• Title/Summary/Keyword: 통증 척도

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A Case Report on Gait Pattern Change of Unilateral Knee Pain Patient Treated by Korean Medicine: Focused on Gait Analysis Results. (편측 슬관절 통증을 호소하는 환자의 증상 개선에 따른 보행 척도의 변화 보고: 보행 분석을 중심으로)

  • Chu, Hong-Min;Kim, Kwang-Ho;Lee, Young-Ung;Park, Kyung-Tae;Jang, Jong-Won;Kim, Sun-Kyung;Lim, Hyeon-Seo;Kim, Cheol-Hyun;Lee, Sang-Kwan;Sung, Kang-Keyng
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.147-155
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    • 2020
  • Objectives : The aim of this study was to analyze changes in the gait pattern of a unilateral knee pain patient after treatment with Korean Medicine therapy. Methods : We conducted gait analysis 4 times over 11 days to analyze changes in gait parameters using gait analysis systems. Results : Velocity, cadence, step length, and stride length were all increased. On the collateral side, both stance phase and double support (%) decreased. These results are similar to those of hemiplegic patients with improvement patterns. Conclusions : Gait analysis could be used as a good evaluation tool for tracking improvements in knee pain.

A Study on the Prediction of Fall Factors for the Elderly Living in the City (도시 생활 노인의 낙상요인 예측에 관한 연구)

  • Lee, Hyun-Ju;Lee, Tae-Yong;Tae, Ki-Sik
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.12 no.1
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    • pp.46-52
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    • 2018
  • The purpose of this study was to investigate the factors affecting falls in 107 elderly living in the city aged 65 or older by evaluating general characteristics, chronic disease status, medical variables related to falls, balance-related confidence, physical ability and depression. Also, the correlations between the significant differences in variables were identified, and the prediction power was determined by deriving the variables with high influence to induce the fall. In the faller group, urinary incontinence, foot pain, lower extremity weakness, number of chronic disease and medication use were significantly higher than those of the nonfaller group. Also, statistically significant differences were evaluated in ABC (Activities-specific Balance Confidence) score, BBS (Berg Balance Scale) score, SGDS (Short Geriatric Depression Scale), FRT (Functional Reach Test) value. The main correlated factor for fall was ABC score, the lower the ABC score, fall risk is increased which is a significant negative impact. When the evaluation is performed by combining those scales, the hit ratio to classify whether faller or nonfaller is increased to 70.01% which is quite higher value.

The Effects of Badminton on the Shoulder and Its Correlation with the Shoulder Pain and Disability Index (배드민턴 동호인들의 참여 특성과 어깨 통증 및 장애 척도의 상관관계 연구)

  • Oh, Tae Young;Ha, Jin Young;Lee, En Ji;Kim, Seol Bi;Kim, Bu Young;Lee, Hae Jung
    • The Journal of Korean Physical Therapy
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    • v.25 no.1
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    • pp.29-35
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    • 2013
  • Purpose: The purpose of this study was to investigate the correlation between shoulder pain and disability index (SPADI) with participation in badminton and to find the effects of badminton on the shoulder joint. Methods: A questionnaire was answered by 143 people with shoulder pain and disability in badminton clubs located in Busan, Gyeongsangnam-do. Out of the 143 subjects (91 males, 52 females), about half (72 people) were over 40 years old, with 71 people over 50 years old. The questionnaire contained 27 questions involving demographic participation characteristics, playing characteristics, and SPADI. Data analysis was performed using the SPSS statistics program to conduct frequency analysis, cross analysis, the t-test, and one-way analysis of variance. Results: The correlation between badminton career, frequency of play, and SPADI was statistically significant. There was a significant increase in SPADI scores for players over 40 years old. The over 40 year old group with less than 5 years of badminton had a significantly increase in SPADI score. The over 50 year old group showed a significantly lower SPADI score compared with the over 40 group. Conclusion: We suggest that beginner badminton players learn correct posture and badminton skills from professionals, participate regularly, and maintain an appropriate intensity/frequency of badminton.

