• Proceedings of the Korea Contents Association Conference
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• 2012.05a
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• pp.173-174
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• 2012

To determine whether position affects measured lung capacity of spinal cord injury patients. The study subjects were 45 patients with spinal cord injury (cervical level 15, thoracic level 15, lumbar level 15). Subjects were provided with a full explanation of the experimental procedures and all provided written consent signifying their voluntary participation. We used a spirometer (Spirometer, Micromedical Ltd, UK) to measure pulmonary function in the supine and sitting positions (straightened upper body at an angle of $90^{\circ}$). Forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), tidal volume (TV), and maximum insufflation capacity (MIC) were also measured. FVC, FEV1, TV, MIC (%) were greater in the supine than in the sitting position for those with injury at the cervical or thoracic injury level. On the other hand, FVC, FEV1, TV, MIC (%) were lower in the supine position for those with an injury at the lumbar level. More attention should be paid to the effect of injury level on measured lung capacity.

• Journal of Acupuncture Research
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• v.37 no.4
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• pp.275-280
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• 2020

This study reports the effectiveness of traditional Korean medicine in treating tetraplegia and respiratory symptoms (including dyspnea) after traumatic cervical spinal cord injury surgery. The patient was treated with complex Korean medical treatment including electroacupuncture, pharmacopuncture, and herbal medicine. The manual muscle test (expanded Medical Research Council system) was used to measure the patient's muscle strength. The Korean version of the modified Barthel index and the functional independent measure were used to evaluate the patient's independence in performing daily activities. Following 2 hospitalizations and treatments, the patient's muscle strength improved > 4+ score for all joints, and the Korean version of the modified Barthel index and functional independent measure scores increased from 26 to 79 and 56 to 95, respectively. Symptoms of dyspnea, coughing, and sputum gradually improved and finally disappeared during hospitalization. This study suggests complex Korean medicine treatment may be effective in the rehabilitation of post-surgical cervical spinal cord injury patients.

• Physical Therapy Korea
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• v.17 no.1
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• pp.9-16
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• 2010

This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.968-978
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• 2023

Objectives: The purpose of this study is to report the effectiveness of Korean medicine treatment on postoperative state patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Methods: A 55-year-old Korean male patient diagnosed with cervical spinal cord injury due to ossification of the posterior longitudinal ligament was treated in an inpatient setting with Korean medicine treatment consisting of herbal medicine, acupuncture, and others from May 22 to August 21. The outcome was evaluated with the American Spinal Injury Association Impairment Scale (AIS), Spinal Cord Independence Measure-III (SCIM-III), modified Japanese Orthopaedic Association scale (mJOA), Numeric Rating Scale (NRS) before and after, or during the treatment period. Results: After 92 days of treatment, the patient's scores on all scales improved. Conclusion: The results suggest that Korean medicine treatment may be effective for postoperative patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Further studies should be conducted on a larger number of patients.

• Journal of Korean Neurosurgical Society
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• v.54 no.4
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• pp.359-362
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• 2013

Chronic hypoventilation due to injury to the brain stem respiratory center or high cervical cord (above the C3 level) can result in dependence to prolonged mechanical ventilation with tracheostomy, frequent nosocomial pneumonia, and prolonged hospitalization. Diaphragm pacing through electrical stimulation of the phrenic nerve is an established treatment for central hypoventilation syndrome. We performed chronic phrenic nerve stimulation for diaphragm pacing with the spinal cord stimulator for pain control in a quadriplegic patient with central apnea due to complete spinal cord injury at the level of C2 from cervical epidural hematoma. After diaphragmatic pacing, the patient who was completely dependent on the mechanical ventilator could ambulate up to three hours every day without aid of mechanical ventilation during the 12 months of follow-up. Diaphragm pacing through unilateral phrenic nerve stimulation with spinal cord stimulator was feasible in an apneic patient with complete quadriplegia who was completely dependent on mechanical ventilation. Diaphragm pacing with the spinal cord stimulator is feasible and effective for the treatment of the central hypoventilation syndrome.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.597-604
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• 2010

Purpose : This study investigated the effects of air stacking exercise on respiratory ability of patients with cervical cord injury. Methods : The subjects of this study were 30 patients with cervical cord injury were randomly placed in an experimental group(n=15) and a control group(n=15), respectively. Basic therapeutic exercise(ROM exercise, stretching exercise, strengthening exercise) were conducted twice a day for 30 minutes each time in all subjects and air stacking exercise was additionally conducted on the experimently group only. Air stacking exercise was conducted for 4 weeks, twice a day, 5 times a week and repeated 10 to 15 times each time. Lung capacity, MIC and, peak cough flow were measured and evaluated. Results : The results showed that FEV1, FVC, MIC, UPCF and APCF were significantly increased(p<.05), but FEV1/FVC didn't show the significant differences in an experimental group. In a control group, the findings showed that FEV1, FVC were increased significantly(p<.05) while FEV1/FVC, MIC, UPCF, and APCF didn't show the significant differences.There were significant differences in FEV1, FVC, MIC, and APCF between a experimental group and a control group in the results of Pulmonary Function Test after conducting the pulmonary rehabilitation. However, no significant differences were found in FEV1/FVC, and UPCF between a experimental and a control group(p>.05). Conclusion : air stacking exercise has positive effects on the improvements of cough functions and that of pulmonary functions such as lung volume, lung elasticity in patients with cervical cord injury.

