• Title/Summary/Keyword: Gait

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Clinical Study on 1 Case of Patient with the Lower Limb Flaccidity-syndrome Diagnosed as the Peripheral Neuropathy (말초신경병증으로 진단된 하지위증환자의 치험 1례)

  • Rhim Eun-Kyung;Cho Young-Kee;Moon Mi-Hyun;Lee Jung-Sub;Choi Sung-Yong;Gug Yun-Jai;Kang Sung-Wook;Lee Eon-Jeong;Lee Seong-Kyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1689-1693
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    • 2005
  • In this case, it is considered that the cause of the lower limb Flaccidity-syndrome is the peripheral neuropathy accompanied with inflammation and in oriental medicine, it is understood that the factors such as lung fluid consumption caused by heat-evil, wetness-heat evil cause the lower limb Flaccidity-syndrome. Because the peripheral neuropathy is regarded as a neuropathy with a series of inflammation reaction producing inflammatory neuropeptides such as substance P, prostaglandin ect., in western medicine, nonsteroidal antiinflammation drug;NASID, lidocaine, capsaicine are prescribed to control this neuropathy. In the view of treatment of the lower limb weakness, Wooseul-tangkami is used to remove the wetness-heat evil and we had a electronic acupuncture on the Yangmyung channel(陽明經) selected in The Yellow Emperor's of internal Medicine and also on Panggwang channel(膀胱經) considered as painful lesion. We experineced a case of the lower limb Flaccidity-syndrome diagnosed as the peripheral neuropathy the patient was treated by wooseul-tangkami, a acupuncture on Yangmyung channel and also Panggwang channel and had a significant improvement in gait ability and the range of motion.

Usefulness of Electrophysiological Tests in Movement Disorders (이상운동 질환에서의 신경생리적 검사법의 유용성)

  • Seo, Man-Wook;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.1 no.2
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    • pp.126-146
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    • 1999
  • In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

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Risk Factors for Hip Fracture among the Elderly (노인들의 고관절골절 위험요인에 관한 환자-대조군 연구)

  • Kim, Yong-Kwon;Cho, Young-Ha
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.25-36
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    • 2002
  • Objectives: This study was conducted to find out risk factors related to elderly hip fracture, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. Methods: The data were collected from 199 cases hospitalized in 4 university hospitals in Pusan from January, 1996 to December, 1998, 193 healthy controls who visited elderly facilities in Pusan. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed for 2-test and multiple logistic regression. The risk factors were shown with odds ratios and their 95% confidence intervals. Results: In univariate analysis, the odds ratio of hip fracture risk was estimated to be 1.9 for the elderly aged 75 years as compare with those aging less than 65 years; 42 for those with job as compared with those without job; 3.3 for those with more than 6 children as compared with those with one or two children. For the variables related to physical characteristics, small height (p=0.015), light weight (p=0.000), and low BMI (p=0.014) were risk factors for elderly hip fracture. Sane variables related to health, such as previous history of illness (OR=3.3.), abnormal blood pressure (OR=1.6), previous fracture history (OR=22), lower limbs weakness (OR=12.1) and gait disturbance (OR=42.6), were significantly associated with the risk of hip fracture. In multiple logistic regression, risk factors for hip fracture were age, having job, lower limb weakness and previous history of illness. The adjusted odds ratios of hip fracture risk among the elderly were age (OR=1.1), having jobs (OR=11.7), weak lower limb (OR=10.8) and previous history of illnesses (OR=3.3), respectively. Conclusion: This study suggests that the plan for improving the daily living environment for the elderly systematically should be implemented to avoid the chances of fall, and that programs encouraging to practice regular exercise for physical activity and to promote health of the elderly should be developed.

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The evaluation of active daily living after patients had stroke - focus on active daily living habit & physical therapy - (뇌졸중 환자의 퇴원 후 일상생활에 대한 고찰 - 일상생활 습관 및 물리치료 중심으로 -)

  • Kim, Hye-Seun;Lee, Chang-Hyun
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.30-37
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    • 2003
  • Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.

