• The Korean Journal of Pain
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• 제32권1호
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• pp.30-38
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• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.8-14
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• 2019

Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.

• Journal of Acupuncture Research
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• 제38권1호
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• pp.1-7
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• 2021

This review of national and international randomized controlled trials of Salviae miltiorrhizae radix pharmacopuncture for lumbar herniated intervertebral discs was performed to assess its clinical efficacy. There were 5 online databases (PubMed, EMBASE, CNKI, NDSL, OASIS, and RISS) searched on June 1st, 2020. Studies were selected according to the inclusion and exclusion criteria and were reviewed by risk of bias assessment. This review included 14 Chinese studies. The sample sizes ranged from 50 to 100. The numbers of treatments ranged from 20 to 30, with most patients receiving 20 treatments. The longest treatment periods were 10-15 and 15-20 days, of which each accounted for 29% of the studies. The most frequently used evaluation indices were the Japanese Orthopedic Association and the Visual Analog Scale scoring method. The most frequently used acupoints were EX18 and BL25, which accounted for 31% of the total number of acupoints. In 50% of the studies, the pharmacopuncture injection volume was 2 mL. Acupuncture treatment was the most common control group. Eleven studies reported that the intervention group had significantly improved symptoms. However, most of the included studies were of low quality.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권2호
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• pp.164-172
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• 2021

Purpose: The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood. Methods: Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Results: Of the 41 patients included in the study 25 were girls (61.0%), mean age was 12.2±4.2 years. EUS was performed for biliary colic in 21 (51.2%), for recurrent pancreatitis in 12 (29.2%), for cholecystitis/cholangitis in 5 (12.2%), and for acute pancreatitis in 3 (7.4%) patients. EUS had a significant clinical effect in the decision of treatment and follow-up of 6/21 biliary colic cases, in diagnosis and follow-up of 6/12 recurrent pancreatitis cases, in decision-making and monitoring of invasive procedures (ERCP/surgery) of 3/5 acute cholecystitis/cholangitis and 2/3 of acute pancreatitis cases as well as in follow-up of the other cases. The effectiveness of EUS in determining direct treatment and invasive intervention was 43.9%. None of the patients had complications related to the EUS procedure. Conclusion: Although current guidelines show that EUS can be used in pediatric patients, this is limited to a few published studies. In this study, it is shown that EUS is a safe method for the diagnosis, follow-up and treatment of common pancreatobiliary pathologies in childhood.

• 대한통합의학회지
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• 제8권4호
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• pp.1-11
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• 2020

Purpose : The purpose of this meta-analysis was to examine the effects of microcurrent on inflammatory musculoskeletal diseases. Methods : Domestic databases (RISS, NDSL, KISS, DBpia, and Kmbase) were searched for studies that conducted clinical trials associated with microcurrent and its impact on inflammatory musculoskeletal diseases. A total of 606 studies published between 2002 and 2019 were identified, with 8 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with blood component, pain, and function. The 8 studies that were included in the study were evaluated using R meta-analysis (version 4.0). The quality of 7 randomized control trials was evaluated using Cochrane risk of bias (ROB). The quality of 1 non-randomized control trial was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression test was carried out to analyze the publishing bias. Results : The following factors had a large effect size involving microcurrent on inflammatory musculoskeletal diseases: blood component (Hedges's g=-2.46, 95 % CI=-4.20~-0.73), pain (Hedges's g=3.51, 95 % CI=2.44~4.77), and function (Hedges's g=3.06, 95 % CI: 1.53~4.58). Except for function (t=1.572, p=.191), Egger's regression test showed that the publishing bias had statistically significant differences. Conclusion : This study provides evidence for the effectiveness of microcurrent on inflammatory musculoskeletal diseases in terms of blood component, pain, and function. However, due to the small sample sizes used in the included studies, the results of our study should be interpreted cautiously, especially considering the publishing bias.

• 대한한방소아과학회지
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• 제35권1호
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• pp.48-62
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• 2021

Objectives The purpose of this study is to obtain knowledge from clinical studies conducted in China to examine the effectiveness of herb medicine in childhood acute leukemia. Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on childhood acute leukemia from the 'CAJ', Chinese Academic Journal from China National Knowledge Infrastructure (CNKI). And then, demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Result 10 RCT studies were selected and analyzed. The control group were given western medicine therapy, the treatment group was given herbal medicine on the basis of the control group. The most commonly used herbal medicine were 淸熱解毒藥, 補氣藥, 補陰藥, 活血祛瘀藥 in 'boosting vital force and driving out evil spirit (扶正祛邪)' way to 'relieve heat (熱毒)' and 'assist the vital force (正氣)'. In the treatment group, complete remission was significantly higher than control group and the decrease in TCM syndrome scores also showed significant effects. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on childhood acute leukemia can be suggested as a new treatment for children who have less response to the conventional therapy, and can supplement the limitations of the western medicine by increasing complete remission and reducing adverse events.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.26-30
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• 2022

Background and Objectives Cough suppression therapy (CST) is a physiotherapy that can be used for patients with chronic refractory cough (CRC). We aimed to investigate the efficacy of CST for CRC. Materials and Method A prospective randomized controlled trial was conducted in 27 patients with CRC. Participants were randomized to receive either standard mucolytic medications for CRC combined with supplemental CST (CST group) or standard medications alone (control group). CST consists of laryngeal hygiene management, humidification, cough suppression technique, breathing method, and counseling. We assessed the symptoms change at baseline and week 4 with the Leicester Cough Questionnaire (LCQ). Secondary efficacy outcomes included the degree of cough Visual Analog Scale (VAS) score (0 to 100 scale). Results From 2019 to 2021, 14 CST group patients and 13 control group patients were included. The improvement was significantly greater in the CST group than in the control group for cough VAS score (36.67 to 13.33 vs. 74.29 to 16.43, p<0.001). Patients in the CST group had a significant improvement in total (70.14 to 107.71, p=0.005), physical (31.42 to 43.86, p=0.015), psychological (23.57 to 40.14, p=0.003), and social (15.14 to 23.71, p=0.005) LCQ scores. However, there was not a significant pre- to post-treatment LCQ score improvement in control group. Conclusion CST might be an effective supplemental intervention for CRC.

• 대한물리치료과학회지
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• 제28권3호
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• pp.88-97
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• 2021

Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.16-23
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• 2022

Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.