• 제목/요약/키워드: Motor outcomes

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Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

  • Kim, Joohyun;Hur, Junseok W.;Lee, Jang-Bo;Park, Jung Yul
    • Journal of Korean Neurosurgical Society
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    • 제59권5호
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    • pp.478-484
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    • 2016
  • Objective : To assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment. Methods : Two groups of patients with single level LDH (L4-5) requiring treatment were retrospectively studied. The surgery group (SG) included 34 patients, and 30 patients who initially refused the surgery were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors of successful outcomes were determined with multivariate logistic regression analysis after the optimal cut off values were established with a receiver operating characteristic curve. Results : There was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31 mm [odds ratio (OR) 2.35; confidence interval (CI) 1.21-3.98] was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23 mm (OR 0.05; CI 0.003-0.89) and high baseline VAS leg (OR 12.63; CI 1.64-97.45) were identified as predictors of successful outcomes of leg pain relief in the NG. Conclusion : The patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

Machine Learning Model for Reduction Deformation of Plastic Motor Housing for Automobiles

  • Seong-Yeol Han
    • Design & Manufacturing
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    • 제18권2호
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    • pp.64-73
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    • 2024
  • The purpose of this paper is to introduce a fusion method that combines the design of experiments (DOE) and machine learning to optimize the bias of plastic products. The study focuses on the plastic motor housing used in automobiles, which is manufactured through plastic injection molding. Achieving optimal molding for the motor housing involves the optimization of various molding conditions, including injection pressure, injection time, holding pressure, mold temperature, and cooling time. Failure to optimize these conditions can lead to increased product deformation. To minimize the deformation of the motor housing, the widely used Taguchi method, which is one of the design of experiment techniques, was employed to identify the injection molding conditions that affect deformation. Machine learning was then applied to various models based on the identified molding conditions. Among the models, the Random Forest model emerged as the most effective in predicting deformation amounts. The validity of the Random Forest model was also confirmed through verification. The verification results demonstrated the excellent prediction accuracy of the trained Random Forest model. By utilizing the validated model, molding conditions that minimize deformation were determined. Implementation of these optimal molding conditions led to a reduction of approximately 5.3% in deformation compared to the conditions before optimization. It is noteworthy that all injection molding outcomes presented in this paper were obtained through robust injection molding simulations, ensuring both research objectivity and speed.

선천성 근성 사경 환아에서 수기신장과 자세와 발달을 이용한 치료의 효과에 대한 무작위 연구 (The Effect of Manual Stretching and Positioning and Developmental Treatment in Congenital Muscular Torticollis: randomized Controlled Trials)

  • 이인희
    • 한국전문물리치료학회지
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    • 제16권1호
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    • pp.34-41
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    • 2009
  • The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.

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실험적 뇌허혈로 인한 편마비 흰쥐에서 운동 적응 훈련이 기능 회복에 미치는 영향 (The Effect of Exercise Adaptive Training on Motor Function after Experimental brain ischemia in Rats)

  • 권영실;김진상
    • The Journal of Korean Physical Therapy
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    • 제13권3호
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    • pp.529-535
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    • 2001
  • The purpose of this study was to test that the exercise adaptive training enhance behavioral outcome significantly after focal brain ischemia in rats. After occlusion of middle cerebral artery in rats, they were housed in individual standard cages fur 24 hours. The control group was sacrificed 24 hours after ischemic event. The experimental group I was housed in standard cages for 7days. The experimental group ll was housed in enriched environment and had got exercise adaptive training fur 7days. The rats were examined five motor behavioral tests. In motor behavioral tests :postural reflex test, limb placement test, beam-walking test, rotarod test, horizontal wire test. The outcomes of control group and group I were significantly lower than the group II. The conclusion was that exercise adaptive training induced functional repair.

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Factors Related to Outcomes of Subthalamic Deep Brain Stimulation in Parkinson's Disease

  • Kim, Hae Yu;Chang, Won Seok;Kang, Dong Wan;Sohn, Young Ho;Lee, Myung Sik;Chang, Jin Woo
    • Journal of Korean Neurosurgical Society
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    • 제54권2호
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    • pp.118-124
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    • 2013
  • Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

신경근전기자극치료가 암환자의 근육 손실에 미치는 영향: 체계적 문헌고찰을 위한 프로토콜 (Effects of Neuromuscular Electrical Stimulation on Muscle Wasting with Cancer Patient: Study Protocol for a Systematic Review)

  • 박은수;김종희;김수담;김동현;오민석;이은정;유화승
    • 한방재활의학과학회지
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    • 제33권2호
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    • pp.49-55
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    • 2023
  • Objectives The purpose of this study is to analyze randomized controlled trials about neuromuscular electrical stimulation for muscle wasting with cancer patient and evaluate it's motor functionality effect. Methods Studies will be searched from 7 online databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure [CNKI], Korean studies Information Service System [KISS], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]). Participants will be cancer patients with muscle loss, regardless of cause, gender, race or age, interventions will be neuromuscular electrical stimulation. Other treatments than interventions will be the control group and the main outcome will be reviewed by motor functionality effect. Results Randomized controlled trials about neuromuscular electrical stimulation for muscle wasting should be included in the study. Primary outcomes include motor functionality effect. Secondary outcomes evaluate adverse event. The data uses Review Manager Software 5.4. Conclusions The conclusion of this study will provide a basis for determining whether neuromuscular electrical stimulation treatment for muscle wasting with cancer patient treatment is an effective and safe treatment method in clinical practice.

