• 재활치료과학
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• 제2권2호
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• pp.5-20
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• 2013

강제유도 운동치료는 2주간 건측의 사용을 억제하기 위해 깨어 있는 시간의 90%를 제한하는 동시에 환측에 매일 6시간 이상 강도 높은 훈련을 실시하는 것이다. 하지만 강제유도 운동치료가 뇌졸중 환자의 임상 적용에 있어서 문제점을 보였고, 이를 최소화하기 위해 수정된 강제유도 운동치료가 고안되었다. 뇌졸중 환자를 대상으로 수정된 강제유도 운동치료의 적용이 다양한 방법으로 연구되어져 왔고, Motor Activity Log(MAL), Fugl-Meyer Assessment(FMA), Wolf Motor Function Test(WMFT), Action Research Arm Test(ARAT), Functional Independence Measure(FIM), Stroke Impact Scale(SIS)을 통해 뇌졸중 환자의 기능 향상에 대한 효과를 증명하였다. 수정된 강제유도 운동치료가 뇌졸중 환자의 상지기능, 일상생활활동과 삶의 질 향상을 위한 치료 방법으로써 작업치료 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• The Korean Journal of Pain
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• 제30권3호
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• pp.207-213
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• 2017

Background: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. Methods: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit. Results: Surgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups. Conclusions: Magnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

• 대한통합의학회지
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• 제8권2호
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• PNF and Movement
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• 제3권1호
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• pp.17-26
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• 2005

Objectives : The purpose of this study is to identify influence that PNF method have an effect in function restoration of the impaired patients of central nervous system. Methods : The data were collected by 15 adult stroke patients. The treatment was based on proprioceptive neuromuscular facilitation techniques. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was significantly increased in the PNF method. The gait velocity, cadence and single support time asymmetry ratio was significantly increased in the PNF method. The Motor Assessment Scale was significantly increased in the PNF method. Conclusions : Based on these results, it is concluded that the forced PNF method for 6 weeks can be improve the temporal-spatial gait parameters including FAP in hemiplegic patients. Therefore, the forced PNF method is useful to improve the function restoration in hemiplegic patients. Further study should be done to analyze the effects of intervention duration of treatment, optimal time to apply the treatment in more long peried.

• Journal of Acupuncture Research
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• 제40권4호
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• pp.319-328
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• 2023

Facial nerve palsy refers to sudden, unilateral lower motor neuron facial paralysis. This study aimed to determine the importance of neck treatment in the treatment of facial paralysis. A literature search was performed on six online databases and other sources until January 15, 2023. A total of 426 papers were retrieved. After excluding duplicated and inconsistent papers, papers not including cervical treatment, and experimental papers on animals, two papers were finally selected. The type of treatment method, therapeutic effects, assessment of the risk of bias in randomized controlled trials, and non-randomized controlled trials and side effects were evaluated. Chiropractic, manual therapy, facial meridian massage, and acupotomy were applied to the face and cervical spine region. The results showed that each treatment had a significant therapeutic effect through evaluation index measurement methods, such as the visual analog scale and Yanagihara's unweighted regional grading system. This study demonstrated the importance of the cervical spine area in the treatment of facial paralysis. However, this study has many limitations. Thus, high-quality randomized controlled comparative studies on the treatment of the cervical spine area only or studies that include cervical spine area treatment as an interventional treatment while performing oriental or comprehensive treatment are needed.

• 한국콘텐츠학회논문지
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• 제10권4호
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• pp.206-215
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• 2010

