Background: This study aimed to investigate the clinical effectiveness of treatment of Korean medicine on superior labrum anterior to posterior (SLAP) lesions. Methods: A total of 55 inpatients diagnosed with SLAP lesions by magnetic resonance imaging, were investigated from May 1st, 2014 to May 31st, 2019 at Haeundae Jaseng Hospital of Korean Medicine. The patients were sorted by gender, age, causing factor, illness duration, period of hospitalization, SLAP lesion type, complications, and treatments. Treatments included acupuncture, pharmacopuncture, Chuna therapy, herbal treatment, and physiotherapy. After treatment, the Numeric Rating Scale, Shoulder Pain and Disability Index, and European Quality of Life 5-Dimension questionnaire were used to evaluate treatment effect. Results: There were more males than females in this study (1:0.83). Patients were more likely to be in their 50s (38.18%), have an unknown etiology (70.91%), and be in the subacute disease stage (41.82%). According to the SLAP lesion type, most of the inpatients had Type 2 lesions (69.09%). For inpatients diagnosed with SLAP lesions, the mean shoulder numeric rating scale score decreased from 5.55 ± 0.90, to 4.07 ± 1.18 (p < 0.001), the mean Shoulder Pain and Disability Index score decreased from 50.35 ± 18.36, to 39.90 ± 19.34 (p < 0.001), and the mean European quality of life 5-dimension index increased from 0.70 ± 0.16, to 0.75 ± 0.13 (p < 0.01) after treatment. Conclusion: Treatment of Korean medicine effectively decreased pain and increased the quality of life of the patients with SLAP lesions in this study.
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.
The Journal of Korean Academic Society of Nursing Education
/
v.5
no.2
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pp.191-205
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1999
The purpose of this study is to identify the influence of family support on hope of the patients with stroke. Subjects were 53 in-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instruments used for this study : The family support scale developed by Kang Hyun Suk(1985). The hope scale developed by Nowotny(1989). The Data were analyzed with descriptive statistics, t-test, ANOVA. Pearson's correlation and simple regression. Data had been collected from December 24, 1998 to January 31, 1999. The results of this study were as follows The mean score of family support was 43.94 and the mean score of the hope was 80.89. The relationship between family support and the hope of the patients with stroke revealed a significant correlation (r= .560, p= .0001). The variables influencing family support and the hope of the patients with stroke were as follows : There was significant difference between family support and general characteristic factor, which was family chief caregiver (p= .002). There was no significant difference between hope and general characteristic factors. but There were significant differences between one of the subscales of hope, 'confidence in the outcome' and general characteristic factors, which were age(p= .021), perceived disability effect(p= .027). There were significant differences between one of the subscales of hope 'possibility of future', and general characteristic factors, which were age(p= .016), education(p= .018). There was significant difference between one of the subscales of hope. 'spiritual belief', and general characteristic factors, which was religion(p= .002). There was significant difference between one of the subscales of hope, 'active involvement', and general characteristic factors, which was family chief caregiver (p= .012). It was found that the higher the degree of perceived family support, the higher the degree of hope. Clearly, the perceived family support can contribute significantly and positively to hope of the patients with stroke. Therefore, nurses should plan interventions to inspire hope level of patients with stroke by family support. The above results may be used as the basic data to seek more efficient way of elevating nursing practice and qualify for the patients with stroke.
Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.
Purpose: The purpose of this study is to examine the EMT student's attitude to the disabled and provide the basic materials of educational program to make them have right awareness and attitude of the disabled. Methods: The subjects of this study were 348 of 339 emergency medical students at three departments of emergency medical in G metropolitan city who gave consent to take part in the research and the data were collected for 10 days from Mar. 2 to 11, 2011. It used DFS (Disability Factor Scale) developed by Siller (1967) and revised and complemented by Lee Jong Nam (1997) after validity and reliability test. Data collected were analyzed with technical statistics, t-test and ANOVA using SPSS/ PC 12.0 Results: The results of this study are summarized as follows. 1. On the question that there are the disabled around the subjects, 74.7% of the respondents answered 'none', and on the question of having concerns on the disabled problems, 61.5% of the respondents answered 'they have no concerns on them'. In addition, on the question of effective methods for improving a negative awareness of the disabled, many of subjects responded the governmental support must be a priority. 2. The subjects' attitude to the disabled scored average 3.13 and they have positive attitude to the disabled. In six sub-areas of attitude to the disabled, tension in contact with the disabled scored 2.90, inferred emotional disorder 2.79, unconditional repulsion 2.78, refusal to friendly relation 2.74, limitation of other functions undamaged 2.66 and distorted identification 2.65. 3. Variable showing a significant difference in the results of analysis according to general characteristics of subjects was age and those who are over '21' showed more positive attitude to the disabled than those who are below '20'. 4. In the results of analysis according to the subjects' disability related characteristics, those who have the disabled in their friends or family and have concerns on the disabled problems have a positive attitude to the disabled. Promotion and education through mass communication for changing the awareness of the disabled into a positive attitude will be most effective. Conclusion: Consequently, positive attitude of EMT student's to the disabled can be fostered by continuous contact with the disabled and their participation in voluntary services in the dimension of individual or school will be important and also the various practical methods such as enlightenment movement and supply of right information through mass communication should be sought.
Background: Patients with chronic low back pain (CLBP) functionally adapt to decreased postural control due to impaired processing of sensory information. Standing postural control has been the focus of recent research in CLBP. Change in postural control may be a risk factor for CLBP, although available studies are not conclusive. Objects: This study aimed to identify the role of partial weight supported treadmill training (PWSTT) in improving balance, dysfunction, and pain in patients with chronic low back pain. Methods: The study included 22 patients with CLBP. Patients in the control group ($n_1=8$) performed three 20 min stabilization exercise sessions per week, for 4 weeks. Patients in the full weight treadmill training group ($n_2=7$) performed treadmill training for 30 min after stabilization exercise. Patients in the PWSTT group ($n_3=7$) performed PWSTT with 20% of their body weight unloaded after stabilization exercises. By using the Biodex balance system, the dynamic balance abilities of the patients in the three groups were assessed in the quiet standing position under combined conditions of visual feedback (eyes open and closed) and platform stability (level 8). The Korean version of the Oswestry Disability Index and visual analogue scale score were used as the main measure. Results: The results of this study showed that dysfunction and pain were significantly improved in all groups. Although dynamic postural stability with eyes closed was significantly improved only in the PWSTT group (p<.05), no significant difference was found in the other groups. Conclusion: The results of this study indicate that PWSTT improved balance, dysfunction and pain in the patients with CLBP. Thus, this intervention is necessary for patients with CLBP with decreased postural control.
Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).
Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.
The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.
Park, In;Lee, Hyo-Jin;Kim, Sang-Ki;Park, Min-Sik;Kim, Yang-Soo
Clinics in Shoulder and Elbow
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v.22
no.3
/
pp.128-134
/
2019
Background: Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods: We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results: Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions: Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.
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