는 입원 1주차 시점에서 최종 follow-up 시점까지 유의한 차이를 보일 만큼의 추가적인 추체 높이 감소를 보이지 않아 향후 좋은 예후를 예상할 수 있다. 통증 VAS 점수는 모든 주별 시점간에서 유의하게 감소되었다.

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Self-management techniques and subsequent changes in pain and function in patients with chronic low back pain (만성 요통 환자의 자가 관리 요법에 따른 통증 및 기능의 변화)

  • Choi, Jun Hyun;Kim, Eun-Shil;Yoon, Yong-Soon;Kim, Ka-Eun;Lee, Mi-Hyun;Jang, Hong-Young
    • Journal of Digital Convergence
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    • v.18 no.10
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    • pp.547-555
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    • 2020
  • To investigate the effects of self-management programs for chronic low back pain (LBP), 63 subjects were assigned to three groups; self-exercise group (SEG), hot pack and low-frequency electrical stimulation group (HEG), and thermo-massage group (TMG). Parameters were the pain numeric rating scale (PNRS), Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ) and Relapse frequency (RF). PNRS, ODI and RMDQ of SEG and TMG sustained effectiveness, however, PNRS, which improved after treatment in HEG, worsened in 6 month. Between the groups, all parameters were better in SEG and TMG compare to HEG. Exercise and thermo-massage can be considered as useful self-management performed at home to prevent the relapse of chronic LBP.

Arthroscopic Outside-in Repair of Tears of the Triangular Fibrocartilage Complex (삼각 섬유연골 복합체의 파열에 대한 관절경적 Outside-in 봉합술)

  • Byun, Jae-Yong;Kang, Shin-Taek;Kim, Bo-Hyun;Hwang, Chan-Ha;Choi, Seung-Woog;Jung, In-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.83-86
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    • 2006
  • Purpose: We repoted the clinical results and introduction of surgical techniques for the patients with tears of the triangular fibrocartilage complex (TFCC) who had arthroscopic management. Materials and Methods: According to Palmer classification, nine patients(9 wrists) with type 1B lesions of the triangular fibrocartilage complex from 2001 to 2004 were included in this study. The mean follow-up period was 28 months. Six were male and three were female, right side was in seven cases and left side in two cases. Nine patients received arthroscopic debridement and repair by outside-in technique. To assess the clinical outcomes, the visual analogue pain scale(VAPS), grip strength, range of motion were investigated. Results: The average of VAPS improved from 6.2 to 1.4. The grip strength of wrists of all nine patients improved after surgery and the range of motion of all wrists reached full range. Conclusion: Arthroscopic repair of type 1B tear of the triangular fibrocartilage complex has satisfactory results. The repair by outside-in technique was simple and we could have secure fixation.

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Clinical & Radiologic Result of Arthroscopic Bankart Repair Using Knotless Suture Anchor (비매듭 금속 봉합 나사못을 이용한 관절경적 방카트 복원술: 임상적 및 방사선학적 결과의 비교)

  • Oh, Jung-Hwan;Lee, Sang-Hoon;Park, Hong-Keun;Jeon, Suk-Ha;Park, Joon-Suk;Kim, Cheol-Ki;Park, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.135-141
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    • 2008
  • Purpose: To study the clinical and radiologic results with arthroscopic Bankart repair using knotless metal suture anchor. Materials and Methods: From February 2001 to January 2005, 68 patients, who underwent arthroscopic Bankart repair using knotless suture anchor and were followed up more than 12 months, were evaluated. A mean follow-up period was 34 months. All shoulders were evaluated by Rowe scoring system, range of motion of the shoulder, pain degree of VAS, and This was compared by radiologic findings after surgery. Results: The Rowe scoring system was 43.30 preoperatively, which improved to 95.55 postoperatively. At last follow-up, there was no significance difference between operated shoulder and non-operated shoulder in range of motion. The degree of VAS was measured from 3.3 preoperatively to 0.5 postoperatively. The radiolucent line was shown around suture anchor in 15 shoulders. 2 shoulders of 15 shoulders were reoperated due to redislocation and anchor arthropathy. In Odds ratio, this group (15 patients) had more 2.6 times the subjective instability than other group (53 patients). Conclusion: Arthroscopic Bankart repair using knotless anchor suture is very effective operative technique. But we have to be careful because the radiolucent line around anchor showed up during a follow -up period may indicate poor prognosis.

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Reliability and Validity of the Korean Version of the Fear of Daily Activities Questionnaire for Patients with Low Back Pain (허리통증 환자의 한국판 일상동작 공포설문지의 신뢰도와 타당도)

  • Cha, Yong-Jun;Kim, Kyoung
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.224-232
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    • 2011
  • The purpose of this study was to test the reliability and validity of the Korean version of the fear of daily activities questionnaire (FDAQ) for low back pain patients. Seventy-three subjects with low back pain were participated in this study. The subjects completed ten standardized self-administered questionnaires that measure fear of specific daily activities. The reliability of the acquired data was determined by the intra-class correlation coefficient (ICC) and the Cronbach's ${\alpha}$ for internal consistency. Constructive validity was analyzed by factor analysis, and concurrent validity was acquired from comparison FDAQ scores to the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. The test-retest reliability of the Korean version of the FDAQ showed good ICC (2,1)= 0.96 (95%CI 0.94.0.98) and Cronbach's alpha value was 0.93. Factor analysis suggested two factors solution consisting of spinal loading and spinal movement/posture, it explained 76.1% of the total variance. The concurrent validity was moderately related with pain and disability. Therefore, the Korean version of the FDAQ is a useful method for measuring the fear of daily activities of patients with low back pain.

A Study on the Pain in Patients with Temporomandibular Disorders using Korean Pain Rating Scale (측두하악장애환자에서 한국어 통증척도를 이용한 통증에 관한 연구)

  • Yoing-Gyu Bae;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.169-180
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    • 1994
  • The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.

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Effects of Chiropractic Using Sacro Occipital Technique on Pain and Physical Function in Patients with Low Back Pain (천골후두골 테크닉을 이용한 카이로프랙틱이 만성 요통환자의 통증과 신체기능에 미치는 영향)

  • Jeong, Ji-Moon;Kim, Jaehee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4402-4411
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    • 2013
  • The aim of this study was to identify the effects of chiropractic treatment using Sacro Occipital Technique (SOT) on low back pain (LBP) and physical functions in patients with chronic LBP. Forty-five women with chronic LBP were randomly assigned to the Diversified Technique (DT), SOT or DT+SOT group and received chiropractic treatment two times a week for 8 weeks. LBP was measured using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) at baseline and after 4 and 8 weeks of treatment. Physical functions were evaluated using lumbar strength, flexibility, and body symmetries. After 4 and 8 weeks, VAS, ODI, and RMDQ were significantly decreased in all 3 groups (all p<.001). Lumbar strength, flexibility, and shoulder and pelvic balances were significantly improved in all 3 groups (all p<.05). In conclusion, our results suggest that SOT and DT both may be effective for reducing LBP and improving physical functions.