본 연구는 백서의 척수손상 후 중강도 저체온법과 수중운동이 운동기능에 미치는 영향을 알아보기 위해 신경학적 운동행동 검사와 면역조직화학적 평가를 실시하였다. 실험대상은 척수손상 유발 후 아무런 처치를 하지 않은 대조군(n=12), 척수손상 유발 직후 저체온법을 적용한 실험군 I(n=12), 척수손상 유발 후 수중운동을 실시한 실험군 II(n=12), 척수손상 유발 직후 저체온법을 적용한 후 수중운동을 실시한 실험군 III(n=12)으로 나누었다. 모든 실험군은 3일, 7일, 14일, 21일에 신경학적 운동행동 검사를 실시하였고, 3일, 7일, 21일에는 면역조직화학적 평가를 실시하였다. BBB 척도에서 14일에 대조군과 비교하여 실험군 II와 III이 통계학적으로 매우 유의한 차이를 보였으며(p<.001), 격자걷기 검사에서 대조군과 비교하여 실험군 III이 통학적으로 유의한 차이를 보였다(p<.05). 면역조직화학적 평가에서, BDNF의 발현량은 실험군 III에서 가장 많이 관찰되었다. 이와 같은 결과를 통해 중강도 저체온법과 수중운동이 척수손상 후 운동기능에 긍정적인 효과가 있음을 알 수 있었다.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.165-170
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• 2020

Objective: To investigate the association between one-leg standing ability and postural control for chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Forty individuals who had a first diagnosis of stroke with hemiparesis before six months and over had participated in this study. To analyze the relationship between one-leg standing ability and postural control in the participants, six clinical measurement tools were used for assessment, including the Timed-Up-and-Go (TUG) test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Fugl-Meyer Assessment (FMA), 5 times sit-to-stand (5TSTS) and one-leg standing (OLS). Results: After analyzation, the OLS scores in the more-affected side showed significant positive correlations with BBS scores (r=0.469, p<0.01), DGI scores (r=0.459, p<0.01).and FMA scores (r=0.425, p<0.01). The OLS scores in the more-affected side showed significant negative correlations with TUG score (r=-0.351, p<0.05). The OLS score in the less-affected side showed significant positive correlations with BBS scores (r=0.485, p<0.01), DGI scores (r=0.488, p<0.01) and FMA score (r=0.352, p<0.05). The OLS scores in the less-affected side showed significant negative correlation with TUG scores (r=-0.392, p<0.05) and 5TSTS (r= -0.430, p<0.01). The OLS scores in the more-affected side showed significant positive correlations with the OLS scores in less-affected side (r=0.712, p<0.01). Conclusions: The results of the study suggest that the OLS time may be moderately correlated with static and dynamic postural stabilities and motor recovery following stroke. This study also suggests that the OLS test is as a simple clinical tool for predicting postural control performance for individuals with chronic hemiparetic stroke.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.42-49
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• 2015

Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.61-70
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• 2019

Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.

• 국제물리치료학회지
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• 제10권2호
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• pp.1803-1809
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• 2019

Background: Cervical mobilization has been applied mainly for the improvement of arm and neck movements and pain reduction, and little research has been done to improve the executive function. Since this kind of so-called mechanical neck pain is one of most common symptoms, there are controversial issues about this with spine alignment. Posteroanterior (PA) mobilization from the Maitland concept is a process of examination, assessment, and treatment of neuromusculoskeletal disorder by manipulative physical therapy. Objective: To examine the short-term benefits of mobilization for patients with non-specific neck pain. Design: Dual-group Pretest-Posttest Design from the Quasi-Experimental research Methods: Fourteen participants (male 8, female 6; 20's of their age) with non-specific neck pains which are distributed all the unilateral or bilateral body side were recruited. Participants were categorized to Neck Pain with Movement Coordination Impairments (NPMCI) and Neck Pain with Mobility Deficits (NPMD) groups according to the results of physical examination. Professional physical therapist who has over 15-years-of clinical experience applicated manipulative therapy for the neck pain, an occupational therapist only conducted evaluations; K-NDI (Korean version of the Neck Disability Index), VAS (Visual Analog Scale), BDS-K (Korean version of Behavioral Dyscontrol Scale) for decreasing possible adverse effects; there were no person who reported other symptoms followed 4 weeks from the trial. Results: In the NPMCI group, data analysis indicated statistical differences between the PA mobilization interventions in NDI and BDS-K; even though, pain was reduced in VAS, this is not a significantly differ. In the NPMD group, data analysis represented statistical differences between the PA mobilization interventions in NDI, VAS and BDS-K; the scores were represented to be increased or the pain got relief. Conclusions: PA mobilization techniques according to Maitland concept have beneficial effects in patients with neck pain and other clinical positive effects which included neck disability, pain itself and motor function of upper extremity.