• The Korean Journal of Rehabilitation Nursing
• /
• v.10 no.2
• /
• pp.108-115
• /
• 2007

Purpose: This study was to investigate the effects of respiratory rehabilitation training on the respiratory functions of hospitalized cervical spinal cord injury patients. Methods: One group pre and post test design was used. Subjects were 20 cervical spinal cord injury inpatients of the national rehabilitation center. Training program consisted of air cumulation training, manual assisted coughing training, and abdominal breathing. Trained rehabilitation nurse implemented 20 minutes program twice a day for 4 weeks. Respiratory function was measured as peak coughing flow rate, and perceived respiratory difficulty after activity on wheel chair for 30 minutes and during speaking and singing. Perceived respiratory difficulty was measured with modified Borg scale. Also content analysis was done with the result of open ended question about subjective feeling about training. All variables were measured 3 times before, 2weeks and 4 weeks after the program. Results: Peak coughing flow rate significantly improved after compared to before training. Also all three perceived respiratory difficulty variables decreased significantly after training. In the content analysis, 'it's easier to cough up phlegm' was the most frequent answered subjective feeling. 'Sound at speaking and coughing became louder', 'respiratory volume increased', and 'comfortable chest feeling' were frequent answered subjective feeling, in order. Conclusion: Although it is preliminary since no control group, respiratory rehabilitation training was found to be effective to improve respiratory function in terms of peak coughing flow rate, perceived respiratory difficulty, and subjective feeling. It is necessary further systemic research to investigate the effects of respiratory rehabilitation training.

• Journal of Trauma and Injury
• /
• v.36 no.4
• /
• pp.411-415
• /
• 2023

An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

• Journal of Korean Medicine Rehabilitation
• /
• v.25 no.3
• /
• pp.91-102
• /
• 2015

Two patients, diagnosed as cervical spinal cord injury, were hospitalized and treated by Korean medical interventions with Functional Electrical Stimulation (FES). The range of motion of the shoulder joint, manual muscle test were adopted to measure the resulting motor recovery after treatment. And the Korean version of Barthel index (K-MBI) was adopted as a method of measuring the improvement of quality of life after treatment. The range of motions and muscle strengths of the shoulder joints were improved. The activities of daily living were slightly improved in case 2, but showed no improvement in case 1. FES was effective for upper extremities rehabilitation of spinal cord injured patients. Further studies are needed to set up an Korean medical protocol for spinal cord injury rehabilitation.

• Physical Therapy Korea
• /
• v.12 no.4
• /
• pp.48-57
• /
• 2005

The purpose of this study was to evaluate the general characteristics, complications and level of social adaptation of spinal cord injured patients. The subjects were one hundred forty five members who were inpatients or outpatients from October 1, 2004 to April 30, 2005 in general hospitals and municipal welfare centers for the handicapped located in the metropolitan city of Gwangju. The following results were obtained using Modified Barthel Index (MBI). 1) Gender distribution was 77.9% male and 22.1% female. The mean age at the time of injury was 35.4 and the mean age during the study was 44.2. 2) The degree of paralysis among the subjects was as follows: 49.0% had complete paralysis and 51.0% suffered incomplete paralysis. The most frequently injured lesion among the subjects was cervical (49.0%), followed by thoracic (35.9%), and lumbar (15.2%). 3) The mean MBI score was 63.5. There was statistically significant difference in the MBI score in the relation between complete and incomplete paralysis, the relation between cervical, thoracic, and lumbar injury, and the relation between a recovery period of less than three years and more than three years according to the characteristics of injury (p<.05). 4) There was statistically significant difference in the MBI score of subjects who had complications concerning spasticity, deformity, urinary tract infection, and sexual dysfunction (p<.05). 5) The most serious emotional pain after spinal cord injury resulted from economic issues, which affected 35.2% of the subjects. The group having a shorter recovery period after spinal cord injury complained of psychological matters, the group having a longer recovery period complained about the surrounding environment (lack of convenient facilities), suggesting statistically significant difference (p<.05). 6) The most common activities of the group with injuries more than ten years old included meeting schoolmates and working, while most common activities of the group with injuries less than three years old included attending religious functions and miscellaneous others (watching TV, spending time with family), suggesting statistically significant difference (p<.05).

• Journal of Korean Physical Therapy Science
• /
• v.3 no.2
• /
• pp.1011-1019
• /
• 1996

The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

• Physical Therapy Korea
• /
• v.12 no.1
• /
• pp.54-62
• /
• 2005

The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.6
• /
• pp.467-469
• /
• 2010

We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/$mm^3$. She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.17 no.2
• /
• pp.111-114
• /
• 2006

Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

• 재활복지
• /
• v.21 no.1
• /
• pp.233-252
• /
• 2017

The purpose of this study is to investigate the influence on respiration, oral motor and articulation using wind-instrument centered music therapy for patients with cervical cord injury who need continuous train of respiratory muscle. Three patients with cervical cord injury who needed continuous training of respiratory muscle were selected and post data was analyzed. The harmonica using both exhalation and inspiration was selected as an wind-instrument. Each session was taken 30 ~ 40 minutes, once a week from total 6 weeks with small group. Material about every session's work was provided for individual to maintain practice after program. Oral motor and articulation test was done to assess reflecting features of maximal expiratory flow and wind-instrument of factor related breath. Maximal expiratory flow has increased by average 25ml more, articulation has increased by 3.16 points more and the movement of oral motor has increased 11.67 points more than pre-test from the analyzation. In the comparison of the details, the increase of oral motor function was confirmed from scores on the jaw and tongue except for the lips. Based on the results of this study, this study suggests that wind-instrument centered music therapy will be a practical and effective intervention for respiratory rehabilitation in patients with cervical cord injury.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.5
• /
• pp.791-798
• /
• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.