A Clinical Report on Chicken Pox Scars Treatment with Sae-ssack Therapy (새싹테라피를 이용한 수두 흉터의 치료 16례)

  • Go, Nam-Gyeong;Choi, Hye-Mee;Lee, Yong-Ho;Jung, Joo-Hee;Ha, JinHee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.2
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    • pp.146-154
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    • 2017
  • Objectives: The purpose of this study was to evaluate the therapeutic efficacy of Sae-ssack(sprout) therapy on the face Chicken Pox scars. Methods: Sixteen patients had scars with varicella on the face were treated with Sae-ssack therapy. Sae-ssack therapy consists of a total of two treatments, a first-stage Sae-ssack acupuncture and a second-stage texture treatment(texture acupuncture and AMTS). The evaluation of the treatment effect was made by the medical staff who did not participate in the procedure, and the PGA(Physician's Global Assessment), SBSES(The Stony Brook Scar Evalustion Score) and patient satisfaction were used as the evaluation index. Results and Conclusions: According to the above indices, the Sae-ssack therapy was evaluated to be effective in the repair of atrophic scars caused by varicella. There were no visible or consistent side effects and patient satisfaction was also very high.

Pilot Study for Scale Development for Measurement of Arthritic Pain Using Pain Terms (통증어휘를 이용한 관절통 척도개발의 예비연구)

  • Lee, Eun-Ok;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.10 no.1
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    • pp.44-53
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    • 2003
  • Purpose : This study was to identify Korean terms appropriate for a new scale using pain terms to assess the pain of the arthritis patients. Method : This study was conducted by secondary analysis of two previous studies, one from Kim's data (1994) and the other from Lee and Choi's(1988). The subjects were 482 patients with arthralgia. Data were analyzed by SPSS Win 11.0, for frequencies, percentages, and means. Results : Five pain groups were sorted out from the sensory pain category, three in the affective pain category, and two in the miscellaneous pain category by selecting groups of pain terms expressed more than 50% by all subjects. Local inflammatory repeated pain terms, simple irritative pain terms, superficial pressure pain terms, traction pain terms, and peripheral nerve terms were included in the sensory pain category, fatigue-related pain terms, digestion-related terms, and suffering-related terms in the affective category, and dull pain terms and body cavity pressure pain category. Among five sample groups terms selected by more than 3 groups with more than 30% of patients were dugumhada, sikungorinda, wooksinwooksinhada, nurudusi apuda, and dangginda in the sensory pain category; nogonhage apuda, gobukhada, and jajungsurupge apuda in the affecte pain category; and buctjockgigunhada and manjimyon apuda in the miscellaneous pain category. Conclusion : Ten pain groups were tentatively selected out of 20 pain groups; 10 pain terms composed of 1 pain term from each group were selected out of 90 pain terms from thesecondarydataofarthriticpainpatients. Implications More detailed clinical studies are needed for the refinement of the scale.

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The Effects of the Action Observation and Visual Feedback Convergence Exercise on the Alignment, Pain and Function of Forward Head Posture and Round Shoulder Posture (동작관찰과 시각적 되먹임 융합 운동이 머리전방자세와 둥근어깨의 정렬, 통증과 기능에 미치는 영향)

  • Kang, Hyo Jeong;Yang, Hoe Song
    • Journal of the Korea Convergence Society
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    • v.9 no.12
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    • pp.123-128
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    • 2018
  • The aim of this study was to determine the effects of the action observation and visual feedback on the alignment, pain and function of forward head posture(FHP) and round shoulder(RS). A total of 24 participants with FHP and RSP were randomly assigned to general exercise(GE, n=8), action observation(AO, n=8), and visual feedback(VF, n=8). All subjects were exercised three times a week for four weeks. The groups were assessed for craniovertebral angle(CVA), round shoulder posture(RSP), visual analog scale(VAS), and neck disability index(NDI) before and after exercise, There was a significant difference in CVA in the GE, AO and RSP, VAS and NDI were significantly different in all groups. AO was more effective than GE, VF for VAS. The results of this study suggest that action observation may be effective to improve the FHP and RS.

