• Title/Summary/Keyword: Musculoskeletal Symptoms

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A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.370-374
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    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

A Cross-Sectional Satisfaction Survey of 845 Traffic Accident Patients Treated with Korean Medicine

  • Kim, No H.;Lee, Yoon J.;Suh, Chang Y.;Lee, Gi B.;Yang, Kyu J.;Kim, Tae-Gyu;Gi, Yu-Mi;Kwon, Mijung;Ha, In-Hyuk
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.69-74
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    • 2018
  • Background: We conducted a cross-sectional study to analyze the pain characteristics and satisfaction scores in traffic accident (TA) patients seeking Korean medicine treatment. Methods: A survey was conducted in 845 outpatients who visited 10 Korean medicine institutions due to TA-associated symptoms from February 25th, 2016 to March 9th, 2016. The questionnaire included information about patient sociodemographic characteristics, accident circumstance details, pain levels, treatment methods, satisfaction and pre-existing musculoskeletal disorders. All statistical analyses were performed using STATA 14.0. Results: A total 754 of the 845 respondents had experienced acute pain of onset within 1-2 days. Pain in the neck or low back was most common, and low back pain (LBP) was more prevalent in pedestrian-vehicle accident cases. Patients showed highest satisfaction with pharmacopuncture treatment, followed by acupuncture and Chuna manual therapy. Although treatments were not completed at the time of the survey, the majority of patients were satisfied with the Korean medicine treatments they received and indicated their intent to reuse this treatment in the future. The degree of pain reduction after treatment was a factor that influenced patient satisfaction with and intention to reuse Korean medicine. Conclusion: This study determined the characteristics and status of TA patients using Korean medicine and suggests the need for further more inclusive studies.

Muscle Function Path Analysis through Muscle Activity Analysis of Human Myofascial Meridians

  • Park, Young Hyun;Hong, Aa Reum;So, Jea Moo
    • Korean Journal of Applied Biomechanics
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    • v.27 no.4
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    • pp.279-285
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    • 2017
  • Objective: The purpose of this study was to perform a muscle function path analysis of muscle function on myofascial meridians. Method: Seven male students (mean age: $22{\pm}3.46years$; mean mass: $72.71{\pm}8.19kg$; mean height: $174{\pm}4.39cm$) without a history of musculoskeletal system symptoms or injuries were recruited for this study. The measurement muscle of the myofascial line was selected along with the muscle presented in "anatomy trains (Thomas W. Myers. 2014)", and the attachment of the surface EMG (Telemyo 2400T G2, USA) pad was determined according to "EMG analysis (Kim Tae Wan et al., 2013)". The subjects underwent maximum volumetric contraction of their fascia line end muscles three times in lying and standing postures and were subjected to the maximum number of contractions of the myofascial line muscle three times in the lying and standing postures. The sampling rate of the EMG signal was set to 1,000 Hz, and the bandwidth was 20 to 350 Hz. The activity of each muscle was quantitated using the Pearson correlation coefficient, and SPSS 22.0 was used for data analysis. Results: In myofascial meridians, a positive correlation in the myofascial connection and a negative correlation in the mechanical connection were observed. Conclusion: Muscles that show significant contract correlations with one another may be expected to be used as an effective clinical marker in muscle strengthening or relaxation therapy, and rehabilitative training. In this study, the correlation of total myofascial meridians may differ without consideration of functional posture. Future studies need to consider these points.

Multiple Schwannomas in the Peripheral Nerve - 3 Cases Report - (말초신경에 생긴 다발성 신경초종 - 증례 보고 3예 -)

  • Kang, Ho-Jung;Lee, Dae-Young;Yoon, Hong-Kee;Hahn, Soo-Bong;Park, Chan-Il;Yang, Seok-Woo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.105-109
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    • 2005
  • This journal reports three cases diagnosed with schwannomatosis in which no clinical symptoms of type 2 neurofibromatosis. The chief complain was pain. In adolescence and adult group, all masses were found. The locations were brachial plexus, popliteal fossa and hand. No hearing impairment, vertigo, tinnitus and visual disturbance was observed in any of the case. Family history was negative. In all cases, there was no evidence of vestibular schwannoma on cranial MRI imaging study. In all cases, Tinel sign was positive. Pathologic diagnosis was positive for schwannoma. Further study and case collection is needed to idenity the clinical manifestation, clinical course and genetic characteristic of schwannomatosis.