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Plantar foot pressure distribution depending on ground conditions and shoe type (지반조건과 신발의 종류에 따른 족저압 분포)

  • Kim, Sang-Hwan;Lee, Hye-Yoon;Kim, Yeon-Deok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2899-2905
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    • 2015
  • This paper presents is a study on the pressure distribution families low in response to ground conditions. Indoor shoes, outdoor shoes, working shoes, are four categories of shoes sports shoes, has been used in the present study, Concrete to target men in their 20s of 45people wearing the 260mm(Euro Code EU40), the experiments were carried out in the sand ground. Measurement of stress and pressure at the time of walking, Techstorm company Insole System the measured toe of the foot using, foot binding, was the metatarsal, the low pressure come from Fujoku four areas measured. Depending on the shoes and ground conditions findings, the results of this study represents the distribution of other stress and pressure, is expected to be useful in the development of a wearable shoe sand soil.

Correlation Between Joint Angular Displacement and Moment in the Human Foot (인체 족부관절의 각변위와 모멘트의 상관관계)

  • 김시열;신성휴;황지혜;최현기
    • Journal of Biomedical Engineering Research
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    • v.24 no.3
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    • pp.209-215
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    • 2003
  • The goal of this study was to investigate the relationship between kinematic and kinetic characteristics of foot joints resisting ground reaction force. Passive elastic joint moment and angular displacement were obtained from the experiment using 3 cameras and force plate. The relationship between joint angle and moment was mathematically modeled by using least square method. The ranges of motion of joints ranged from 5$^{\circ}$ to 7$^{\circ}$ except metatarsophalangeal joint. In the study, we presented simple mathematical models that could relate joint angle and plantar pressure. From this model, we can got the kinematic data of joints which is not available from conventional motion analysis. Furthermore, the model can be used not only for biomechanical model which simulates gait but also for clinical evaluation.

A Case Report of MELAS syndrome Improved by Oriental Medicine Treatment (한방치료 후 호전된 MELAS 증후군 증례 1례)

  • Seong, Kee-Moon;Yu, Deok-Seon;Choi, Byoung-Sun;Heo, Rae-Kyong;Jang, Myung-Jun;Lee, In-Yung;Song, Bong-Keun
    • Herbal Formula Science
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    • v.18 no.2
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    • pp.267-277
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    • 2010
  • Objective : Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes (MELAS) syndrome is a progressive neurodegenerative disorder. The typical presentation of patients with MELAS syndrome includes features such as mitochondrial encephalomyopathy, lactic acidosis, and stroke like episodes. Other features, such as seizures, diabetes mellitus, hearing loss, cardiac disease, short stature, endocrinopathies, exercise intolerance, and neuropsychiatric dysfunction are clearly part of the disorder. Approximately 80% of patients with the clinical characteristics of MELAS syndrome have a genetic mutation. This progressive disorder is reported to have a high morbidity and mortality. This case report is intended to estimate clinical effects of oriental meedicinal treatment of MELAS syndrome. Methods : A 44 year old female patient diagnosed as MELSA syndrome was treated with general oriental medicinal therapy including acupuncture, moxibustion, cupping, pharmacupunture and herbal medication in 20XX in Wonkwang Medical Center Gwangju. And the changes in symptoms and signs were evaluated as time dependently. Results : Although there is currently no curable treatment and MEALS syndrome is tend to progress, our treatment showed improvement in general weakness, gait disturbance and pain in the patient. Conclusion : Our case report suggests that various oriental medicinal treatment could be effective for improvement of MELAS syndrome and may represent a new potential therapeutic approach to control the disease. It could be applied to improve general condition, prevent relapse, enhance the quality of life and reduce complaints in the patient.