Assessment for the Needs to Develop Hospice Training Program for Nurses (간호사를 위한 호스피스 연수교육 요구도 조사)

  • Kwon, So-Hi;Yang, Seong-Kyeong;Park, Myung-Hee;Choe, Sang-Ok
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.147-155
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    • 2008
  • Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

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The Efficacy of Ultrasonography-guided S1 Selective Nerve Root Block (초음파를 이용한 제 1천추 선택적 신경근 차단술의 유용성)

  • Jeon, Young Dae;Kim, Tae Gyun;Shim, Dae Moo;Kim, Chang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.113-119
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    • 2014
  • Purpose: This study was to evaluate effect and efficiency of S1 selective nerve root block using ultrasonography-guided compared with fluoroscopy-guided for lumbar disc herniation or spinal stenosis patients. Materials and Methods: Between February 2012 and December 2013, 38 patients who were with lower leg radiating pain for more than 1months and underwent S1 selective spinal nerve root block in our institution, were reviewed. They divided into two groups: Group A included 18 patients with ultrasonography-guided and Group B included 20 patients with fluoroscopy-guided. Treatment effectiveness was assessed using a visual analogue scale (VAS) and the Korea Modified Oswestry Disability Index (K-MODI). They were evaluated its preoperatively, postoperatively and 1 month later. We were recorded whole procedure time. Results: VAS was improved from 7.4 to 4.7 at 1 month in group A and from 7.39 to 4.36 at 1month in group B. K-MODI was improved from 72.8 to 43.3 at 1month in group A and from 73.8 to 44.1 at 1month in group B. Whole procedure time were $477.53{\pm}115.02s$, $492.47{\pm}144.38s$ in group A, group B, respectively. But there was no significant difference in VAS and K-MODI between two groups. Conclusion: Ultrasonography-guided sacral nerve root block is effective and accurate method in sacral radiating pain.

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The Influence of Urinary Incontinence and Depression in Elderly on the Quality of the Life (노인의 요실금과 우울증이 삶의 질에 미치는 영향)

  • Kim, Jihyun;Lee, Joongsuk;Nam, Beomwoo;Choi, Jin-Yong;Yang, Sang-Kuk;Yim, Hyeon Woo;Jo, Sun-jin;Jeong, Hyunsuk
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.129-135
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    • 2017
  • Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

Effect of Aprepitant in Patient with Gastroparesis and Related Disorders (위마비증과 만성 구역 구토 증후군 환자에서 Aprepitant의 효과)