• The Journal of the Korean life insurance medical association
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• v.27 no.2
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• pp.107-111
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• 2008

The Cervical spondylotic myelopathy (CSM) is degenerative compressive myelopathy which initiation of symptoms seems to be induced by minor cervical trauma or spontaneous event. There was a case of Claim medical examination which was requested to discriminate the cause of ambulatory quadriparesis. Patient asserted that the onset of his myelopathy was followed by minor trauma. The author considered the medical recordings, MRI scan, Claim reports by claim manager. The space available for cord was the smallest at C3-4 level. But on MRI findings, the spinal cord at C3-4 level seemed to be already damaged. There were no recent injury evidences such as hemorrhages, spinal cord contusions, edema, soft tissue hemorrhages. If the space available for cord was small enough to compress the spinal cord, the serious neurologic deficits, non-ambulatory quadriplegia, etc were commonly induced by cervical extension trauma. Patient's asserts did not correspond to his clinical course after cervical trauma. The author reports a case of medical examination for the relationship between symptom onset of cervical spondylotic myelopathy and minor trauma within author's experience.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.904-909
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• 2000

Objectives : Most cases of cervical ossification of the posterior longitudinal ligament(OPLL) present with myelopathy or myeloradiculopathy, which sometimes is further complicated by minor trauma to the spinal cord. The main purpose of surgery in these patients is the alleviation symptoms but also as protection against further deterioration. The purpose of this study is to analyze the influence of trauma on the surgical outcome in patients with cervical OPLL. Methods : Over the past 13 years, we have operated on 123 patients with myelopathy associated with cevical OPLL. Among these, thirty patients had cervical cord injury associated with major or minor trauma and their clinical and radiographic data were reviewed retrosepctively. Results : As to cause of trauma, seventeen were related with traffic accident and 13 were related with minor slipping injury. The pre- and post-operative motor power were significantly weaker in the patients with trauma, but the degree of motor improvement was significantly higher(trauma group : $0.90{\pm}1.49$, non-trauma group : $0.41{\pm}0.80$). Conclusion : These results indicate that even indirect minor trauma to the cervical spine can cause irreversible changes to the spinal cord if this is associated with underlying cervical stenosis with OPLL. Although less favorable results may be anticipated in patients with trauma, operative decompression could improve motor power and protect further deterioration.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.582-591
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• 2018

Objective : To evaluate the magnetic resonance (MR) imaging features that have a statistically significant association with the need for a tracheostomy in patients with cervical spinal cord injury (SCI) during the acute stage of injury. Methods : This study retrospectively reviewed the clinical data of 130 patients with cervical SCI. We analyzed the factors believed to increase the risk of requiring a tracheostomy, including the severity of SCI, the level of injury as determined by radiological assessment, three quantitative MR imaging parameters, and eleven qualitative MR imaging parameters. Results : Significant differences between the non-tracheostomy and tracheostomy groups were determined by the following five factors on multivariate analysis : complete SCI (p=0.007), the radiological level of C5 and above (p=0.038), maximum canal compromise (MCC) (p=0.010), lesion length (p=0.022), and osteophyte formation (p=0.015). For the MCC, the cut-off value was 46%, and the risk of requiring a tracheostomy was three times higher at an interval between 50-60% and ten times higher between 60-70%. For lesion length, the cut-off value was 20 mm, and the risk of requiring a tracheostomy was two times higher at an interval between 20-30 mm and fourteen times higher between 40-50 mm. Conclusion : The American Spinal Injury Association grade A, a radiological injury level of C5 and above, an MCC ${\geq}50%$, a lesion length ${\geq}20mm$, and osteophyte formation at the level of injury were considered to be predictive values for requiring tracheostomy intervention in patients with cervical SCI.

• PNF and Movement
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• v.14 no.3
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• pp.245-254
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• 2016

Purpose: This study investigates the influence of elastic resistance exercise using proprioceptive neuromuscular facilitation (PNF) on the daily activities of a patient with incomplete spinal cord injury. The result will be proposed as background data for effective intervention in a patient with incomplete spinal cord injury. Methods: The target subject was a patient with incomplete spinal cord injury to the cervical cord (C6). Elastic resistance exercise based on PNF was performed for 30 min daily, five times a week, for eight weeks. The ASIS motor scale was applied to test the muscular strength of the upper limb, and the spinal cord independence measure II (SCIM II) was used to evaluate the capacity of daily activity. Results: By applying elastic resistance exercise based on PNF, the muscular strength of the upper limb increased and the performance of daily activity improved. Conclusion: Because elastic resistance exercise based on PNF positively influences the ASIA motor scale and SCIM II of the patient with incomplete spinal cord injury. It can be used for training programs to improve the capacity of daily activity of the patient.