The Effect of Manual Acupuncture Therapy on Symptoms of the Patients with Idiopathic Parkinson's Disease (특발성 파킨슨병 환자의 증상에 대한 침치료 효과)

  • 하지영;이상훈;인창식;박상민;강중원;장대일;이윤호
    • The Journal of Korean Medicine
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    • v.24 no.3
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    • pp.172-183
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    • 2003
  • Objective : This study was designed to determine whether manual acupuncture therapy is effective for symptoms of patients with idiopathic Parkinson's disease. Methods : Nineteen patients consecutively enrolled in this study. The subjects were divided into two groups : the first group (n=12) discontinued antiparkinsonian drug treatment, the second group (n=7) continued antiparkinsonian drug treatment Acupuncture therapy was performed twice a week for 8 weeks. In the first group, the acupuncture was performed after 2 weeks of drug wash-out period. The patient's symptoms were assessed at pre-treatment, 4 weeks and 8 weeks after the acupuncture by unified Parkinson's disease rating scale (UPDRS), modified Hoehn-Yahr (H-Y) stage, Schwab & England activity of daily living and Freezing of Gait Questionnaire(FOGQ). Results : In the first group that discontinued. antiparkinsonian drug treatment, the total UPDRS scores were significantly improved after 4 weeks (p=0.0l4) and after 8 weeks (p=0.049) compared to the pre-treatment. Particularly, the scores of UPDRS III were significantly improved after 8 weeks (p=0.032). In the second group that continued antiparkinsonian drug treatment, the total UPDRS scores were significantly improved after 4 weeks (p=0.027) and after 8 weeks (p=0.018). Particularly, the scores of UPDRS II were significantly improved after 4 weeks (p=0.042) and after 8 weeks (p=0.043), and UPDRS IV were significantly improved after 8 weeks (p=0.043). The scores of ADL were significantly improved after 8 weeks (p=0.046). Conclusion : This study suggests that manual acupuncture therapy is effective for the improvement of certain symptoms in patients with idiopathic Parkinson's disease.

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Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction

  • Kim, Il-Kyu;Cho, Hyun-Young;Pae, Sang-Pill;Jung, Bum-Sang;Cho, Hyun-Woo;Seo, Ji-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.6
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    • pp.257-262
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    • 2013
  • Objectives: Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. Materials and Methods: An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Results: Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Conclusion: Patients who undergo tibial grafts must be careful of excessive external force after the operation.

The change of ankle of plantar pressure and range of motion joint according to treadmill gradients (트레드밀보행 시 경사도에 따른 족저압과 발목관절의 관절가동범위의 변화)

  • Kim, Tae-Ho;Kim, Byoung-Gon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.1
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    • pp.39-47
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    • 2008
  • Purpose : The purpose of this study was to investigate the change of the peak plantar pressure distribution under the foot areas and the range of motion (ROM) of ankle joint according to gradients in treadmill gait. Method : Thirty normal subjects (15 male and 15 female) walked on treadmill at three gradient conditions ($0^{\circ}$, $10^{\circ}$, and $15^{\circ}$) in normal speed. The ankle ROM was measured using the CMS70P that is three dimensional analyzer for excursion of ankle ROM, plantar flexion, and dorsi flexion. The peak plantar pressure distribution under the hallux, 1st metatarsal head (MTH) and heel was measured using the F -Scan system with an in-shoe sensor. Data was collected from 9 steps of left sife foot in at each gradient condition while all subjects walked. Result : As the treadmill gradient increased, the excursion of ankle joint was significantly increased (p<.05). Also, plantar flexion and dorsi flexion was significantly increased according to treadmill gradients (p<.05). The peak plantar pressure under the 1st MTH was significantly increased (p<.05) and the peak plantar pressure under the heel was significantly decreased (p<.05) as the treadmill gradient increased. No significant different in the peak plantar pressure under the hallux was observed. Conclusion : This study suggests that physical therapy for patients who have limited ankle ROM should be considered sufficient range of motion for functional ambulation. And individuals that have painful forefoot syndromes, including metatarsalgia, hallux valgus, and plantar ulceration should be careful in walking to uphill, as there is high plantar pressure under the forefoot.

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