  • Jung, Kyoungwon;Park, Moo In
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.325-328
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    • 2018
  • 위마비증(gastroparesis)이나 만성 구역 구토 증후군(chronic unexplained nausea and vomiting)으로 인한 구역과 구토에 대한 치료는 일반적으로 사용하는 위장관 촉진제에 만족스럽지 못한 경우가 많고, 여러 부작용으로 인하여 장기적으로 사용하기 어려워 보다 효과적인 치료 방법이 필요하다. 최근 미국에서 발표된 본 연구는 위마비증이나 연관 증후군 환자에서 구역과 구토 증상을 줄이기 위한 aprepitant(neurokinin-1 receptor antagonist) 치료의 효과를 분석한 것으로, 향후 일반적인 치료에 불응성 위마비증 환자에서 새로운 약제 사용을 시도해볼 수 있어 소개하고자 한다. 본 Aprepitant for the Relief of Nausea (APRON) 연구는 기질적 질환을 배제하기 위하여 최근 2년 이내 위내시경이 정상이며, 적어도 6개월 이상 조기 포만감(early satiety), 식후 만복감(postprandial fullness), 팽만감(bloating) 그리고 명치부 통증(epigastric pain)을 유발하는 증상과 함께 만성적인 구역이 있는 18세 이상의 성인 중 4시간의 위배출 검사를 시행받은 환자를 대상으로 하였다. 객관적인 지표로 0점에서 45점까지 보이는 9-증상 Gastroparesis Cardinal Symptom Index(GCSI)가 2주 이상 총 21점 이상이며, 0-100 mm의 visual analog scale (VAS)의 7일간의 구역 증상 평균 25 mm 이상인 환자를 대상으로 하였다. 일주일에 3일 이상 narcotics를 사용하였거나 와파린이나 pimozide, terfenadien, astemizole, cisapride를 복용하였던 환자, 2배 이상으로 간 효소 수치상승을 보이거나 Child-Pugh score 10점 이상, aprepitant에 알레르기를 보이는 환자는 제외되었다. 그렇지만 metoclopramide나 erythromycin을 안정적으로 사용 중인 환자는 제외되지 않았다. 위배출 검사는 2시간에서 60% 이상 남아 있거나 4시간에서 10% 이상 남아 있는 경우에 지연된 것으로 정의되었으며, 지연된 위배출 검사 결과 자체는 환자의 등록 기준에 포함되진 않았다. 등록 기준에 포함된 환자는 1:1로 무작위 배정되어 하루 한 번 125 mg의 aprepitant 복용군과 위약군으로 나누어져 연구가 진행되었으며, 약제 복용 4주간 2주 간격으로, 그리고 복용 후 2주 뒤까지 구역 증상의 호전 정도와 약제 안전성을 확인하였다. 이러한 효과를 판정하기 위하여 환자가 방문하는 동안 GCSI를 포함한 Patient Assessment of Upper GI Symptoms (PAGI-SYM), Gastrointestinal Symptom Rating Scale, daily VAS, daily diary version of the GCSI 그리고 정신 측정 도구와 삶의 질 도구인 Patient health Questionnaire 15와 Short Form 36 version이 측정되었다. 구역에 대한 aprepitant와 위약의 치료 효과의 일차적 판정은 이전 항암 요법에 대한 aprepitant 연구와 같이 28일 평균 VAS 25 mm 미만이거나 치료 전 7일간의 VAS와 비교하여 28일 치료 기간 동안 25 mm 이상 감소한 경우로 정의하였고, 이차 결과는 구역의 매일 시간, 치료 중 구역이 없는 날짜의 퍼센트, PAGI-SYM score의 개선 등으로 확인하였다. 2013년 4월부터 2015년 7월까지 총 126명의 환자가 등록되어 aprepitant군 63명, 위약군 63명으로 무작위 배정되었다. 전체의 57%인 72명에서 위배출 지연이 보였으며, 나머지 43%에서는 정상 또는 빠른 위배출 소견을 보여 만성적으로 설명할 수 없는 구역과 구토에 포함된 환자군으로 확인되었다. 또한 29%에서 당뇨를 가지고 있었으며, 8%에서 수면제를 사용하고 있었다. 최종적으로 aprepitant군은 59명, 위약군은 63명이 연구를 끝까지 종료하였다. 일차 결과에서 aprepitant 군 46%, 위약군 40%의 구역 호전을 보여 두 치료군 간에 통계적으로 의미 있는 차이는 보이지 않았다(상대 위험도 1.2, 95% CI: 0.8-1.7; p=0.43). 그러나 일차 분석의 두 가지 척도(28일 평균 VAS 25 mm 미만과 기저 VAS보다 평균 28일 VAS의 25 mm 이상 감소)를 모두 함께 고려한 민감도 분석에서는 aprepitant군이 37% (22/59)로 위약군의 17%(11/63)에 비하여 통계적으로 의미 있는 구역의 호전을 보였다(상대 위험도 2.1, 95% CI: 1.1-4.1; p=0.01). 또한 이차 분석을 살펴보면 aprepitant군에서 PAGI-SYM 중증도 지수로 확인하였을 때, 구역(1.8 vs. 1.0; p=0.005)과 구토(1.6 vs. 0.5; p=0.001)의 중증도 및 매일 구역 시간의 감소를 보였고, 28일 동안 구역이 없는 날짜의 퍼센트 증가 소견을 보였다. 다른 이차 결과 분석에서 aprepitant군이 PAGI-SYM 중증도 지수의 GCSI 종합 점수(1.3 vs. 0.7; p=0.001), 상당한 증상호전, 구역 구토의 세부 점수, 팽만감 세부 점수 그리고 위식도 역류 증상 점수에서 호전을 보였고, 매일 일기로 표현한 daily diary version of the GCSI에 상복부 통증 중증도, 전체 증상 그리고 Gastrointestinal Symptom Rating Scale의 종합 점수에서 호전을 보였다. 연구 중 발생한 부작용은 주로 경증과 중등도 정도의 부작용이 주로 발생하였지만, aprepitant군(35% vs. 17% 위약군, p=0.04)에서 더 많이 발생하였다. 결론적으로 위마비증 또는 위마비증 유사 증후군으로 인한 만성 구역 및 구토 환자의 무작위 시험에서 aprepitant는 VAS 점수를 통한 주요 결과를 분석하였을 때는 구역의 중증도를 호전시키지 못하였지만 다른 이차적 결과에 대해서는 위약군에 대하여 호전 소견을 보였다. 따라서 aprepitant에 효과적인 반응을 보이는 위마비증 환자를 감별하는 추가 임상시험이 필요할 것으로 판단된다.