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Physiotherapy Management for COVID-19 (코비드-19와 물리치료적 접근)

  • Han, Yun-A;Roh, Hyo-Lyun
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.3
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    • pp.135-147
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    • 2020
  • PURPOSE: The purpose of this paper is to provide a review of physiotherapy intervention for patients with COVID-19 during their hospital admission and post-discharge. METHODS: The recommendations and guidelines of physiotherapy management, medical management, and general information of the WHO, Australian Physiotherapist, European Respiratory Society, British Thoracic Society, and American Thoracic Society were reviewed. RESULTS: This paper contains general information on COVID-19, including medical management, and the importance of physiotherapy approaches including an assessment of the patients' function, such as the 6-minute walking test, five sit to stand or sit to stand for one minute to measure their function as their recovery journey. The patients' quality of life, anxiety, and depression should be considered. Physiotherapy management should be based on an assessment of the patient's presenting impairments, including inclusion and exclusion of physiotherapy intervention. The paper also approaches step by step with the disease progress, from an intensive care unit, the general ward in the acute phase, through to the rehabilitation ward if needed, and post-discharge as an outpatient.. CONCLUSION: The paper has a limitation due to the unknown factor of the natural history of COVID-19. Depending on the patients' recovery journey and the rehabilitation needed, any physiotherapy interventions should focus on what the patients' need on their journey to recovery, e.g., pulmonary, cardiac, neurological, and general rehabilitation. In addition, applying personal protection equipment for treating physiotherapists is a mandatory requirement because this protects from the transmission of COVID-19.

Cognition and Memory Impairment after Operation in Ruptured Cerebral Aneurysm Patients (뇌동맥류 파열 환자의 수술후 인지기능과 기억력장애에 관한 연구)

  • Kim, Byung Joo;Choi, Chang Hwa;Kim, Dae Jin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.842-848
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    • 2001
  • Objectives : The mortality rate of subarachnoid hemorrhage(SAH) has been reduced recently due to refinement of microsurgical technique and improved perioperative management. Also, many survivors of SAH show excellent neurological recoveries. However, we found that a high proportion of the survivors do not fully regain their premorbid status in cognitive and memory function. Object of this study is to evaluate which factors might influence on cognitive and memory impairment in ruptured aneurysmal SAH patients. Methods : In this prospective study, a series of 66 patients with aneurysmal subarachnoid hemorrhage(SAH) from 1996 to 1998, most of whom had a "good" or "fair" neurological outcome, were assessed with various tests of cognition and memory function. All patients underwent clipping operation by pterional approach. Right side approach was performed in 16 case and left 21 cases. K-WAIS(Korean-Wechsler Adult Intelligence Scale) was used as method of cognition and memory function test. The time interval between SAH and assessment varied between 4 months and 8 months, averaging 6.2 months. Statistical analyses were carried out for each test score to see whether aneurysm site(A-com : non A-com), route of approach, age and sex, vasospasm, Hunt-Hess grade and Fisher CT group at admission, Glasgow Outcome Scale(GOS) at discharge affect cognitive and memory function. Results : Aneurysm site was not shown to be associated with performance on any test, and the initial grade (Hunt-Hess grade, Fisher CT group) of SAH and vasospasm had only minimal predictive values. The grade at discharge( GOS) was proved to be the best predictor of impairment of cognition and memory function within 1 year after operation. Conclusion : The authors conclude that the diffuse effects of SAH are more important than focal neuropathology in relation to cognitive impairment in this group of patients.

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A Case Report of Korean Medicine Treatment for A Patient with Variant Angina and Asthma Symptoms (천식 증상을 가진 변형 협심증 환자에 대한 한방치료 증례보고)

  • Kim, Min-joo;Kwo, Tae-ha
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.864-873
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    • 2022
  • Objective: The purpose of this case study was to report the symptom improvement effect of integrative Korean medicine treatment based on Pyongsim Solution: Cheonwangbosim-dan in a patient with variant angina and asthma symptoms. Methods: This 68-year-old male patient was treated with Pyongsim Solution, Gamihyangsayukgunja-tang, Gwakhyangjunggi-san, acupuncture, pharmacopuncture, and cupping therapy for 24 days. The European Quality of Life-5 Dimensions-5 Levels profile, Numerical Rating Scale score, and pulse rate per minute were measured on admission, at two weeks of hospitalization, and upon discharge to assess the clinical outcomes. Results: After treatment, the "mobility" dimension profile of the European Quality of Life-5 Dimensions-5 Levels changed from 1 to 1, "self-care" changed from 1 to 1, "usual activity" changed from 3 to 2, "pain/discomfort" changed from 4 to 3, and "anxiety/depression" changed from 3 to 2. The Numerical Rating Scale score for chest pain decreased from 7 to 5, chest tightness decreased from 6 to 4, sleep disturbance decreased from 6 to 3, polydipsia decreased from 5 to 3, and stomach discomfort decreased from 5 to 3. All the profiles of these five dimensions were unchanged for 11 days in the period between the two weeks of hospitalization and discharge. There were also no changes in the profiles of either "mobility" or "self-care" throughout the entire 24-day hospitalization period. Conclusion: This case report shows that integrative Korean medicine treatment based on Pyongsim Solution can improve the symptoms of patients with variant angina and mild intermittent asthma, suggesting that Pyongsim Solution could be an important herbal medication for treatment.