운동훈련이 미만성 축삭손상을 일으킨 흰쥐의 해마에 미치는 영향 (Effect of Motor Training on Hippocampus after Diffuse Axonal Injury in the Rats)

  • 천송희
    • 한국콘텐츠학회논문지
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    • 제9권1호
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    • pp.348-358
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    • 2009
  • 미만성 축삭손상(diffuse axonal injury)은 외상성 뇌손상의 일반적인 형태이며, 인지 장애의 주요 원인으로 생각되어 진다. 흔들린 아기 증후군(shaken baby syndrome)과 같이 뇌에 전단력이 심하게 가해졌을 때도 신체 장애 뿐만 아니라 인지 장애가 특징적으로 나타난다. 신체 활동은 건강 증진과 더불어 기억 및 학습과 관련된 해마의 기능 향상에도 영향을 미친다. 본 연구의 목적은 흰쥐를 대상으로 미만성 축삭 손상을 일으킨 후 반복적인 운동 훈련을 통해 운동 수행력을 관찰하고 해마에서 GAP-43의 발현을 통해 축삭 재생의 변화를 관찰하는 것이었다. 실험동물은 운동 훈련을 적용시키는 실험군과 대조군으로 구분하였고, 각각의 군을 다시 1일, 7일 및 14일군으로 구분하였다. 그 결과, 운동 훈련을 적용시킨 실험군이 대조군보다 운동 수행력의 향상이 더 유의했으며, 해마에서 GAP-43의 발현도 같은 양상을 나타냈다. 이러한 차이는 7일군과 14일군보다 1일군과 7일군 사이에 더 크게 나타났다. 그러므로 미만성 축삭손상 후 운동 훈련은 운동 수행력의 향상에 영향을 미치며, 인지와 관련된 해마의 구조적 변화도 야기 시키는 것으로 생각된다.

Factors Influencing the Motor Development of Children with Cerebral Palsy: Differences in Pediatric Physical Therapists' Perceptions

  • 김장곤
    • The Journal of Korean Physical Therapy
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    • 제23권4호
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    • pp.7-13
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    • 2011
  • Purpose: The purpose of this article is to identify whether the physical therapists perceive the important factors influencing the motor development in children with cerebral palsy differently. Methods: Study participants included 58 pediatric physical therapists. They were recruited from the internet communities for physical therapists. The data was collected through a web-based questionnaire using Google Documents tool. Questionnaire was focused on the importance (10-point scale) of each factor influencing the motor development in children with cerebral palsy. The mean scale of each factor was compared by itself and according to the participants' career characteristics. Results: The personality characteristics received the least importance rating (6.77) in comparison with other domains (healthcare service: 7.70, family ecology: 7.53, secondary impairment: 7.53, primary impairment: 7.45). In the detailed items, home exercise (8.33) received the highest mean importance rating, while sociability (6.03) received the lowest mean importance rating. Comparing the importance of factors by the type of work institution, subjects working in the welfare institutions perceived the contextual factors (personality characteristics, family ecology, healthcare service) as more important than those working in the medical institutions. Conclusion: The authorsuggests that pediatric physical therapists should try to have an identical approach by reaching a consensus. Also, the support for family-centered service to children with cerebral palsy should be strengthened.

중풍 편마비 환자의 손 기능 회복에 대한 팔사혈(八邪穴) 자침(刺鍼)의 임상적 효과 (The Clinical Effectiveness of Acupuncture at Palsa(BaXie) for Hand Function in Hemiparetic Patients after Stroke)

  • 김자영;정선미;박찬규;민은경;왕덕중
    • Journal of Acupuncture Research
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    • 제25권5호
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    • pp.97-104
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    • 2008
  • Objectives : Investigate the effectiveness of an acupuncture at Palsa(BaXie) in hemiparetic patients after stroke. Methods : Acupuncture at Palsa(BaXie) applied to thirty one hemiparetic patients who had been by general treatment after stroke. The other thirty one hemiparetic patients had only general treatment. Outcomes were assessed by Medical research council scale motor grade(MRCSMG) of wrist, grip power, Fugl-Meyer Motor Scale(FMS) of hand, and Motricity Index(MI) of fingers. Results : The patients exhibited substantial improvements on grip power and Fugl-Meyer Motor Scale of hand, but Medical research council scale motor grade of wrist and Motricity Index of fingers have not significantly meaningful differences between sample and control group. Conclusions : Acupuncture at Palsa(BaXie) may be an effective method of improving hand function of hemiparetic patients after stroke.

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Pain in amyotrophic lateral sclerosis: a narrative review

  • Kwak, Soyoung
    • Journal of Yeungnam Medical Science
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    • 제39권3호
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    • pp.181-189
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    • 2022
  • Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.