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A Study on Changes in Trends of Disease of Residents Who Received Treatment at Nam Jeju County Primary Health Care Post(1997~2003) (남제주군 보건진료소 이용 주민의 상병양상변화 고찰(1997년~2003년))

  • Kang, Na-Yon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.2 no.2
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    • pp.133-144
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    • 2007
  • Purpose: The purpose of this study was to examine the trends of disease of residents who had treatment in primary health care posts in N-county over the past seven years (1997-2003). The data will assist in planning responses to changes in the health care environment and in planning health promotion programs. Method: A retrospective descriptive survey was conducted of the computerized records of primary health care done by community health practitioners over the last seven years. Cross analysis was conducted among the data using SAS, and the results were displayed in frequencies and percentages. The data were collected from May to September 2004. Results: The results of the study are as follows: 1. The six most frequent diseases were ranked as follows: diseases of the 1) respiratory system, 2) musculoskeletal system and connective tissue, 3) digestive system, 4) skin and subcutaneous tissue, 5) circulatory system, and 6) symptoms, signs and abnormal clinical and laboratory findings. Especially in 2002, circulatory system related disease rose two steps in the ranking and digestive system related disease went a step down. 2. The patients' use of primary health care posts over the past seven years continued to increase on the whole. Conclusions: According to these results, each primary health care post should carry out special health promotion programs that fit the local society of N- county and are in accordance with changes in health care needs.

Functional Taping Technique for Chronic Back Pain and Lower Extremity Pain - McConnell's Approach (만성 요통과 하지 통증에 대한 기능적 테이핑 기법 - McConnell 접근법 -)

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.50-59
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    • 2008
  • Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

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A Case of Tuberculous Arthritis on Left Knee Joint in a Child (소아에서 발생한 슬관절의 결핵성 관절염)

  • Lee, Hye Jin;Lee, Ji Hun;Mok, Hye Rin;Lee, Soo Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.174-179
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    • 2006
  • Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.

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The Impact of The Cervical Exercise Training on Post-traumatic Stress Disorder Patient's Cervical Pain Levels and Depression Factor (경부운동훈련이 외상 후 스트레스 장애 환자의 경부통증 수준, 우울 요인에 미치는 영향)

  • Park, Sung-doo;Shin, Young-il;Kim, Myung-joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.21 no.1
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    • pp.37-42
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    • 2015
  • Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

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Effect of Aqueous Extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on Functional Recovery and Expressions of Inflammatory Mediators after Sciatic Nerve Crushed Injury in Rat (숙지양근탕(熟地養筋湯) 추출물이 흰쥐 좌골신경 손상 후에 기능회복과 염증 매개 인자 발현에 미치는 영향)

  • Jang, Gun;Song, Yun-Kyoung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.33-48
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    • 2013
  • Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. Sukjiyanggeun-Tang(shudiyangjin-tang), in oriental medicine, has been used to treat various musculoskeletal disorders. Methods : In the present study, the effects of aqueous extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), inducible nitric oxide synthase(iNOS), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot analysis for COX-2 iNOS, and TNF-${\alpha}$, and Immunofluorescence test for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2, iNOS and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury, In contrast, treatment with Sukjiyanggeun-Tang(shudiyangjin-tang) improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Sukjiyanggeun-Tang(shudiyangjin-tang) treatment also suppressed COX-2, iNOS, and TNF-${\alpha}$ expressions and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that Sukjiyanggeun-Tang(shudiyangjin-tang) is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.

Nursing Interventions of the Lupus Patient (루푸스(Lupus) 환자의 간호중재)

  • Kim, Myung-Ja;Sohng, Kyeong-Yae
    • Journal of muscle and joint health
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    • v.2 no.2
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    • pp.197-208
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    • 1995
  • The purpose of this study is to describe specific system manifestations and suggested nursing interventions in patients with lupus. Lupus is a chronic, inflammatory, multisystemic disorder of the immune system. Antibodies are formed which react against the person's own normal tissue. This abnormal response can be very damaging and leads to the many manifestations of the lupus. Lupus can affect any part of the body, and patients experience symptoms in organs involved. So lupus patients have integumentary, blood, central nervous system, eye, gastrointestinal, musculoskeletal, kidney, heart and lining membranes, reproductive system involvement. The courses are unpredictable and very individualized. Lupus varies greatly in severity from mild cases requiring minimal interventions to those in which significant damage occurs to vital organs such as the lungs, heart, kidney and brain which ultimately can be fatal. In addition to direct physical care, the nursing professional has an excellent position from which to support the lupus patient. Patients need assistance with receiving current, accurate information about the disease process and also to be helped in developing realistic expectations and goals. Nursing interventions for the patient with lupus is challenge drawing on at the resources, knowledge and strengths the nursing teams have to offer. Because of the unpredictable, highly individualized and frequently changing the nature of the disease itself as well as the intricacy of the patient's needs. The nurse has a key role in its management. The patient and nurse, working together, have much to offer each other. These are of inestimable value to the patient. As the nurse listens to the patient and learns what problems the patient perceives, can guide the patient in a self-help program that allows to adapt to living with a chronic illness.

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