Ventricular septal defect with aortic insufficiency -one case report- (대동맥판폐쇄부전을 합병한 심실중격결손의 치험례)

  • 이철범
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.455-461
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    • 1980
  • This is one case report of surgically treated ventricular septal defect [VSD] with aortic insufficiency [AI] at department of thoracic and cardiovascular surgery, Hanyang university hospital. He had had progressive dyspnea on exertion and palpitation for 3 years prior to admission to our hospital. On examination, the blood pressure was 120/0 mmHg and the pulse rate 88 times/min. Bobbing motion of the head, Water hammer pulse, Corringan`s pulse, Quincke`s pulse and to and fro murmur were present. The heart murmur was consistent with .VSD and AI. Cardiomegaly was seen in chest X-ray. EKG, echocardiogram, aortogram and right heart catheterization was performed. On Sep. 9, 1980, open heart surgery was performed under the impression of VSD with AI. Infracrystal type VSD measuring 2 x 1.5 cm in diameter was closed with Teflon patch graft through the transverse ventriculotomy. AI was due to prolapsed, elongated right coronary and noncoronary cusp, especially noncoronary cusp. The prolapsed, elongated aortic leaflets were plicated by placing three 8-figure sutures between the free edge and the base of the leaflet [Frater`s method] through a transverse aortotomy. Postoperatively, he made an uneventful recovery, his blood pressure was 120/70 mmHg and showed no signs AI or residual shunt at discharge.

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The Relationship among Depression, Self-esteem and ADL in the Case of the Hospitalized Elderly Patients with Chronic Disease (만성질환으로 입원한 노인 환자의 우울, 자아존중감 및 일상생활수행능력(ADL)간 관계연구)

  • Yeo, Yeon-Og;Yoo, Eun-Kwang
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.676-686
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    • 2010
  • Purpose: This study has aimed to examine the relationship among self-esteem, Activities of Daily Living (ADL) and depression reported by hospitalized elderly patients with chronic diseases. Methods: A descriptive correlation study by means of a self-report questionnaire or face-to-face interview was used to collect data from 119 elderly patients who were hospitalized in a General Hospital from January 5 to February 25, 2010. Their levels of depression was measured using Short-Form Geriatric Depression Scale, self esteem using Jeon's, and activities of daily living using K-ADL. Results: 80.7% of the subjects experienced depression. Depression correlates with self-esteem (r=-.67) and ADL (r=.45). The influencing factors on depression were self-esteem, ADL, subjective health status, and family support satisfaction ($R^2=.57$), while self esteem in itself explained 45% of variance in depression. Conclusion: These findings indicate the importance of early detection of depression, which starts from the admission of patients and the continuing evaluation/management in daily life after discharge to ensure their well-being and quality of life. The development of program empowering self esteem, ADL and subjective health status with adequate family support during hospitalization and in daily life is indispensible.

Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors (노인 환자의 골관절염 수술 후 발생한 섬망과 섬망 위험요인)

  • Park, Eun A;Kim, Min Young
    • Journal of muscle and joint health
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    • v.22 no.2
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    • pp.57-66
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    • 2015
  • Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

The Effects of Constant Use of Yeoldahanso-tang on Liver Function (열다한소탕(熱多寒少湯)이 간기능에 미치는 영향)

  • Kim, Tae-Hwan;Hong, Sol-Yi;Han, Da-Nim;Lim, Eun-Chul
    • Journal of Sasang Constitutional Medicine
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    • v.19 no.3
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    • pp.217-226
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    • 2007
  • 1. Objectives The purpose of this study was to evaluate whether use of Yeoldahanso-tang(熱多寒少湯) may injure the liver function. We clinically studied the change of liver function rest in patients who were admitted in Dongseo Oriental Medical Hospital. 2. Methods We analyzed rhe serum alkaline phosphatase(AIP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), ${\gamma}$-glutamyl transpeptidase(${\gamma}$-GT), total bilirubin of 25 patients from 1st. July. 2004 to 15th. October. 2007 admitted in Dongseo Oriental Medical Hospital. Liver function test were done on admission and before discharge. 3. Results For most patients, the values of AIP, AST, ALT, ${\gamma}$-GT and total bilirubin were within normal range or decreased. 4. Conclusions This study suggests that Yeoldahanso-tang(熱多寒少湯) does not injure liver function of human.

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RVOT Obstruction Caused by Projection of The Herniated Aortic Cusp Through Subpulmonic VSD (심실중격결손증에 속발한 대동맥판탈출에 의한 우심실유출로 협착 [1례 보고])

  • 이병우
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.254-259
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    • 1981
  • This is a case of successfully surgically treated RVOT obstruction caused by projection of the herniated aortic cusp through subpulmonic supracristal VSD at Department of Thoracic and Cardiovascular Sugery, Hanyang University Hospital. The patient was a 17 year old boy. Congenital heart anomaly was suspected at 2 years of his age. He had palpitation, dyspnea on exertion and epistaxis for 2 years prior to admission to our hospital. On examination, the blood pressure was 170/0mmHg. And the pulse rate was 100/rain. Widening of pulse pressure, water hammer pulse [bounding pulse]. To and fro murmur and head nodding were noted. Cardiomegaly was seen in chest x-ray. EKG, Echocardiography, Cardiac catheterization and angiocardiography were performed. On April 27, 81. Open heart surgery was performed under the impression of VSD combined with AI. On Rt. ventriculotomy, we noticed RVOT obstruction caused by prolapsed rt coronary cusp through a VSD. The subpulmonic supracristal VSD measuring 2.5 x 3 Cm in diameter was closed with Teflon patch graft and then the prolapsed aortic leaflet was plicated by placing three 8-figure suture between the free edge and the base of the leaflet through transverse aortotomy. After operation, excellent result was obtained: B.P, was 110/50mmHg and any sign of AI or residual shunt was not found at discharge.

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A Case Study of a Serious Antibiotics-associated diarrhea Patient Treated with Modified Hyangsayukgunja-tang (중증 항생제 유발 설사 환자에 대한 향사육군자탕(香砂六君子湯) 가감방(加減方) 투여 1예)

  • Park, Soim;Kang, Da-Hyun;Seo, Ho-Seok;Kim, Jin-Won
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.121-131
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    • 2014
  • Objectives : The purpose of this study is to report a therapeutic effects of a Korean herbal prescription for antibiotics-associated diarrhea. Methods : Modified Hyangsayukgunja-tang was prescribed once or twice a day to a antibiotics-associated diarrhea patient. To observe the therapeutic effects, the frequency of defecation was counted and Bristol Stool Form Index was used. Laboratory tests were conducted periodically. Results : The frequency of defecation was decreased from 9 times a day to once a day. According to Bristol Stool Form Index, stool form was improved from Type 7 to Type 5. The level of red blood cell, hemoglobin and albumin increased slightly from the day of admission to discharge. Conclusions : Hyangsayukgunja-tang can be a choosable treatment option for a serious antibiotics-associated diarrhea.

The Comparison of Effective between Acupuncture and Bee Venom Acupuncture on the Treatment of Acute Lumbar Herniation of Intervertebral Disc (급성기 요추간판탈출증에 있어 봉약침 치료의 효과에 대한 비교 연구)

  • Cha, Jung-Ho;Chang, So-Young;Lee, Tae-Ho;Owi, Jong-Song;Lee, Eun-Yong
    • Journal of Pharmacopuncture
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    • v.9 no.2
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    • pp.67-71
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    • 2006
  • Objective : Herniation of Intervertebral Disc(HIVD) is the most common disease causing low back pain. Acupuncture and Bee Venom Acupuncture has been us ε d for treatment of HIVD. This study is to investigate the effective of Bee Venom Acupuncture for HIVD. Methods : We researched 18 patients who were diagnosed by CT and MRI as having HIVD, and treated them Acupuncture only or Acupuncture and Bee Venom Acupuncture. We compared the VAS and ROM angle of two groups. Results & Conclusions : 1. In admission date, no significant improvement between Acupuncture group and Bee Venom Acupuncture group 2. In variation of flexion and extension, Bee Venom Acupuncture group shows statistically significant improvement 3. In VAS, Bee Venom Acupuncture group shows statistically significant improvement for 1 week and discharge day